Sample records for observed previous studies

  1. Four Forensic Entomology Case Studies: Records and Behavioral Observations on Seldom Reported Cadaver Fauna With Notes on Relevant Previous Occurrences and Ecology.

    PubMed

    Lindgren, Natalie K; Sisson, Melissa S; Archambeault, Alan D; Rahlwes, Brent C; Willett, James R; Bucheli, Sibyl R

    2015-03-01

    A yearlong survey of insect taxa associated with human decomposition was conducted at the Southeast Texas Applied Forensic Science (STAFS) facility located in the Center for Biological Field Studies of Sam Houston State University in Huntsville, TX. During this study, four insect-cadaver interactions were observed that represent previously poorly documented yet forensically significant interactions: Syrphidae maggots colonized a corpse in an aquatic situation; Psychodidae adults mated and oviposited on an algal film that was present on a corpse that had been recently removed from water; several Panorpidae were the first insects to feed upon a freshly placed corpse in the autumn; and a noctuid caterpillar was found chewing and ingesting dried human skin. Baseline knowledge of insect-cadaver interactions is the foundation of forensic entomology, and unique observations have the potential to expand our understanding of decomposition ecology. © The Author 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  2. Effect of donepezil in patients with Alzheimer's disease previously untreated or treated with memantine or nootropic agents in Germany: an observational study.

    PubMed

    Klinger, Tatjana; Ibach, Bernd; Schoenknecht, Peter; Kamleiter, Martin; Silver, Gabrielle; Schroeder, Johannes; Mielke, Ruediger

    2005-05-01

    This open-label, prospective, observational, Post-Marketing Surveillance (PMS) study assessed the efficacy and safety of donepezil in patients who had been switched from therapies currently used in Germany to treat Alzheimer's disease (AD), such as memantine and nootropics, due to insufficient efficacy or poor tolerability. A treatment-naive population was included as a comparator. Patients with AD were treated with donepezil and observed for a period of approximately 3 months. A cognitive assessment was made using the Mini-Mental State Examination (MMSE). Quality of life (QoL) was assessed by the investigators who answered the question 'How did therapy with donepezil influence the QoL of the patient and/or his family over the observation period?' and was graded using three ratings: improved/unchanged/worsened. Adverse events (AEs) were also monitored. A total of 913 patients entered the study (mean +/- SD MMSE score 18.03 +/- 5.34). Efficacy assessments were analyzed for three groups: an overall group of patients who had received any form of prior AD drug therapy (N+ group; n = 709); a subgroup of patients from the N+ group who had received prior memantine therapy only (M+ group; n = 111) and patients who were drug treatment naive (N- group; n = 204). In the evaluable population donepezil improved MMSE scores by 2.21 +/- 3.47 points on average, with similar improvements observed in all three groups. QoL was judged to be improved in at least 70% of patients, again with similar results obtained for all three groups. Donepezil was well tolerated, with 85 of 913 (9.3%) patients reporting AEs. The most common AEs were those typically seen with cholinergic therapies (i.e., diarrhoea, vomiting and nausea). In this observational PMS study, donepezil was shown to be efficacious and well tolerated in patients who were being insufficiently treated with memantine or nootropic therapy. The magnitude of response was similar to that observed in patients who were previously

  3. Neuropsychiatric and cardiometabolic comorbidities in patients with previously diagnosed Cushing's disease: a longitudinal observational study.

    PubMed

    Dimopoulou, C; Geraedts, V; Stalla, G K; Sievers, C

    2015-03-27

    Only few studies have systematically investigated neuropsychiatric aspects in patients with Cushing's disease (CD). Pain syndromes have been described in patients with pituitary adenomas, but so far no systematical investigation has been conducted in patients with CD. Additionally, CD has an association with cardiometabolic comorbidities which ultimately leads to increased morbidity and mortality. Long-term treatment of the hypercortisolic state cannot prevent the persistence of an unfavourable cardiometabolic risk profile. Finally, chronic hypercortisolism is known to impact the health-related quality of life (HRQoL). We aim to systematically investigate the neuropsychiatric and cardiometabolic comorbidities, as well as assess the HRQoL, in patients with previously diagnosed CD in a longitudinal fashion. In this longitudinal study, we will assess 20 patients with CD displaying biochemical control 24 months after recruitment in the initial cross-sectional study (n=80). This will be a mixed cohort including patients after surgical, after radiation therapy and/or under current medical treatment for CD. Primary outcomes include changes in mean urinary free cortisol and changes in specific pain patterns. Secondary/exploratory neuropsychiatric domains include depression, anxiety, personality, sleep, body image and quality of life. Secondary/exploratory cardiometabolic domains include anthropometric parameters, cardiometabolic risk biomarkers and insulin resistance. Additional domains will be investigated if warranted by clinical indication. Safety assessment under medical therapy will include liver enzymes, ECG abnormalities and hyperglycaemia. Risk of damage from study-conditioned measures is very small and considered ethically justified. Dual-energy X-ray absorptiometry may call for detailed fracture risk assessment. However, the radiation dose is very small and only administered on clinical indication; therefore, it is considered ethically justified. This protocol

  4. Neuropsychiatric and cardiometabolic comorbidities in patients with previously diagnosed Cushing's disease: a longitudinal observational study

    PubMed Central

    Dimopoulou, C; Geraedts, V; Stalla, G K; Sievers, C

    2015-01-01

    Introduction Only few studies have systematically investigated neuropsychiatric aspects in patients with Cushing's disease (CD). Pain syndromes have been described in patients with pituitary adenomas, but so far no systematical investigation has been conducted in patients with CD. Additionally, CD has an association with cardiometabolic comorbidities which ultimately leads to increased morbidity and mortality. Long-term treatment of the hypercortisolic state cannot prevent the persistence of an unfavourable cardiometabolic risk profile. Finally, chronic hypercortisolism is known to impact the health-related quality of life (HRQoL). We aim to systematically investigate the neuropsychiatric and cardiometabolic comorbidities, as well as assess the HRQoL, in patients with previously diagnosed CD in a longitudinal fashion. Methods and analysis In this longitudinal study, we will assess 20 patients with CD displaying biochemical control 24 months after recruitment in the initial cross-sectional study (n=80). This will be a mixed cohort including patients after surgical, after radiation therapy and/or under current medical treatment for CD. Primary outcomes include changes in mean urinary free cortisol and changes in specific pain patterns. Secondary/exploratory neuropsychiatric domains include depression, anxiety, personality, sleep, body image and quality of life. Secondary/exploratory cardiometabolic domains include anthropometric parameters, cardiometabolic risk biomarkers and insulin resistance. Additional domains will be investigated if warranted by clinical indication. Safety assessment under medical therapy will include liver enzymes, ECG abnormalities and hyperglycaemia. Ethics and dissemination Risk of damage from study-conditioned measures is very small and considered ethically justified. Dual-energy X-ray absorptiometry may call for detailed fracture risk assessment. However, the radiation dose is very small and only administered on clinical indication

  5. Medication safety research by observational study design.

    PubMed

    Lao, Kim S J; Chui, Celine S L; Man, Kenneth K C; Lau, Wallis C Y; Chan, Esther W; Wong, Ian C K

    2016-06-01

    Observational studies have been recognised to be essential for investigating the safety profile of medications. Numerous observational studies have been conducted on the platform of large population databases, which provide adequate sample size and follow-up length to detect infrequent and/or delayed clinical outcomes. Cohort and case-control are well-accepted traditional methodologies for hypothesis testing, while within-individual study designs are developing and evolving, addressing previous known methodological limitations to reduce confounding and bias. Respective examples of observational studies of different study designs using medical databases are shown. Methodology characteristics, study assumptions, strengths and weaknesses of each method are discussed in this review.

  6. Plantar pressure in diabetic peripheral neuropathy patients with active foot ulceration, previous ulceration and no history of ulceration: a meta-analysis of observational studies.

    PubMed

    Fernando, Malindu Eranga; Crowther, Robert George; Pappas, Elise; Lazzarini, Peter Anthony; Cunningham, Margaret; Sangla, Kunwarjit Singh; Buttner, Petra; Golledge, Jonathan

    2014-01-01

    Elevated dynamic plantar pressures are a consistent finding in diabetes patients with peripheral neuropathy with implications for plantar foot ulceration. This meta-analysis aimed to compare the plantar pressures of diabetes patients that had peripheral neuropathy and those with neuropathy with active or previous foot ulcers. Published articles were identified from Medline via OVID, CINAHL, SCOPUS, INFORMIT, Cochrane Central EMBASE via OVID and Web of Science via ISI Web of Knowledge bibliographic databases. Observational studies reporting barefoot dynamic plantar pressure in adults with diabetic peripheral neuropathy, where at least one group had a history of plantar foot ulcers were included. Interventional studies, shod plantar pressure studies and studies not published in English were excluded. Overall mean peak plantar pressure (MPP) and pressure time integral (PTI) were primary outcomes. The six secondary outcomes were MPP and PTI at the rear foot, mid foot and fore foot. The protocol of the meta-analysis was published with PROPSERO, (registration number CRD42013004310). Eight observational studies were included. Overall MPP and PTI were greater in diabetic peripheral neuropathy patients with foot ulceration compared to those without ulceration (standardised mean difference 0.551, 95% CI 0.290-0.811, p<0.001; and 0.762, 95% CI 0.303-1.221, p = 0.001, respectively). Sub-group analyses demonstrated no significant difference in MPP for those with neuropathy with active ulceration compared to those without ulcers. A significant difference in MPP was found for those with neuropathy with a past history of ulceration compared to those without ulcers; (0.467, 95% CI 0.181- 0.753, p = 0.001). Statistical heterogeneity between studies was moderate. Plantar pressures appear to be significantly higher in patients with diabetic peripheral neuropathy with a history of foot ulceration compared to those with diabetic neuropathy without a history of ulceration. More

  7. Low temperature magneto-morphological characterisation of coronene and the resolution of previously observed unexplained phenomena

    NASA Astrophysics Data System (ADS)

    Potticary, Jason; Boston, Rebecca; Vella-Zarb, Liana; Few, Alex; Bell, Christopher; Hall, Simon R.

    2016-12-01

    The polyaromatic hydrocarbon coronene has been the molecule of choice for understanding the physical properties of graphene for over a decade. The modelling of the latter by the former was considered to be valid, as since it was first synthesised in 1932, the physical behaviour of coronene has been determined extremely accurately. We recently discovered however, an unforeseen polymorph of coronene, which exists as an enantiotrope with the previously observed crystal structure. Using low-temperature magnetisation and crystallographic measurements, we show here for the first time that the electronic and magnetic properties of coronene depend directly on the temperature at which it is observed, with hysteretic behaviour exhibited between 300 K and 100 K. Furthermore we determine that this behaviour is a direct result of the appearance and disappearance of the newly-discovered polymorph during thermal cycling. Our results not only highlight the need for theoretical models of graphene to take into account this anomalous behaviour at low temperatures, but also explain puzzling experimental observations of coronene dating back over 40 years.

  8. 40 CFR 152.93 - Citation of a previously submitted valid study.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Data Submitters' Rights § 152.93 Citation of a previously submitted valid study. An applicant may demonstrate compliance for a data requirement by citing a valid study previously submitted to the Agency. The... the original data submitter, the applicant may cite the study only in accordance with paragraphs (b...

  9. Chronic Chagas disease: PCR-xenodiagnosis without previous microscopic observation is a useful tool to detect viable Trypanosoma cruzi.

    PubMed

    Saavedra, Miguel; Zulantay, Inés; Apt, Werner; Martínez, Gabriela; Rojas, Antonio; Rodríguez, Jorge

    2013-01-01

    We evaluate the elimination of the microscopic stage of conventional xenodiagnosis (XD) to optimize the parasitological diagnosis of Trypanosoma cruzi in chronic Chagas disease. To this purpose we applied under informed consent two XD cages to 150 Chilean chronic chagasic patients. The fecal samples (FS) of the triatomines at 30, 60 and 90 days post feeding were divided into two parts: in one a microscopic search for mobile trypomastigote and/or epimastigote forms was performed. In the other part, DNA extraction-purification for PCR directed to the conserved region of kDNA minicircles of trypanosomes (PCR-XD), without previous microscopic observation was done. An XD was considered positive when at least one mobile T. cruzi parasite in any one of three periods of incubation was observed, whereas PCR-XD was considered positive when the 330 bp band specific for T. cruzi was detected. 25 of 26 cases with positive conventional XD were PCR-XD positive (concordance 96.2%), whereas 85 of 124 cases with negative conventional XD were positive by PCR-XD (68.5%). Human chromosome 12 detected by Real-time PCR used as exogenous internal control of PCR-XD reaction allowed to discounting of PCR inhibition and false negative in 40 cases with negative PCR-XD. PCR-XD performed without previous microscopic observation is a useful tool for detection of viable parasites with higher efficiency then conventional XD.

  10. Modified directly observed treatment for tuberculosis versus self-administered therapy: an observational study in rural Greece.

    PubMed

    Charokopos, N; Tsiros, G; Foka, A; Voila, P; Chrysanthopoulos, K; Spiliopoulou, I; Jelastopulu, E

    2013-01-01

    Directly Observed Treatment (DOT) is the key element of DOTS (directly observed treatment, short course), part of the internationally recommended control strategy for tuberculosis (TB). The evaluation of DOT has not been widely evaluated in rural areas in developed settings. The aim of this pilot study was to evaluate a modified DOT program (MDOT) by a general practitioner (GP) in a rural area of southwest Greece, where there is substantial underreporting of TB cases. Thirteen new TB cases with 30 close contacts were compared with 41 past-treated TB subjects (controls) with 111 close contacts in this observational, case-control study. Home visits by a GP were conducted and comparison of various data (laboratory findings, treatment outcomes, questionnaire-based parameters, on-site recorded conditions) was performed in both newly detected pulmonary TB cases and previously treated TB cases managed without DOT intervention. MDOT by GP implementation revealed that 11 cases (84.6%) were successfully treated, one (7.7%) case died, and one (7.7%) was lost to follow up. None of the close contacts of new TB cases was infected with active TB, while 6.3% of previously-treated TB subjects were infected with active TB and had to receive a complete anti-TB regimen. Chemoprophylaxis was administered to 13.3% of close contacts of new cases; whereas 12.6% of close contacts of previously-treated patients received chemoprophylaxis. This pilot study revealed that a GP is able to implement a program based on DOT resulting in high treatment adherence and prevention of TB compared with the conventional self-administration of treatment.

  11. A previous hamstring injury affects kicking mechanics in soccer players.

    PubMed

    Navandar, Archit; Veiga, Santiago; Torres, Gonzalo; Chorro, David; Navarro, Enrique

    2018-01-10

    Although the kicking skill is influenced by limb dominance and sex, how a previous hamstring injury affects kicking has not been studied in detail. Thus, the objective of this study was to evaluate the effect of sex and limb dominance on kicking in limbs with and without a previous hamstring injury. 45 professional players (males: n=19, previously injured players=4, age=21.16 ± 2.00 years; females: n=19, previously injured players=10, age=22.15 ± 4.50 years) performed 5 kicks each with their preferred and non-preferred limb at a target 7m away, which were recorded with a three-dimensional motion capture system. Kinematic and kinetic variables were extracted for the backswing, leg cocking, leg acceleration and follow through phases. A shorter backswing (20.20 ± 3.49% vs 25.64 ± 4.57%), and differences in knee flexion angle (58 ± 10o vs 72 ± 14o) and hip flexion velocity (8 ± 0rad/s vs 10 ± 2rad/s) were observed in previously injured, non-preferred limb kicks for females. A lower peak hip linear velocity (3.50 ± 0.84m/s vs 4.10 ± 0.45m/s) was observed in previously injured, preferred limb kicks of females. These differences occurred in the backswing and leg-cocking phases where the hamstring muscles were the most active. A variation in the functioning of the hamstring muscles and that of the gluteus maximus and iliopsoas in the case of a previous injury could account for the differences observed in the kicking pattern. Therefore, the effects of a previous hamstring injury must be considered while designing rehabilitation programs to re-educate kicking movement.

  12. Evaluation of Multiclass Model Observers in PET LROC Studies

    NASA Astrophysics Data System (ADS)

    Gifford, H. C.; Kinahan, P. E.; Lartizien, C.; King, M. A.

    2007-02-01

    A localization ROC (LROC) study was conducted to evaluate nonprewhitening matched-filter (NPW) and channelized NPW (CNPW) versions of a multiclass model observer as predictors of human tumor-detection performance with PET images. Target localization is explicitly performed by these model observers. Tumors were placed in the liver, lungs, and background soft tissue of a mathematical phantom, and the data simulation modeled a full-3D acquisition mode. Reconstructions were performed with the FORE+AWOSEM algorithm. The LROC study measured observer performance with 2D images consisting of either coronal, sagittal, or transverse views of the same set of cases. Versions of the CNPW observer based on two previously published difference-of-Gaussian channel models demonstrated good quantitative agreement with human observers. One interpretation of these results treats the CNPW observer as a channelized Hotelling observer with implicit internal noise

  13. Doubly charged coronene clusters—Much smaller than previously observed

    NASA Astrophysics Data System (ADS)

    Mahmoodi-Darian, Masoomeh; Raggl, Stefan; Renzler, Michael; Goulart, Marcelo; Huber, Stefan E.; Mauracher, Andreas; Scheier, Paul; Echt, Olof

    2018-05-01

    The smallest doubly charged coronene cluster ions reported so far, Cor152+, were produced by charge exchange between bare coronene clusters and He2+ [H. A. B. Johansson et al., Phys. Rev. A 84, 043201 (2011)]. These dications are at least five times larger than the estimated Rayleigh limit, i.e., the size at which the activation barrier for charge separation vanishes. Such a large discrepancy is unheard of for doubly charged atomic or molecular clusters. Here we report the mass spectrometric observation of doubly charged coronene trimers, produced by electron ionization of helium nanodroplets doped with coronene. The observation implies that Cor32+ features a non-zero fission barrier too large to overcome under the present experimental conditions. The height of the barriers for the dimer and trimer has been estimated by means of density functional theory calculations. A sizeable barrier for the trimer has been revealed in agreement with the experimental findings.

  14. [Cutaneous melanoma associated with previous nevus].

    PubMed

    Gutiérrez, María P; Barengo, Mónica; Mainardi, Claudio; Garay, Iliana; Kurpis, María; Ruiz Lascano, Alejandro

    2009-01-01

    The malignant melanoma is a neoplasia originated from the melanocytes located in the skin and other locations. Even though there is not information regarding its incidence and prevalence in our country, its most important risk factors are known. The melanoma can originate de novo or from previous melanocytic lesions. The concept that a melanocytic nevus can serve as a precursor lesion is supported by clinical and histological evidence. An observational, retrospective and analytical study was carried out in the Hospital Privado de Córdoba. The objective was to determine which is the frequency of association of malignant melanomas that develop on previous nevus. A total of 134 melanomas were analyzed. In 32 cases (24%), the melanomas were histologically associated with nevus, in individuals with Breslow's depth bigger than 1 mm the percentage of association was 16.3% while in those exhibiting Breslow smaller than 1 mm the percentage of association was 38.1%. Having evaluated the melanomas in relation to the Breslow and Clark classification, we observed that the nevus associated melanoma group showed less Breslow thickness and low Clark levels, which, by statistical analysis were shown to be significant predictors of the probabilty of finding this association (p < 0.027). This study demonstrates that the tumor thickness by itself is an independent predictive factor of the association melanoma-nevus. However, the rest of the variables studied did not throw significant results from the statistical point of view. In conclusion, patients must be educated for the control of new pigmented injuries as well as for the modification of preexisting nevi.

  15. Meteor Shower Records: A Reference Table of Observations from Previous Centuries

    NASA Astrophysics Data System (ADS)

    Koseki, M.

    2009-10-01

    Meteor history shows the complex nature of meteor showers. The author presents the Comae Berenicids as an example of the difficulties in defining meteor showers for visibility using different observational techniques. It is not useful to give a fixed or coded name to a 'meteor shower' because it may not be real and could lead observers to fictitious results.

  16. Everolimus for Previously Treated Advanced Gastric Cancer: Results of the Randomized, Double-Blind, Phase III GRANITE-1 Study

    PubMed Central

    Ohtsu, Atsushi; Ajani, Jaffer A.; Bai, Yu-Xian; Bang, Yung-Jue; Chung, Hyun-Cheol; Pan, Hong-Ming; Sahmoud, Tarek; Shen, Lin; Yeh, Kun-Huei; Chin, Keisho; Muro, Kei; Kim, Yeul Hong; Ferry, David; Tebbutt, Niall C.; Al-Batran, Salah-Eddin; Smith, Heind; Costantini, Chiara; Rizvi, Syed; Lebwohl, David; Van Cutsem, Eric

    2013-01-01

    Purpose The oral mammalian target of rapamycin inhibitor everolimus demonstrated promising efficacy in a phase II study of pretreated advanced gastric cancer. This international, double-blind, phase III study compared everolimus efficacy and safety with that of best supportive care (BSC) in previously treated advanced gastric cancer. Patients and Methods Patients with advanced gastric cancer that progressed after one or two lines of systemic chemotherapy were randomly assigned to everolimus 10 mg/d (assignment schedule: 2:1) or matching placebo, both given with BSC. Randomization was stratified by previous chemotherapy lines (one v two) and region (Asia v rest of the world [ROW]). Treatment continued until disease progression or intolerable toxicity. Primary end point was overall survival (OS). Secondary end points included progression-free survival (PFS), overall response rate, and safety. Results Six hundred fifty-six patients (median age, 62.0 years; 73.6% male) were enrolled. Median OS was 5.4 months with everolimus and 4.3 months with placebo (hazard ratio, 0.90; 95% CI, 0.75 to 1.08; P = .124). Median PFS was 1.7 months and 1.4 months in the everolimus and placebo arms, respectively (hazard ratio, 0.66; 95% CI, 0.56 to 0.78). Common grade 3/4 adverse events included anemia, decreased appetite, and fatigue. The safety profile was similar in patients enrolled in Asia versus ROW. Conclusion Compared with BSC, everolimus did not significantly improve overall survival for advanced gastric cancer that progressed after one or two lines of previous systemic chemotherapy. The safety profile observed for everolimus was consistent with that observed for everolimus in other cancers. PMID:24043745

  17. Matched cohort study of external cephalic version in women with previous cesarean delivery.

    PubMed

    Keepanasseril, Anish; Anand, Keerthana; Soundara Raghavan, Subrahmanian

    2017-07-01

    To evaluate the efficacy and safety of external cephalic version (ECV) among women with previous cesarean delivery. A retrospective study was conducted using data for women with previous cesarean delivery and breech presentation who underwent ECV at or after 36 weeks of pregnancy during 2011-2016. For every case, two multiparous women without previous cesarean delivery who underwent ECV and were matched for age and pregnancy duration were included. Characteristics and outcomes were compared between groups. ECV was successful for 32 (84.2%) of 38 women with previous cesarean delivery and 62 (81.6%) in the control group (P=0.728). Multivariate regression analysis confirmed that previous cesarean was not associated with ECV success (odds ratio 1.89, 95% confidence interval 0.19-18.47; P=0.244). Successful vaginal delivery after successful ECV was reported for 19 (59.4%) women in the previous cesarean delivery group and 52 (83.9%) in the control group (P<0.001). No ECV-associated complications occurred in women with previous cesarean delivery. To avoid a repeat cesarean delivery, ECV can be offered to women with breech presentation and previous cesarean delivery who are otherwise eligible for a trial of labor. © 2017 International Federation of Gynecology and Obstetrics.

  18. Accelerated hyperfractionated intensity-modulated radiotherapy for recurrent/unresectable rectal cancer in patients with previous pelvic irradiation: results of a phase II study.

    PubMed

    Cai, Gang; Zhu, Ji; Hu, Weigang; Zhang, Zhen

    2014-12-11

    This study was conducted to investigate the local effects and toxicity of accelerated hyperfractionated intensity-modulated radiotherapy for recurrent/unresectable rectal cancer in patients with previous pelvic irradiation. Twenty-two patients with recurrent/unresectable rectal cancer who previously received pelvic irradiation were enrolled in our single-center trial between January 2007 and August 2012. Reirradiation was scheduled for up to 39 Gy in 30 fractions using intensity-modulated radiotherapy plans. The dose was delivered via a hyperfractionation schedule of 1.3 Gy twice daily. Patient follow-up was performed by clinical examination, CT/MRI, or PET/CT every 3 months for the first 2 years and every 6 months thereafter. Tumor response was evaluated 1 month after reirradiation by CT/MRI based on the RECIST criteria. Adverse events were assessed using the National Cancer Institute (NCI) common toxicity criteria (version 3.0). The median time from the end of the initial radiation therapy to reirradiation was 30 months (range, 18-93 months). Overall local responses were observed in 9 patients (40.9%). None of the patients achieved a complete response (CR), and 9 patients (40.9%) had a partial response (PR). Thirteen patients failed to achieve a clinical response: 12 (54.5%) presented with stable disease (SD) and 1 (4.5%) with progressive disease (PD). Among all the patients who underwent reirradiation, partial or complete symptomatic relief was achieved in 6 patients (27.3%) and 13 patients (59.1%), respectively. Grade 4 acute toxicity and treatment-related deaths were not observed. The following grade 3 acute toxicities were observed: diarrhea (2 patients, 9.1%), cystitis (1 patient, 4.5%), dermatitis (1 patient, 4.5%), and intestinal obstruction (1 patient, 4.5%). Late toxicity was infrequent. Chronic severe diarrhea, small bowel obstruction, and dysuria were observed in 2 (9.1%), 1 (4.5%) and 2 (9.1%) of the patients, respectively. This study showed that

  19. The spectrum of Phobos from Phobos 2 observations at 0.3-2.6 microns: Comparison to previous data and meteorite analogs

    NASA Technical Reports Server (NTRS)

    Murchie, Scott; Erard, Stephane

    1993-01-01

    The surface of Phobos has been proposed to consist of carbonaceous chondrite or optically darkened ordinary chondrite ('black chondrite'). Measurements of Phobos's spectrum are key evidence for testing these hypotheses. Disk-integrated measurements were obtained by the Mariner 9 UV spectrometer, Viking Lander cameras, and groundbased observations. In 1989 disk-resolved measurements of Phobos and Mars were obtained by three instruments on Phobos 2: the KRFM spectrometer, which covered the wavelength range 0.32 - 0.6 microns; the ISM imaging spectrometer, which covered the wavelength range 0.76 - 3.16 microns; and the VSK TV cameras, whose wavelength ranges overlap those of KRFM and ISM. Here we report analysis of the Phobos 2 measurements completed since earlier results were reported. We validated calibration of the Phobos measurements using observations of Mars for reference, and compared them with pre-1989 measurements. We also combined spectra from the three detectors to produce an integrated spectrum of Phobos from 0.3 - 2.6 microns. Phobos 2 results agree well with previous measurements, contrary to some reports. The general shape of the spectrum is consistent with both proposed analogues. However position and depth of the previously unobserved 1 micron absorption are more diagnostic, and indicate the composition of typical surfaces to be more consistent with black chondrite.

  20. Survival of previously measles-vaccinated and measles-unvaccinated children in an emergency situation: an unplanned study.

    PubMed

    Aaby, Peter; Garly, May-Lill; Balé, Carlitos; Martins, Cesario; Jensen, Henrik; Lisse, Ida; Whittle, Hilton

    2003-09-01

    Previous studies have suggested that standard measles vaccine may reduce mortality by more than the number of deaths thought to be caused by measles infection in areas with high mortality. However, these observations have not been based on randomized trials. During the recent war in Guinea-Bissau, most children fled from the city of Bissau and immunization services in the country broke down for several months. We were performing a trial in which children were randomized at 6 months of age to receive either measles vaccine or inactivated polio vaccine. Because of the war many children did not receive the dose of measles vaccine planned for 9 months of age. We were able to monitor mortality during the war and after. Included in the study were 433 children 6 to 11 months of age. Fifteen children died (3.6%) during the first 3 months of the war before vaccination programs were resumed, 4 of 214 measles-vaccinated children and 11 of 219 children who had received inactivated polio vaccine. The effect of measles vaccine was marked for girls [mortality rate ratio (MR), 0.00; 95% confidence limits, 0.0 to 0.37], whereas there was no difference for boys (MR = 1.02; 95% confidence limits, 0.25 to 3.88). In a combined analysis controlling for factors that differed between the two groups, the MR for measles-vaccinated children was 0.30 (95% confidence limits, 0.08 to 0.87). Prolonging the period of observation to the end of 1998 or including the prewar period did not modify the significant beneficial effect of measles vaccine for girls. Twenty-two of the children in the cohort were reported to have had measles, 8 cases occurring during the 3 months of the war. Exclusion of measles cases in the analysis did not change the results; children who had received measles vaccine had a MR of 0.28 (95% confidence limits, 0.06 to 0.89) during the first 3 months of the war. Consistent with previous observational studies, measles vaccination was associated with a reduction in mortality that

  1. Effect of clinical information and previous exam execution on observer agreement and reliability in the analysis of hysteroscopic video-recordings.

    PubMed

    Martinho, Margarida Suzel Lopes; da Costa Santos, Cristina Maria Nogueira; Silva Carvalho, João Luís Mendonça; Bernardes, João Francisco Montenegro Andrade Lima

    2018-02-01

    Inter-observer agreement and reliability in hysteroscopic image assessment remain uncertain and the type of factors that may influence it has only been studied in relation to the experience of hysteroscopists. We aim to assess the effect of clinical information and previous exam execution on observer agreement and reliability in the analysis of hysteroscopic video-recordings. Ninety hysteroscopies were video-recorded and randomized into a group without (Group 1) and with clinical information (Group 2). The videos were independently analyzed by three hysteroscopists, regarding lesion location, dimension, and type, as well as decision to perform a biopsy. One of the hysteroscopists had executed all the exams before. Proportions of agreement (PA) and kappa statistics (κ) with 95% confidence intervals (95% CI) were used. In Group 2, there was a higher proportion of a normal diagnosis (p < 0.001) and a lower proportion of biopsies recommended (p = 0.027). Observer agreement and reliability were better in Group 2, with the PA and κ ranging, respectively, from 0.73 (95% CI 0.62, 0.83) and 0.44 (95% CI 0.26, 0.63), for image quality, to 0.94 (95% CI 0.88, 0.99) and 0.85 (95% CI 0.65, 0.95), for the decision to perform a biopsy. Execution of the exams before the analysis of the video-recordings did not significantly affect the results. With clinical information, agreement and reliability in the overall analysis of hysteroscopic video-recordings may reach almost perfect results and this was not significantly affected by the execution of the exams before the analysis. However, there is still uncertainty in the analysis of specific endometrial cavity abnormalities.

  2. Incidence and Risk of Cardiac Events in Patients With Previously Treated Multiple Myeloma Versus Matched Patients Without Multiple Myeloma: An Observational, Retrospective, Cohort Study.

    PubMed

    Kistler, Kristin D; Kalman, Jill; Sahni, Gagan; Murphy, Brian; Werther, Winifred; Rajangam, Kanya; Chari, Ajai

    2017-02-01

    Multiple myeloma (MM) patients have age-, disease-, and treatment-related risk factors for cardiac events. We analyzed the 2006 to 2011 MarketScan database to determine whether the risk of cardiac events is greater in MM patients than in non-MM patients. Included were 1723 MM patients treated with corticosteroids and ≥ 3 drugs (bortezomib, immunomodulatory derivatives, and alkylating agents or anthracyclines). The index date (ID) was the date on which the 3-drug exposure criterion was met. Also included were 8615 age- and gender-matched non-MM patients (5:1). The distribution of non-MM patients' IDs matched that of the MM patients' IDs. Baseline was 6 months before the ID. The follow-up duration was from the ID to study end (ie, 2011 or end of enrollment or prescription drug coverage). Hazard ratios (HRs) and 95% confidence intervals (CIs) were adjusted for baseline variables when the univariate analyses showed a 10% difference. The median duration of observation was 9 months (range, 0-60 months) for MM patients and 19 months (range, 0-66 months) for non-MM patients. The risk of any cardiac event (HR, 2.2; 95% CI, 1.9-2.5), dysrhythmia (HR, 4.1; 95% CI, 3.5-4.8), congestive heart failure (HR, 2.9; 95% CI, 2.2-3.7), cardiomyopathy (HR, 2.6; 95% CI, 1.8-3.8), and conduction disorders (HR, 1.7; 95% CI, 1.2-2.5) was significantly greater for MM than for non-MM patients. The incidence of hypertensive or arterial events and ischemic heart disease was similar between the 2 groups. The present study provides the first known comparison of cardiac event risk in patients with MM versus age- and gender-matched patients without MM. The cardiac event risk was greater in MM patients with ≥ 3 previous drugs for any cardiac event, dysrhythmias, congestive heart failure, cardiomyopathy, and conduction disorders compared with patients without MM. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Assessing validity of observational intervention studies - the Benchmarking Controlled Trials.

    PubMed

    Malmivaara, Antti

    2016-09-01

    Benchmarking Controlled Trial (BCT) is a concept which covers all observational studies aiming to assess impact of interventions or health care system features to patients and populations. To create and pilot test a checklist for appraising methodological validity of a BCT. The checklist was created by extracting the most essential elements from the comprehensive set of criteria in the previous paper on BCTs. Also checklists and scientific papers on observational studies and respective systematic reviews were utilized. Ten BCTs published in the Lancet and in the New England Journal of Medicine were used to assess feasibility of the created checklist. The appraised studies seem to have several methodological limitations, some of which could be avoided in planning, conducting and reporting phases of the studies. The checklist can be used for planning, conducting, reporting, reviewing, and critical reading of observational intervention studies. However, the piloted checklist should be validated in further studies. Key messages Benchmarking Controlled Trial (BCT) is a concept which covers all observational studies aiming to assess impact of interventions or health care system features to patients and populations. This paper presents a checklist for appraising methodological validity of BCTs and pilot-tests the checklist with ten BCTs published in leading medical journals. The appraised studies seem to have several methodological limitations, some of which could be avoided in planning, conducting and reporting phases of the studies. The checklist can be used for planning, conducting, reporting, reviewing, and critical reading of observational intervention studies.

  4. Influence of Previous Knowledge, Language Skills and Domain-Specific Interest on Observation Competency

    ERIC Educational Resources Information Center

    Kohlhauf, Lucia; Rutke, Ulrike; Neuhaus, Birgit

    2011-01-01

    Many epoch-making biological discoveries (e.g. Darwinian Theory) were based upon observations. Nevertheless, observation is often regarded as "just looking" rather than a basic scientific skill. As observation is one of the main research methods in biological sciences, it must be considered as an independent research method and systematic practice…

  5. Observational Studies: Cohort and Case-Control Studies

    PubMed Central

    Song, Jae W.; Chung, Kevin C.

    2010-01-01

    Observational studies are an important category of study designs. To address some investigative questions in plastic surgery, randomized controlled trials are not always indicated or ethical to conduct. Instead, observational studies may be the next best method to address these types of questions. Well-designed observational studies have been shown to provide results similar to randomized controlled trials, challenging the belief that observational studies are second-rate. Cohort studies and case-control studies are two primary types of observational studies that aid in evaluating associations between diseases and exposures. In this review article, we describe these study designs, methodological issues, and provide examples from the plastic surgery literature. PMID:20697313

  6. EPA observational studies of children's respiratory health in the Detroit and Dearborn, Michigan

    EPA Science Inventory

    Previous research has suggested that long-term exposures to mobile-source emissions might be associated with the development of allergies and asthma in children. Between 2004 and 2007, EPA scientists successfully conducted nested observational studies of children aged 7-12 years ...

  7. Can previously sedentary females use the feeling scale to regulate exercise intensity in a gym environment? an observational study.

    PubMed

    Hamlyn-Williams, Charlotte C; Tempest, Gavin; Coombs, Sarah; Parfitt, Gaynor

    2015-01-01

    Recent research suggests that the Feeling Scale (FS) can be used as a method of exercise intensity regulation to maintain a positive affective response during exercise. However, research to date has been carried out in laboratories and is not representative of natural exercise environments. The purpose of this study was to evaluate whether sedentary women can self-regulate their exercise intensity using the FS to experience positive affective responses in a gym environment using their own choice of exercise mode; cycling or treadmill. Fourteen females (24.9 years ± 5.2; height 166.7 ± 5.7 cm; mass 66.3 ± 13.4 kg; BMI 24.1 ± 5.5)) completed a submaximal exercise test and each individual's ventilatory threshold ([Formula: see text]) was identified. Following this, three 20 min gym-based exercise trials, either on a bike or treadmill were performed at an intensity that was self-selected and perceived to correspond to the FS value of +3 (good). Oxygen uptake, heart rate (HR) and ratings of perceived exertion (RPE) were measured during exercise at the participants chosen intensity. Results indicated that on average participants worked close to their [Formula: see text] and increased their exercise intensity during the 20-min session. Participants worked physiologically harder during cycling exercise. Consistency of oxygen uptake, HR and RPE across the exercise trials was high. The data indicate that previously sedentary women can use the FS in an ecological setting to regulate their exercise intensity and that regulating intensity to feel 'good' should lead to individuals exercising at an intensity that would result in cardiovascular gains if maintained.

  8. Intravenous Chemotherapy Compounding Errors in a Follow-Up Pan-Canadian Observational Study.

    PubMed

    Gilbert, Rachel E; Kozak, Melissa C; Dobish, Roxanne B; Bourrier, Venetia C; Koke, Paul M; Kukreti, Vishal; Logan, Heather A; Easty, Anthony C; Trbovich, Patricia L

    2018-05-01

    Intravenous (IV) compounding safety has garnered recent attention as a result of high-profile incidents, awareness efforts from the safety community, and increasingly stringent practice standards. New research with more-sensitive error detection techniques continues to reinforce that error rates with manual IV compounding are unacceptably high. In 2014, our team published an observational study that described three types of previously unrecognized and potentially catastrophic latent chemotherapy preparation errors in Canadian oncology pharmacies that would otherwise be undetectable. We expand on this research and explore whether additional potential human failures are yet to be addressed by practice standards. Field observations were conducted in four cancer center pharmacies in four Canadian provinces from January 2013 to February 2015. Human factors specialists observed and interviewed pharmacy managers, oncology pharmacists, pharmacy technicians, and pharmacy assistants as they carried out their work. Emphasis was on latent errors (potential human failures) that could lead to outcomes such as wrong drug, dose, or diluent. Given the relatively short observational period, no active failures or actual errors were observed. However, 11 latent errors in chemotherapy compounding were identified. In terms of severity, all 11 errors create the potential for a patient to receive the wrong drug or dose, which in the context of cancer care, could lead to death or permanent loss of function. Three of the 11 practices were observed in our previous study, but eight were new. Applicable Canadian and international standards and guidelines do not explicitly address many of the potentially error-prone practices observed. We observed a significant degree of risk for error in manual mixing practice. These latent errors may exist in other regions where manual compounding of IV chemotherapy takes place. Continued efforts to advance standards, guidelines, technological innovation, and

  9. Molecular Carbon in the Galaxy: Laboratory and Observational Studies

    NASA Technical Reports Server (NTRS)

    Saykally, Richard James

    2003-01-01

    In a collaboration with the Mats Larsson group from Stockholm, we carried out a new measurement of the rate of dissociative recombination of H(sup *, sub j), using a new pulsed supersonic beam source of rotationally cold H(sup *, sub j). This source was first designed and characterized in our lab by IR cavity ringdown spectroscopy, determining a rotationaYtranslationa1 temperature of 20-60K, depending on conditions. This new source was then taken to Stockholm for the recombination rate studies at the CRYRING storage ring. The recombination rate constant measured against temperature yields values consistent with the most recent calculations, whereas previous experimental measurements varied over a range of 10(exp 4) and were poor agreement with theory. This is a crucial achievement for understanding the ion chemistry of diffuse clouds. Moreover, this result in combination with recent observations implies a greatly enhanced (factor of 40) cosmic ray ionization rate in a diffuse cloud (zeta Persei) relative to previous studies. The implications of this are discussed in our recent Nature paper. An enhanced cosmic-ray flux towards zeta Persei inferred from a laboratory study of the H(sup *, sub j)-e(sup -) recombination rate.

  10. Prospective clinical observational study evaluating gender-associated differences of preoperative pain intensity.

    PubMed

    Tafelski, Sascha; Kerper, Léonie F; Salz, Anna-Lena; Spies, Claudia; Reuter, Eva; Nachtigall, Irit; Schäfer, Michael; Krannich, Alexander; Krampe, Henning

    2016-07-01

    Previous studies reported conflicting results concerning different pain perceptions of men and women. Recent research found higher pain levels in men after major surgery, contrasted by women after minor procedures. This trial investigates differences in self-reported preoperative pain intensity between genders before surgery.Patients were enrolled in 2011 and 2012 presenting for preoperative evaluation at the anesthesiological assessment clinic at Charité University hospital. Out of 5102 patients completing a computer-assisted self-assessment, 3042 surgical patients with any preoperative pain were included into this prospective observational clinical study. Preoperative pain intensity (0-100 VAS, visual analog scale) was evaluated integrating psychological cofactors into analysis.Women reported higher preoperative pain intensity than men with median VAS scores of 30 (25th-75th percentiles: 10-52) versus 21 (10-46) (P < 0.001). Adjusted multiple regression analysis showed that female gender remained statistically significantly associated with higher pain intensity (P < 0.001). Gender differences were consistent across several subgroups especially with varying patterns in elderly. Women scheduled for minor and moderate surgical procedures showed largest differences in overall pain compared to men.This large clinical study observed significantly higher preoperative pain intensity in female surgical patients. This gender difference was larger in the elderly potentially contradicting the current hypothesis of a primary sex-hormone derived effect. The observed variability in specific patient subgroups may help to explain heterogeneous findings of previous studies.

  11. Challenges in translating endpoints from trials to observational cohort studies in oncology

    PubMed Central

    Ording, Anne Gulbech; Cronin-Fenton, Deirdre; Ehrenstein, Vera; Lash, Timothy L; Acquavella, John; Rørth, Mikael; Sørensen, Henrik Toft

    2016-01-01

    Clinical trials are considered the gold standard for examining drug efficacy and for approval of new drugs. Medical databases and population surveillance registries are valuable resources for post-approval observational research, which are increasingly used in studies of benefits and risk of new cancer drugs. Here, we address the challenges in translating endpoints from oncology trials to observational studies. Registry-based cohort studies can investigate real-world safety issues – including previously unrecognized concerns – by examining rare endpoints or multiple endpoints at once. In contrast to clinical trials, observational cohort studies typically do not exclude real-world patients from clinical practice, such as old and frail patients with comorbidity. The observational cohort study complements the clinical trial by examining the effectiveness of interventions applied in clinical practice and by providing evidence on long-term clinical outcomes, which are often not feasible to study in a clinical trial. Various endpoints can be included in clinical trials, such as hard endpoints, soft endpoints, surrogate endpoints, and patient-reported endpoints. Each endpoint has it strengths and limitations for use in research studies. Endpoints used in oncology trials are often not applicable in observational cohort studies which are limited by the setting of standard clinical practice and by non-standardized endpoint determination. Observational studies can be more helpful moving research forward if they restrict focus to appropriate and valid endpoints. PMID:27354827

  12. LAPAROSCOPY AFTER PREVIOUS LAPAROTOMY

    PubMed Central

    Godinjak, Zulfo; Idrizbegović, Edin; Begić, Kerim

    2006-01-01

    Following the abdominal surgery, extensive adhesions often occur and they can cause difficulties during laparoscopic operations. However, previous laparotomy is not considered to be a contraindication for lap-aroscopy. The aim of this study is to present that an insertion of Veres needle in the region of umbilicus is a safe method for creating a pneumoperitoneum for laparoscopic operations after previous laparotomy. In the last three years, we have performed 144 laparoscopic operations in patients that previously underwent one or two laparotomies. Pathology of digestive system, genital organs, Cesarean Section or abdominal war injuries were the most common causes of previous laparotomy. During those operations or during entering into abdominal cavity we have not experienced any complications, while in 7 patients we performed conversion to laparotomy following the diagnostic laparoscopy. In all patients an insertion of Veres needle and trocar insertion in the umbilical region was performed, namely a technique of closed laparoscopy. Not even in one patient adhesions in the region of umbilicus were found, and no abdominal organs were injured. PMID:17177649

  13. Seasonally Transported Aerosol Layers Over Southeast Atlantic are Closer to Underlying Clouds than Previously Reported

    NASA Technical Reports Server (NTRS)

    Rajapakshe, Chamara; Zhang, Zhibo; Yorks, John E.; Yu, Hongbin; Tan, Qian; Meyer, Kerry; Platnick, Steven; Winker, David M.

    2017-01-01

    From June to October, low-level clouds in the southeast (SE) Atlantic often underlie seasonal aerosol layers transported from African continent. Previously, the Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observation (CALIPSO) 532 nm lidar observations have been used to estimate the relative vertical location of the above-cloud aerosols (ACA) to the underlying clouds. Here we show new observations from NASA's Cloud-Aerosol Transport System (CATS) lidar. Two seasons of CATS 1064 nm observations reveal that the bottom of the ACA layer is much lower than previously estimated based on CALIPSO 532 nm observations. For about 60% of CATS nighttime ACA scenes, the aerosol layer base is within 360 m distance to the top of the underlying cloud. Our results are important for future studies of the microphysical indirect and semidirect effects of ACA in the SE Atlantic region.

  14. Assessing validity of observational intervention studies – the Benchmarking Controlled Trials

    PubMed Central

    Malmivaara, Antti

    2016-01-01

    Abstract Background: Benchmarking Controlled Trial (BCT) is a concept which covers all observational studies aiming to assess impact of interventions or health care system features to patients and populations. Aims: To create and pilot test a checklist for appraising methodological validity of a BCT. Methods: The checklist was created by extracting the most essential elements from the comprehensive set of criteria in the previous paper on BCTs. Also checklists and scientific papers on observational studies and respective systematic reviews were utilized. Ten BCTs published in the Lancet and in the New England Journal of Medicine were used to assess feasibility of the created checklist. Results: The appraised studies seem to have several methodological limitations, some of which could be avoided in planning, conducting and reporting phases of the studies. Conclusions: The checklist can be used for planning, conducting, reporting, reviewing, and critical reading of observational intervention studies. However, the piloted checklist should be validated in further studies.Key messagesBenchmarking Controlled Trial (BCT) is a concept which covers all observational studies aiming to assess impact of interventions or health care system features to patients and populations.This paper presents a checklist for appraising methodological validity of BCTs and pilot-tests the checklist with ten BCTs published in leading medical journals. The appraised studies seem to have several methodological limitations, some of which could be avoided in planning, conducting and reporting phases of the studies.The checklist can be used for planning, conducting, reporting, reviewing, and critical reading of observational intervention studies. PMID:27238631

  15. Airglow studies using observations made with the GLO instrument on the Space Shuttle

    NASA Astrophysics Data System (ADS)

    Alfaro Suzan, Ana Luisa

    2009-12-01

    Our understanding of Earth's upper atmosphere has advanced tremendously over the last few decades due to our enhanced capacity for making remote observations from space. Space based observations of Earth's daytime and nighttime airglow emissions are very good examples of such enhancements to our knowledge. The terrestrial nighttime airglow, or nightglow, is barely discernible to the naked eye as viewed from Earth's surface. However, it is clearly visible from space - as most astronauts have been amazed to report. The nightglow consists of emissions of ultraviolet, visible and near-infrared radiation from electronically excited oxygen molecules and atoms and vibrationally excited OH molecules. It mostly emanates from a 10 km thick layer located about 100 km above Earth's surface. Various photochemical models have been proposed to explain the production of the emitting species. In this study some unique observations of Earth's nightglow made with the GLO instrument on NASA's Space Shuttle, are analyzed to assess the proposed excitation models. Previous analyses of these observations by Broadfoot and Gardner (2001), performed using a 1-D inversion technique, have indicated significant spatial structures and have raised serious questions about the proposed nightglow excitation models. However, the observation of such strong spatial structures calls into serious question the appropriateness of the adopted 1-D inversion technique and, therefore, the validity of the conclusions. In this study a more rigorous 2-D tomographic inversion technique is developed and applied to the available GLO data to determine if some of the apparent discrepancies can be explained by the limitations of the previously applied 1-D inversion approach. The results of this study still reveal some potentially serious inadequacies in the proposed photochemical models. However, alternative explanations for the discrepancies between the GLO observations and the model expectations are suggested. These

  16. A case-crossover study of transient risk factors influence on occupational injuries: a study protocol based on a review of previous studies.

    PubMed

    Oesterlund, Anna H; Lander, Flemming; Lauritsen, Jens

    2016-10-01

    The occupational injury incident rate remains relatively high in the European Union. The case-crossover study gives a unique opportunity to study transient risk factors that normally would be very difficult to approach. Studies like this have been carried out in both America and Asia, but so far no relevant research has been conducted in Europe. Case-crossover studies of occupational injuries were collected from PubMed and Embase and read through. Previous experiences concerning method, exposure and outcome, time-related measurements and construction of the questionnaire were taken into account in the preparation of a pilot study. Consequently, experiences from the pilot study were used to design the study protocol. Approximately 2000 patients with an occupational injury will be recruited from the emergency departments in Herning and Odense, Denmark. A standardised questionnaire will be used to collect basic demographic data and information on eight transient risk factors. Based on previous studies and knowledge on occupational injuries the transient risk factors we chose to examine were: time pressure, performing a task with a different method/using unaccustomed technique, change in working surroundings, using a phone, disagreement, feeling ill, being distracted and using malfunctioning machinery/tools or work material. Exposure time 'just before the injury' will be compared with two control periods, 'previous day at the same time of the injury' (pair match) and the previous work week (usual frequency). This study protocol describes a unique opportunity to calculate the effect of transient risk factors on occupational injuries in a European setting. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. Effects of previous ovarian surgery for endometriosis on the outcome of assisted reproduction treatment.

    PubMed

    Geber, Selmo; Ferreira, Daniela Parreiras; Spyer Prates, Luis Felipe Víctor; Sales, Liana; Sampaio, Marcos

    2002-01-01

    Endometriosis affects 2-50% of women at reproductive age. Surgery is an option for treatment, but there is no convincing evidence that it promotes a significant improvement in fertility. Also, the removal of ovarian endometrioma might lead to a reduction in the follicular reserve and response to stimulation. Therefore, the aim of this study was to evaluate the effect of previous ovarian surgery for endometriosis on the ovarian response in assisted reproduction treatment cycles and its pregnancy outcome. A total of 61 women, with primary infertility and previously having undergone ovarian surgery for endometriosis, who had received 74 IVF/intracytoplasmic sperm injection (ICSI) cycles, were studied (study group). A further 74 patients with primary infertility who underwent 77 IVF/ICSI cycles within#10; the same period of time, at the same clinic and without previous ovarian surgery or endometriosis were studied as a control group. Patients were matched for age and treatment performed. Patients previous ovarian surgery had fewer retrieved oocytes than the patients in the control group (P = 0.049). The number of ampoules used for ovulation induction, duration of folliculogenesis; (days), number of follicles and fertilization rate was similar in both groups. The same was observed for pregnancy rates, with 24 patients (53.3%) having had previous ovarian surgery and 27 (56.2%) in the control group becoming pregnant. Patients >35 years with previous ovarian surgery needed more ampoules for ovulation induction (P = 0.017) and had fewer follicles and oocytes than women in the control group (P = 0.001). Duration of folliculogenesis was similar in both groups, as was fertilization rate. A total of 10 patients achieved pregnancy in the study group (34.5%) and 14 (48.3%) in the control group. Although a lower pregnancy rate was observed in patients who had undergone previous ovarian surgery, this difference was not statistically significant (P = 0.424). In

  18. 3-D microphysical model studies of Arctic denitrification: comparison with observations

    NASA Astrophysics Data System (ADS)

    Davies, S.; Mann, G. W.; Carslaw, K. S.; Chipperfield, M. P.; Kettleborough, J. A.; Santee, M. L.; Oelhaf, H.; Wetzel, G.; Sasano, Y.; Sugita, T.

    2005-11-01

    fit to MLS observations. Both adjustments would be required to bring the model into agreement with the MIPAS-B observations. The agreement between the model and observations suggests that a NAT-only denitrification scheme (without ice), which was discounted by previous studies, must now be considered as one mechanism for the observed Arctic denitrification. The timing of onset and the rate of denitrification remain poorly constrained by the available observations.

  19. 3-D microphysical model studies of Arctic denitrification: comparison with observations

    NASA Astrophysics Data System (ADS)

    Davies, S.; Mann, G. W.; Carslaw, K. S.; Chipperfield, M. P.; Kettleborough, J. A.; Santee, M. L.; Oelhaf, H.; Wetzel, G.; Sasano, Y.; Sugita, T.

    2005-01-01

    . Both adjustments would be required to bring the model into agreement with the MIPAS-B observations. The agreement between the model and observations suggests that a NAT-only denitrification scheme (without ice), which was discounted by previous studies, must now be considered as one mechanism for the observed Arctic denitrification. The timing of onset and the rate of denitrification remain poorly constrained by the available observations.

  20. Reoccurrence of retained placenta at a subsequent delivery: an observational study.

    PubMed

    Alufi, Anat; Mizrachi, Yossi; Lurie, Samuel

    2017-05-01

    To test the generalizability of previously reported increased risk of reoccurrence of retained placenta in yet another setting. In this observational retrospective study we longitudinally followed women who had a vaginal delivery complicated by a partial or complete retained placenta at Edith Wolfson Medical Center between 1 January 2009 and 31 December 2012. The study group included parturient women who had a partial or complete retained placenta after a vaginal delivery (n = 90). The control group included parturient women who did not have a partial or complete retained placenta after a vaginal delivery from the same time period using the same inclusion criteria (n = 90). Retained partial or complete placenta at a previous delivery was found to be an independent risk factor for retained partial or complete placenta in a subsequent delivery (adjusted OR 9.8, 95%CI 1.2 to 80.6, p = 0.032) and for retained partial or complete placenta and/or postpartum hemorrhage in a subsequent delivery (adjusted OR 14.1, 95% CI 1.7 to 111.9, p = 0.012), after controlling for gestational age and induction of labor at previous delivery. Retained partial or complete placenta at an index delivery increases the risk of reoccurrence of retained partial or complete placenta in a subsequent delivery.

  1. [Prevalence of previously diagnosed diabetes mellitus in Mexico.

    PubMed

    Rojas-Martínez, Rosalba; Basto-Abreu, Ana; Aguilar-Salinas, Carlos A; Zárate-Rojas, Emiliano; Villalpando, Salvador; Barrientos-Gutiérrez, Tonatiuh

    2018-01-01

    To compare the prevalence of previously diagnosed diabetes in 2016 with previous national surveys and to describe treatment and its complications. Mexico's national surveys Ensa 2000, Ensanut 2006, 2012 and 2016 were used. For 2016, logistic regression models and measures of central tendency and dispersion were obtained. The prevalence of previously diagnosed diabetes in 2016 was 9.4%. The increase of 2.2% relative to 2012 was not significant and only observed in patients older than 60 years. While preventive measures have increased, the access to medical treatment and lifestyle has not changed. The treatment has been modified, with an increase in insulin and decrease in hypoglycaemic agents. Population aging, lack of screening actions and the increase in diabetes complications will lead to an increase on the burden of disease. Policy measures targeting primary and secondary prevention of diabetes are crucial.

  2. Strengthening the reliability and credibility of observational epidemiology studies by creating an Observational Studies Register.

    PubMed

    Swaen, Gerard M H; Carmichael, Neil; Doe, John

    2011-05-01

    To evaluate the need for the creation of a system in which observational epidemiology studies are registered; an Observational Studies Register (OSR). The current scientific process for observational epidemiology studies is described. Next, a parallel is made with the clinical trials area, where the creation of clinical trial registers has greatly restored and improved their credibility and reliability. Next, the advantages and disadvantages of an OSR are compared. The advantages of an OSR outweigh its disadvantages. The creation of an OSR, similar to the existing Clinical Trials Registers, will improve the assessment of publication bias and will provide an opportunity to compare the original study protocol with the results reported in the publication. Reliability, credibility, and transparency of observational epidemiology studies are strengthened by the creation of an OSR. We propose a structured, collaborative, and coordinated approach for observational epidemiology studies that can provide solutions for existing weaknesses and will strengthen credibility and reliability, similar to the approach currently used in clinical trials, where Clinical Trials Registers have played a key role in strengthening their scientific value. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. Meta-Analysis of Cognitive Functioning in Breast Cancer Survivors Previously Treated With Standard-Dose Chemotherapy

    PubMed Central

    Jim, Heather S.L.; Phillips, Kristin M.; Chait, Sari; Anne Faul, Leigh; Popa, Mihaela A.; Lee, Yun-Hsiang; Hussin, Mallory G.; Jacobsen, Paul B.; Small, Brent J.

    2012-01-01

    Purpose Evidence is mixed regarding long-term cognitive deficits in patients treated with chemotherapy. Previous meta-analyses have not focused specifically on the postchemotherapy period and have not incorporated several recent studies. The goal of the current study was to conduct a meta-analysis of cognitive functioning in breast cancer survivors who were treated with chemotherapy ≥ 6 months previously. Methods A search of PubMed, PsycInfo, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library yielded 2,751 abstracts, which were independently evaluated by pairs of raters. Meta-analysis was conducted on 17 studies of 807 patients previously treated with standard-dose chemotherapy for breast cancer. Neuropsychological tests were categorized according to eight cognitive domains: attention, executive functioning, information processing, motor speed, verbal ability, verbal memory, visual memory, and visuospatial ability. Results Deficits in cognitive functioning were observed in patients treated with chemotherapy relative to controls or prechemotherapy baseline in the domains of verbal ability (g = −0.19; P < .01) and visuospatial ability (g = −0.27; P < .01). Patients treated with chemotherapy performed worse than noncancer controls in verbal ability and worse than patients treated without chemotherapy in visuospatial ability (both P < .01). Age, education, time since treatment, and endocrine therapy did not moderate observed cognitive deficits in verbal ability or visuospatial ability (all P ≥ .51). Conclusion Results indicate that, on average, observed cognitive deficits in patients with breast cancer previously treated with chemotherapy are small in magnitude and limited to the domains of verbal ability and visuospatial ability. This information can be used to inform interventions to educate patients with breast cancer regarding the long-term impact of chemotherapy on cognitive functioning. PMID:22927526

  4. Summary of Previous Chamber or Controlled Anthrax Studies and Recommendations for Possible Additional Studies

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

    Piepel, Gregory F.; Amidan, Brett G.; Morrow, Jayne B.

    2010-12-29

    This report and an associated Excel file(a) summarizes the investigations and results of previous chamber and controlled studies(b) to characterize the performance of methods for collecting, storing and/or transporting, extracting, and analyzing samples from surfaces contaminated by Bacillus anthracis (BA) or related simulants. This report and the Excel are the joint work of the Pacific Northwest National Laboratory (PNNL) and the National Institute of Standards and Technology (NIST) for the Department of Homeland Security, Science and Technology Directorate. The report was originally released as PNNL-SA-69338, Rev. 0 in November 2009 with limited distribution, but was subsequently cleared for release withmore » unlimited distribution in this Rev. 1. Only minor changes were made to Rev. 0 to yield Rev. 1. A more substantial update (including summarizing data from other studies and more condensed summary tables of data) is underway« less

  5. Validation of an image-based technique to assess the perceptual quality of clinical chest radiographs with an observer study

    NASA Astrophysics Data System (ADS)

    Lin, Yuan; Choudhury, Kingshuk R.; McAdams, H. Page; Foos, David H.; Samei, Ehsan

    2014-03-01

    We previously proposed a novel image-based quality assessment technique1 to assess the perceptual quality of clinical chest radiographs. In this paper, an observer study was designed and conducted to systematically validate this technique. Ten metrics were involved in the observer study, i.e., lung grey level, lung detail, lung noise, riblung contrast, rib sharpness, mediastinum detail, mediastinum noise, mediastinum alignment, subdiaphragm-lung contrast, and subdiaphragm area. For each metric, three tasks were successively presented to the observers. In each task, six ROI images were randomly presented in a row and observers were asked to rank the images only based on a designated quality and disregard the other qualities. A range slider on the top of the images was used for observers to indicate the acceptable range based on the corresponding perceptual attribute. Five boardcertificated radiologists from Duke participated in this observer study on a DICOM calibrated diagnostic display workstation and under low ambient lighting conditions. The observer data were analyzed in terms of the correlations between the observer ranking orders and the algorithmic ranking orders. Based on the collected acceptable ranges, quality consistency ranges were statistically derived. The observer study showed that, for each metric, the averaged ranking orders of the participated observers were strongly correlated with the algorithmic orders. For the lung grey level, the observer ranking orders completely accorded with the algorithmic ranking orders. The quality consistency ranges derived from this observer study were close to these derived from our previous study. The observer study indicates that the proposed image-based quality assessment technique provides a robust reflection of the perceptual image quality of the clinical chest radiographs. The derived quality consistency ranges can be used to automatically predict the acceptability of a clinical chest radiograph.

  6. Urinary tract infections in hospital pediatrics: many previous antibiotherapy and antibiotics resistance, including fluoroquinolones.

    PubMed

    Garraffo, A; Marguet, C; Checoury, A; Boyer, S; Gardrat, A; Houivet, E; Caron, F

    2014-02-01

    We studied antibiotic resistance in pediatric UTIs and we evaluated the impact of antibiotic exposure in the previous 12 months, very little French data being available for this population. We conducted a multicenter prospective study including children consulting for, or admitted in 2 hospitals. Prior antibiotic exposure was documented from their health record. One hundred and ten patients (73 girls), 11 days to 12 years of age, were included in 10 months. Ninety-six percent presented with pyelonephritis, associated to uropathy for 25%. Escherichia coli was predominant (78%), followed by Proteus spp. and Enterococcus spp. The antibiotic resistance rate of E. coli was high and close to that reported for adults with complicated UTIs: amoxicillin 60%, amoxicillin-clavulanate 35%, cefotaxim 5%, trimethoprim-sulfametoxazole 26%, nalidixic acid 9%, ciprofloxacin 7%, gentamycin 1%, nitrofurantoin and fosfomycin 0%. The antibiotic exposure in the previous 12 months involved 62 children (56%) most frequently with β-lactams (89%) for a respiratory tract infection (56%). A clear relationship between exposure and resistance was observed for amoxicillin (71% vs. 46%), first generation (65% vs. 46%) and third generation (9% vs. 3%) cephalosporins, or trimethoprim-sulfamethoxazole (36% vs. 15%). However, antibiotic exposure could not account alone for the results, as suggested by the 7% of ciprofloxacin resistance, observed without any identified previous treatment. Bacterial species and antibiotic resistance level in children are similar to those reported for adults. Antibiotic exposure in the previous 12 months increases the risk of resistance but other factors are involved (previous antibiotic therapies and fecal-oral or mother-to-child transmission). Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  7. Outcomes after Stroke in Patients with Previous Pressure Ulcer: A Nationwide Matched Retrospective Cohort Study.

    PubMed

    Lee, Shang-Yi; Chou, Chia-Lun; Hsu, Sanford P C; Shih, Chun-Chuan; Yeh, Chun-Chieh; Hung, Chih-Jen; Chen, Ta-Liang; Liao, Chien-Chang

    2016-01-01

    Factors associated with poststroke adverse events were not completely understood. The purpose of this study was to investigate whether stroke patients with previous pressure ulcers had more adverse events after stroke. Using the claims data from Taiwan's National Health Insurance Research Database, we conducted a retrospective cohort study matched by propensity score. Three thousand two first-ever stroke patients with previous pressure ulcer and 3002 first-ever stroke patients without pressure ulcer were investigated between 2002 and 2009. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of complications and 30-day mortality after stroke associated with previous pressure ulcer were calculated in the multivariate logistic regressions. Patients with pressure ulcer had significantly higher risk than control for poststroke urinary tract infection (OR: 1.56, 95% CI: 1.38-1.78), pneumonia (OR: 1.35, 95% CI: 1.16-1.58), gastrointestinal bleeding (OR: 1.31, 95% CI: 1.04-1.66), and epilepsy (OR: 1.84, 95% CI: 1.83-1.85). Stroke patients with pressure ulcer had increased 30-day poststroke mortality (OR: 2.01, 95% CI: 1.55-2.61), particularly in those treated with debridement (OR: 2.87, 95% CI: 1.85-4.44) or high quantity of antibiotics (OR: 4.01, 95% CI: 2.10-7.66). Pressure ulcer was associated with poststroke mortality in both genders and patients aged 60 years or older. This study showed increased poststroke complications and mortality in patients with previous pressure ulcer, which suggests the urgent need for monitoring stroke patients for pressure ulcer history. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  8. A previously undiscovered group of chimpanzees (Pan troglodytes verus) is observed living in the Tonkolili district of Sierra Leone.

    PubMed

    Halloran, Andrew R; Cloutier, Christina T; Sesay, Papanie Bai

    2013-06-01

    A previously undocumented group of wild chimpanzees (Pan troglodytes verus) was recently discovered along the Pampana River in the Tonkolili District of Sierra Leone. Based on interviews from local residents (N = 6), we estimate the group size to be approximately 30 individuals. Though this population does not show up in the most recent census of chimpanzees in Sierra Leone, it concurs with findings that indicate most of the chimpanzees in Sierra Leone live scattered throughout the country alongside villages, rather than in protected areas. During a three-week observation in the area, two chimpanzees were hunted and killed. The reason for these deaths, along with other reported instances of hunting in the area, are primarily due to crop-raiding and competition for resources between chimpanzees and humans. We conclude that this is a heavily imperiled population. Based on the ecology of the area and composition of local villages, we propose a number of conservation strategies that will promote a symbiotic relationship between the chimpanzees and human populations residing in the area. © 2013 Wiley Periodicals, Inc.

  9. Vaginal birth after caesarean section prediction models: a UK comparative observational study.

    PubMed

    Mone, Fionnuala; Harrity, Conor; Mackie, Adam; Segurado, Ricardo; Toner, Brenda; McCormick, Timothy R; Currie, Aoife; McAuliffe, Fionnuala M

    2015-10-01

    Primarily, to assess the performance of three statistical models in predicting successful vaginal birth in patients attempting a trial of labour after one previous lower segment caesarean section (TOLAC). The statistically most reliable models were subsequently subjected to validation testing in a local antenatal population. A retrospective observational study was performed with study data collected from the Northern Ireland Maternity Service Database (NIMATs). The study population included all women that underwent a TOLAC (n=385) from 2010 to 2012 in a regional UK obstetric unit. Data was collected from the Northern Ireland Maternity Service Database (NIMATs). Area under the curve (AUC) and correlation analysis was performed. Of the three prediction models evaluated, AUC calculations for the Smith et al., Grobman et al. and Troyer and Parisi Models were 0.74, 0.72 and 0.65, respectively. Using the Smith et al. model, 52% of women had a low risk of caesarean section (CS) (predicted VBAC >72%) and 20% had a high risk of CS (predicted VBAC <60%), of whom 20% and 63% had delivery by CS. The fit between observed and predicted outcome in this study cohort using the Smith et al. and Grobman et al. models were greatest (Chi-square test, p=0.228 and 0.904), validating both within the population. The Smith et al. and Grobman et al. models could potentially be utilized within the UK to provide women with an informed choice when deciding on mode of delivery after a previous CS. Crown Copyright © 2015. Published by Elsevier Ireland Ltd. All rights reserved.

  10. Previous Fractures at Multiple Sites Increase the Risk for Subsequent Fractures: The Global Longitudinal Study of Osteoporosis in Women

    PubMed Central

    Gehlbach, Stephen; Saag, Kenneth G.; Adachi, Jonathan D.; Hooven, Fred H.; Flahive, Julie; Boonen, Steven; Chapurlat, Roland D.; Compston, Juliet E.; Cooper, Cyrus; Díez-Perez, Adolfo; Greenspan, Susan L.; LaCroix, Andrea Z.; Netelenbos, J. Coen; Pfeilschifter, Johannes; Rossini, Maurizio; Roux, Christian; Sambrook, Philip N.; Silverman, Stuart; Siris, Ethel S.; Watts, Nelson B.; Lindsay, Robert

    2016-01-01

    Previous fractures of the hip, spine, or wrist are well-recognized predictors of future fracture, but the role of other fracture sites is less clear. We sought to assess the relationship between prior fracture at 10 skeletal locations and incident fracture. The Global Longitudinal Study of Osteoporosis in Women (GLOW) is an observational cohort study being conducted in 17 physician practices in 10 countries. Women ≥ 55 years answered questionnaires at baseline and at 1 and/or 2 years (fractures in previous year). Of 60,393 women enrolled, follow-up data were available for 51,762. Of these, 17.6%, 4.0%, and 1.6% had suffered 1, 2, or ≥3 fractures since age 45. During the first 2 years of follow-up, 3149 women suffered 3683 incident fractures. Compared with women with no prior fractures, women with 1, 2, or ≥ 3 prior fractures were 1.8-, 3.0-, and 4.8-fold more likely to have any incident fracture; those with ≥3 prior fractures were 9.1-fold more likely to sustain a new vertebral fracture. Nine of 10 prior fracture locations were associated with an incident fracture. The strongest predictors of incident spine and hip fractures were prior spine fracture (hazard ratio 7.3) and hip (hazard ratio 3.5). Prior rib fractures were associated with a 2.3-fold risk of subsequent vertebral fracture, previous upper leg fracture predicted a 2.2-fold increased risk of hip fracture; women with a history of ankle fracture were at 1.8-fold risk of future fracture of a weight-bearing bone. Our findings suggest that a broad range of prior fracture sites are associated with an increased risk of incident fractures, with important implications for clinical assessments and risk model development. PMID:22113888

  11. TU-FG-209-11: Validation of a Channelized Hotelling Observer to Optimize Chest Radiography Image Processing for Nodule Detection: A Human Observer Study

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

    Sanchez, A; Little, K; Chung, J

    Purpose: To validate the use of a Channelized Hotelling Observer (CHO) model for guiding image processing parameter selection and enable improved nodule detection in digital chest radiography. Methods: In a previous study, an anthropomorphic chest phantom was imaged with and without PMMA simulated nodules using a GE Discovery XR656 digital radiography system. The impact of image processing parameters was then explored using a CHO with 10 Laguerre-Gauss channels. In this work, we validate the CHO’s trend in nodule detectability as a function of two processing parameters by conducting a signal-known-exactly, multi-reader-multi-case (MRMC) ROC observer study. Five naive readers scored confidencemore » of nodule visualization in 384 images with 50% nodule prevalence. The image backgrounds were regions-of-interest extracted from 6 normal patient scans, and the digitally inserted simulated nodules were obtained from phantom data in previous work. Each patient image was processed with both a near-optimal and a worst-case parameter combination, as determined by the CHO for nodule detection. The same 192 ROIs were used for each image processing method, with 32 randomly selected lung ROIs per patient image. Finally, the MRMC data was analyzed using the freely available iMRMC software of Gallas et al. Results: The image processing parameters which were optimized for the CHO led to a statistically significant improvement (p=0.049) in human observer AUC from 0.78 to 0.86, relative to the image processing implementation which produced the lowest CHO performance. Conclusion: Differences in user-selectable image processing methods on a commercially available digital radiography system were shown to have a marked impact on performance of human observers in the task of lung nodule detection. Further, the effect of processing on humans was similar to the effect on CHO performance. Future work will expand this study to include a wider range of detection/classification tasks and

  12. Observational and modeling studies of heat, moisture, precipitation, and global-scale circulation patterns

    NASA Technical Reports Server (NTRS)

    Vincent, Dayton G.; Robertson, Franklin

    1993-01-01

    The research sponsored by this grant is a continuation and an extension of the work conducted under a previous contract, 'South Pacific Convergence Zone and Global-Scale Circulations'. In the prior work, we conducted a detailed investigation of the South Pacific convergence zone (SPCZ), and documented many of its significant features and characteristics. We also conducted studies of its interaction with global-scale circulation features through the use of both observational and modeling studies. The latter was accomplished toward the end of the contract when Dr. James Hurrell, then a Ph.D. candidate, successfully ported the NASA GLA general circulation model (GCM) to Purdue University. In our present grant, we have expanded our previous research to include studies of other convectively-driven circulation systems in the tropics besides the SPCZ. Furthermore, we have continued to examine the relationship between these convective systems and global-scale circulation patterns. Our recent research efforts have focused on three objectives: (1) determining the periodicity of large-scale bands of organized convection in the tropics, primarily synoptic to intraseasonal time scales in the Southern Hemisphere; (2) examining the relative importance of tropical versus mid-latitude forcing for Southern Hemisphere summertime subtropical jets, particularly over the Pacific Ocean; and (3) estimating tropical precipitation, especially over oceans, using observational and budget methods. A summary list of our most significant accomplishments in the past year is given.

  13. Using non-specialist observers in 4AFC human observer studies

    NASA Astrophysics Data System (ADS)

    Elangovan, Premkumar; Mackenzie, Alistair; Dance, David R.; Young, Kenneth C.; Wells, Kevin

    2017-03-01

    Virtual clinical trials (VCTs) are an emergent approach for rapid evaluation and comparison of various breast imaging technologies and techniques using computer-based modeling tools. Increasingly 4AFC (Four alternative forced choice) virtual clinical trials are used to compare detection performances of different breast imaging modalities. Most prior studies have used physicists and/or radiologists and physicists interchangeably. However, large scale use of statistically significant 4AFC observer studies is challenged by the individual time commitment and cost of such observers, often drawn from a limited local pool of specialists. This work aims to investigate whether non-specialist observers can be used to supplement such studies. A team of five specialist observers (medical physicists) and five non-specialists participated in a 4AFC study containing simulated 2D-mammography and DBT (digital breast tomosynthesis) images, produced using the OPTIMAM toolbox for VCTs. The images contained 4mm irregular solid masses and 4mm spherical targets at a range of contrast levels embedded in a realistic breast phantom background. There was no statistically significant difference between the detection performance of medical physicists and non-specialists (p>0.05). However, non-specialists took longer to complete the study than their physicist counterparts, which was statistically significant (p<0.05). Overall, the results from both observer groups indicate that DBT has a lower detectable threshold contrast than 2D-mammography for both masses and spheres, and both groups found spheres easier to detect than irregular solid masses.

  14. Impact of Availability and Use of ART/PMTCT Services on Fertility Desires of Previously Pregnant Women in Rakai, Uganda: A Retrospective Cohort Study.

    PubMed

    Litwin, Lindsay E; Makumbi, Frederick E; Gray, Ronald; Wawer, Maria; Kigozi, Godfrey; Kagaayi, Joseph; Nakigozi, Gertrude; Lutalo, Tom; Serwada, David; Brahmbhatt, Heena

    2015-07-01

    To assess fertility desires by availability and use of antiretroviral therapy and prevention of mother-to-child transmission (ART/PMTCT) services in Rakai, Uganda. Retrospective analyses of longitudinal data from the Rakai Community Cohort Study. Study participants were retrospectively identified and categorized by HIV status. Availability of ART/PMTCT services in Rakai was defined in three periods: (1) pre-ART/PMTCT (<2005), (2) ART/PMTCT rollout (2005-2006), and (3) universal ART/PMTCT (>2006); and use of ART/PMTCT was coded as yes if the woman received services. Trends in fertility desires were assessed by χ. "Modified" Poisson regression was performed using generalized linear models with a log link and Poisson family to estimate prevalence rate ratios (PRRs) and 95% confidence intervals (CIs) of desire for another child among previously and currently pregnant women; PRRs were adjusted for demographic and behavioral factors. A total of 4227 sexually active women in Rakai, including 436 HIV+ women, contributed 13,970 observations over 5 survey rounds. Fertility desires increased in the population in the ART/PMTCT rollout [adjusted (adj.) PRR: 1.08, 95% CI: 1.04 to 1.13] and the universal availability periods (adj. PRR: 1.11, 95% CI: 1.08 to 1.14) compared with pre-ART/PMTCT period. A total of 862 woman observations used ART/PMTCT services. Fertility desires were similar among ART/PMTCT service users and nonusers in cross-sectional analysis (adj. PRR: 0.84, 95% CI: 0.62 to 1.14) and 1 year after ART/PMTCT use (adj. PRR: 1.27, 95% CI: 0.83 to 1.94). Availability of ART/PMTCT may increase fertility desires of previously pregnant women in Rakai, Uganda. Use of ART/PMTCT services was not correlated with fertility desires of previously or current pregnant women.

  15. Collisions in outer space produced an icosahedral phase in the Khatyrka meteorite never observed previously in the laboratory.

    PubMed

    Bindi, Luca; Lin, Chaney; Ma, Chi; Steinhardt, Paul J

    2016-12-08

    We report the first occurrence of an icosahedral quasicrystal with composition Al 62.0(8) Cu 31.2(8) Fe 6.8(4) , outside the measured equilibrium stability field at standard pressure of the previously reported Al-Cu-Fe quasicrystal (Al x Cu y Fe z , with x between 61 and 64, y between 24 and 26, z between 12 and 13%). The new icosahedral mineral formed naturally and was discovered in the Khatyrka meteorite, a recently described CV3 carbonaceous chondrite that experienced shock metamorphism, local melting (with conditions exceeding 5 GPa and 1,200 °C in some locations), and rapid cooling, all of which likely resulted from impact-induced shock in space. This is the first example of a quasicrystal composition discovered in nature prior to being synthesized in the laboratory. The new composition was found in a grain that has a separate metal assemblage containing icosahedrite (Al 63 Cu 24 Fe 13 ), currently the only other known naturally occurring mineral with icosahedral symmetry (though the latter composition had already been observed in the laboratory prior to its discovery in nature). The chemistry of both the icosahedral phases was characterized by electron microprobe, and the rotational symmetry was confirmed by means of electron backscatter diffraction.

  16. Collisions in outer space produced an icosahedral phase in the Khatyrka meteorite never observed previously in the laboratory

    PubMed Central

    Bindi, Luca; Lin, Chaney; Ma, Chi; Steinhardt, Paul J.

    2016-01-01

    We report the first occurrence of an icosahedral quasicrystal with composition Al62.0(8)Cu31.2(8)Fe6.8(4), outside the measured equilibrium stability field at standard pressure of the previously reported Al-Cu-Fe quasicrystal (AlxCuyFez, with x between 61 and 64, y between 24 and 26, z between 12 and 13%). The new icosahedral mineral formed naturally and was discovered in the Khatyrka meteorite, a recently described CV3 carbonaceous chondrite that experienced shock metamorphism, local melting (with conditions exceeding 5 GPa and 1,200 °C in some locations), and rapid cooling, all of which likely resulted from impact-induced shock in space. This is the first example of a quasicrystal composition discovered in nature prior to being synthesized in the laboratory. The new composition was found in a grain that has a separate metal assemblage containing icosahedrite (Al63Cu24Fe13), currently the only other known naturally occurring mineral with icosahedral symmetry (though the latter composition had already been observed in the laboratory prior to its discovery in nature). The chemistry of both the icosahedral phases was characterized by electron microprobe, and the rotational symmetry was confirmed by means of electron backscatter diffraction. PMID:27929519

  17. Pedagogical strategies used in clinical medical education: an observational study

    PubMed Central

    2010-01-01

    Background Clinical teaching is a complex learning situation influenced by the learning content, the setting and the participants' actions and interactions. Few empirical studies have been conducted in order to explore how clinical supervision is carried out in authentic situations. In this study we explore how clinical teaching is carried out in a clinical environment with medical students. Methods Following an ethnographic approach looking for meaning patterns, similarities and differences in how clinical teachers manage clinical teaching; non-participant observations and informal interviews were conducted during a four month period 2004-2005. The setting was at a teaching hospital in Sweden. The participants were clinical teachers and their 4th year medical students taking a course in surgery. The observations were guided by the aim of the study. Observational notes and notes from informal interviews were transcribed after each observation and all data material was analysed qualitatively. Results Seven pedagogical strategies were found to be applied, namely: 1) Questions and answers, 2) Lecturing, 3) Piloting, 4) Prompting, 5) Supplementing, 6) Demonstrating, and 7) Intervening. Conclusions This study contributes to previous research in describing a repertoire of pedagogical strategies used in clinical education. The findings showed that three superordinate qualitatively different ways of teaching could be identified that fit Ramsden's model. Each of these pedagogical strategies encompass different focus in teaching; either a focus on the teacher's knowledge and behaviour or the student's behaviour and understanding. We suggest that an increased awareness of the strategies in use will increase clinical teachers' teaching skills and the consequences they will have on the students' ability to learn. The pedagogical strategies need to be considered and scrutinized in further research in order to verify their impact on students' learning. PMID:20105340

  18. Creation of an ensemble of simulated cardiac cases and a human observer study: tools for the development of numerical observers for SPECT myocardial perfusion imaging

    NASA Astrophysics Data System (ADS)

    O'Connor, J. Michael; Pretorius, P. Hendrik; Gifford, Howard C.; Licho, Robert; Joffe, Samuel; McGuiness, Matthew; Mehurg, Shannon; Zacharias, Michael; Brankov, Jovan G.

    2012-02-01

    Our previous Single Photon Emission Computed Tomography (SPECT) myocardial perfusion imaging (MPI) research explored the utility of numerical observers. We recently created two hundred and eighty simulated SPECT cardiac cases using Dynamic MCAT (DMCAT) and SIMIND Monte Carlo tools. All simulated cases were then processed with two reconstruction methods: iterative ordered subset expectation maximization (OSEM) and filtered back-projection (FBP). Observer study sets were assembled for both OSEM and FBP methods. Five physicians performed an observer study on one hundred and seventy-nine images from the simulated cases. The observer task was to indicate detection of any myocardial perfusion defect using the American Society of Nuclear Cardiology (ASNC) 17-segment cardiac model and the ASNC five-scale rating guidelines. Human observer Receiver Operating Characteristic (ROC) studies established the guidelines for the subsequent evaluation of numerical model observer (NO) performance. Several NOs were formulated and their performance was compared with the human observer performance. One type of NO was based on evaluation of a cardiac polar map that had been pre-processed using a gradient-magnitude watershed segmentation algorithm. The second type of NO was also based on analysis of a cardiac polar map but with use of a priori calculated average image derived from an ensemble of normal cases.

  19. Risk of retained placenta in women previously delivered by caesarean section: a population-based cohort study.

    PubMed

    Belachew, J; Cnattingius, S; Mulic-Lutvica, A; Eurenius, K; Axelsson, O; Wikström, A K

    2014-01-01

    To evaluate whether women with a caesarean section at their first delivery have an increased risk of retained placenta at their second delivery. Population-based cohort study. Sweden. All women with their first and second singleton deliveries in Sweden during the years 1994-2006 (n = 258,608). Women with caesarean section or placental abruption in their second pregnancy were not included in the study population. The risk of retained placenta at second delivery was estimated for women with a first delivery by caesarean section (n = 19,458), using women with a first vaginal delivery as reference (n = 239,150). Risks were calculated as odds ratios by unconditional logistic regression analysis with 95% confidence intervals (95%) after adjustments for maternal, delivery, and infant characteristics. Retained placenta with normal (≤1000 ml) and heavy (>1000 ml) bleeding. The overall rate of retained placenta was 2.07%. In women with a previous caesarean section and in women with previous vaginal delivery, the corresponding rates were 3.44% and 1.96%, respectively. Compared with women with a previous vaginal delivery, women with a previous caesarean section had an increased risk of retained placenta (adjusted OR 1.45; 95% CI 1.32-1.59), and the association was more pronounced for retained placenta with heavy bleeding (adjusted OR 1.61; 95% CI 1.44-1.79). Our report shows an increased risk for retained placenta in women previously delivered by caesarean section, a finding that should be considered in discussions of mode of delivery. © 2013 Royal College of Obstetricians and Gynaecologists.

  20. Early death in those previously hospitalised for mental healthcare in Scotland: a nationwide cohort study, 1986-2010.

    PubMed

    Ajetunmobi, Omotomilola; Taylor, Mark; Stockton, Diane; Wood, Rachael

    2013-07-30

    To compare the mortality in those previously hospitalised for mental disorder in Scotland to that experienced by the general population. Population-based historical cohort study using routinely available psychiatric hospital discharge and death records. All Scotland. Individuals with a first hospital admission for mental disorder between 1986 and 2009 who had died by 31 December 2010 (34 243 individuals). The main outcome measure was death from any cause, 1986-2010. Excess mortality was presented as standardised mortality ratios (SMRs) and years of life lost (YLL). Excess mortality was assessed overall and by age, sex, main psychiatric diagnosis, whether the psychiatric diagnosis was 'complicated' (ie, additional mental or physical ill-health diagnoses present), cause of death and time period of first admission. 111 504 people were included in the study, and 34 243 had died by 31 December 2010. The average reduction in life expectancy for the whole cohort was 17 years, with eating disorders (39-year reduction) and 'complicated' personality disorders (27.5-year reduction) being worst affected. 'Natural' causes of death such as cardiovascular disease showed modestly elevated relative risk (SMR1.7), but accounted for 67% of all deaths and 54% of the total burden of YLL. Non-natural deaths such as suicide showed higher relative risk (SMR5.2) and tended to occur at a younger age, but were less common overall (11% of all deaths and 22% of all YLL). Having a 'complicated' diagnosis tended to elevate the risk of early death. No worsening of the overall excess mortality experienced by individuals with previous psychiatric admission over time was observed. Early death for those hospitalised with mental disorder is common, and represents a significant inequality even in well-developed healthcare systems. Prevention of suicide and cardiovascular disease deserves particular attention in the mentally disordered.

  1. A Detailed Study and Synthesis of Flow Observables in the IP-Glasma+MUSIC+UrQMD Framework

    NASA Astrophysics Data System (ADS)

    McDonald, Scott; Shen, Chun; Fillion-Gourdeau, François; Jeon, Sangyong; Gale, Charles

    2017-11-01

    In this work we use the IP-Glasma+MUSIC+UrQMD framework to systematically study a wide range of hadronic flow observables at 2.76 TeV. In addition to the single particle spectra and anisotropic flow coefficients vn previously studied in [S. McDonald, C. Shen, F. Fillion-Gourdeau, S. Jeon and C. Gale, arxiv:arXiv:1609.02958 [hep-ph

  2. Case Study Observational Research: A Framework for Conducting Case Study Research Where Observation Data Are the Focus.

    PubMed

    Morgan, Sonya J; Pullon, Susan R H; Macdonald, Lindsay M; McKinlay, Eileen M; Gray, Ben V

    2017-06-01

    Case study research is a comprehensive method that incorporates multiple sources of data to provide detailed accounts of complex research phenomena in real-life contexts. However, current models of case study research do not particularly distinguish the unique contribution observation data can make. Observation methods have the potential to reach beyond other methods that rely largely or solely on self-report. This article describes the distinctive characteristics of case study observational research, a modified form of Yin's 2014 model of case study research the authors used in a study exploring interprofessional collaboration in primary care. In this approach, observation data are positioned as the central component of the research design. Case study observational research offers a promising approach for researchers in a wide range of health care settings seeking more complete understandings of complex topics, where contextual influences are of primary concern. Future research is needed to refine and evaluate the approach.

  3. Jumping performance differences among elite professional handball players with or without previous ACL reconstruction.

    PubMed

    Setuain, I; Millor, N; Alfaro, J; Gorostiaga, E; Izquierdo, M

    2015-10-01

    Handball is one of the most challenging sports for the knee joint. Persistent strength and jumping capacity alterations may be observed among athletes who have suffered anterior cruciate ligament (ACL) injury. The aim of this study was to examine unilateral and bilateral jumping ability differences between previously ACL-reconstructed rehabilitated elite handball athletes and sex, age and uninjured sport activity level-pairs of control players. It was a Cross-sectional study with one factor: previous ACL injury. We recruited 22 male (6 ACL-reconstructed and 16 uninjured control players) and 21 female (6 ACL-reconstructed and 15 uninjured control players) elite handball players who were evaluated 6.2±3.4 years after surgical ACL reconstruction. A battery of jump tests, including both bilateral and unilateral maneuvers, was performed. Two-tailed unpaired (intergroup comparison) and paired (intragroup comparison) t-tests were performed for mean comparisons. The P-value cut-off for significance was set at <0.05. The previously ACL-reconstructed female athletes showed a lower bilateral drop jump contact time (0.429±179.9 vs. 0.349±151 s, P<0.05) and less distance reached (3.820±0.54 vs. 4.428±0.44 m, P<0.05) in the unilateral triple hop for distance (UTHD) on their reconstructed leg compared with the dominant legs of the uninjured control athletes. No significant differences were observed for any other recorded variable. Among the male athletes, no significant differences between groups were found for the studied jumping variables. Previously ACL-reconstructed elite female handball athletes demonstrated both lower vertical bilateral drop jump (VBDJ) contact times and lower UTHD scores for the injured leg several years after injury. These deficits could contribute to an increase in ACL re-injury risk.

  4. Previous exposure in a high-risk area for travellers' diarrhoea within the past year is associated with a significant protective effect for travellers' diarrhoea: a prospective observational cohort study in travellers to South Asia.

    PubMed

    Kuenzli, Esther; Juergensen, David; Kling, Kerstin; Jaeger, Veronika K; DeCrom, Susan; Steffen, Robert; Widmer, Andreas F; Battegay, Manuel; Hatz, Christoph; Neumayr, Andreas

    2017-09-01

    Travellers' diarrhoea is the most common health problem in travellers. Depending on the region visited, up to 40% of travellers develop diarrhoea during a 2-week trip. The aim of this study was to assess risk factors for TD among travellers to the Indian subcontinent. An observational prospective multicentre cohort study investigated travellers to the Indian subcontinent. Participants completed questionnaires assessing the incidence of travellers' diarrhoea and identifying potential risk factors. Covariates were assessed univariately, followed by a multivariate regression. Two-hundred and twenty-six travellers were enrolled into the study, 178 filled in both pre- and post-travel questionnaires. Overall, the attack rate of travellers' diarrhoea was 38.2%. Travel destination is a key risk factor for the occurrence of TD. Travelling to India or Nepal vs Bhutan is associated with an increased risk for TD (OR 6.68 and 6.62, respectively). A length of stay of more than 3 weeks compared to less than 2 weeks is also associated with a significantly increased risk (OR 5.45). Having stayed in a high-risk area for travellers' diarrhoea within the past year before the current trip is associated with a significantly decreased risk (OR 0.19). No association was found between consumption of high risk food (i.e. tap water, ice cream, raw meat and hamburgers) and travellers' diarrhoea. Travellers' diarrhoea is a frequent problem in travellers to the Indian subcontinent. Previous exposure in a high-risk area for travellers' diarrhoea within the past year appears to have a significant protective effect. Furthermore, an association between the occurrence of travellers' diarrhoea and travel destination and length of stay, respectively, was observed. Consumption of risk food did not confer a TD risk in our study. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  5. Multiwavelength Observations of the Previously Unidentified Blazar RX J0648.7+1516

    NASA Astrophysics Data System (ADS)

    Aliu, E.; Aune, T.; Beilicke, M.; Benbow, W.; Böttcher, M.; Bouvier, A.; Bradbury, S. M.; Buckley, J. H.; Bugaev, V.; Cannon, A.; Cesarini, A.; Ciupik, L.; Connolly, M. P.; Cui, W.; Decerprit, G.; Dickherber, R.; Duke, C.; Errando, M.; Falcone, A.; Feng, Q.; Finnegan, G.; Fortson, L.; Furniss, A.; Galante, N.; Gall, D.; Gillanders, G. H.; Godambe, S.; Griffin, S.; Grube, J.; Gyuk, G.; Hanna, D.; Hivick, B.; Holder, J.; Huan, H.; Hughes, G.; Hui, C. M.; Humensky, T. B.; Kaaret, P.; Karlsson, N.; Kertzman, M.; Kieda, D.; Krawczynski, H.; Krennrich, F.; Maier, G.; Majumdar, P.; McArthur, S.; McCann, A.; Moriarty, P.; Mukherjee, R.; Nelson, T.; Ong, R. A.; Orr, M.; Otte, A. N.; Park, N.; Perkins, J. S.; Pichel, A.; Pohl, M.; Prokoph, H.; Quinn, J.; Ragan, K.; Reyes, L. C.; Reynolds, P. T.; Roache, E.; Rose, H. J.; Ruppel, J.; Saxon, D. B.; Sembroski, G. H.; Skole, C.; Smith, A. W.; Staszak, D.; Tešić, G.; Theiling, M.; Thibadeau, S.; Tsurusaki, K.; Tyler, J.; Varlotta, A.; Vassiliev, V. V.; Wakely, S. P.; Weekes, T. C.; Weinstein, A.; Williams, D. A.; Zitzer, B.; VERITAS Collaboration; Ciprini, S.; Fumagalli, M.; Kaplan, K.; Paneque, D.; Prochaska, J. X.

    2011-12-01

    We report on the VERITAS discovery of very high energy (VHE) gamma-ray emission above 200 GeV from the high-frequency-peaked BL Lac (HBL) object RX J0648.7+1516 (GB J0648+1516), associated with 1FGL J0648.8+1516. The photon spectrum above 200 GeV is fitted by a power law dN/dE = F 0(E/E 0)-Γ with a photon index Γ of 4.4 ± 0.8stat ± 0.3syst and a flux normalization F 0 of (2.3 ± 0.5stat ± 1.2sys) × 10-11 TeV-1 cm-2 s-1 with E 0 = 300 GeV. No VHE variability is detected during VERITAS observations of RX J0648.7+1516 between 2010 March 4 and April 15. Following the VHE discovery, the optical identification and spectroscopic redshift were obtained using the Shane 3 m Telescope at the Lick Observatory, showing the unidentified object to be a BL Lac type with a redshift of z = 0.179. Broadband multiwavelength observations contemporaneous with the VERITAS exposure period can be used to subclassify the blazar as an HBL object, including data from the MDM observatory, Swift-UVOT, and X-Ray Telescope, and continuous monitoring at photon energies above 1 GeV from the Fermi Large Area Telescope (LAT). We find that in the absence of undetected, high-energy rapid variability, the one-zone synchrotron self-Compton (SSC) model overproduces the high-energy gamma-ray emission measured by the Fermi-LAT over 2.3 years. The spectral energy distribution can be parameterized satisfactorily with an external-Compton or lepto-hadronic model, which have two and six additional free parameters, respectively, compared to the one-zone SSC model.

  6. Multiwavelength Observations Of The Previously Unidentified Blazar RX J0648.7+1516

    DOE PAGES

    Aliu, E.

    2011-11-15

    We report on the VERITAS discovery of very-high-energy (VHE) gammaray emission above 200 GeV from the high-frequency-peaked BL Lac object RXJ0648.7+1516 (GBJ0648+1516), associated with 1FGL J0648.8+1516. The photon spectrum above 200 GeV is fit by a power law dN/dE = F0(E/E0) -Γ with a photon index Γ of 4.4 ± 0.8stat ± 0.3syst and a flux normalization F0 of (2.3±0.5stat ±1.2sys)×10 -11 TeV -1cm -2s -1 with E0 = 300 GeV. No VHE variability is detected during VERITAS observations of RXJ0648.7+1516 between 2010 March 4 and April 15. Following the VHE discovery, the optical identification and spectroscopic redshift were obtainedmore » using the Shane 3–m Telescope at the Lick Observatory, showing the unidentified object to be a BL Lac type with a redshift of z = 0.179. Broadband multiwavelength observations contemporaneous with the VERITAS exposure period can be used to sub-classify the blazar as a high-frequency-peaked BL Lac (HBL) object, including data from the MDM observatory, Swift -UVOT and XRT, and continuous monitoring at photon energies above 1 GeV from the Fermi Large Area Telescope (LAT). We find that in the absence of undetected, high-energy rapid variability, the one-zone synchrotron self-Compton model (SSC) overproduces the high-energy gamma-ray emission measured by the Fermi -LAT over 2.3 years. The SED can be parameterized satisfactorily with an external-Compton or lepto-hadronic model, which have two and six additional free parameters, respectively, compared to the one-zone SSC model.« less

  7. Dissociation in decision bias mechanism between probabilistic information and previous decision

    PubMed Central

    Kaneko, Yoshiyuki; Sakai, Katsuyuki

    2015-01-01

    Target detection performance is known to be influenced by events in the previous trials. It has not been clear, however, whether this bias effect is due to the previous sensory stimulus, motor response, or decision. Also it remains open whether or not the previous trial effect emerges via the same mechanism as the effect of knowledge about the target probability. In the present study, we asked normal human subjects to make a decision about the presence or absence of a visual target. We presented a pre-cue indicating the target probability before the stimulus, and also a decision-response mapping cue after the stimulus so as to tease apart the effect of decision from that of motor response. We found that the target detection performance was significantly affected by the probability cue in the current trial and also by the decision in the previous trial. While the information about the target probability modulated the decision criteria, the previous decision modulated the sensitivity to target-relevant sensory signals (d-prime). Using functional magnetic resonance imaging (fMRI), we also found that activation in the left intraparietal sulcus (IPS) was decreased when the probability cue indicated a high probability of the target. By contrast, activation in the right inferior frontal gyrus (IFG) was increased when the subjects made a target-present decision in the previous trial, but this change was observed specifically when the target was present in the current trial. Activation in these regions was associated with individual-difference in the decision computation parameters. We argue that the previous decision biases the target detection performance by modulating the processing of target-selective information, and this mechanism is distinct from modulation of decision criteria due to expectation of a target. PMID:25999844

  8. Confronting the bomber: coping at the site of previous terror attacks.

    PubMed

    Strous, Rael D; Mishaeli, Nurit; Ranen, Yaniv; Benatov, Joy; Green, Dovid; Zivotofsky, Ari Z

    2007-03-01

    Terror exposure has become commonplace in Israel, with civilians needing to develop appropriate coping mechanisms. This study investigated coping mechanisms of those who are able to return to leisure activity at sites of previous terror attacks. A specially designed questionnaire, exploring knowledge of the terror event, previous terror exposure, coping mechanisms, state of anxiety, and mood, was administered to 93 restaurant attendees at sites of well-known recent terror attacks (2001-2005). Most respondents were aware of the previous terror attack (92.3%) and most reported no fear at revisiting (70.3%), with 20.9% reporting some anxiety and 5.5% reporting moderate or severe anxiety. Sixty percent reported that they have no fear that a terror attack will reoccur at the same place. Some (27.7%) reported change in practices or decrease in one or more activity, especially use of public transport (18%). The most helpful reported resource for facilitating stress coping following a suicide bombing was to "call or be in touch with friends or relatives," and least helpful was "medicines." Over half of respondents (53%) reported that the current security climate affected their mood. Older individuals and females were more affected by terror events. Study observations confirm that resilience develops in the general population in response to ongoing terror attacks. Response to terror is heterogeneous with a range of coping mechanisms expressed.

  9. Training induces scapular dyskinesis in pain-free competitive swimmers: a reliability and observational study.

    PubMed

    Madsen, Pernille H; Bak, Klaus; Jensen, Susanne; Welter, Ulrik

    2011-03-01

    Scapular dyskinesis is a major etiological factor in overhead athletes' shoulder problems. Our hypotheses were to evaluate if (1) visual observation of scapular dyskinesis during scaption has substantial interobserver reliability, and (2) scapular dyskinesis may be induced by swim training in pain-free swimmers. A reliability and observational study. Bachelor project at a college institution and at a private sports orthopedic hospital. Seventy-eight competitive swimmers with no history of shoulder pain were included in the study. Fourteen swimmers were evaluated regarding reliability. Inclusion criteria were competitive swimmers with high training volume who previously had no shoulder pain. Observations of scapular dyskinesis (yes/no) during simple scaption. The interobserver reliability of scaption and wall push-up was evaluated in 14 swimmers using kappa analysis. Prevalence of scapular dyskinesis at 4 time intervals during a swim training session. The scaption test resulted in a weighted kappa value of 0.75. Scapular dyskinesis was seen in 29 shoulders (37%) after the first time interval, in another 24 (cumulated prevalence 68%) after one-half of the training session, and in an additional 4 swimmers (cumulated prevalence 73%) after three-quarters of the training session. During the last quarter of the training session, another 7 swimmers had dyskinesis, resulting in a cumulated prevalence of 82%. The prevalence of abnormal scapular kinesis during a normal training session is high in previously pain-free swimmers. The prevalence increases with more training and occurs early during the training session.

  10. Ibrutinib versus previous standard of care: an adjusted comparison in patients with relapsed/refractory chronic lymphocytic leukaemia.

    PubMed

    Hansson, Lotta; Asklid, Anna; Diels, Joris; Eketorp-Sylvan, Sandra; Repits, Johanna; Søltoft, Frans; Jäger, Ulrich; Österborg, Anders

    2017-10-01

    This study explored the relative efficacy of ibrutinib versus previous standard-of-care treatments in relapsed/refractory patients with chronic lymphocytic leukaemia (CLL), using multivariate regression modelling to adjust for baseline prognostic factors. Individual patient data were collected from an observational Stockholm cohort of consecutive patients (n = 144) diagnosed with CLL between 2002 and 2013 who had received at least second-line treatment. Data were compared with results of the RESONATE clinical trial. A multivariate Cox proportional hazards regression model was used which estimated the hazard ratio (HR) of ibrutinib versus previous standard of care. The adjusted HR of ibrutinib versus the previous standard-of-care cohort was 0.15 (p < 0.0001) for progression-free survival (PFS) and 0.36 (p < 0.0001) for overall survival (OS). A similar difference was observed also when patients treated late in the period (2012-) were compared separately. Multivariate analysis showed that later line of therapy, male gender, older age and poor performance status were significant independent risk factors for worse PFS and OS. Our results suggest that PFS and OS with ibrutinib in the RESONATE study were significantly longer than with previous standard-of-care regimens used in second or later lines in routine healthcare. The approach used, which must be interpreted with caution, compares patient-level data from a clinical trial with outcomes observed in a daily clinical practice and may complement results from randomised trials or provide preliminary wider comparative information until phase 3 data exist.

  11. An open-label, single arm, phase III clinical study to evaluate the efficacy and safety of CJ smallpox vaccine in previously vaccinated healthy adults.

    PubMed

    Kim, Nak-Hyun; Kang, Yu Min; Kim, Gayeon; Choe, Pyoeng Gyun; Song, Jin Su; Lee, Kwang-Hee; Seong, Baik-Lin; Park, Wan Beom; Kim, Nam Joong; Oh, Myoung-don

    2013-10-25

    The increased possibility of bioterrorism has led to reinitiation of smallpox vaccination. In Korea, more than 30 years have passed since the last smallpox vaccinations, and even people who were previously vaccinated are not regarded as adequately protected against smallpox. We evaluated the efficacy and safety of CJ-50300, a newly developed cell culture-derived smallpox vaccine, in healthy adults previously vaccinated against smallpox. We conducted an open label, single arm, phase III clinical trial to evaluate the efficacy and safety of CJ-50300. Healthy volunteers, previously vaccinated against smallpox, born between 1950 and 1978 were enrolled. CJ-50300 was administered with a bifurcated needle over the deltoid muscle according to the recommended method. The rate of the cutaneous take reaction, humoral immunogenicity, and safety of the vaccine was assessed. Of 145 individuals enrolled for vaccination, 139 completed the study. The overall rates of cutaneous take reactions and humoral immunogenicity were 95.0% (132/139) and 88.5% (123/139), respectively. Although 95.9% (139/145) reported adverse events related to vaccination, no serious adverse reactions were observed. CJ-50300 can be used safely and effectively in healthy adults previously vaccinated against smallpox. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. Effective Teaching and Learning Environments and Principal Self-Efficacy in Oklahoma: Replication of a Previous Study

    ERIC Educational Resources Information Center

    Berry, Kathryn

    2013-01-01

    The purpose of this study was to replicate a previous study by Smith et al. (2006) that explored principal self-efficacy beliefs for facilitating effective instructional environments at their schools. There has been limited research conducted on principal's self-efficacy, and the studies that have been completed on the topic have not been…

  13. Ways of learning: Observational studies versus experiments

    USGS Publications Warehouse

    Shaffer, T.L.; Johnson, D.H.

    2008-01-01

    Manipulative experimentation that features random assignment of treatments, replication, and controls is an effective way to determine causal relationships. Wildlife ecologists, however, often must take a more passive approach to investigating causality. Their observational studies lack one or more of the 3 cornerstones of experimentation: controls, randomization, and replication. Although an observational study can be analyzed similarly to an experiment, one is less certain that the presumed treatment actually caused the observed response. Because the investigator does not actively manipulate the system, the chance that something other than the treatment caused the observed results is increased. We reviewed observational studies and contrasted them with experiments and, to a lesser extent, sample surveys. We identified features that distinguish each method of learning and illustrate or discuss some complications that may arise when analyzing results of observational studies. Findings from observational studies are prone to bias. Investigators can reduce the chance of reaching erroneous conclusions by formulating a priori hypotheses that can be pursued multiple ways and by evaluating the sensitivity of study conclusions to biases of various magnitudes. In the end, however, professional judgment that considers all available evidence is necessary to render a decision regarding causality based on observational studies.

  14. Consent for pediatric anesthesia: an observational study.

    PubMed

    Lagana, Zoe; Foster, Andrew; Bibbo, Adriana; Dowling, Kate; Cyna, Allan M

    2012-08-01

    Informed consent prior to anesthesia is an important part of the pediatric pre-anesthetic consultation. This study aimed to observe and identify the number and nature of the anesthesia risks considered and communicated to parents/guardians and children during the pediatric informed consent process on the day of elective surgery. A convenience sample of anesthetists had their pre-anesthesia consultations voice recorded, prior to elective surgery, during a 4-month period at the largest tertiary referral centre for pediatric care in South Australia. A data collection form was used to note baseline demographic data, and voice recording transcripts were independently documented by two researchers and subsequently compared for accuracy regarding the number and nature of risks discussed. Of the 96 voice recordings, 91 (92%) were suitable for the analysis. The five most commonly discussed risks were as follows: nausea and vomiting (36%); sore throat (35%); allergy (29%); hypoxia (25%); and emergence delirium (19%). Twenty-seven pre-anesthetic consultations (30%) were found to have had no discussion of anesthetic risk at all while a further 23 consultations (26%) incorporated general statements inferring that anesthesia carried risks, but with no elaboration about their nature, ramifications or incidence. The median number of risks (IQR) specifically mentioned per consultation was higher, 3 (1) vs 1 (1), P < 0.05, when the consultation was performed by a trainee rather than a consultant anesthetist and when the patient had previous anesthesia experience odds ratio 0.34, 95% CI [0.13, 0.87], P = 0.025. The pediatric anesthesia risk discussion is very variable. Trainees tend to discuss more specific risks than consultants and a patient's previous experience of anesthesia was associated with a more limited discussion of anesthesia risk. © 2011 Blackwell Publishing Ltd.

  15. Use of acetaminophen and risk of endometrial cancer: evidence from observational studies.

    PubMed

    Ding, Yuan-Yuan; Yao, Peng; Verma, Surya; Han, Zhen-Kai; Hong, Tao; Zhu, Yong-Qiang; Li, Hong-Xi

    2017-05-23

    Previous meta-analyses suggested that aspirin was associated with reduced risk of endometrial cancer. However, there has been no study comprehensively summarize the evidence of acetaminophen use and risk of endometrial cancer from observational studies. We systematically searched electronic databases (PubMed , EMBASE, Web of Science, and Cochrane Library) for relevant cohort or case-control studies up to February 28, 2017. Two independent authors performed the eligibility evaluation and data extraction. All differences were resolved by discussion. A random-effects model was applied to estimate summary relative risks (RRs) with 95% CIs. All statistical tests were two-sided. Seven observational studies including four prospective cohort studies and three case-control studies with 3874 endometrial cancer cases were included for final analysis. Compared with never use acetaminophen, ever use this drug was not associated with risk of endometrial cancer (summarized RR = 1.02; 95% CI: 0.93-1.13, I2 = 0%). Similar null association was also observed when compared the highest category of frequency/duration with never use acetaminophen (summarized RR = 0.88; 95% CI: 0.70-1.11, I2 = 15.2%). Additionally, the finding was robust in the subgroup analyses stratified by study characteristics and adjustment for potential confounders and risk factors. There was no evidence of publication bias by a visual inspection of a funnel plot and formal statistical tests. In summary, the present meta-analysis reveals no association between acetaminophen use and risk of endometrial cancer. More large scale prospective cohort studies are warranted to confirm our findings and carry out the dose-response analysis of aforementioned association.

  16. Pedestrian crossing behavior, an observational study in the city of Ushuaia, Argentina.

    PubMed

    Poó, Fernando Martín; Ledesma, Ruben Daniel; Trujillo, Roberto

    2018-04-03

    Pedestrian crashes are a critical problem in Latin American countries. However, little research has been published about pedestrians and even less about their behaviors in a naturalistic context. The objective of the present research was to explore risky pedestrian crossing behaviors in traffic intersections in an argentine city (Ushuaia). It is focused in different stages of the crossing process, traffic code violations, and other potentially risky behaviors such as distractions. A high frequency of risky behaviors among pedestrians was expected. Moreover, according to previous findings, it was hypothesized that men and younger pedestrians would show riskier behaviors. Participants were 802 pedestrians (53.9% females) observed at several intersections (with and without traffic lights) in the city of Ushuaia. Behaviors were codified following a standardized observation protocol. Observers documented information on behavior previous to, during, and after crossing. Gender and age were also registered. Data were gathered through video recording. Frequency analyses of observed behaviors were conducted for the total sample, as well as by gender and by age group. A general crossing risk index was calculated to facilitate comparisons between the genders and age groups. We conducted an analysis of variance to evaluate gender and age differences for this index. A high proportion of risky behaviors were observed among pedestrians. The majority of pedestrian waited in the street (as opposed to on the sidewalk) before crossing, did not comply with traffic lights, or crossed outside the crosswalk. A large number of pedestrians were distracted while crossing. Men presented higher scores on risky behaviors than women. No differences were observed by age group. The high level of risk behaviors during the different stages of street crossing is worrisome and reinforces the idea that pedestrians are responsible for many of the conflicts with motorists. Many of the risky behaviors

  17. Previous cerebrovascular disease is an important predictor of clinical outcomes in elderly patients with percutaneous coronary interventions: The Nobori-Biolimus eluting stent prospective multicenter 1-year observational registry in South Korea

    PubMed Central

    Kim, Yong Hoon; Her, Ae-Young; Kim, Byeong-Keuk; Shin, Dong-Ho; Kim, Jung-Sun; Ko, Young-Guk; Choi, Donghoon; Hong, Myeong-Ki; Jang, Yangsoo

    2017-01-01

    Objective: The appropriate selection of elderly patients for revascularization has become increasingly important because these subsets of patients are more likely to experience a major cardiac or cerebrovascular event—percutaneous coronary intervention (PCI). The objective of this study was to determine important independent risk factor for predicting clinical outcomes in the elderly patients after successful PCI, particularly in a series of South Korean population. Methods: This study is prospective, multicenter, observational cross-sectional study. A total of 1,884 consecutive patients who underwent successful PCI with Nobori® Biolimus A9-eluting stents were enrolled between April 2010 and December 2012. They were divided into two groups according to the age: patients <75 years old (younger patient group) and ≥75 years old (elderly patient group). The primary endpoint was major adverse cardiac or cerebrovascular events (MACCE) at 1-year after index PCI. Results: The 1-year cumulative incidence of MACCE (12.9% vs. 4.3%, p<0.001) and total death (7.1% vs. 1.5%, p<0.001) was significantly higher in the elderly group than in younger group. Previous cerebrovascular disease was significantly correlated with MACCE in elderly patients 1-year after PCI (hazard ratio, 2.804; 95% confidence interval, 1.290–6.093 p=0.009). Conclusion: Previous cerebrovascular disease is important independent predictor of the MACCE in elderly patients at 1-year after PCI with Nobori® Biolimus A9-eluting stents especially in a series of South Korean population. Therefore, careful PCI with intensive monitoring and management can improve major clinical outcomes after successful PCI in elderly patients with previous cerebrovascular disease compared with younger patients. PMID:28554989

  18. Prospective relationships between body weight and physical activity: an observational analysis from the NAVIGATOR study.

    PubMed

    Preiss, David; Thomas, Laine E; Wojdyla, Daniel M; Haffner, Steven M; Gill, Jason M R; Yates, Thomas; Davies, Melanie J; Holman, Rury R; McMurray, John J; Califf, Robert M; Kraus, William E

    2015-08-14

    While bidirectional relationships exist between body weight and physical activity, direction of causality remains uncertain and previous studies have been limited by self-reported activity or weight and small sample size. We investigated the prospective relationships between weight and physical activity. Observational analysis of data from the Nateglinide And Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) study, a double-blinded randomised clinical trial of nateglinide and valsartan, respectively. Multinational study of 9306 participants. Participants with biochemically confirmed impaired glucose tolerance had annual measurements of both weight and step count using research grade pedometers, worn for 7 days consecutively. Along with randomisation to valsartan or placebo plus nateglinide or placebo, participants took part in a lifestyle modification programme. Longitudinal regression using weight as response value and physical activity as predictor value was conducted, adjusted for baseline covariates. Analysis was then repeated with physical activity as response value and weight as predictor value. Only participants with a response value preceded by at least three annual response values were included. Adequate data were available for 2811 (30%) of NAVIGATOR participants. Previous weight (χ(2)=16.8; p<0.0001), but not change in weight (χ(2)=0.1; p=0.71) was inversely associated with subsequent step count, indicating lower subsequent levels of physical activity in heavier individuals. Change in step count (χ(2)=5.9; p=0.02) but not previous step count (χ(2)=0.9; p=0.34) was inversely associated with subsequent weight. However, in the context of trajectories already established for weight (χ(2) for previous weight measurements 747.3; p<0.0001) and physical activity (χ(2) for previous step count 432.6; p<0.0001), these effects were of limited clinical importance. While a prospective bidirectional relationship was observed between weight and

  19. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies.

    PubMed

    von Elm, Erik; Altman, Douglas G; Egger, Matthias; Pocock, Stuart J; Gøtzsche, Peter C; Vandenbroucke, Jan P

    2014-12-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the Web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. Are merging black holes born from stellar collapse or previous mergers?

    NASA Astrophysics Data System (ADS)

    Gerosa, Davide; Berti, Emanuele

    2017-06-01

    Advanced LIGO detectors at Hanford and Livingston made two confirmed and one marginal detection of binary black holes during their first observing run. The first event, GW150914, was from the merger of two black holes much heavier that those whose masses have been estimated so far, indicating a formation scenario that might differ from "ordinary" stellar evolution. One possibility is that these heavy black holes resulted from a previous merger. When the progenitors of a black hole binary merger result from previous mergers, they should (on average) merge later, be more massive, and have spin magnitudes clustered around a dimensionless spin ˜0.7 . Here we ask the following question: can gravitational-wave observations determine whether merging black holes were born from the collapse of massive stars ("first generation"), rather than being the end product of earlier mergers ("second generation")? We construct simple, observationally motivated populations of black hole binaries, and we use Bayesian model selection to show that measurements of the masses, luminosity distance (or redshift), and "effective spin" of black hole binaries can indeed distinguish between these different formation scenarios.

  1. Previous pregnancy outcomes and subsequent pregnancy anxiety in a Quebec prospective cohort

    PubMed Central

    Shapiro, Gabriel D.; Séguin, Jean R.; Muckle, Gina; Monnier, Patricia; Fraser, William D.

    2017-01-01

    Introduction Pregnancy anxiety is an important psychosocial risk factor that may be more strongly associated with adverse birth outcomes than other measures of stress. Better understanding of the upstream predictors and causes of pregnancy anxiety could help to identify high-risk women for adverse maternal and infant outcomes. The objective of the present study was to measure the associations between five past pregnancy outcomes (live preterm birth (PTB), live term birth, miscarriage at <20 weeks, stillbirth at ≥20 weeks, and elective abortion) and pregnancy anxiety at three trimesters in a subsequent pregnancy. Methods Analyses were conducted using data from the 3D Cohort Study, a Canadian birth cohort. Data on maternal demographic characteristics and pregnancy history for each known previous pregnancy were collected via interviewer-administered questionnaires at study entry. Pregnancy anxiety for the index study pregnancy was measured prospectively by self-administered questionnaire following three prenatal study visits. Results Of 2366 participants in the 3D Study, 1505 had at least one previous pregnancy. In linear regression analyses with adjustment for confounding variables, prior live term birth was associated with lower pregnancy anxiety in all three trimesters, whereas prior miscarriage was significantly associated with higher pregnancy anxiety in the first trimester. Prior stillbirth was associated with greater pregnancy anxiety in the third trimester. Prior elective abortion was significantly associated with higher pregnancy anxiety scores in the first and second trimesters, with an association of similar magnitude observed in the third trimester. Discussion Our findings suggest that the outcomes of previous pregnancies should be incorporated, along with demographic and psychosocial characteristics, into conceptual models framing pregnancy anxiety. PMID:28079434

  2. Efficacy and safety of nivolumab in previously treated patients with non-small cell lung cancer: A multicenter retrospective cohort study.

    PubMed

    Fujimoto, Daichi; Yoshioka, Hiroshige; Kataoka, Yuki; Morimoto, Takeshi; Kim, Young Hak; Tomii, Keisuke; Ishida, Tadashi; Hirabayashi, Masataka; Hara, Satoshi; Ishitoko, Manabu; Fukuda, Yasushi; Hwang, Moon Hee; Sakai, Naoki; Fukui, Motonari; Nakaji, Hitoshi; Morita, Mitsunori; Mio, Tadashi; Yasuda, Takehiro; Sugita, Takakazu; Hirai, Toyohiro

    2018-05-01

    Nivolumab has been shown to be effective and safe in previously treated patients with advanced non-small cell lung cancer (NSCLC). However, little is known regarding its performance in real-world (i.e., non-trial) settings. Furthermore, nivolumab efficacy is unknown in patients who are ineligible for clinical trials or who are categorized into small subgroups in such trials. We conducted a 15-center, observational, retrospective cohort study of patients with advanced NSCLC who received nivolumab monotherapy between January and December 2016. Of 613 patients included in our study, 141 had poor performance status (PS) and 106 were EGFR mutation - or ALK rearrangement-positive. The response and disease control rates were 20% and 44%, respectively; the estimated 1-year progression-free survival (PFS) was 18%. Multivariate analysis identified never smoking, poor PS, and EGFR mutation/ALK rearrangement as independent negative predictors of PFS. The most frequently reported grade ≥3 adverse event was pneumonitis (5% of patients). Severe pneumonitis (grade ≥3) occurred significantly earlier than mild pneumonitis (1.6 vs. 2.3 months, P = 0.031). Patients with pneumonitis achieved higher response rates and longer PFS than those without (37% vs. 18%, and 5.8 vs. 2.1 months, respectively; P = 0.002). Smoking status, PS, and EGFR mutation/ALK rearrangement were independent predictors of PFS. Our study elucidated nivolumab's efficacy in previously underreported patient populations; i.e., those with poor PS and/or with driver oncogenes. We also found that pneumonitis is not infrequent, and carries key implications for outcomes. These data should be useful for improving the clinical courses of nivolumab-treated patients with NSCLC. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. How safe do teenagers behave on Facebook? An observational study.

    PubMed

    Vanderhoven, Ellen; Schellens, Tammy; Valcke, Martin; Raes, Annelies

    2014-01-01

    The substantial use of social network sites by teenagers has raised concerns about privacy and security. Previous research about behavior on social network sites was mostly based on surveys and interviews. Observational research overcomes problems inherent to this research method, for example social desirability. However, existing observational research mostly focuses on public profiles of young adults. Therefore, the current observation-study includes 1050 public and non-public Facebook-profiles of teenagers (13-18) to investigate (1) what kind of information teenagers post on their profile, (2) to what extent they protect this information using privacy-settings and (3) how much risky information they have on their profile. It was found that young people mostly post pictures, interests and some basic personal information on their profile. Some of them manage their privacy-settings as such that this information is reserved for friends' eyes only, but a lot of information is accessible on the friends-of-friends' pages. Although general risk scores are rather low, more detailed analyses show that teenagers nevertheless post a significant amount of risky information. Moreover, older teenagers and girls post more (risky) information while there are no differences in applying privacy settings. We found no differences in the Facebook behavior of teenagers enrolled in different education forms. Implications of these results are discussed.

  4. How Safe Do Teenagers Behave on Facebook? An Observational Study

    PubMed Central

    Vanderhoven, Ellen; Schellens, Tammy; Valcke, Martin; Raes, Annelies

    2014-01-01

    The substantial use of social network sites by teenagers has raised concerns about privacy and security. Previous research about behavior on social network sites was mostly based on surveys and interviews. Observational research overcomes problems inherent to this research method, for example social desirability. However, existing observational research mostly focuses on public profiles of young adults. Therefore, the current observation-study includes 1050 public and non-public Facebook-profiles of teenagers (13–18) to investigate (1) what kind of information teenagers post on their profile, (2) to what extent they protect this information using privacy-settings and (3) how much risky information they have on their profile. It was found that young people mostly post pictures, interests and some basic personal information on their profile. Some of them manage their privacy-settings as such that this information is reserved for friends' eyes only, but a lot of information is accessible on the friends-of-friends' pages. Although general risk scores are rather low, more detailed analyses show that teenagers nevertheless post a significant amount of risky information. Moreover, older teenagers and girls post more (risky) information while there are no differences in applying privacy settings. We found no differences in the Facebook behavior of teenagers enrolled in different education forms. Implications of these results are discussed. PMID:25162234

  5. The real-world effectiveness and safety of fingolimod in relapsing-remitting multiple sclerosis patients: An observational study

    PubMed Central

    Damas, Fátima; Páramo, Maria Dolores; Ruiz-Peña, Juan Luis; Navarro, Guillermo

    2017-01-01

    Fingolimod approval was based mainly on two clinical trials, FREEDOMS and TRANSFORMS, which demonstrated the efficacy and safety of fingolimod in patients with multiple sclerosis (MS). We present an observational study that validates these trials findings in a real-world setting, whereby the effectiveness and safety of fingolimod was assessed in Seville’s’ (Spain) clinical practice. This retrospective study in MS patients assessed effectiveness (relapses, EDSS, gadolinium-enhancing T1 and new/enlarged T2-weighted lesions): total cohort (n = 249) and stratified according to prior treatment (glatiramer acetate/interferon beta-1 [immunomodulator], natalizumab, naïve), gender, basal EDSS score, basal Gd+ lesions, ARR prior to treatment, age at treatment initiation and number of prior treatments. A multivariante model was used to assess the ARR with baseline characteristics. The safety profile (adverse events [AEs]) was also described. Fingolimod reduced the annualized relapse rate (ARR) by 75%, 67% and 85% in the total cohort, patients previously treated with immunomodulatory and naïve patients (p<0.0001 all cases). However, patients previously treated with natalizumab kept a constant ARR. The ARR results and the consequent increase in the proportion of relapse-free patients were independent of the age at treatment initiation, number of prior treatments, gender and basal Gd+ lesions. Although fingolimod was effective regardless the basal EDSS score and ARR prior to fingolimod treatment, better outcomes were observed in patients with basal EDSS score <3 (0.2 vs. 0.4; p = 0.0244) and ARR ≥ 2 prior to fingolimod treatment (p = 0.0338). Only the basal EDSS score was association with ARR in the first 24 months of fingolimod treatment in the multivariante model (p = 0.0439). The cumulative probability of disability progression was 20% (month-24) in the total cohort, and was independent from prior treatment, age at treatment initiation, number of prior treatments

  6. Acceleration and Orientation Jumping Performance Differences Among Elite Professional Male Handball Players With or Without Previous ACL Reconstruction: An Inertial Sensor Unit-Based Study.

    PubMed

    Setuain, Igor; González-Izal, Miriam; Alfaro, Jesús; Gorostiaga, Esteban; Izquierdo, Mikel

    2015-12-01

    Handball is one of the most challenging sports for the knee joint. Persistent biomechanical and jumping capacity alterations can be observed in athletes with an anterior cruciate ligament (ACL) injury. Commonly identified jumping biomechanical alterations have been described by the use of laboratory technologies. However, portable and easy-to-handle technologies that enable an evaluation of jumping biomechanics at the training field are lacking. To analyze unilateral/bilateral acceleration and orientation jumping performance differences among elite male handball athletes with or without previous ACL reconstruction via a single inertial sensor unit device. Case control descriptive study. At the athletes' usual training court. Twenty-two elite male (6 ACL-reconstructed and 16 uninjured control players) handball players were evaluated. The participants performed a vertical jump test battery that included a 50-cm vertical bilateral drop jump, a 20-cm vertical unilateral drop jump, and vertical unilateral countermovement jump maneuvers. Peak 3-dimensional (X, Y, Z) acceleration (m·s(-2)), jump phase duration and 3-dimensional orientation values (°) were obtained from the inertial sensor unit device. Two-tailed t-tests and a one-way analysis of variance were performed to compare means. The P value cut-off for significance was set at P < .05. The ACL-reconstructed male athletes did not show any significant (P < .05) residual jumping biomechanical deficits regarding the measured variables compared with players who had not suffered this knee injury. A dominance effect was observed among non-ACL reconstructed controls but not among their ACL-reconstructed counterparts (P < .05). Elite male handball athletes with previous ACL reconstruction demonstrated a jumping biomechanical profile similar to control players, including similar jumping performance values in both bilateral and unilateral jumping maneuvers, several years after ACL reconstruction. These findings are in

  7. Effects of Ramadan fasting on cardiovascular risk factors: a prospective observational study.

    PubMed

    Nematy, Mohsen; Alinezhad-Namaghi, Maryam; Rashed, Masoud Mahdavi; Mozhdehifard, Mostafa; Sajjadi, Seyedeh Sania; Akhlaghi, Saeed; Sabery, Maryam; Mohajeri, Seyed Amir R; Shalaey, Neda; Moohebati, Mohsen; Norouzy, Abdolreza

    2012-09-10

    Previous research has shown that Ramadan fasting has beneficial effects on cardiovascular risk factors, however there are controversies. In the present study, the effect of Ramadan fasting on cardiovascular risk factors has been investigated. This is a prospective observational study that was carried out in a group of patients with at least one cardiovascular risk factor (including history of documented previous history of either coronary artery disease (CAD), metabolic syndrome or cerebro-vascular disease in past 10 y). Eighty two volunteers including 38 male and 44 female, aged 29-70 y, mean 54.0 ± 10 y, with a previous history of either coronary artery disease, metabolic syndrome or cerebro-vascular disease were recruited. Subjects attended the metabolic unit after at least 10 h fasting, before and after Ramadan who were been fasting for at least 10 days. A fasting blood sample was obtained, blood pressure was measured and body mass index (BMI) was calculated. Lipids profile, fasting blood sugar (FBS) and insulin, homocysteine (hcy), high-sensitivity C-reactive protein (hs-CRP) and complete blood count (CBC) were analyzed on all blood samples. A significant improvement in 10 years coronary heart disease risk (based on Framingham risk score) was found (13.0 ± 8 before Ramadan and 10.8 ±7 after Ramadan, P <0.001, t test).There was a significant higher HDL-c, WBC, RBC and platelet count (PLT), and lower plasma cholesterol, triglycerides, LDL-c, VLDL-c, systolic blood pressure, body mass index and waist circumference after Ramadan (P <0.05, t test). The changes in FBS, insulin, Homeostasis Model Assessment Insulin Resistance (HOMA-IR), hcy, hs-CRP and diastolic blood pressure before and after Ramadan were not significant (P >0.05, t test). This study shows a significant improvement in 10 years coronary heart disease risk score and other cardiovascular risk factors such as lipids profile, systolic blood pressure, weight, BMI and waist circumference

  8. Clinical Impact Research - how to choose experimental or observational intervention study?

    PubMed

    Malmivaara, Antti

    2016-11-01

    Interventions directed to individuals by health and social care systems should increase health and welfare of patients and customers. This paper aims to present and define a new concept Clinical Impact Research (CIR) and suggest which study design, either randomized controlled trial (RCT) (experimental) or benchmarking controlled trial (BCT) (observational) is recommendable and to consider the feasibility, validity, and generalizability issues in CIR. The new concept is based on a narrative review of the literature and on author's idea that in intervention studies, there is a need to cover comprehensively all the main impact categories and their respective outcomes. The considerations on how to choose the most appropriate study design (RCT or BCT) were based on previous methodological studies on RCTs and BCTs and on author's previous work on the concepts benchmarking controlled trial and system impact research (SIR). The CIR covers all studies aiming to assess the impact for health and welfare of any health (and integrated social) care or public health intervention directed to an individual. The impact categories are accessibility, quality, equality, effectiveness, safety, and efficiency. Impact is the main concept, and within each impact category, both generic- and context-specific outcome measures are needed. CIR uses RCTs and BCTs. CIR should be given a high priority in medical, health care, and health economic research. Clinicians and leaders at all levels of health care can exploit the evidence from CIR. Key messages The new concept of Clinical Impact Research (CIR) is defined as a research field aiming to assess what are the impacts of healthcare and public health interventions targeted to patients or individuals. The term impact refers to all effects caused by the interventions, with particular emphasis on accessibility, quality, equality, effectiveness, safety, and efficiency. CIR uses two study designs: randomized controlled trials (RCTs) (experimental

  9. Cultivating cohort studies for observational translational research.

    PubMed

    Ransohoff, David F

    2013-04-01

    "Discovery" research about molecular markers for diagnosis, prognosis, or prediction of response to therapy has frequently produced results that were not reproducible in subsequent studies. What are the reasons, and can observational cohorts be cultivated to provide strong and reliable answers to those questions? Experimental Selected examples are used to illustrate: (i) what features of research design provide strength and reliability in observational studies about markers of diagnosis, prognosis, and response to therapy? (ii) How can those design features be cultivated in existing observational cohorts, for example, within randomized controlled clinical trial (RCT), other existing observational research studies, or practice settings like health maintenance organization (HMOs)? Examples include a study of RNA expression profiles of tumor tissue to predict prognosis of breast cancer, a study of serum proteomics profiles to diagnose ovarian cancer, and a study of stool-based DNA assays to screen for colon cancer. Strengths and weaknesses of observational study design features are discussed, along with lessons about how features that help assure strength might be "cultivated" in the future. By considering these examples and others, it may be possible to develop a process of "cultivating cohorts" in ongoing RCTs, observational cohort studies, and practice settings like HMOs that have strong features of study design. Such an effort could produce sources of data and specimens to reliably answer questions about the use of molecular markers in diagnosis, prognosis, and response to therapy.

  10. Risk of new or recurrent cancer under immunosuppressive therapy in patients with IBD and previous cancer.

    PubMed

    Beaugerie, Laurent; Carrat, Fabrice; Colombel, Jean-Frédéric; Bouvier, Anne-Marie; Sokol, Harry; Babouri, Abdenour; Carbonnel, Franck; Laharie, David; Faucheron, Jean-Luc; Simon, Tabassome; de Gramont, Aimery; Peyrin-Biroulet, Laurent

    2014-09-01

    To explore the risk of new or recurrent cancer among patients with IBD and previous cancer, exposed or not to immunosuppressants. Among the 17 047 patients of the CESAME prospective observational cohort who were enrolled from May 2004 to June 2005, and followed-up until December 2007, we identified 405 patients with cancer diagnosed previous to study entry. We calculated the rates of incident cancer in patients with or without previous cancer, and we assessed by survival analysis and nested case-control study the impact of immunosuppressants on the risk of incident new or recurrent cancer in patients with previous cancer. The rate of incident cancer was 21.1/1000 patient-years (PY) and 6.1/1000 PY in patients with and without previous cancer, respectively. The multivariate-adjusted HR of incident cancer between patients with and without previous cancer was 1.9 (95% CI 1.2 to 3.0, p=0.003). Among patients with previous cancer, the rates of new and recurrent cancers were, respectively, 13.2/1000 PY and 6.0/1000 PY in the 312 patients who were not taking immunosuppressant at the time of study entry, and 23.1/1000 PY and 3.9/1000 PY in the 93 patients treated with immunosuppressants at study entry. There was no significant association between the exposure to immunosuppressants and the risk of new or recurrent cancer. Patients with IBD with a history of cancer are at increased risk of developing any (new or recurrent) cancer, with a predominant incidence of new cancers. Treatment with immunosuppressants has no overall major impact per se on this risk. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. The Alberta smoke plume observation study

    NASA Astrophysics Data System (ADS)

    Anderson, Kerry; Pankratz, Al; Mooney, Curtis; Fleetham, Kelly

    2018-02-01

    A field project was conducted to observe and measure smoke plumes from wildland fires in Alberta. This study used handheld inclinometer measurements and photos taken at lookout towers in the province. Observations of 222 plumes were collected from 21 lookout towers over a 6-year period from 2010 to 2015. Observers reported the equilibrium and maximum plume heights based on the plumes' final levelling heights and the maximum lofting heights, respectively. Observations were tabulated at the end of each year and matched to reported fires. Fire sizes at assessment times and forest fuel types were reported by the province. Fire weather conditions were obtained from the Canadian Wildland Fire Information System (CWFIS). Assessed fire sizes were adjusted to the appropriate size at plume observation time using elliptical fire-growth projections. Though a logical method to collect plume observations in principle, many unanticipated issues were uncovered as the project developed. Instrument limitations and environmental conditions presented challenges to the investigators, whereas human error and the subjectivity of observations affected data quality. Despite these problems, the data set showed that responses to fire behaviour conditions were consistent with the physical processes leading to plume rise. The Alberta smoke plume observation study data can be found on the Canadian Wildland Fire Information System datamart (Natural Resources Canada, 2018) at http://cwfis.cfs.nrcan.gc.ca/datamart.

  12. Observational study of contracts processing at 29 CTSA sites.

    PubMed

    Kiriakis, James; Gaich, Nicholas; Johnston, S Claiborne; Kitterman, Darlene; Rosenblum, Daniel; Salberg, Libby; Rifkind, Adam

    2013-08-01

    We measured contracts final negotiation (FN) and full execution (FE) times using shared definitions in a prospective observational study of management of contracts for clinical trials at 29 CTSA institutions. Median FN and FE times were reached in 39 and 91 days, respectively; mean times for FN and FE were 55 and 103 days, respectively. Individual site medians ranged from 3 to 116 days for FN and 34 to 197 days for FE. The use of master agreements (MAs) and previously negotiated terms (PNTs) was associated with significant reduction of FN times by a mean of 33 days (p < 0) and 22 days (p < 0.001), respectively. PNTs, but not MAs, were associated with significantly reduced FE time (22 days, p < 0.007). Gap analysis revealed a gap of 22 days between contracts negotiation and Institutional Review Board (IRB) review and intervals of 33 days (contracts) and 48 days (IRB review) during which the process steps were being conducted alone, suggesting a potential benefit with parallel processing. These baseline data support a plan to investigate root causes of prolonged study start-up time by examining causes of variation and outliers. © 2013 Wiley Periodicals, Inc.

  13. Observational Study of Contracts Processing at 29 CTSA Sites

    PubMed Central

    Kiriakis, James; Gaich, Nicholas; Johnston, S. Claiborne; Kitterman, Darlene; Salberg, Libby; Rifkind, Adam

    2013-01-01

    Abstract We measured contracts final negotiation (FN) and full execution (FE) times using shared definitions in a prospective observational study of management of contracts for clinical trials at 29 CTSA institutions. Median FN and FE times were reached in 39 and 91 days, respectively; mean times for FN and FE were 55 and 103 days, respectively. Individual site medians ranged from 3 to 116 days for FN and 34 to 197 days for FE. The use of master agreements (MAs) and previously negotiated terms (PNTs) was associated with significant reduction of FN times by a mean of 33 days (p < 0) and 22 days (p < 0.001), respectively. PNTs, but not MAs, were associated with significantly reduced FE time (22 days, p < 0.007). Gap analysis revealed a gap of 22 days between contracts negotiation and Institutional Review Board (IRB) review and intervals of 33 days (contracts) and 48 days (IRB review) during which the process steps were being conducted alone, suggesting a potential benefit with parallel processing. These baseline data support a plan to investigate root causes of prolonged study start‐up time by examining causes of variation and outliers. PMID:23919362

  14. Burnout among rural hospital doctors in the Western Cape: Comparison with previous South African studies.

    PubMed

    Liebenberg, Andrew R; Coetzee Jnr, Johan F; Conradie, Hofmeyr H; Coetzee, Johan F

    2018-05-24

    Burnout among doctors negatively affects health systems and, ultimately,patient care. To determine the prevalence of burnout among doctors working in the district health system in the Overberg and Cape Winelands districts of the Western Cape Province and to compare the findings with those of previous South African studies. Rural district hospitals. During 2013, a validated questionnaire (Maslach Burnout Inventory) was sent to 42 doctors working in the district health system within the referral area of the Worcester Hospital, consisting of the Overberg health district and the eastern half of the Cape Winelands. Response rate was 85.7%. Clinically significant burnout was found among 81% of respondents. High levels of burnout on all three subscales were present in 31% of participants.Burnout rates were similar to those of a previous study conducted among doctors working in the Cape Town Metropolitan Municipality primary health care facilities. Scores for emotional exhaustion (EE) and depersonalisation (DP) were greater than those of a national survey;however, the score for personal accomplishment (PA) was greater. EE and PA scores weresimilar to that of a study of junior doctors working in the Red Cross Children's Hospital;however, EE was smaller. This study demonstrates high burnout rates among doctors working at district level hospitals, similar to the prevalence thereof in the Cape Town Metropolitan primary health care facilities. Health services planning should include strategies to address and prevent burnout of which adequate staffing and improved work environment are of prime importance.

  15. National Rates of Uterine Rupture are not Associated with Rates of Previous Caesarean Delivery: Results from the Nordic Obstetric Surveillance Study.

    PubMed

    Colmorn, Lotte B; Langhoff-Roos, Jens; Jakobsson, Maija; Tapper, Anna-Maija; Gissler, Mika; Lindqvist, Pelle G; Källen, Karin; Gottvall, Karin; Klungsøyr, Kari; Bøhrdahl, Per; Bjarnadóttir, Ragnhild I; Krebs, Lone

    2017-05-01

    Previous caesarean delivery and intended mode of delivery after caesarean are well-known individual risk factors for uterine rupture. We examined if different national rates of uterine rupture are associated with differences in national rates of previous caesarean delivery and intended mode of delivery after a previous caesarean delivery. This study is an ecological study based on data from a retrospective cohort in the Nordic countries. Data on uterine rupture were collected prospectively in each country as part of the Nordic obstetric surveillance study and included 91% of all Nordic deliveries. Information on the comparison population was retrieved from the national medical birth registers. Incidence rate ratios by previous caesarean delivery and intended mode of delivery after caesarean were modelled using Poisson regression. The incidence of uterine rupture was 7.8/10 000 in Finland and 4.6/10 000 in Denmark. Rates of caesarean (21.3%) and previous caesarean deliveries (11.5%) were highest in Denmark, while the rate of intended vaginal delivery after caesarean was highest in Finland (72%). National rates of uterine rupture were not associated with the population rates of previous caesarean but increased by 35% per 1% increase in the population rate of intended vaginal delivery and in the subpopulation of women with previous caesarean delivery by 4% per 1% increase in the rate of intended vaginal delivery. National rates of uterine rupture were not associated with national rates of previous caesarean, but increased with rates of intended vaginal delivery after caesarean. © 2017 John Wiley & Sons Ltd.

  16. Compliance with Seat Belt Use in Makurdi, Nigeria: An Observational Study

    PubMed Central

    Popoola, SO; Oluwadiya, KS; Kortor, JN; Denen-Akaa, P; Onyemaechi, NOC

    2013-01-01

    Background: Seat belts are designed to reduce injuries due to road crash among vehicle occupants. Aims: This study aims to determine the availability of seat belt in vehicles and compliance with seat belt use among vehicle occupants. Materials and methods: This was a 24-h direct observational study of seat belt usage among vehicle occupants in Makurdi, Benue State, Nigeria. By direct surveillance and using a datasheet, we observed 500 vehicles and their occupants for seat belt availability and compliance with its use. Chi-square test was used for test of significance between variables. Results: Twenty-five (5.0%) of the observed 500 vehicles had no seat belt at all. Overall, compliance was 277/486 (57.0%). Use of seat belt was highest in the afternoon with 124/194 (64.4%), followed by 111/188 (59.0%) in the morning and 42/95 (44.2%) at night. Compliance was highest among car occupants [209/308 (67.9%)] and private vehicles, and lowest among commercial vehicle occupants. Compliance among female drivers was 77.1% compared with 51.4% among male drivers. Among drivers, the mean age of seat belt users was 38.4 (7.7) years, which was significantly younger than the 41.3 (8.7) years mean age of non-users. Similar figures were obtained among other vehicle occupants. Conclusions: Compared with previous studies, seat belt usage has improved among Nigerian road users, but there is still room for improvement, especially early in the mornings and at nights. Since these were times when law enforcement agencies were not likely to be on the roads, we advocate for improved coverage by enforcement agents to enforce better compliance. PMID:24116327

  17. Distractor Repetitions Retrieve Previous Responses and Previous Targets: Experimental Dissociations of Distractor-Response and Distractor-Target Bindings

    ERIC Educational Resources Information Center

    Giesen, Carina; Rothermund, Klaus

    2014-01-01

    Even an irrelevant distractor stimulus is integrated into event files. Subsequently repeating the distractor triggers retrieval of the event file; however, an unresolved issue concerns the question of "what" is retrieved by the distractor. While recent studies predominantly assume that the distractor retrieves the previous response, it…

  18. Reduced live-birth rates after IVF/ICSI in women with previous unilateral oophorectomy: results of a multicentre cohort study.

    PubMed

    Lind, Tekla; Holte, Jan; Olofsson, Jan I; Hadziosmanovic, Nermin; Gudmundsson, Johannes; Nedstrand, Elizabeth; Lood, Mikael; Berglund, Lars; Rodriguez-Wallberg, Kenny

    2018-02-01

    Is there a reduced live-birth rate (LBR) after IVF/ICSI treatment in women with a previous unilateral oophorectomy (UO)? A significantly reduced LBR after IVF/ICSI was found in women with previous UO when compared with women with intact ovaries in this large multicentre cohort, both crudely and after adjustment for age, BMI, fertility centre and calendar period and regardless of whether the analysis was based on transfer of embryos in the fresh cycle only or on cumulative results including transfers using frozen-thawed embryos. Similar pregnancy rates after IVF/ICSI have been previously reported in case-control studies and small cohort studies of women with previous UO versus women without ovarian surgery. In all previous studies multiple embryos were transferred. No study has previously evaluated LBR in a large cohort of women with a history of UO. This research was a multicentre cohort study, including five reproductive medicine centres in Sweden: Carl von Linné Clinic (A), Karolinska University Hospital (B), Uppsala University Hospital (C), Linköping University Hospital (D) and Örebro University Hospital (E). The women underwent IVF/ICSI between January 1999 and November 2015. Single embryo transfer (SET) was performed in approximately 70% of all treatments, without any significant difference between UO exposed women versus controls (68% versus 71%), respectively (P = 0.32), and a maximum of two embryos were transferred in the remaining cases. The dataset included all consecutive treatments and fresh and frozen-thawed cycles. The exposed cohort included 154 women with UO who underwent 301 IVF/ICSI cycles and the unexposed control cohort consisted of 22 693 women who underwent 41 545 IVF/ICSI cycles. Overall, at the five centres (A-E), the exposed cohort underwent 151, 34, 35, 41 and 40 treatments, respectively, and they were compared with controls of the same centre (18 484, 8371, 5575, 4670 and 4445, respectively). The primary outcome was LBR, which was

  19. Dynamic Modulation of Human Motor Activity When Observing Actions

    PubMed Central

    Press, Clare; Cook, Jennifer; Blakemore, Sarah-Jayne; Kilner, James

    2012-01-01

    Previous studies have demonstrated that when we observe somebody else executing an action many areas of our own motor systems are active. It has been argued that these motor activations are evidence that we motorically simulate observed actions; this motoric simulation may support various functions such as imitation and action understanding. However, whether motoric simulation is indeed the function of motor activations during action observation is controversial, due to inconsistency in findings. Previous studies have demonstrated dynamic modulations in motor activity when we execute actions. Therefore, if we do motorically simulate observed actions, our motor systems should also be modulated dynamically, and in a corresponding fashion, during action observation. Using magnetoencephalography, we recorded the cortical activity of human participants while they observed actions performed by another person. Here, we show that activity in the human motor system is indeed modulated dynamically during action observation. The finding that activity in the motor system is modulated dynamically when observing actions can explain why studies of action observation using functional magnetic resonance imaging have reported conflicting results, and is consistent with the hypothesis that we motorically simulate observed actions. PMID:21414901

  20. Feasibility of aerosol drug delivery to sleeping infants: a prospective observational study.

    PubMed

    Amirav, Israel; Newhouse, Michael T; Luder, Anthony; Halamish, Asaf; Omar, Hamza; Gorenberg, Miguel

    2014-03-26

    Delivery of inhaled medications to infants is usually very demanding and is often associated with crying and mask rejection. It has been suggested that aerosol administration during sleep may be an attractive alternative. Previous studies in sleeping children were disappointing as most of the children awoke and rejected the treatment. The SootherMask (SM) is a new, gentle and innovative approach for delivering inhaled medication to infants and toddlers. The present pilot study describes the feasibility of administering inhaled medications during sleep using the SM. Prospective observational study. Out patients. 13 sleeping infants with recurrent wheezing who regularly used pacifiers and were <12 months old. Participants inhaled technetium99mDTPA-labelled normal saline aerosol delivered via a Respimat Soft Mist Inhaler (SMI) (Boehringer-Ingelheim, Germany) and SM + InspiraChamber (IC; InspiRx Inc, New Jersey, USA). The two major outcomes were the acceptability of the treatment and the lung deposition (per cent of emitted dose). All infants who fulfilled the inclusion criteria successfully received the SM treatment during sleep without difficulty. Mean lung deposition (±SD) averaged 1.6±0.5% in the right lung. This study demonstrated that the combination of Respimat, IC and SM was able to administer aerosol therapy to all the sleeping infants who were regular pacifier users with good lung deposition. Administration of aerosols during sleep is advantageous since all the sleeping children accepted the mask and ensuing aerosol therapy under these conditions, in contrast to previous studies in which there was frequent mask rejection using currently available devices. NCT01120938.

  1. CHEERS Results on Mrk 573: A Study of Deep Chandra Observations

    NASA Astrophysics Data System (ADS)

    Paggi, Alessandro; Wang, Junfeng; Fabbiano, Giuseppina; Elvis, Martin; Karovska, Margarita

    2012-09-01

    We present results on Mrk 573 obtained as part of the CHandra survey of Extended Emission-line Regions in nearby Seyfert galaxies (CHEERS). Previous studies showed that this source features a biconical emission in the soft X-ray band closely related to the narrow-line region as mapped by the [O III] emission line and the radio emission, though on a smaller scale; we investigate the properties of soft X-ray emission from this source with new deep Chandra observations. Making use of the subpixel resolution of the Chandra/ACIS image and point-spread function deconvolution, we resolve and study substructures in each ionizing cone. The two cone spectra are fitted with a photoionization model, showing a mildly photoionized phase diffused over the bicone. Thermal collisional gas at about ~1.1 keV and ~0.8 keV appears to be located between the nucleus and the "knots" resolved in radio observations, and between the "arcs" resolved in the optical images, respectively; this can be interpreted in terms of shock interaction with the host galactic plane. The nucleus shows a significant flux decrease across the observations indicating variability of the active galactic nucleus (AGN), with the nuclear region featuring a higher ionization parameter with respect to the bicone region. The long exposure allows us to find extended emission up to ~7 kpc from the nucleus along the bicone axis. Significant emission is also detected in the direction perpendicular to the ionizing cones, disagreeing with the fully obscuring torus prescribed in the AGN unified model and suggesting instead the presence of a clumpy structure.

  2. Statin adherence and risk of acute cardiovascular events among women: a cohort study accounting for time-dependent confounding affected by previous adherence.

    PubMed

    Lavikainen, Piia; Helin-Salmivaara, Arja; Eerola, Mervi; Fang, Gang; Hartikainen, Juha; Huupponen, Risto; Korhonen, Maarit Jaana

    2016-06-03

    Previous studies on the effect of statin adherence on cardiovascular events in the primary prevention of cardiovascular disease have adjusted for time-dependent confounding, but potentially introduced bias into their estimates as adherence and confounders were measured simultaneously. We aimed to evaluate the effect when accounting for time-dependent confounding affected by previous adherence as well as time sequence between factors. Retrospective cohort study. Finnish healthcare registers. Women aged 45-64 years initiating statin use for primary prevention of cardiovascular disease in 2001-2004 (n=42 807). Acute cardiovascular event defined as a composite of acute coronary syndrome and acute ischaemic stroke was our primary outcome. Low-energy fractures were used as a negative control outcome to evaluate the healthy-adherer effect. During the 3-year follow-up, 474 women experienced the primary outcome event and 557 suffered a low-energy fracture. The causal HR estimated with marginal structural model for acute cardiovascular events for all the women who remained adherent (proportion of days covered ≥80%) to statin therapy during the previous adherence assessment year was 0.78 (95% CI: 0.65 to 0.94) when compared with everybody remaining non-adherent (proportion of days covered <80%). The result was robust against alternative model specifications. Statin adherers had a potentially reduced risk of experiencing low-energy fractures compared with non-adherers (HR 0.90, 95% CI 0.76 to 1.07). Our study, which took into account the time dependence of adherence and confounders, as well as temporal order between these factors, is support for the concept that adherence to statins in women in primary prevention decreases the risk of acute cardiovascular events by about one-fifth in comparison to non-adherence. However, part of the observed effect of statin adherence on acute cardiovascular events may be due to the healthy-adherer effect. Published by the BMJ Publishing

  3. The early postpartum experience of previously infertile mothers.

    PubMed

    Ladores, Sigrid; Aroian, Karen

    2015-01-01

    To explore the lived experience of becoming a new mother from the unique perspectives of previously infertile women. A descriptive phenomenological design was used to extract the fundamental structure of the postpartum experience of previously infertile mothers. Central Florida. Twelve first-time, previously infertile mothers age 27 to 43 years. Face-to-face interviews were conducted twice with each participant. Recorded interviews were transcribed verbatim and analyzed using Colaizzi's approach. Two main themes emerged that described the early postpartum experience of first-time, previously infertile mothers: (a) lingering identity as infertile and (b) gratitude for the gift of motherhood. Participants reported that their lingering identities as infertile and immense gratitude for the gift of motherhood propelled them to establish unrealistic expectations to be perfect mothers. When they were unable to live up this expectation, they censored their feelings of inadequacy, guilt, and shame. Findings from this study may help to sensitize health care providers to the difficulties faced by previously infertile women during their transition to motherhood. © 2015 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  4. Systematic Observation of an Expert Driver's Gaze Strategy—An On-Road Case Study

    PubMed Central

    Lappi, Otto; Rinkkala, Paavo; Pekkanen, Jami

    2017-01-01

    In this paper we present and qualitatively analyze an expert driver's gaze behavior in natural driving on a real road, with no specific experimental task or instruction. Previous eye tracking research on naturalistic tasks has revealed recurring patterns of gaze behavior that are surprisingly regular and repeatable. Lappi (2016) identified in the literature seven “qualitative laws of gaze behavior in the wild”: recurring patterns that tend to go together, the more so the more naturalistic the setting, all of them expected in extended sequences of fully naturalistic behavior. However, no study to date has observed all in a single experiment. Here, we wanted to do just that: present observations supporting all the “laws” in a single behavioral sequence by a single subject. We discuss the laws in terms of unresolved issues in driver modeling and open challenges for experimental and theoretical development. PMID:28496422

  5. Embedding clinical interventions into observational studies

    PubMed Central

    Newman, Anne B.; Avilés-Santa, M. Larissa; Anderson, Garnet; Heiss, Gerardo; Howard, Wm. James; Krucoff, Mitchell; Kuller, Lewis H.; Lewis, Cora E.; Robinson, Jennifer G.; Taylor, Herman; Treviño, Roberto P.; Weintraub, William

    2017-01-01

    Novel approaches to observational studies and clinical trials could improve the cost-effectiveness and speed of translation of research. Hybrid designs that combine elements of clinical trials with observational registries or cohort studies should be considered as part of a long-term strategy to transform clinical trials and epidemiology, adapting to the opportunities of big data and the challenges of constrained budgets. Important considerations include study aims, timing, breadth and depth of the existing infrastructure that can be leveraged, participant burden, likely participation rate and available sample size in the cohort, required sample size for the trial, and investigator expertise. Community engagement and stakeholder (including study participants) support are essential for these efforts to succeed. PMID:26611435

  6. The effect of previous traumatic injury on homicide risk.

    PubMed

    Griffin, Russell L; Davis, Gregory G; Levitan, Emily B; MacLennan, Paul A; Redden, David T; McGwin, Gerald

    2014-07-01

    Research has reported that a strong risk factor for traumatic injury is having a previous injury (i.e., recidivism). To date, the only study examining the relationship between recidivism and homicide reported strong associations, but was limited by possible selection bias. The current matched case-control study utilized coroner's data from 2004 to 2008. Subjects were linked to trauma registry data to determine whether the person had a previous traumatic injury. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for the association between homicide and recidivism. Homicide risk was increased for those having a previous traumatic injury (OR 1.81, 95% CI 1.09-2.99) or a previous intentional injury (OR 2.53, 95% CI 1.24-5.17). These results suggest an association between homicide and injury recidivism, and that trauma centers may be an effective setting for screening individuals for secondary prevention efforts of homicide through violence prevention programs. © 2014 American Academy of Forensic Sciences.

  7. Women's decision-making processes and the influences on their mode of birth following a previous caesarean section in Taiwan: a qualitative study.

    PubMed

    Chen, Shu-Wen; Hutchinson, Alison M; Nagle, Cate; Bucknall, Tracey K

    2018-01-17

    Vaginal birth after caesarean (VBAC) is an alternative option for women who have had a previous caesarean section (CS); however, uptake is limited because of concern about the risks of uterine rupture. The aim of this study was to explore women's decision-making processes and the influences on their mode of birth following a previous CS. A qualitative approach was used. The research comprised three stages. Stage I consisted of naturalistic observation at 33-34 weeks' gestation. Stage II involved interviews with pregnant women at 35-37 weeks' gestation. Stage III consisted of interviews with the same women who were interviewed postnatally, 1 month after birth. The research was conducted in a private medical centre in northern Taiwan. Using a purposive sampling, 21 women and 9 obstetricians were recruited. Data collection involved in-depth interviews, observation and field notes. Constant comparative analysis was employed for data analysis. Ensuring the safety of mother and baby was the focus of women's decisions. Women's decisions-making influences included previous birth experience, concern about the risks of vaginal birth, evaluation of mode of birth, current pregnancy situation, information resources and health insurance. In communicating with obstetricians, some women complied with obstetricians' recommendations for repeat caesarean section (RCS) without being informed of alternatives. Others used four step decision-making processes that included searching for information, listening to obstetricians' professional judgement, evaluating alternatives, and making a decision regarding mode of birth. After birth, women reflected on their decisions in three aspects: reflection on birth choices; reflection on factors influencing decisions; and reflection on outcomes of decisions. The health and wellbeing of mother and baby were the major concerns for women. In response to the decision-making influences, women's interactions with obstetricians regarding birth choices

  8. Clinical Impact Research – how to choose experimental or observational intervention study?

    PubMed Central

    Malmivaara, Antti

    2016-01-01

    Abstract Background: Interventions directed to individuals by health and social care systems should increase health and welfare of patients and customers. Aims: This paper aims to present and define a new concept Clinical Impact Research (CIR) and suggest which study design, either randomized controlled trial (RCT) (experimental) or benchmarking controlled trial (BCT) (observational) is recommendable and to consider the feasibility, validity, and generalizability issues in CIR. Methods: The new concept is based on a narrative review of the literature and on author’s idea that in intervention studies, there is a need to cover comprehensively all the main impact categories and their respective outcomes. The considerations on how to choose the most appropriate study design (RCT or BCT) were based on previous methodological studies on RCTs and BCTs and on author’s previous work on the concepts benchmarking controlled trial and system impact research (SIR). Results: The CIR covers all studies aiming to assess the impact for health and welfare of any health (and integrated social) care or public health intervention directed to an individual. The impact categories are accessibility, quality, equality, effectiveness, safety, and efficiency. Impact is the main concept, and within each impact category, both generic- and context-specific outcome measures are needed. CIR uses RCTs and BCTs. Conclusions: CIR should be given a high priority in medical, health care, and health economic research. Clinicians and leaders at all levels of health care can exploit the evidence from CIR. Key messagesThe new concept of Clinical Impact Research (CIR) is defined as a research field aiming to assess what are the impacts of healthcare and public health interventions targeted to patients or individuals.The term impact refers to all effects caused by the interventions, with particular emphasis on accessibility, quality, equality, effectiveness, safety, and efficiency. CIR uses two study

  9. Embedding clinical interventions into observational studies.

    PubMed

    Newman, Anne B; Avilés-Santa, M Larissa; Anderson, Garnet; Heiss, Gerardo; Howard, Wm James; Krucoff, Mitchell; Kuller, Lewis H; Lewis, Cora E; Robinson, Jennifer G; Taylor, Herman; Treviño, Roberto P; Weintraub, William

    2016-01-01

    Novel approaches to observational studies and clinical trials could improve the cost-effectiveness and speed of translation of research. Hybrid designs that combine elements of clinical trials with observational registries or cohort studies should be considered as part of a long-term strategy to transform clinical trials and epidemiology, adapting to the opportunities of big data and the challenges of constrained budgets. Important considerations include study aims, timing, breadth and depth of the existing infrastructure that can be leveraged, participant burden, likely participation rate and available sample size in the cohort, required sample size for the trial, and investigator expertise. Community engagement and stakeholder (including study participants) support are essential for these efforts to succeed. Copyright © 2015. Published by Elsevier Inc.

  10. Youth suicide: an insight into previous hospitalisation for injury and sociodemographic conditions from a nationwide cohort study.

    PubMed

    Zambon, Francesco; Laflamme, Lucie; Spolaore, Paolo; Visentin, Cristiana; Hasselberg, Marie

    2011-06-01

    This study investigates the degree to which a previous hospitalisation for injury of any intent is a risk of subsequent youth suicide and whether this association is influenced by family socioeconomic status or economic stress. A nationwide register-based cohort study was conducted covering all Swedish subjects born between January 1977 and December 1991 (N=1,616,342, male/female ratio=1.05). The cohort subjects were followed-up from January 1998 to December 2003, when aged 7-26 years. Poisson regression and the likelihood ratio test (95% CI) were used to assess the age-adjusted effect of hospitalisation for injuries of various intent on youth suicide and its effect once adjusted for family sociodemographic and social circumstances. Each set of exposures was associated independently and significantly with suicide mortality. Being hospitalised for self-inflicted injuries or injuries of undetermined intent was associated with a risk of suicide 36 to 47 times, respectively, that of subjects never hospitalised in the period under study (95% CI 28.36 to 45.58 and 26.67 to 83.87 for self-inflicted injuries and for events of undetermined intent, respectively; overall p<0.01). Similarly, previous events of unintentional injury markedly increased the risk of suicide (RR 3.08; 95% CI 2.26 to 4.19). These effects were solid and not substantially altered after adjustment for family demographic and socioeconomic circumstances. A strong association exists between previous hospitalisation for injury of any intent and youth suicide. The association is robust and unaltered by family socioeconomic circumstances.

  11. Is Dandy-Walker malformation associated with "distal 13q deletion syndrome"? Findings in a fetus supporting previous observations.

    PubMed

    Alanay, Yasemin; Aktaş, Dilek; Utine, Eda; Talim, Beril; Onderoğlu, Lütfü; Cağlar, Melda; Tunçbilek, Ergül

    2005-07-30

    We report on a fetus with a large deletion of the distal part of the long arm of chromosome 13, (del(13)(q14 --> qter)) congenital anomalies of the urinary system, lungs and extremities, and Dandy-Walker malformation (DWM). Although DWM has been associated with many chromosomal abnormalities and genetic syndromes, its relation to the distal 13q has been demonstrated recently. In 2002, McCormack et al., described two patients with deletions of the long arm of chromosome 13 who had multiple congenital abnormalities along with holoprosencephaly (HPE) and DWM. The phenotypic features and autopsy findings of a fetus with "distal 13q deletion syndrome" at 22 weeks gestation are discussed and comparison with the previous two cases is made. The findings support the previous hypothesis suggesting that haploinsufficiency at a locus within 13q22-33 due to microdeletions may be responsible for isolated DWM in some of the patients. Detailed examination of 13q (13q22-33) by means of conventional and molecular cytogenetic methods is necessary in cases with DWM. Copyright 2005 Wiley-Liss, Inc.

  12. Distracted Biking: An Observational Study.

    PubMed

    Wolfe, Elizabeth Suzanne; Arabian, Sandra Strack; Breeze, Janis L; Salzler, Matthew J

    2016-01-01

    Commuting via bicycle is a very popular mode of transportation in the Northeastern United States. Boston, MA, has seen a rapid increase in bicycle ridership over the past decade, which has raised concerns and awareness about bicycle safety. An emerging topic in this field is distracted bicycle riding. This study was conducted to provide descriptive data on the prevalence and type of distracted bicycling in Boston at different times of day. This was a cross-sectional study in which observers tallied bicyclists at 4 high traffic intersections in Boston during various peak commuting hours for 2 types of distractions: auditory (earbuds/phones in or on ears), and visual/tactile (electronic device or other object in hand). Nineteen hundred seventy-four bicyclists were observed and 615 (31.2%), 95% CI [29, 33%], were distracted. Of those observed, auditory distractions were the most common (N = 349; 17.7%), 95% CI [16, 19], p = .0003, followed by visual/tactile distractions (N = 266; 13.5%), 95% CI [12, 15]. The highest proportion (40.7%), 95% CI [35, 46], of distracted bicyclists was observed during the midday commute (between 13:30 and 15:00). Distracted bicycling is a prevalent safety concern in the city of Boston, as almost a third of all bicyclists exhibited distracted behavior. Education and public awareness campaigns should be designed to decrease distracted bicycling behaviors and promote bicycle safety in Boston. An awareness of the prevalence of distracted biking can be utilized to promote bicycle safety campaigns dedicated to decreasing distracted bicycling and to provide a baseline against which improvements can be measured.

  13. An observational study of the initial management of hypothyroidism in France: the ORCHIDÉE study

    PubMed Central

    Delemer, Brigitte; Aubert, Jean-Pierre; Nys, Pierre; Landron, Frédéric; Bouée, Stéphane

    2012-01-01

    Objective To document the initial management of hypothyroidism in France with respect to diagnostic setting, investigations, and therapeutic approach. Design Observational study of the management by primary care practitioners (PCPs) and endocrinologists of patients diagnosed with, and treated for, hypothyroidism during the enrollment period or the previous 6 months. Methods A representative sample of PCPs and endocrinologists enrolled up to five consecutive patients and reported sociodemographic, clinical, therapeutic, and laboratory data. Data were submitted at baseline and at the first measurement of TSH after starting the treatment. Results The analysis population comprised 1255 patients (mean (s.d.) age 52.8 (16.3) years; 84% female). Hypothyroidism was suspected on clinical grounds in 77% of patients, with goiter in 16%. Autoimmune thyroiditis, supported by positive anti-thyroid antibodies, was the most frequent diagnosis (59%), followed by iatrogenic causes (28%), of which thyroidectomy was the most common. The median baseline TSH was 8.6 mIU/l, suggesting a high incidence of subclinical hypothyroidism. Imaging studies were requested in over 75% of patients, with ultrasound performed in 98% and scintigraphy performed in 19% of these patients. Both groups of physicians treated their patients almost exclusively with levothyroxine. Endocrinologists were more likely than PCPs to provide counseling on how to take medication correctly. Conclusions This observational study of a large cohort of patients with newly diagnosed hypothyroidism in France illustrates current practice and indicates some areas where physician education may be required to optimize adherence to guidelines and cost-effectiveness. PMID:23034782

  14. Polychlorinated biphenyl exposure, diabetes and endogenous hormones: a cross-sectional study in men previously employed at a capacitor manufacturing plant

    PubMed Central

    2012-01-01

    Background Studies have shown associations of diabetes and endogenous hormones with exposure to a wide variety of organochlorines. We have previously reported positive associations of polychlorinated biphenyls (PCBs) and inverse associations of selected steroid hormones with diabetes in postmenopausal women previously employed in a capacitor manufacturing plant. Methods This paper examines associations of PCBs with diabetes and endogenous hormones in 63 men previously employed at the same plant who in 1996 underwent surveys of their exposure and medical history and collection of bloods and urine for measurements of PCBs, lipids, liver function, hematologic markers and endogenous hormones. Results PCB exposure was positively associated with diabetes and age and inversely associated with thyroid stimulating hormone and triiodothyronine-uptake. History of diabetes was significantly related to total PCBs and all PCB functional groupings, but not to quarters worked and job score, after control for potential confounders. None of the exposures were related to insulin resistance (HOMA-IR) in non-diabetic men. Conclusions Associations of PCBs with specific endogenous hormones differ in some respects from previous findings in postmenopausal women employed at the capacitor plant. Results from this study, however, do confirm previous reports relating PCB exposure to diabetes and suggest that these associations are not mediated by measured endogenous hormones. PMID:22931295

  15. Polychlorinated biphenyl exposure, diabetes and endogenous hormones: a cross-sectional study in men previously employed at a capacitor manufacturing plant.

    PubMed

    Persky, Victoria; Piorkowski, Julie; Turyk, Mary; Freels, Sally; Chatterton, Robert; Dimos, John; Bradlow, H Leon; Chary, Lin Kaatz; Burse, Virlyn; Unterman, Terry; Sepkovic, Daniel W; McCann, Kenneth

    2012-08-29

    Studies have shown associations of diabetes and endogenous hormones with exposure to a wide variety of organochlorines. We have previously reported positive associations of polychlorinated biphenyls (PCBs) and inverse associations of selected steroid hormones with diabetes in postmenopausal women previously employed in a capacitor manufacturing plant. This paper examines associations of PCBs with diabetes and endogenous hormones in 63 men previously employed at the same plant who in 1996 underwent surveys of their exposure and medical history and collection of bloods and urine for measurements of PCBs, lipids, liver function, hematologic markers and endogenous hormones. PCB exposure was positively associated with diabetes and age and inversely associated with thyroid stimulating hormone and triiodothyronine-uptake. History of diabetes was significantly related to total PCBs and all PCB functional groupings, but not to quarters worked and job score, after control for potential confounders. None of the exposures were related to insulin resistance (HOMA-IR) in non-diabetic men. Associations of PCBs with specific endogenous hormones differ in some respects from previous findings in postmenopausal women employed at the capacitor plant. Results from this study, however, do confirm previous reports relating PCB exposure to diabetes and suggest that these associations are not mediated by measured endogenous hormones.

  16. A Numerical Climate Observing Network Design Study

    NASA Technical Reports Server (NTRS)

    Stammer, Detlef

    2003-01-01

    This project was concerned with three related questions of an optimal design of a climate observing system: 1. The spatial sampling characteristics required from an ARGO system. 2. The degree to which surface observations from ARGO can be used to calibrate and test satellite remote sensing observations of sea surface salinity (SSS) as it is anticipated now. 3. The more general design of an climate observing system as it is required in the near future for CLIVAR in the Atlantic. An important question in implementing an observing system is that of the sampling density required to observe climate-related variations in the ocean. For that purpose this project was concerned with the sampling requirements for the ARGO float system, but investigated also other elements of a climate observing system. As part of this project we studied the horizontal and vertical sampling characteristics of a global ARGO system which is required to make it fully complementary to altimeter data with the goal to capture climate related variations on large spatial scales (less thanAttachment: 1000 km). We addressed this question in the framework of a numerical model study in the North Atlantic with an 1/6 horizontal resolution. The advantage of a numerical design study is the knowledge of the full model state. Sampled by a synthetic float array, model results will therefore allow to test and improve existing deployment strategies with the goal to make the system as optimal and cost-efficient as possible. Attachment: "Optimal observations for variational data assimilation".

  17. Twelve previously unknown phage genera are ubiquitous in global oceans

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

    Holmfeldt, Karin; Solonenko, Natalie; Shah, Manesh B

    Viruses are fundamental to ecosystems ranging from oceans to humans, yet our ability to study them is bottlenecked by the lack of ecologically relevant isolates, resulting in unknowns dominating culture-independent surveys. Here we present genomes from 31 phages infecting multiple strains of the aquatic bacterium Cellulophaga baltica (Bacteroidetes) to provide data for an underrepresented and environmentally abundant bacterial lineage. Comparative genomics delineated 12 phage groups that (i) each represent a new genus, and (ii) represent one novel and four wellknown viral families. This diversity contrasts the few well-studied marine phage systems, but parallels the diversity of phages infecting human-associated bacteria.more » Although all 12 Cellulophaga phages represent new genera, the podoviruses and icosahedral, nontailed ssDNA phages were exceptional, with genomes up to twice as large as those previously observed for each phage type. Structural novelty was also substantial, requiring experimental phage proteomics to identify 83% of the structural proteins. The presence of uncommon nucleotide metabolism genes in four genera likely underscores the importance of scavenging nutrient-rich molecules as previously seen for phages in marine environments. Metagenomic recruitment analyses suggest that these particular Cellulophaga phages are rare and may represent a first glimpse into the phage side of the rare biosphere. However, these analyses also revealed that these phage genera are widespread, occurring in 94% of 137 investigated metagenomes. Together, this diverse and novel collection of phages identifies a small but ubiquitous fraction of unknown marine viral diversity and provides numerous environmentally relevant phage host systems for experimental hypothesis testing.« less

  18. Twelve previously unknown phage genera are ubiquitous in global oceans.

    PubMed

    Holmfeldt, Karin; Solonenko, Natalie; Shah, Manesh; Corrier, Kristen; Riemann, Lasse; Verberkmoes, Nathan C; Sullivan, Matthew B

    2013-07-30

    Viruses are fundamental to ecosystems ranging from oceans to humans, yet our ability to study them is bottlenecked by the lack of ecologically relevant isolates, resulting in "unknowns" dominating culture-independent surveys. Here we present genomes from 31 phages infecting multiple strains of the aquatic bacterium Cellulophaga baltica (Bacteroidetes) to provide data for an underrepresented and environmentally abundant bacterial lineage. Comparative genomics delineated 12 phage groups that (i) each represent a new genus, and (ii) represent one novel and four well-known viral families. This diversity contrasts the few well-studied marine phage systems, but parallels the diversity of phages infecting human-associated bacteria. Although all 12 Cellulophaga phages represent new genera, the podoviruses and icosahedral, nontailed ssDNA phages were exceptional, with genomes up to twice as large as those previously observed for each phage type. Structural novelty was also substantial, requiring experimental phage proteomics to identify 83% of the structural proteins. The presence of uncommon nucleotide metabolism genes in four genera likely underscores the importance of scavenging nutrient-rich molecules as previously seen for phages in marine environments. Metagenomic recruitment analyses suggest that these particular Cellulophaga phages are rare and may represent a first glimpse into the phage side of the rare biosphere. However, these analyses also revealed that these phage genera are widespread, occurring in 94% of 137 investigated metagenomes. Together, this diverse and novel collection of phages identifies a small but ubiquitous fraction of unknown marine viral diversity and provides numerous environmentally relevant phage-host systems for experimental hypothesis testing.

  19. A statistical study of EMIC waves observed by Cluster: 1. Wave properties

    NASA Astrophysics Data System (ADS)

    Allen, R. C.; Zhang, J.-C.; Kistler, L. M.; Spence, H. E.; Lin, R.-L.; Klecker, B.; Dunlop, M. W.; André, M.; Jordanova, V. K.

    2015-07-01

    Electromagnetic ion cyclotron (EMIC) waves are an important mechanism for particle energization and losses inside the magnetosphere. In order to better understand the effects of these waves on particle dynamics, detailed information about the occurrence rate, wave power, ellipticity, normal angle, energy propagation angle distributions, and local plasma parameters are required. Previous statistical studies have used in situ observations to investigate the distribution of these parameters in the magnetic local time versus L-shell (MLT-L) frame within a limited magnetic latitude (MLAT) range. In this study, we present a statistical analysis of EMIC wave properties using 10 years (2001-2010) of data from Cluster, totaling 25,431 min of wave activity. Due to the polar orbit of Cluster, we are able to investigate EMIC waves at all MLATs and MLTs. This allows us to further investigate the MLAT dependence of various wave properties inside different MLT sectors and further explore the effects of Shabansky orbits on EMIC wave generation and propagation. The statistical analysis is presented in two papers. This paper focuses on the wave occurrence distribution as well as the distribution of wave properties. The companion paper focuses on local plasma parameters during wave observations as well as wave generation proxies.

  20. Trans-catheter aortic valve implantation after previous aortic homograft surgery.

    PubMed

    Drews, Thorsten; Pasic, Miralem; Buz, Semih; Unbehaun, Axel

    2011-12-01

    In patients with previous heart surgery, the operative risk is elevated during conventional aortic valve re-operations. Trans-catheter aortic valve implantation is a new method for the treatment of high-risk patients. Nevertheless, this new procedure carries potential risks in patients with previous homograft implantation in aortic position. Between April 2008 and February 2011, 345 consecutive patients (mean EuroSCORE (European System for Cardiac Operative Risk Evaluation): 38 ± 20%; mean Society of Thoracic Surgeons (STS) Mortality Score: 19 ± 16%; mean age: 80 ± 8 years; 111 men and 234 women) underwent trans-apical aortic valve implantation. In three patients, previous aortic homograft implantation had been performed. Homograft degeneration causing combined valve stenosis and incompetence made re-operation necessary. In all three patients, the aortic valve could be implanted using the trans-apical approach, and the procedure was successful. In two patients, there was slight paravalvular leakage of the aortic prosthesis and the other patient had slight central leakage. Neither ostium obstruction nor mitral valve damage was observed. Trans-catheter valve implantation can be performed successfully after previous homograft implantation. Particular care should be taken to achieve optimal valve positioning, not to obstruct the ostium of the coronary vessels due to the changed anatomic situation and not to cause annulus rupture. Copyright © 2011 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

  1. Action observation network in childhood: a comparative fMRI study with adults.

    PubMed

    Biagi, Laura; Cioni, Giovanni; Fogassi, Leonardo; Guzzetta, Andrea; Sgandurra, Giuseppina; Tosetti, Michela

    2016-11-01

    Very little is known about the action observation network and the mirror neuron system (AON/MNS) in children and its age-related properties compared with those observed in adults. In the present fMRI study we explored the activation of areas belonging to the AON/MNS in children and adults during observation of complex hand-grasping actions, as compared to observation of simple grasping acts executed with the left and the right hand, seen from a first person perspective. The results indicate that during the action observation tasks in children there was activation of a cortical network similar to that found in adults, including the premotor cortex, the posterior part of the inferior frontal gyrus and the posterior parietal lobe. However, the activation in children was more widespread and showed a higher inter-subject variability compared with adults. Furthermore, the activated network seems more lateralized to the left hemisphere in adults and more bilateral in children, with a linear growth of lateralization index as a function of age. Finally, in children the activation in the anterior intraparietal cortex (AIP) of each hemisphere was higher during observation of the contralateral hand (hand identity effect) and during the observation of complex actions relative to simple grasping acts, confirming the role of AIP for action-related hand identity previously described in adults. These results support the assumption that structure and size of action representations are sensitive to mechanisms of development and show physiological plasticity. These properties of the AON/MNS could constitute a powerful tool for spontaneous reorganization and recovery of motor deficits after brain injury in children and in adults, as well as for specific rehabilitation programmes. © 2015 John Wiley & Sons Ltd.

  2. Rapid mineralisation of the herbicide isoproturon in soil from a previously treated Danish agricultural field.

    PubMed

    Sørensen, Sebastian R; Aamand, Jens

    2003-10-01

    Mineralisation of the phenylurea herbicide isoproturon (3-(4-isopropylphenyl)-1,1-dimethylurea) and two of its known metabolites, 3-(4-isopropylphenyl)-1-methylurea (monodesmethyl-isoproturon) and 4-isopropylaniline, was studied in Danish agricultural soils with or without previous exposure to isoproturon. A potential for rapid mineralisation of isoproturon and the two metabolites was present in soils sampled from three plots within an agricultural field previously treated regularly with the herbicide, with 34-45%, 51-58% and 33-36% of the added [phenyl-U-14C]isoproturon, [phenyl-U-14C]monodesmethyl-isoproturon and [phenyl-U-14C]4-isopropylaniline metabolised to [14C]carbon dioxide within 30 days at 20 degrees C. In contrast, such extensive mineralisation of these three compounds was not observed within this period in soils sampled from two other agricultural fields without previous treatment with isoproturon. The mineralisation patterns indicated growth-linked metabolism of the three compounds in the previously exposed soils, and doubling times for [14C]carbon dioxide production ranged from 1.6 to 3.2, 1.0 to 2.1 and 1.3 to 1.7 days for isoproturon, monodesmethyl-isoproturon and 4-isopropylaniline, respectively. The ability to mineralise [phenyl-U-14C]isoproturon to [14C]carbon dioxide was successfully sub-cultured to a fresh mineral medium which provided isoproturon as sole source of carbon and nitrogen. One of the soils sampled from an agricultural field not previously treated with isoproturon showed accelerated mineralisation of [phenyl-U-14C]4-isopropylaniline toward the end of the experiment, with a doubling time for [14C]carbon dioxide production of 7.4days. This study indicates that the occurrence of rapid mineralisation of the phenyl ring of isoproturon to carbon dioxide is related to previous exposure to the herbicide, which suggests that microbial adaptation upon repeated isoproturon use may occur within agricultural fields.

  3. A phase II study of pralatrexate with vitamin B12 and folic acid supplementation for previously treated recurrent and/or metastatic head and neck squamous cell cancer.

    PubMed

    Ho, Alan L; Lipson, Brynna L; Sherman, Eric J; Xiao, Han; Fury, Matthew G; Apollo, Arlyn; Seetharamu, Nagashree; Sima, Camelia S; Haque, Sofia; Lyo, John K; Sales, Roberta; Cox, Lisa; Pfister, David G

    2014-06-01

    Pralatrexate (Fotolyn(TM); Allos Therapeutics Inc.) is an antifolate dihydrofolate reductase (DHFR) inhibitor. We conducted a phase II study of pralatrexate with folic acid and B12 supplementation in patients with recurrent and/or metastatic head and neck squamous cell cancer (R/M HNSCC). This was a single-arm, Simon optimal two stage phase II study. Patients with R/M HNSCC previously treated with chemotherapy were eligible. The study was initiated with a dosing schedule of pralatrexate 190 mg/m(2) biweekly on a 4-week cycle with vitamin supplementation. Due to toxicity concerns, the dosing was modified to 30 mg/m(2) weekly for 3 weeks in a 4-week cycle with vitamin supplementation. Radiologic imaging was to be obtained about every 2 cycles. Thirteen subjects were enrolled; 12 were treated. Seven of the twelve patients had previously received ≥2 lines of chemotherapy. The most common grade 3 toxicity was mucositis (3 patients). Seven patients did not complete two cycles of therapy due to progression of disease (4), toxicity (1), death (1), and withdrawal of consent (1). Two deaths occurred: one due to disease progression and the other was an unwitnessed event that was possibly related to pralatrexate. No clinical activity was observed. The median overall survival was 3.1 months. The study was closed early due to lack of efficacy. Pralatrexate does not possess clinical activity against previously treated R/M HNSCC. Evaluation of pralatrexate in other clinical settings of HNSCC management with special considerations for drug toxicity may be warranted.

  4. Distracted Biking: An Observational Study

    PubMed Central

    Wolfe, Elizabeth Suzanne; Arabian, Sandra Strack; Breeze, Janis L; Salzler, Matthew J.

    2016-01-01

    Commuting via bicycle is a very popular mode of transportation in the Northeastern United States (US). Boston, MA has seen a rapid increase in bicycle ridership over the past decade which has raised concerns and awareness about bicycle safety. An emerging topic in this field is distracted bicycle riding. This study was conducted to provide descriptive data on the prevalence and type of distracted bicycling in Boston at different times of day. This was a cross-sectional study in which observers tallied bicyclists at four high traffic intersections in Boston during various peak commuting hours for two types of distractions: auditory (ear buds/phones in or on ears), and visual/tactile (electronic device or other object in hand). Nineteen hundred seventy-four bicyclists were observed and 615 (31.2%, 95% CI: 29%-33%) were distracted. Of those observed, auditory distractions were the most common (N= 349 [17.7%, 95% CI: 16%-19%], p=0.0003) followed by visual/tactile distractions (N= 266 [13.5%, 95% CI: 12%-15%]). The highest proportion (40.7%, 95% CI: 35%-46%) of distracted bicyclists was observed during the midday commute (between 13:30-15:00). Distracted bicycling is a prevalent safety concern in the city of Boston, as almost one-third of all bicyclists exhibited distracted behavior. Education and public awareness campaigns should be designed to decrease distracted bicycling behaviors and promote bicycle safety in Boston. An awareness of the prevalence of distracted biking can be utilized to promote bicycle safety campaigns dedicated to decreasing distracted bicycling and to provide a baseline against which improvements can be measured. PMID:26953533

  5. The value of including observational studies in systematic reviews was unclear: a descriptive study.

    PubMed

    Seida, Jennifer; Dryden, Donna M; Hartling, Lisa

    2014-12-01

    To evaluate (1) how often observational studies are included in comparative effectiveness reviews (CERs); (2) the rationale for including observational studies; (3) how data from observational studies are appraised, analyzed, and graded; and (4) the impact of observational studies on strength of evidence (SOE) and conclusions. Descriptive study of 23 CERs published through the Effective Health Care Program of the U.S. Agency for Healthcare Research and Quality. Authors searched for observational studies in 20 CERs, of which 18 included a median of 11 (interquartile range, 2-31) studies. Sixteen CERs incorporated the observational studies in their SOE assessments. Seventy-eight comparisons from 12 CERs included evidence from both trials and observational studies; observational studies had an impact on SOE and conclusions for 19 (24%) comparisons. There was diversity across the CERs regarding decisions to include observational studies; study designs considered; and approaches used to appraise, synthesize, and grade SOE. Reporting and methods guidance are needed to ensure clarity and consistency in how observational studies are incorporated in CERs. It was not always clear that observational studies added value in light of the additional resources needed to search for, select, appraise, and analyze such studies. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Inferring interventional predictions from observational learning data.

    PubMed

    Meder, Bjorn; Hagmayer, York; Waldmann, Michael R

    2008-02-01

    Previous research has shown that people are capable of deriving correct predictions for previously unseen actions from passive observations of causal systems (Waldmann & Hagmayer, 2005). However, these studies were limited, since learning data were presented as tabulated data only, which may have turned the task more into a reasoning rather than a learning task. In two experiments, we therefore presented learners with trial-by-trial observational learning input referring to a complex causal model consisting of four events. To test the robustness of the capacity to derive correct observational and interventional inferences, we pitted causal order against the temporal order of learning events. The results show that people are, in principle, capable of deriving correct predictions after purely observational trial-by-trial learning, even with relatively complex causal models. However, conflicting temporal information can impair performance, particularly when the inferences require taking alternative causal pathways into account.

  7. Quality of Parent-Adolescent Conversations about Sex and Adolescent Sexual Behavior: An Observational Study

    PubMed Central

    Rogers, Adam A.; Ha, Thao; Stormshak, Elizabeth A.; Dishion, Thomas J.

    2015-01-01

    PURPOSE Studies suggest that the quality of parent-adolescent communication about sex uniquely predicts adolescent sexual behavior. Previous studies have relied predominantly on self-report data. Observational methods, which are not susceptible to self-report biases, may be useful in examining the associations between the quality of parent-adolescent communication about sex and adolescent sexual behavior more objectively. METHOD With a sample of adolescents (N = 55, 58% male, 44% White, Mage = 15.8) and their parents, we used hierarchical logistic regression analyses to examine the associations between the observed quality of parent-adolescent communication about dating and sex and the likelihood of adolescents’ sexual intercourse. RESULTS The quality of parent-adolescent communication about dating and sex predicted sexual behavior. Specifically, lecturing was associated with a higher likelihood of adolescents having had sexual intercourse. CONCLUSIONS The quality of parent-adolescent communication about sex is a unique correlate of adolescent sexual behavior and warrants further investigation. Thus, it serves as a potential target of preventive interventions that aim to foster adolescent sexual health behaviors. PMID:26206438

  8. Rituximab versus an alternative TNF inhibitor in patients with rheumatoid arthritis who failed to respond to a single previous TNF inhibitor: SWITCH-RA, a global, observational, comparative effectiveness study.

    PubMed

    Emery, P; Gottenberg, J E; Rubbert-Roth, A; Sarzi-Puttini, P; Choquette, D; Taboada, V M Martínez; Barile-Fabris, L; Moots, R J; Ostor, A; Andrianakos, A; Gemmen, E; Mpofu, C; Chung, C; Gylvin, L Hinsch; Finckh, A

    2015-06-01

    To compare the effectiveness of rituximab versus an alternative tumour necrosis factor (TNF) inhibitor (TNFi) in patients with rheumatoid arthritis (RA) with an inadequate response to one previous TNFi. SWITCH-RA was a prospective, global, observational, real-life study. Patients non-responsive or intolerant to a single TNFi were enrolled ≤4 weeks after starting rituximab or a second TNFi. Primary end point: change in Disease Activity Score in 28 joints excluding patient's global health component (DAS28-3)-erythrocyte sedimentation rate (ESR) over 6 months. 604 patients received rituximab, and 507 an alternative TNFi as second biological therapy. Reasons for discontinuing the first TNFi were inefficacy (n=827), intolerance (n=263) and other (n=21). A total of 728 patients were available for primary end point analysis (rituximab n=405; TNFi n=323). Baseline mean (SD) DAS28-3-ESR was higher in the rituximab than the TNFi group: 5.2 (1.2) vs 4.8 (1.3); p<0.0001. Least squares mean (SE) change in DAS28-3-ESR at 6 months was significantly greater in rituximab than TNFi patients: -1.5 (0.2) vs -1.1 (0.2); p=0.007. The difference remained significant among patients discontinuing the initial TNFi because of inefficacy (-1.7 vs -1.3; p=0.017) but not intolerance (-0.7 vs -0.7; p=0.894). Seropositive patients showed significantly greater improvements in DAS28-3-ESR with rituximab than with TNFi (-1.6 (0.3) vs -1.2 (0.3); p=0.011), particularly those switching because of inefficacy (-1.9 (0.3) vs -1.5 (0.4); p=0.021). The overall incidence of adverse events was similar between the rituximab and TNFi groups. These real-life data indicate that, after discontinuation of an initial TNFi, switching to rituximab is associated with significantly improved clinical effectiveness compared with switching to a second TNFi. This difference was particularly evident in seropositive patients and in those switched because of inefficacy. Published by the BMJ Publishing Group Limited

  9. Pilot Study of an Individualised Early Postpartum Intervention to Increase Physical Activity in Women with Previous Gestational Diabetes

    PubMed Central

    McIntyre, Harold David; Peacock, Ann; Miller, Yvette D.; Koh, Denise; Marshall, Alison L.

    2012-01-01

    Optimal strategies to prevent progression towards overt diabetes in women with recent gestational diabetes remain ill defined. We report a pilot study of a convenient, home based exercise program with telephone support, suited to the early post-partum period. Twenty eight women with recent gestational diabetes were enrolled at six weeks post-partum into a 12 week randomised controlled trial of Usual Care (n = 13) versus Supported Care (individualised exercise program with regular telephone support; n = 15). Baseline characteristics (Mean ± SD) were: Age  33 ± 4  years; Weight 80 ± 20 kg and Body Mass Index (BMI) 30.0 ± 9.7 kg/m2. The primary outcome, planned physical activity {Median (Range)}, increased by 60 (0–540) mins/week in the SC group versus 0 (0–580) mins/week in the UC group (P = 0.234). Walking was the predominant physical activity. Body weight, BMI, waist circumference, % body fat, fasting glucose and insulin did not change significantly over time in either group. This intervention designed to increase physical activity in post-partum women with previous gestational diabetes proved feasible. However, no measurable improvement in metabolic or biometric parameters was observed over a three month period. PMID:22548057

  10. Factors influencing return-to-work after cerebrovascular disease: the importance of previous cardiovascular risk.

    PubMed

    Catalina-Romero, Carlos; Ruilope, Luis Miguel; Sánchez-Chaparro, Miguel Angel; Valdivielso, Pedro; Cabrera-Sierra, Martha; Fernández-Labandera, Carlos; Ruiz-Moraga, Montserrat; Gonzalez-Quintela, Arturo; Calvo-Bonacho, Eva

    2015-09-01

    The role of prior cardiovascular risk (CVR) in the multifactorial process of returning to work after a cerebrovascular event has not been adequately investigated. Therefore, the objective of the present study was to analyse the association between previous CVR level, cardiovascular risk factors (CVRFs) and return-to-work (RTW) following cerebrovascular disease. This was a prospective observational study. We analysed a cohort of 348 patients who had experienced an episode of cerebrovascular disease-related work absence. These individuals were selected from the ICARIA study (Ibermutuamur CArdiovascular RIsk Assessment). Global CVR was assessed using the SCORE system. We investigated the association between demographics, work-related variables, CVRFs and RTW following a cerebrovascular event. We found that a total of 254 individuals (73.0%; 95% CI: 68.3-77.7) returned to work after cerebrovascular disease. Also, we observed a median loss of 12 working years due to disability. Moreover, adjusting for potential confounders revealed that low CVR level and the absence of the following CVRFs was associated with a higher likelihood of RTW: low vs moderate-to-high CVR level (OR: 2.55; 95% CI: 1.42-4.57), no hypertension before stroke (OR: 1.95; 95% CI: 1.11-3.41), non-smoker status (OR: 2.26; 95% CI: 1.30-3.93) and no previous diabetes (OR: 2.46; 95% CI: 1.26-4.79). Low CVR, along with the absence of several CVRFs, can be used to predict RTW rates following cerebrovascular events. Therefore, controlling hypertension, tobacco consumption and diabetes might contribute to the effectiveness of multidisciplinary rehabilitation and/or secondary/tertiary prevention programs for cerebrovascular disease. © The European Society of Cardiology 2014.

  11. Meta-analyses including data from observational studies.

    PubMed

    O'Connor, Annette M; Sargeant, Jan M

    2014-02-15

    Observational studies represent a wide group of studies where the disease or condition of interest is naturally occurring and the investigator does not control allocation to interventions or exposures. Observational studies are used to test hypotheses about the efficacy of interventions or about exposure-disease relationships, to estimate incidence or prevalence of conditions, and to assess the sensitivity and specificity of diagnostic assays. Experimental-study designs and randomized controlled trials (RCTs) can also contribute to the body of evidence about such questions. Meta-analyses (either with or without systematic reviews) aim to combine information from primary research studies to better describe the entire body of work. The aim of meta-analyses may be to obtain a summary effect size, or to understand factors that affect effect sizes. In this paper, we discuss the role of observational studies in meta-analysis questions and some factors to consider when deciding whether a meta-analysis should include results from such studies. Our suggestion is that one should only include studies that are not at high risk of inherent bias when calculating a summary effect size. Study design however can be a meaningful variable in assessment of outcome heterogeneity. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. The biomechanics of running in athletes with previous hamstring injury: A case-control study.

    PubMed

    Daly, C; Persson, U McCarthy; Twycross-Lewis, R; Woledge, R C; Morrissey, D

    2016-04-01

    Hamstring injury is prevalent with persistently high reinjury rates. We aim to inform hamstring rehabilitation by exploring the electromyographic and kinematic characteristics of running in athletes with previous hamstring injury. Nine elite male Gaelic games athletes who had returned to sport after hamstring injury and eight closely matched controls sprinted while lower limb kinematics and muscle activity of the previously injured biceps femoris, bilateral gluteus maximus, lumbar erector spinae, rectus femoris, and external oblique were recorded. Intergroup comparisons of muscle activation ratios and kinematics were performed. Previously injured athletes demonstrated significantly reduced biceps femoris muscle activation ratios with respect to ipsilateral gluteus maximus (maximum difference -12.5%, P = 0.03), ipsilateral erector spinae (maximum difference -12.5%, P = 0.01), ipsilateral external oblique (maximum difference -23%, P = 0.01), and contralateral rectus femoris (maximum difference -22%, P = 0.02) in the late swing phase. We also detected sagittal asymmetry in hip flexion (maximum 8°, P = 0.01), pelvic tilt (maximum 4°, P = 0.02), and medial rotation of the knee (maximum 6°, P = 0.03) effectively putting the hamstrings in a lengthened position just before heel strike. Previous hamstring injury is associated with altered biceps femoris associated muscle activity and potentially injurious kinematics. These deficits should be considered and addressed during rehabilitation. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Subsequent childbirth after a previous traumatic birth.

    PubMed

    Beck, Cheryl Tatano; Watson, Sue

    2010-01-01

    Nine percent of new mothers in the United States who participated in the Listening to Mothers II Postpartum Survey screened positive for meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for posttraumatic stress disorder after childbirth. Women who have had a traumatic birth experience report fewer subsequent children and a longer length of time before their second baby. Childbirth-related posttraumatic stress disorder impacts couples' physical relationship, communication, conflict, emotions, and bonding with their children. The purpose of this study was to describe the meaning of women's experiences of a subsequent childbirth after a previous traumatic birth. Phenomenology was the research design used. An international sample of 35 women participated in this Internet study. Women were asked, "Please describe in as much detail as you can remember your subsequent pregnancy, labor, and delivery following your previous traumatic birth." Colaizzi's phenomenological data analysis approach was used to analyze the stories of the 35 women. Data analysis yielded four themes: (a) riding the turbulent wave of panic during pregnancy; (b) strategizing: attempts to reclaim their body and complete the journey to motherhood; (c) bringing reverence to the birthing process and empowering women; and (d) still elusive: the longed-for healing birth experience. Subsequent childbirth after a previous birth trauma has the potential to either heal or retraumatize women. During pregnancy, women need permission and encouragement to grieve their prior traumatic births to help remove the burden of their invisible pain.

  14. Previous prelabor or intrapartum cesarean delivery and risk of placenta previa.

    PubMed

    Downes, Katheryne L; Hinkle, Stefanie N; Sjaarda, Lindsey A; Albert, Paul S; Grantz, Katherine L

    2015-05-01

    The purpose of this study was to examine the association between previous cesarean delivery and subsequent placenta previa while distinguishing cesarean delivery before the onset of labor from intrapartum cesarean delivery. We conducted a retrospective cohort study of electronic medical records from 20 Utah hospitals (2002-2010) with restriction to the first 2 singleton deliveries of nulliparous women at study entry (n=26,987). First pregnancy delivery mode was classified as (1) vaginal (reference), (2) cesarean delivery before labor onset (prelabor), or (3) cesarean delivery after labor onset (intrapartum). Risk of second delivery previa was estimated by previous delivery mode with the use of logistic regression and was adjusted for maternal age, insurance, smoking, comorbidities, previous pregnancy loss, and history of previa. Most first deliveries were vaginal (82%; n=22,142), followed by intrapartum cesarean delivery (14.6%; n=3931), or prelabor cesarean delivery (3.4%; n=914). Incidence of second delivery previa was 0.29% (n=78) and differed by previous delivery mode: vaginal, 0.24%; prelabor cesarean delivery, 0.98%; intrapartum cesarean delivery, 0.38% (P<.001). Relative to vaginal delivery, previous prelabor cesarean delivery was associated with an increased risk of second delivery previa (adjusted odds ratio, 2.62; 95% confidence interval, 1.24-5.56). There was no significant association between previous intrapartum cesarean delivery and previa (adjusted odds ratio, 1.22; 95% confidence interval, 0.68-2.19). Previous prelabor cesarean delivery was associated with a >2-fold significantly increased risk of previa in the second delivery, although the approximately 20% increased risk of previa that was associated with previous intrapartum cesarean delivery was not significant. Although rare, the increased risk of placenta previa after previous prelabor cesarean delivery may be important when considering nonmedically indicated prelabor cesarean delivery

  15. Trial of labour and vaginal birth after previous caesarean section: A population based study of Eastern African immigrants in Victoria, Australia.

    PubMed

    Belihu, Fetene B; Small, Rhonda; Davey, Mary-Ann

    2017-03-01

    Variations in caesarean section (CS) between some immigrant groups and receiving country populations have been widely reported. Often, African immigrant women are at higher risk of CS than the receiving population in developed countries. However, evidence about subsequent mode of birth following CS for African women post-migration is lacking. The objective of this study was to examine differences in attempted and successful vaginal birth after previous caesarean (VBAC) for Eastern African immigrants (Eritrea, Ethiopia, Somalia and Sudan) compared with Australian-born women. A population-based observational study was conducted using the Victorian Perinatal Data Collection. Pearson's chi-square test and logistic regression analysis were performed to generate adjusted odds ratios for attempted and successful VBAC. Victoria, Australia. 554 Eastern African immigrants and 24,587 Australian-born eligible women with previous CS having singleton births in public care. 41.5% of Eastern African immigrant women and 26.1% Australian-born women attempted a VBAC with 50.9% of Eastern African immigrants and 60.5% of Australian-born women being successful. After adjusting for maternal demographic characteristics and available clinical confounding factors, Eastern African immigrants were more likely to attempt (OR adj 1.94, 95% CI 1.57-2.47) but less likely to succeed (OR adj 0.54 95% CI 0.41-0.71) in having a VBAC. There are disparities in attempted and successful VBAC between Eastern African origin and Australian-born women. Unsuccessful VBAC attempt is more common among Eastern African immigrants, suggesting the need for improved strategies to select and support potential candidates for vaginal birth among these immigrants to enhance success and reduce potential complications associated with failed VBAC attempt. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  16. Challenging previous conceptions of vegetarianism and eating disorders.

    PubMed

    Fisak, B; Peterson, R D; Tantleff-Dunn, S; Molnar, J M

    2006-12-01

    The purpose of this study was to replicate and expand upon previous research that has examined the potential association between vegetarianism and disordered eating. Limitations of previous research studies are addressed, including possible low reliability of measures of eating pathology within vegetarian samples, use of only a few dietary restraint measures, and a paucity of research examining potential differences in body image and food choice motives of vegetarians versus nonvegetarians. Two hundred and fifty-six college students completed a number of measures of eating pathology and body image, and a food choice motives questionnaire. Interestingly, no significant differences were found between vegetarians and nonvegetarians in measures of eating pathology or body image. However, significant differences in food choice motives were found. Implications for both researchers and clinicians are discussed.

  17. Repeat immigration: A previously unobserved source of heterogeneity?

    PubMed

    Aradhya, Siddartha; Scott, Kirk; Smith, Christopher D

    2017-07-01

    Register data allow for nuanced analyses of heterogeneities between sub-groups which are not observable in other data sources. One heterogeneity for which register data is particularly useful is in identifying unique migration histories of immigrant populations, a group of interest across disciplines. Years since migration is a commonly used measure of integration in studies seeking to understand the outcomes of immigrants. This study constructs detailed migration histories to test whether misclassified migrations may mask important heterogeneities. In doing so, we identify a previously understudied group of migrants called repeat immigrants, and show that they differ systematically from permanent immigrants. In addition, we quantify the degree to which migration information is misreported in the registers. The analysis is carried out in two steps. First, we estimate income trajectories for repeat immigrants and permanent immigrants to understand the degree to which they differ. Second, we test data validity by cross-referencing migration information with changes in income to determine whether there are inconsistencies indicating misreporting. From the first part of the analysis, the results indicate that repeat immigrants systematically differ from permanent immigrants in terms of income trajectories. Furthermore, income trajectories differ based on the way in which years since migration is calculated. The second part of the analysis suggests that misreported migration events, while present, are negligible. Repeat immigrants differ in terms of income trajectories, and may differ in terms of other outcomes as well. Furthermore, this study underlines that Swedish registers provide a reliable data source to analyze groups which are unidentifiable in other data sources.

  18. Observational studies of roAp stars

    NASA Astrophysics Data System (ADS)

    Sachkov, M.

    2014-11-01

    Rapidly oscillating Ap (roAp) stars are high-overtone, low-degree p-mode pulsators that are also chemically peculiar magnetic A stars. Until recently the classical asteroseismic analysis i.e. frequency analysis, of these stars was based on ground and space photometric observations. Significant progress was achieved through access to uninterrupted, ultra-high-precision data from MOST, COROT and Kepler satellites. Over the last ten years the study of roAp stars has been altered drastically from an observational point of view through studies of time-resolved, high-resolution spectra. Their unusual pulsational characteristics, caused by an interplay between the short vertical lengths of the pulsation waves and strong stratification of chemical elements, allow us to examine the upper roAp atmosphere in more detail than is possible for any star except the Sun. In this paper I review the results of recent studies of the pulsations of roAp stars.

  19. Analysis of Over 10,000 Cases Finds No Association between Previously-Reported Candidate Polymorphisms and Ovarian Cancer Outcome

    PubMed Central

    White, Kristin L.; Vierkant, Robert A.; Fogarty, Zachary C.; Charbonneau, Bridget; Block, Matthew S.; Pharoah, Paul D.P.; Chenevix-Trench, Georgia; Rossing, Mary Anne; Cramer, Daniel W.; Pearce, C. Leigh; Schildkraut, Joellen M.; Menon, Usha; Kjaer, Susanne Kruger; Levine, Douglas A.; Gronwald, Jacek; Culver, Hoda Anton; Whittemore, Alice S.; Karlan, Beth Y.; Lambrechts, Diether; Wentzensen, Nicolas; Kupryjanczyk, Jolanta; Chang-Claude, Jenny; Bandera, Elisa V.; Hogdall, Estrid; Heitz, Florian; Kaye, Stanley B.; Fasching, Peter A.; Campbell, Ian; Goodman, Marc T.; Pejovic, Tanja; Bean, Yukie; Lurie, Galina; Eccles, Diana; Hein, Alexander; Beckmann, Matthias W.; Ekici, Arif B.; Paul, James; Brown, Robert; Flanagan, James; Harter, Philipp; du Bois, Andreas; Schwaab, Ira; Hogdall, Claus K.; Lundvall, Lene; Olson, Sara H.; Orlow, Irene; Paddock, Lisa E.; Rudolph, Anja; Eilber, Ursula; Dansonka-Mieszkowska, Agnieszka; Rzepecka, Iwona K.; Ziolkowska-Seta, Izabela; Brinton, Louise; Yang, Hannah; Garcia-Closas, Montserrat; Despierre, Evelyn; Lambrechts, Sandrina; Vergote, Ignace; Walsh, Christine; Lester, Jenny; Sieh, Weiva; McGuire, Valerie; Rothstein, Joseph H.; Ziogas, Argyrios; Lubiński, Jan; Cybulski, Cezary; Menkiszak, Janusz; Jensen, Allan; Gayther, Simon A.; Ramus, Susan J.; Gentry-Maharaj, Aleksandra; Berchuck, Andrew; Wu, Anna H.; Pike, Malcolm C.; Van Den Berg, David; Terry, Kathryn L.; Vitonis, Allison F.; Doherty, Jennifer A.; Johnatty, Sharon; deFazio, Anna; Song, Honglin; Tyrer, Jonathan; Sellers, Thomas A.; Phelan, Catherine M.; Kalli, Kimberly R.; Cunningham, Julie M.; Fridley, Brooke L.; Goode, Ellen L.

    2013-01-01

    Background Ovarian cancer is a leading cause of cancer-related death among women. In an effort to understand contributors to disease outcome, we evaluated single-nucleotide polymorphisms (SNPs) previously associated with ovarian cancer recurrence or survival, specifically in angiogenesis, inflammation, mitosis, and drug disposition genes. Methods Twenty-seven SNPs in VHL, HGF, IL18, PRKACB, ABCB1, CYP2C8, ERCC2, and ERCC1 previously associated with ovarian cancer outcome were genotyped in 10,084 invasive cases from 28 studies from the Ovarian Cancer Association Consortium with over 37,000 observed person-years and 4,478 deaths. Cox proportional hazards models were used to examine the association between candidate SNPs and ovarian cancer recurrence or survival with and without adjustment for key covariates. Results We observed no association between genotype and ovarian cancer recurrence or survival for any of the SNPs examined. Conclusions These results refute prior associations between these SNPs and ovarian cancer outcome and underscore the importance of maximally powered genetic association studies. Impact These variants should not be used in prognostic models. Alternate approaches to uncovering inherited prognostic factors, if they exist, are needed. PMID:23513043

  20. Apatinib for metastatic breast cancer in non-clinical trial setting: Satisfying efficacy regardless of previous anti-angiogenic treatment.

    PubMed

    Lin, Ying; Wu, Zheng; Zhang, Jian; Hu, Xichun; Wang, Zhonghua; Wang, Biyun; Cao, Jun; Wang, Leiping

    2017-06-01

    Apatinib is a novel tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor 2. This study aimed to evaluate the efficacy and safety of apatinib in metastatic breast cancer (MBC) under non-clinical trial setting, and to study the impact of previous antiangiogenic treatment to the efficacy of apatinib. 52 MBC patients treated with apatinib under non-clinical trial setting in Fudan University Shanghai Cancer Center between January 1st 2015 and October 1st 2016 were included. All patients were included in time-to-treatment failure (TTF) analysis, while 45 patients were enrolled for progression-free survival (PFS) and overall survival (OS) analysis because 7 of the patients with treatment discontinuation due to intolerable toxicities had too short time for efficacy assessment. Impact of previous exposure to antiangiogenic treatment and other factors to patients' survival were analyzed by Log-rank analysis and Cox multivariate analysis. The median PFS, median OS, and median TTF were 4.90 (95% confidence interval [CI] 3.44 - 6.36), 10.3 (unable to calculate 95% CI), and 3.93 (95% CI 1.96 - 5.90) months, respectively. Previous treatment of bevacizumab did not affect the efficacy of apatinib. Previous exposure to anthracycline, age of 60 years or older and palmar-plantar erythrodysesthesia syndrome were independent predictors for prolonged PFS. Discontinuation of treatment was more common in age group of 60 years or older than that in younger group, although the difference was not significant. Although toxicities were generally managable, a previously unrecorded grade 3~4 adverse event of dyspnea has been observed. This study confirmed the encouraging efficacy and manageable safety of apatinib on pretreated MBC patients in non-clinical trial setting. For the first time to our knowledge, this study found that previous treatment of bevacizumab did not affect the efficacy of apatinib, and reported an undocumented severe adverse effect of dyspnea.

  1. Impact of previous vascular burden on in-hospital and long-term mortality in patients with ST-segment elevation myocardial infarction.

    PubMed

    Consuegra-Sánchez, Luciano; Melgarejo-Moreno, Antonio; Galcerá-Tomás, José; Alonso-Fernández, Nuria; Díaz-Pastor, Angela; Escudero-García, Germán; Jaulent-Huertas, Leticia; Vicente-Gilabert, Marta

    2014-06-01

    Patients with a current acute coronary syndrome and previous ischemic heart disease, peripheral arterial disease, and/or cerebrovascular disease are reported to have a poorer outcome than those without these previous conditions. It is uncertain whether this association with outcome is observed at long-term follow-up. Prospective observational study, including 4247 patients with ST-segment elevation myocardial infarction. Detailed clinical data and information on previous ischemic heart disease, peripheral arterial disease, and cerebrovascular disease ("vascular burden") were recorded. Multivariate models were performed for in-hospital and long-term (median, 7.2 years) all-cause mortality. One vascular territory was affected in 1131 (26.6%) patients and ≥ 2 territories in 221 (5.2%). The total in-hospital mortality rate was 12.3% and the long-term incidence density was 3.5 deaths per 100 patient-years. A background of previous ischemic heart disease (odds ratio = 0.83; P = .35), peripheral arterial disease (odds ratio = 1.30; P = .34), or cerebrovascular disease (stroke) (odds ratio = 1.15; P = .59) was not independently predictive of in-hospital death. In an adjusted model, previous cerebrovascular disease and previous peripheral arterial disease were both predictors of mortality at long-term follow-up (hazard ratio = 1.57; P < .001; and hazard ratio = 1.34; P = .001; respectively). Patients with ≥ 2 diseased vascular territories showed higher long-term mortality (hazard ratio = 2.35; P < .001), but not higher in-hospital mortality (odds ratio = 1.07; P = .844). In patients with a diagnosis of ST-segment elevation acute myocardial infarction, the previous vascular burden determines greater long-term mortality. Considered individually, previous cerebrovascular disease and peripheral arterial disease were predictors of mortality at long-term after hospital discharge. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights

  2. Observational studies are complementary to randomized controlled trials.

    PubMed

    Grootendorst, Diana C; Jager, Kitty J; Zoccali, Carmine; Dekker, Friedo W

    2010-01-01

    Randomized controlled trials (RCTs) are considered the gold standard study design to investigate the effect of health interventions, including treatment. However, in some situations, it may be unnecessary, inappropriate, impossible, or inadequate to perform an RCT. In these special situations, well-designed observational studies, including cohort and case-control studies, may provide an alternative to doing nothing in order to obtain estimates of treatment effect. It should be noted that such studies should be performed with caution and correctly. The aims of this review are (1) to explain why RCTs are considered the optimal study design to evaluate treatment effects, (2) to describe the situations in which an RCT is not possible and observational studies are an adequate alternative, and (3) to explain when randomization is not needed and can be approximated in observational studies. Examples from the nephrology literature are used for illustration. Copyright 2009 S. Karger AG, Basel.

  3. Changes in association between previous therapeutic abortion and preterm birth in Scotland, 1980 to 2008: a historical cohort study.

    PubMed

    Oliver-Williams, Clare; Fleming, Michael; Monteath, Kirsten; Wood, Angela M; Smith, Gordon C S

    2013-01-01

    Numerous studies have demonstrated that therapeutic termination of pregnancy (abortion) is associated with an increased risk of subsequent preterm birth. However, the literature is inconsistent, and methods of abortion have changed dramatically over the last 30 years. We hypothesized that the association between previous abortion and the risk of preterm first birth changed in Scotland between 1 January 1980 and 31 December 2008. We studied linked Scottish national databases of births and perinatal deaths. We analysed the risk of preterm birth in relation to the number of previous abortions in 732,719 first births (≥24 wk), adjusting for maternal characteristics. The risk (adjusted odds ratio [95% CI]) of preterm birth was modelled using logistic regression, and associations were expressed for a one-unit increase in the number of previous abortions. Previous abortion was associated with an increased risk of preterm birth (1.12 [1.09-1.16]). When analysed by year of delivery, the association was strongest in 1980-1983 (1.32 [1.21-1.43]), progressively declined between 1984 and 1999, and was no longer apparent in 2000-2003 (0.98 [0.91-1.05]) or 2004-2008 (1.02 [0.95-1.09]). A statistical test for interaction between previous abortion and year was highly statistically significant (p<0.001). Analysis of data for abortions among nulliparous women in Scotland 1992-2008 demonstrated that the proportion that were surgical without use of cervical pre-treatment decreased from 31% to 0.4%, and that the proportion of medical abortions increased from 18% to 68%. Previous abortion was a risk factor for spontaneous preterm birth in Scotland in the 1980s and 1990s, but the association progressively weakened and disappeared altogether by 2000. These changes were paralleled by increasing use of medical abortion and cervical pre-treatment prior to surgical abortion. Although it is plausible that the two trends were related, we could not test this directly as the data on the method

  4. Previous history of tuberculosis is associated with rheumatoid arthritis.

    PubMed

    Shen, T-C; Lin, C-L; Wei, C-C; Chen, C-H; Tu, C-Y; Hsia, T-C; Shih, C-M; Hsu, W-H; Chung, C-J; Sung, F-C; Kao, C-H

    2015-11-01

    Previous studies have suggested that mycobacterial infections could trigger autoimmune diseases, including rheumatoid arthritis (RA). To explore the association between previous tuberculosis (TB) and RA. We conducted a case-control study using data obtained from the National Health Insurance (NHI) system of Taiwan. We identified 26 535 adults with RA from 2002 to 2011, with the date of diagnosis as the index date. This number was randomly selected and frequency-matched four times by age, sex and the year of index date from among non-RA individuals. Odds ratios (ORs) of RA were calculated for associations with TB. Compared with controls, RA patients had a crude OR of 1.77 for TB (95%CI 1.61-1.94). The strength of the association between RA and TB remained at the same level after controlling for other potential risk factors (adjusted OR 1.73, 95%CI 1.57-1.90), although RA patients tended to have a higher prevalence of hypertension, coronary artery disease and kidney disease. TB was much more prevalent in RA patients than in control subjects. Prospective cohort studies are required to establish a causal relationship between previous TB and RA.

  5. The phenomenon of claimed memories of previous lives: possible interpretations and importance.

    PubMed

    Stevenson, I

    2000-04-01

    Several disorders or abnormalities observed in medicine and psychology are not explicable (or not fully explicable) by genetics and environmental influences, either alone or together. These include phobias and philias observed in early infancy, unusual play in childhood, homosexuality, gender identity disorder, a child's idea of having parents other than its own, differences in temperament manifested soon after birth, unusual birthmarks and their correspondence with wounds on a deceased person, unusual birth defects, and differences (physical and behavioral) between monozygotic twins. The hypothesis of previous lives can contribute to the further understanding of these phenomena. Copyright 2000 Harcourt Publishers Ltd.

  6. Previous induced abortion among young women seeking abortion-related care in Kenya: a cross-sectional analysis.

    PubMed

    Kabiru, Caroline W; Ushie, Boniface A; Mutua, Michael M; Izugbara, Chimaraoke O

    2016-05-14

    Unsafe abortion is a leading cause of death among young women aged 10-24 years in sub-Saharan Africa. Although having multiple induced abortions may exacerbate the risk for poor health outcomes, there has been minimal research on young women in this region who have multiple induced abortions. The objective of this study was therefore to assess the prevalence and correlates of reporting a previous induced abortion among young females aged 12-24 years seeking abortion-related care in Kenya. We used data on 1,378 young women aged 12-24 years who presented for abortion-related care in 246 health facilities in a nationwide survey conducted in 2012. Socio-demographic characteristics, reproductive and clinical histories, and physical examination assessment data were collected from women during a one-month data collection period using an abortion case capture form. Nine percent (n = 98) of young women reported a previous induced abortion prior to the index pregnancy for which they were receiving care. Statistically significant differences by previous history of induced abortion were observed for area of residence, religion and occupation at bivariate level. Urban dwellers and unemployed/other young women were more likely to report a previous induced abortion. A greater proportion of young women reporting a previous induced abortion stated that they were using a contraceptive method at the time of the index pregnancy (47 %) compared with those reporting no previous induced abortion (23 %). Not surprisingly, a greater proportion of young women reporting a previous induced abortion (82 %) reported their index pregnancy as unintended (not wanted at all or mistimed) compared with women reporting no previous induced abortion (64 %). Our study results show that about one in every ten young women seeking abortion-related care in Kenya reports a previous induced abortion. Comprehensive post-abortion care services targeting young women are needed. In particular, post

  7. Placental location, postpartum hemorrhage and retained placenta in women with a previous cesarean section delivery: a prospective cohort study.

    PubMed

    Belachew, Johanna; Eurenius, Karin; Mulic-Lutvica, Ajlana; Axelsson, Ove

    2017-08-01

    Women previously giving birth with cesarean section have an increased risk of postpartum hemorrhage (PPH) and retained placenta. The objective of this study was to determine if anterior placental location increased the risk of PPH and retained placenta in such women. We performed a prospective cohort study on 400 women with cesarean section delivery in a previous pregnancy. Ultrasound examinations were performed at gestational week 28-30, and placental location, myometrial thickness, and three-dimensional vascularization index (VI) were recorded. Data on maternal age, parity, BMI, smoking, gestational week at delivery, induction, delivery mode, oxytocin, preeclampsia, PPH, retained placenta, and birth weight were obtained for all women. Outcome measures were PPH (≥1,000 mL) and retained placenta. The overall incidence of PPH was 11.0% and of retained placenta 3.5%. Twenty-three women (11.8%) with anterior placenta had PPH compared to 12 (6.9%) with posterior or fundal locations. The odds ratio was 1.94, but it did not reach statistical significance. There was no significant risk increase for retained placenta in women with anterior placentae. Seven of eight women with placenta previa had PPH, and four had retained placenta. The overall risk of PPH and retained placenta was high for women with previous cesarean section. Anterior location of the placenta in such women tended to impose an increased risk for PPH but no risk increase of retained placenta. Placenta previa in women with previous cesarean section is associated with a high risk for PPH and retained placenta.

  8. Placental location, postpartum hemorrhage and retained placenta in women with a previous cesarean section delivery: a prospective cohort study

    PubMed Central

    Belachew, Johanna; Eurenius, Karin; Mulic-Lutvica, Ajlana; Axelsson, Ove

    2017-01-01

    Objective Women previously giving birth with cesarean section have an increased risk of postpartum hemorrhage (PPH) and retained placenta. The objective of this study was to determine if anterior placental location increased the risk of PPH and retained placenta in such women. Materials and methods We performed a prospective cohort study on 400 women with cesarean section delivery in a previous pregnancy. Ultrasound examinations were performed at gestational week 28–30, and placental location, myometrial thickness, and three-dimensional vascularization index (VI) were recorded. Data on maternal age, parity, BMI, smoking, gestational week at delivery, induction, delivery mode, oxytocin, preeclampsia, PPH, retained placenta, and birth weight were obtained for all women. Outcome measures were PPH (≥1,000 mL) and retained placenta. Results The overall incidence of PPH was 11.0% and of retained placenta 3.5%. Twenty-three women (11.8%) with anterior placenta had PPH compared to 12 (6.9%) with posterior or fundal locations. The odds ratio was 1.94, but it did not reach statistical significance. There was no significant risk increase for retained placenta in women with anterior placentae. Seven of eight women with placenta previa had PPH, and four had retained placenta. Conclusions The overall risk of PPH and retained placenta was high for women with previous cesarean section. Anterior location of the placenta in such women tended to impose an increased risk for PPH but no risk increase of retained placenta. Placenta previa in women with previous cesarean section is associated with a high risk for PPH and retained placenta. PMID:28826360

  9. Iodine-131 induced hepatotoxicity in previously healthy patients with Grave's disease.

    PubMed

    Jhummon, Navina Priya; Tohooloo, Bhavna; Qu, Shen

    2013-01-01

    To describe the association of the rare and serious complication of liver toxicity in previously healthy Grave's disease (GD) patients after the treatment with radioactive iodine (131)I (RAI). We report the clinical, laboratory and pathologic findings of 2 cases of severe liver toxicity associated with the treatment with RAI in previously healthy patients with GD. Clinical examination and laboratory investigations excluded viral hepatitis, autoimmune hepatitis, granulomatous disease, primary biliary disease, extrahepatic biliary obstruction, and heart failure. Case 1: A previously healthy 52-years old man reportedly having a typical GD but following RAI treatment, concomitantly developed severe liver toxicity that required 1 week of treatment in hospital. Case 2: A previously healthy 34-years old woman is reported as having a typical GD but developed jaundice following RAI treatment that required several weeks of in hospital treatment in the hepato-biliary department. In both cases, the liver dysfunction resolved after intensive treatment with hepato-protective agents. In this report the therapeutic considerations as well as the pathogenetic possibilities are reviewed. To the best of our knowledge, this is the first description of the association observed, which is rare but may be severe and should be considered in any case of thyrotoxicosis where a liver dysfunction develops after the treatment with radioactive iodine (131)I.

  10. Quality of Parent-Adolescent Conversations About Sex and Adolescent Sexual Behavior: An Observational Study.

    PubMed

    Rogers, Adam A; Ha, Thao; Stormshak, Elizabeth A; Dishion, Thomas J

    2015-08-01

    Studies suggest that the quality of parent-adolescent communication about sex uniquely predicts adolescent sexual behavior. Previous studies have relied predominantly on self-report data. Observational methods, which are not susceptible to self-report biases, may be useful in examining the associations between the quality of parent-adolescent communication about sex and adolescent sexual behavior more objectively. With a sample of adolescents (N = 55, 58% male, 44% white, Mage = 15.8) and their parents, we used hierarchical logistic regression analyses to examine the associations between the observed quality of parent-adolescent communication about dating and sex and the likelihood of adolescents' sexual intercourse. The quality of parent-adolescent communication about dating and sex predicted sexual behavior. Specifically, lecturing was associated with a higher likelihood of adolescents having had sexual intercourse. The quality of parent-adolescent communication about sex is a unique correlate of adolescent sexual behavior and warrants further investigation. Thus, it serves as a potential target of preventive interventions that aim to foster adolescent sexual health behaviors. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  11. Phase I study of 3-weekly combination chemotherapy using epirubicin, oxaliplatin, and S-1 (EOS) in patients with previously untreated advanced gastric cancer.

    PubMed

    Sym, Sun Jin; Hong, Junsik; Jung, Minkyu; Park, Jinny; Cho, Eun Kyung; Lee, Woon Ki; Chung, Min; Kim, Hyung-Sik; Lee, Jae Hoon; Shin, Dong Bok

    2012-08-01

    This study was performed to determine the recommended dose (RD) and dose-limiting toxicity (DLT) associated with epirubicin, oxaliplatin, and S-1 (EOS) combination therapy in patients with previously untreated advanced gastric cancer (AGC). Previously untreated patients with histologically proven metastatic AGC, with an ECOG performance status of 0-2, were enrolled in this study. A fixed dose of epirubicin (50 mg/m(2)) and oxaliplatin (130 mg/m(2)) was intravenously administered on day 1 of treatment, followed by oral S-1 administration twice daily on days 1-14. The S-1 dose was escalated according to the following schedule: level I, 35 mg/m(2); level II, 40 mg/m(2); level III, 45 mg/m(2); Level IV, 50 mg/m(2). Each cycle was repeated every 21 days. DLTs were evaluated during the first two cycles of treatment. Nineteen patients with a median age of 53 years (range, 40-71 years) were enrolled in this study. One case of DLT (grade 4 neutropenia lasting more than 5 days) developed from among the six dose level II patients, while 2 DLTs (grade 3 diarrhea and nausea) were observed among the 4 dose level III patients. Based on these results, dose level II was determined as the RD. Of the 13 patients with measurable lesions, eight achieved partial response, three showed stable disease, and the objective response rate was 61.5 % (95 % confidence interval (CI), 13.3-66.6 %). The median progression-free survival and overall survival of all patients was 6.8 months (95 % CI, 1.4-9.5 months) and 13.3 months (95 % CI, 1.9-24.6 months), respectively. The RD of the EOS regimen in patients with previously untreated AGC was 50 mg/m(2) of epirubicin and 130 mg/m(2) of oxaliplatin on day 1, with administration of 40 mg/m(2) of S-1 twice a day on days 1-14 for each 21-day cycle. The EOS regimen described produced promising results.

  12. Is Previous Respiratory Disease a Risk Factor for Lung Cancer?

    PubMed Central

    Denholm, Rachel; Schüz, Joachim; Straif, Kurt; Stücker, Isabelle; Jöckel, Karl-Heinz; Brenner, Darren R.; De Matteis, Sara; Boffetta, Paolo; Guida, Florence; Brüske, Irene; Wichmann, Heinz-Erich; Landi, Maria Teresa; Caporaso, Neil; Siemiatycki, Jack; Ahrens, Wolfgang; Pohlabeln, Hermann; Zaridze, David; Field, John K.; McLaughlin, John; Demers, Paul; Szeszenia-Dabrowska, Neonila; Lissowska, Jolanta; Rudnai, Peter; Fabianova, Eleonora; Dumitru, Rodica Stanescu; Bencko, Vladimir; Foretova, Lenka; Janout, Vladimir; Kendzia, Benjamin; Peters, Susan; Behrens, Thomas; Vermeulen, Roel; Brüning, Thomas; Kromhout, Hans

    2014-01-01

    Rationale: Previous respiratory diseases have been associated with increased risk of lung cancer. Respiratory conditions often co-occur and few studies have investigated multiple conditions simultaneously. Objectives: Investigate lung cancer risk associated with chronic bronchitis, emphysema, tuberculosis, pneumonia, and asthma. Methods: The SYNERGY project pooled information on previous respiratory diseases from 12,739 case subjects and 14,945 control subjects from 7 case–control studies conducted in Europe and Canada. Multivariate logistic regression models were used to investigate the relationship between individual diseases adjusting for co-occurring conditions, and patterns of respiratory disease diagnoses and lung cancer. Analyses were stratified by sex, and adjusted for age, center, ever-employed in a high-risk occupation, education, smoking status, cigarette pack-years, and time since quitting smoking. Measurements and Main Results: Chronic bronchitis and emphysema were positively associated with lung cancer, after accounting for other respiratory diseases and smoking (e.g., in men: odds ratio [OR], 1.33; 95% confidence interval [CI], 1.20–1.48 and OR, 1.50; 95% CI, 1.21–1.87, respectively). A positive relationship was observed between lung cancer and pneumonia diagnosed 2 years or less before lung cancer (OR, 3.31; 95% CI, 2.33–4.70 for men), but not longer. Co-occurrence of chronic bronchitis and emphysema and/or pneumonia had a stronger positive association with lung cancer than chronic bronchitis “only.” Asthma had an inverse association with lung cancer, the association being stronger with an asthma diagnosis 5 years or more before lung cancer compared with shorter. Conclusions: Findings from this large international case–control consortium indicate that after accounting for co-occurring respiratory diseases, chronic bronchitis and emphysema continue to have a positive association with lung cancer. PMID:25054566

  13. No discrimination against previous mates in a sexually cannibalistic spider

    NASA Astrophysics Data System (ADS)

    Fromhage, Lutz; Schneider, Jutta M.

    2005-09-01

    In several animal species, females discriminate against previous mates in subsequent mating decisions, increasing the potential for multiple paternity. In spiders, female choice may take the form of selective sexual cannibalism, which has been shown to bias paternity in favor of particular males. If cannibalistic attacks function to restrict a male's paternity, females may have little interest to remate with males having survived such an attack. We therefore studied the possibility of female discrimination against previous mates in sexually cannibalistic Argiope bruennichi, where females almost always attack their mate at the onset of copulation. We compared mating latency and copulation duration of males having experienced a previous copulation either with the same or with a different female, but found no evidence for discrimination against previous mates. However, males copulated significantly shorter when inserting into a used, compared to a previously unused, genital pore of the female.

  14. Development of an observational measure of healthcare worker hand-hygiene behaviour: the hand-hygiene observation tool (HHOT).

    PubMed

    McAteer, J; Stone, S; Fuller, C; Charlett, A; Cookson, B; Slade, R; Michie, S

    2008-03-01

    Previous observational measures of healthcare worker (HCW) hand-hygiene behaviour (HHB) fail to provide adequate standard operating procedures (SOPs), accounts of inter-rater agreement testing or evidence of sensitivity to change. This study reports the development of an observational tool in a way that addresses these deficiencies. Observational categories were developed systematically, guided by a clinical guideline, previous measures and pilot hand-hygiene behaviour observations (HHOs). The measure, a simpler version of the Geneva tool, consists of HHOs (before and after low-risk, high-risk or unobserved contact), HHBs (soap, alcohol hand rub, no action, unknown), and type of HCW. Inter-observer agreement for each category was assessed by observation of 298 HHOs and HHBs by two independent observers on acute elderly and intensive care units. Raw agreement (%) and Kappa were 77% and 0.68 for HHB; 83% and 0.77 for HHO; and 90% and 0.77 for HCW. Inter-observer agreement for overall compliance of a group of HCWs was assessed by observation of 1191 HHOs and HHBs by two pairs of independent observers. Overall agreement was good (intraclass correlation coefficient = 0.79). Sensitivity to change was examined by autoregressive time-series modelling of longitudinal observations for 8 months on the intensive therapy unit during an Acinetobacter baumannii outbreak and subsequent strengthening of infection control measures. Sensitivity to change was demonstrated by a rise in compliance from 80 to 98% with an odds ratio of increased compliance of 7.00 (95% confidence interval: 4.02-12.2) P < 0.001.

  15. Previous injuries and some training characteristics predict running-related injuries in recreational runners: a prospective cohort study.

    PubMed

    Hespanhol Junior, Luiz Carlos; Pena Costa, Leonardo Oliveira; Lopes, Alexandre Dias

    2013-12-01

    What is the incidence of running-related injuries (RRIs) in recreational runners? Which personal and training characteristics predict RRIs in recreational runners? Prospective cohort study. A total of 200 recreational runners answered a fortnightly online survey containing questions about their running routine, races, and presence of RRI. These runners were followed-up for a period of 12 weeks. The primary outcome of this study was running-related injury. The incidence of injuries was calculated taking into account the exposure to running and was expressed by RRI/1000 hours. The association between potential predictive factors and RRIs was estimated using generalised estimating equation models. A total of 84 RRIs were registered in 60 (31%) of the 191 recreational runners who completed all follow-up surveys. Of the injured runners 30% (n=18/60) developed two or more RRIs, with 5/18 (28%) being recurrences. The incidence of RRI was 10 RRI/1000 hours of running exposure. The main type of RRI observed was muscle injuries (30%, n=25/84). The knee was the most commonly affected anatomical region (19%, n=16/84). The variables associated with RRI were: previous RRI (OR 1.88, 95% CI 1.01 to 3.51), duration of training although the effect was very small (OR 1.01, 95% CI 1.00 to 1.02), speed training (OR 1.46, 95% CI 1.02 to 2.10), and interval training (OR 0.61, 95% CI 0.43 to 0.88). Physiotherapists should be aware and advise runners that past RRI and speed training are associated with increased risk of further RRI, while interval training is associated with lower risk, although these associations may not be causative. Copyright © 2013 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

  16. Observing Protein & Energy Nutrition (OPEN) Study

    Cancer.gov

    The Observing Protein and Energy Nutrition (OPEN) Study was designed to assess dietary measurement error by comparing results from self-reported dietary intake data with four dietary biomarkers: doubly labeled water and urinary nitrogen, sodium, and potassium.

  17. Observational study of Arctium lappa in the treatment of acne vulgaris.

    PubMed

    Miglani, Anjali; Manchanda, Raj K

    2014-07-01

    Arctium lappa (Lappa) is used in traditional Western and Chinese medicine for acne. It is mentioned in homeopathic literature for acne, but its effect has not previously been evaluated. To determine the effectiveness of homeopathic medicine Lappa in treatment of acne vulgaris. An uncontrolled observational interventional study was conducted on human subjects who fulfilled the inclusion criteria and gave written informed consent. Lappa was prescribed in potencies starting from 6c rising to 1M as required, over a period of 6 months. Objective assessment was change in acne lesion counts supplemented with Global Acne Grading System (GAGS) and subjective assessment by using Acne-Specific Quality of Life questionnaire (Acne-QoL). Out of 34 human subjects, 32 completed the follow-up. Statistical significant results were seen in lesion counts, GAGS and Acne-QoL score (p value <0.001). Lappa has shown positive effects in the treatment of acne especially of inflammatory type. Further controlled, randomized studies with larger sample size are desirable. Trial is registered at ClinicalTrials.gov Identifier: NCT01040390. Copyright © 2013 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.

  18. A pragmatic observational feasibility study on integrated treatment for musculoskeletal disorders: Design and protocol.

    PubMed

    Hu, Xiao-yang; Hughes, John; Fisher, Peter; Lorenc, Ava; Purtell, Rachel; Park, A-La; Robinson, Nicola

    2016-02-01

    Musculoskeletal disorders (MSD) comprise a wide range of conditions, associated with an enormous pain and impaired mobility, and are affecting people's lives and work. Management of musculoskeletal disorders typically involves a multidisciplinary team approach. Positive findings have been found in previous studies evaluating the effectiveness of complementary therapies, though little attention has been paid to evaluating of the effectiveness of integrated packages of care combining conventional and complementary approaches for musculoskeletal conditions in a National Health Service (NHS) setting. To determine the feasibility of all aspects of a pragmatic observational study designed: (1) to evaluate the effectiveness and cost effectiveness of integrated treatments for MSDs in an integrated NHS hospital in the UK; (2) to determine the acceptability of the study design and research process to patients; (3) to explore patients' expectation and experience of receiving integrated treatments. This is an observational feasibility study, with 1-year recruitment and 1-year follow-up, conducted in Royal London Hospital for Integrated Medicine, University College London Hospital Trust, UK. All eligible patients with MSDs newly referred to the hospital were included in the study. Interventions are integrated packages of care (conventional and complementary) as currently provided in the hospital. SF-36™ Health Survey, short form Brief Pain Inventory, Visual Analogue Scale, and modified Client Service Receipt Inventory will be assessed at 4/5 time points. Semi-structured interview/focus group will be carried out before treatment, and 1 year after commence of treatment. We intend to conduct a pragmatic observational study of integrated medical treatment of MSDs at a public sector hospital. It will inform the design of a future trial including recruitment, retention, suitability of the outcome measures and patients experiences.

  19. Research Methods in Healthcare Epidemiology and Antimicrobial Stewardship-Observational Studies.

    PubMed

    Snyder, Graham M; Young, Heather; Varman, Meera; Milstone, Aaron M; Harris, Anthony D; Munoz-Price, Silvia

    2016-10-01

    Observational studies compare outcomes among subjects with and without an exposure of interest, without intervention from study investigators. Observational studies can be designed as a prospective or retrospective cohort study or as a case-control study. In healthcare epidemiology, these observational studies often take advantage of existing healthcare databases, making them more cost-effective than clinical trials and allowing analyses of rare outcomes. This paper addresses the importance of selecting a well-defined study population, highlights key considerations for study design, and offers potential solutions including biostatistical tools that are applicable to observational study designs. Infect Control Hosp Epidemiol 2016;1-6.

  20. Alternate Healthy Eating Index 2010, Dietary Inflammatory Index and risk of mortality: results from the Whitehall II cohort study and meta-analysis of previous Dietary Inflammatory Index and mortality studies.

    PubMed

    Shivappa, Nitin; Hebert, James R; Kivimaki, Mika; Akbaraly, Tasnime

    2017-08-01

    We aimed to examine the association between the Alternative Healthy Eating Index updated in 2010 (AHEI-2010), the Dietary Inflammatory Index (DIITM) and risk of mortality in the Whitehall II study. We also conducted a meta-analysis on the DII-based results from previous studies to summarise the overall evidence. Data on dietary behaviour assessed by self-administered repeated FFQ and on mortality status were available for 7627 participants from the Whitehall II cohort. Cox proportional hazards regression models were performed to assess the association between cumulative average of AHEI-2010 and DII scores and mortality risk. During 22 years of follow-up, 1001 participants died (450 from cancer, 264 from CVD). Both AHEI-2010 (mean=48·7 (sd 10·0)) and DII (mean=0·37 (sd 1·41)) were associated with all-cause mortality. The fully adjusted hazard ratio (HR) per sd, were 0·82; 95 % CI 0·76, 0·88 for AHEI-2010 and 1·18; 95 % CI 1·08, 1·29 for DII. Significant associations were also observed with cardiovascular and cancer mortality risk. For DII, a meta-analysis (using fixed effects) from this and four previous studies showed a positive association of DII score with all-cause (HR=1·04; 95 % CI 1·03, 1·05, 28 891deaths), cardiovascular (HR=1·05; 95 % CI 1·03, 1·07, 10 424 deaths) and cancer mortality (HR=1·05; 95 % CI 1·03, 1·07, n 8269).The present study confirms the validity to assess overall diet through AHEI-2010 and DII in the Whitehall II cohort and highlights the importance of considering diet indices related to inflammation when evaluating all-cause, cardiovascular and cancer mortality risk.

  1. Inter-observer and intra-observer agreement between embryologists during selection of a single Day 5 embryo for transfer: a multicenter study.

    PubMed

    Storr, Ashleigh; Venetis, Christos A; Cooke, Simon; Kilani, Suha; Ledger, William

    2017-02-01

    What is the inter-observer and intra-observer agreement between embryologists when selecting a single Day 5 embryo for transfer? The inter-observer and intra-observer agreement between embryologists when selecting a single Day 5 embryo for transfer was generally good, although not optimal, even among experienced embryologists. Previous research on the morphological assessment of early stage (two pronuclei to Day 3) embryos has shown varying levels of inter-observer and intra-observer agreement. However, single blastocyst transfer is now becoming increasingly popular and there are no published data that assess inter-observer and intra-observer agreement when selecting a single embryo for Day 5 transfer. This was a prospective study involving 10 embryologists working at five different IVF clinics within a single organization between July 2013 and November 2015. The top 10 embryologists were selected based on their yearly Quality Assurance Program scores for blastocyst grading and were asked to morphologically grade all Day 5 embryos and choose a single embryo for transfer in a survey of 100 cases using 2D images. A total of 1000 decisions were therefore assessed. For each case, Day 5 images were shown, followed by a Day 3 and Day 5 image of the same embryo. Subgroup analyses were also performed based on the following characteristics of embryologists: the level of clinical embryology experience in the laboratory; amount of research experience; number of days per week spent grading embryos. The agreement between these embryologists and the one that scored the embryos on the actual day of transfer was also evaluated. Inter-observer and intra-observer variability was assessed using the kappa coefficient to evaluate the extent of agreement. This study showed that all 10 embryologists agreed on the embryo chosen for transfer in 50 out of 100 cases. In 93 out of 100 cases, at least 6 out of the 10 embryologists agreed. The inter-observer and intra-observer agreement among

  2. The GreenCut: re-evaluation of physiological role of previously studied proteins and potential novel protein functions.

    PubMed

    Heinnickel, Mark L; Grossman, Arthur R

    2013-10-01

    Based on comparative genomics, a list of proteins present in the green algal, flowering and nonflowering plant lineages, but not detected in nonphotosynthetic organisms, was assembled (Merchant et al., Science 318:245-250, 2007; Karpowicz et al., J Biol Chem 286:21427-21439, 2011). This protein grouping, previously designated the GreenCut, was established using stringent comparative genomic criteria; they are those Chlamydomonas reinhardtii proteins with orthologs in Arabidopsis thaliana, Physcomitrella patens, Oryza sativa, Populus tricocarpa and at least one of the three Ostreococcus species with fully sequenced genomes, but not in bacteria, yeast, fungi or mammals. Many GreenCut proteins are also present in red algae and diatoms and a subset of 189 have been identified as encoded on nearly all cyanobacterial genomes. Of the current GreenCut proteins (597 in total), approximately half have been studied previously. The functions or activities of a number of these proteins have been deduced from phenotypic analyses of mutants (defective for genes encoding specific GreenCut proteins) of A. thaliana, and in many cases the assigned functions do not exist in C. reinhardtii. Therefore, precise physiological functions of several previously studied GreenCut proteins are still not clear. The GreenCut also contains a number of proteins with certain conserved domains. Three of the most highly conserved domains are the FK506 binding, cyclophilin and PAP fibrillin domains; most members of these gene families are not well characterized. In general, our analysis of the GreenCut indicates that many processes critical to green lineage organisms remain unstudied or poorly characterized. We have begun to examine the functions of some GreenCut proteins in detail. For example, our work on the CPLD38 protein has demonstrated that it has an essential role in photosynthetic function and the stability of the cytochrome b 6 f complex.

  3. A study about the interest and previous contact of high school students with Astronomy

    NASA Astrophysics Data System (ADS)

    Carvalho, C. L.; Zanitti, M. H. R.; Felicidade, B. L.; Gomes, A. D. T.; Dias, E. W.; Coelho, F. O.

    2016-04-01

    The currently problems in Astronomy teaching in Brazilian Basic Education contrast with the space, and the popularity that astronomical themes have in various media in the country. In this work, we present the results of a study about the interest, and previous contact of high school students from a public school in the city of "São João del-Rei"/MG with topics related to Astronomy. The study and the pedagogical intervention were carried out by students of the PIBID/CAPES/UFSJ. The intervention was performed through an oral exposition with the students' participation, followed by the use of the Stellarium program. The results suggest the majority of students surveyed are interested in Astronomy, and have had some contact with the area. However, some inconsistencies in their responses were identified and examined. The implications for research and for Astronomy Education are discussed. We also make some considerations about relationship between the lack of specific knowledge and the misinformation as one possible reason for the little interest of students in various areas of Science.

  4. Urethrotomy has a much lower success rate than previously reported.

    PubMed

    Santucci, Richard; Eisenberg, Lauren

    2010-05-01

    We evaluated the success rate of direct vision internal urethrotomy as a treatment for simple male urethral strictures. A retrospective chart review was performed on 136 patients who underwent urethrotomy from January 1994 through March 2009. The Kaplan-Meier method was used to analyze stricture-free probability after the first, second, third, fourth and fifth urethrotomy. Patients with complex strictures (36) were excluded from the study for reasons including previous urethroplasty, neophallus or previous radiation, and 24 patients were lost to followup. Data were available for 76 patients. The stricture-free rate after the first urethrotomy was 8% with a median time to recurrence of 7 months. For the second urethrotomy stricture-free rate was 6% with a median time to recurrence of 9 months. For the third urethrotomy stricture-free rate was 9% with a median time to recurrence of 3 months. For procedures 4 and 5 stricture-free rate was 0% with a median time to recurrence of 20 and 8 months, respectively. Urethrotomy is a popular treatment for male urethral strictures. However, the performance characteristics are poor. Success rates were no higher than 9% in this series for first or subsequent urethrotomy during the observation period. Most of the patients in this series will be expected to experience failure with longer followup and the expected long-term success rate from any (1 through 5) urethrotomy approach is 0%. Urethrotomy should be considered a temporizing measure until definitive curative reconstruction can be planned. 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  5. Characteristics of Latinas in Puerto Rico and the US mainland receiving teriparatide in the DANCE observational study.

    PubMed

    Ruff, Valerie A; Acosta, Agaph; Soto-Raices, Oscar; Sierra-Zorita, Radamés; Toro-Torres, Ramón; Rodríguez-Ginorio, Henry; Comulada, Angel; Chiang, Alan Y; Krohn, Kelly; Taylor, Kathleen A

    2014-09-01

    The Direct Assessment of Nonvertebral Fractures in Community Experience (DANCE) study investigated the use of teriparatide in men and women with osteoporosis in the United States (US) and Puerto Rico (PR). In a sub-analysis, we evaluated whether the baseline characteristics of Latinas differed from those of white women in the study population and whether any patient attributes affected physicians' decisions to prescribe teriparatide. We assessed 3 patient cohorts treated with teriparatide 20 microg once daily for up to 24 months: 1) PR Latinas, 2) US Latinas, and 3) white women on the US mainland (white women). We analyzed differences related to ethnicity (Latina vs. white) and geography (PR vs. US mainland). Overall, 302 of the 3243 women (9%) enrolled in DANCE were Latina (205 of these 302 Latinas resided in PR). Significant differences were observed in 7 of 11 baseline characteristics. White women had more prior fragility fractures and family history of hip fracture than Latinas, while PR Latinas were generally older than US Latinas and had more comorbid conditions. A similar proportion of subjects in each cohort had received prior osteoporosis therapy. Physicians prescribed teriparatide more often for Latinas based on multiple risk factors for fracture and intolerance to previous osteoporosis therapy and to white women based on inadequate response to previous therapy or new (incident) fractures. Overall, Latinas were less persistent with teriparatide therapy than white women. We observed significant differences related to ethnicity and geography in the baseline demographics of Latinas enrolled in the DANCE study, criteria cited by physicians for initiating teriparatide therapy, and treatment persistence.

  6. Evaluation of cleansing methods for previously worn prostheses.

    PubMed

    Glass, R Thomas; Conrad, Robert S; Bullard, James W; Goodson, Leigh B; Mehta, Naresh; Lech, Stanley J; Loewy, Zvi G

    2011-04-01

    Although there are many product claims that address the issue of denture sanitization, controlled scientific studies on previously worn dentures have not been performed. The purpose of this study was to evaluate procedures directed at sanitizing previously worn contaminated dentures from two regions of the United States. This study examined 51 previously worn dentures from two regions. An established method of denture retrieval, sectioning, and culturing was used, including isolation of anaerobes. Evaluation of microbial contamination posttreatment was used to determine the effects of soaking dentures in Polident (US and European formulations) for varying periods of times/temperatures, microwaving dentures with varying temperatures, sonicating dentures, and immersing the dentures while using a vacuum. A combination of analysis of variance (ANOVA) and general linear model (GLM) of the SPSS was used to analyze the data with P < .05 being considered statistically significant when using a two-tailed test. While all Polident treatments were found to significantly reduce microorganism loads in dentures, extended soaking (8 hours) and 65 degrees C (5 minutes) were the most effective. Microwaving was slightly more effective than either sonication or vacuum. Regardless the treatment, dentures underwent sanitization rather than sterilization. Denture-borne microorganisms can be significantly reduced by using a Polident solution for 8 hours at room temperature or for 5 minutes at 65 degrees C. Microwaving, sonication, and use of a vacuum were less effective. ClLINICAL IMPLICATIONS The importance of daily use of Polident solution for 8 hours or for 5 minutes at 65 degrees C to sanitize worn prostheses must be stressed.

  7. Ifosfamide in previously untreated disseminated neuroblastoma. Results of Study 3A of the European Neuroblastoma Study Group.

    PubMed

    Kellie, S J; De Kraker, J; Lilleyman, J S; Bowman, A; Pritchard, J

    1988-05-01

    A prospective study of the effectiveness of ifosfamide as a single agent in the management of previously untreated patients with Evans stage IV neuroblastoma was undertaken. Eighteen children aged more than 1 year were treated with ifosfamide (IFX) 3 g/m2 daily for 2 days immediately after diagnosis and 3 weeks later. Treatment was continued with combination chemotherapy using vincristine, cyclophosphamide, cisplatinum and etoposide (OPEC) or a variant. Mesna (2-mercaptoethane sulphonate) was given to all patients during IFX treatment to prevent urotoxicity. Eight of the 18 patients (44%) responded to IFX. Nine had greater than 66% reduction in baseline tumor volume. Of 15 evaluable patients with raised pre-treatment urinary catecholamine excretion, six (40%) achieved greater than 50% reduction in pretreatment levels. Two of 10 patients evaluable for bone marrow response had complete clearance. Toxicity was mild in all patients. Upon completing 'first line' therapy, only four patients (22%) achieved a good partial remission (GPR) or complete response (CR). Median survival was 11 months. There was a lower rate of attaining GPR and shortened median survival in patients receiving phase II IFX before OPEC or variant, compared to patients with similar pre-treatment characteristics treated with OPEC from diagnosis in an earlier study.

  8. Changes in Association between Previous Therapeutic Abortion and Preterm Birth in Scotland, 1980 to 2008: A Historical Cohort Study

    PubMed Central

    Oliver-Williams, Clare; Fleming, Michael; Monteath, Kirsten; Wood, Angela M.; Smith, Gordon C. S.

    2013-01-01

    Background Numerous studies have demonstrated that therapeutic termination of pregnancy (abortion) is associated with an increased risk of subsequent preterm birth. However, the literature is inconsistent, and methods of abortion have changed dramatically over the last 30 years. We hypothesized that the association between previous abortion and the risk of preterm first birth changed in Scotland between 1 January 1980 and 31 December 2008. Methods and Findings We studied linked Scottish national databases of births and perinatal deaths. We analysed the risk of preterm birth in relation to the number of previous abortions in 732,719 first births (≥24 wk), adjusting for maternal characteristics. The risk (adjusted odds ratio [95% CI]) of preterm birth was modelled using logistic regression, and associations were expressed for a one-unit increase in the number of previous abortions. Previous abortion was associated with an increased risk of preterm birth (1.12 [1.09–1.16]). When analysed by year of delivery, the association was strongest in 1980–1983 (1.32 [1.21–1.43]), progressively declined between 1984 and 1999, and was no longer apparent in 2000–2003 (0.98 [0.91–1.05]) or 2004–2008 (1.02 [0.95–1.09]). A statistical test for interaction between previous abortion and year was highly statistically significant (p<0.001). Analysis of data for abortions among nulliparous women in Scotland 1992–2008 demonstrated that the proportion that were surgical without use of cervical pre-treatment decreased from 31% to 0.4%, and that the proportion of medical abortions increased from 18% to 68%. Conclusions Previous abortion was a risk factor for spontaneous preterm birth in Scotland in the 1980s and 1990s, but the association progressively weakened and disappeared altogether by 2000. These changes were paralleled by increasing use of medical abortion and cervical pre-treatment prior to surgical abortion. Although it is plausible that the two trends were related

  9. Deep Chandra observations of Pictor A

    NASA Astrophysics Data System (ADS)

    Hardcastle, M. J.; Lenc, E.; Birkinshaw, M.; Croston, J. H.; Goodger, J. L.; Marshall, H. L.; Perlman, E. S.; Siemiginowska, A.; Stawarz, Ł.; Worrall, D. M.

    2016-02-01

    We report on deep Chandra observations of the nearby broad-line radio galaxy Pictor A, which we combine with new Australia Telescope Compact Array (ATCA) observations. The new X-ray data have a factor of 4 more exposure than observations previously presented and span a 15 yr time baseline, allowing a detailed study of the spatial, temporal and spectral properties of the AGN, jet, hotspot and lobes. We present evidence for further time variation of the jet, though the flare that we reported in previous work remains the most significantly detected time-varying feature. We also confirm previous tentative evidence for a faint counterjet. Based on the radio through X-ray spectrum of the jet and its detailed spatial structure, and on the properties of the counterjet, we argue that inverse-Compton models can be conclusively rejected, and propose that the X-ray emission from the jet is synchrotron emission from particles accelerated in the boundary layer of a relativistic jet. For the first time, we find evidence that the bright western hotspot is also time-varying in X-rays, and we connect this to the small-scale structure in the hotspot seen in high-resolution radio observations. The new data allow us to confirm that the spectrum of the lobes is in good agreement with the predictions of an inverse-Compton model and we show that the data favour models in which the filaments seen in the radio images are predominantly the result of spatial variation of magnetic fields in the presence of a relatively uniform electron distribution.

  10. Periodontitis and type 2 diabetes among women with previous gestational diabetes: epidemiological and immunological aspects in a follow-up of three years.

    PubMed

    Esteves Lima, Rafael Paschoal; Cota, Luis Otávio Miranda; Silva, Tarcília Aparecida; Cortelli, Sheila Cavalca; Cortelli, José Roberto; Costa, Fernando Oliveira

    2017-01-01

    The aim of this study was to verify the incidence on the development of type 2 diabetes in women with previous gestational diabetes with and without periodontitis after a three-year time interval. Initial sample of this follow-up study consisted of 90 women diagnosed with gestational diabetes who underwent periodontal examination. After three years, 49 women were subjected to new periodontal examination and biological, behavioral, and social data of interest were collected. Additionally, the quantification of the C-reactive protein in blood samples was performed. Fasting glucose and glycated hemoglobin levels were requested. Saliva samples were collected for quantification of interleukin 6 and 10, tumor necrosis factor α, matrix metalloproteinase 2 and 9. The incidence of type 2 diabetes mellitus was 18.4% and of periodontitis was 10.2%. There was no significant difference in the incidence of type 2 diabetes mellitus among women with and without periodontitis. It was observed impact of C-reactive protein in the development of type 2 diabetes mellitus. However, it was not observed impact of periodontitis on the development of type 2 diabetes mellitus among women with previous gestational diabetes. It was not observed impact of periodontitis on the development of type 2 diabetes among women with previous gestational diabetes. The impact of C-reactive protein in the development of type 2 diabetes mellitus highlights the importance of an inflammatory process in the diabetes pathogenesis.

  11. What about the Misgav-Ladach surgical technique in patients with previous cesarean sections?

    PubMed

    Bolze, Pierre-Adrien; Massoud, Mona; Gaucherand, Pascal; Doret, Muriel

    2013-03-01

    The Misgav-Ladach technique is recommended worldwide to perform cesarean sections but there is no consensus about the appropriate technique to use in patients with previous cesarean sections. This study evaluated the feasibility of the Misgav-Ladach technique in patients with previous cesarean sections. This prospective cohort study included all women undergoing cesarean section after 36 weeks of gestation over a 5-month period, with the Misgav-Ladach technique as first choice, whatever the previous number of cesarean sections. Among the 204 patients included, the Misgav-Ladach technique was successful in 100%, 80%, and 65.6% of patients with no, one, and multiple previous cesarean sections, respectively. When successful, the Misgav-Ladach technique was associated with a shorter incision to birth interval in patients with no previous cesarean section compared with patients with one or multiple previous cesarean sections. Anterior rectus aponeurosis fibrosis and severe peritoneal adherences were the two main reasons explaining the Misgav-Ladach technique failure. The Misgav-Ladach technique is possible in over three-fourths of patients with previous cesarean sections with a slight increase in incision to birth interval compared with patients without previous cesarean section. Further studies comparing the Misgav-Ladach and the Pfannenstiel techniques in women with previous cesarean should be done. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  12. Issues of reporting in observational studies in veterinary medicine.

    PubMed

    Sargeant, Jan M; O'Connor, Annette M

    2014-02-15

    Observational studies are common in veterinary medicine; the results may be used to inform decision-making, future research, or as inputs to systematic reviews or risk assessment. To be of use, the results must be published, all of the outcomes that were assessed must be included in the publication, and the research (methods and results) must be reported in sufficient detail that the reader can evaluate the internal and external validity. In human healthcare, concerns about the completeness of reporting - and evidence that poor reporting is associated with study results - have led to the creation of reporting guidelines; these include the STROBE statement for observational studies. There is evidence from a limited body of research that there also are reporting inadequacies in veterinary observational studies. There are differences between human and veterinary observational studies that might be relevant to recommendations for reporting. Such differences include: the use of observational studies in animal populations for simultaneously estimating disease frequency and risk-factor identification; the distinction between the animal owners who consent to participate and the animals that are the study subjects; and the complexity of organizational levels inherent in animal research (in particular, for studies in livestock species). In veterinary medicine, it is common to have clustering within outcomes (due to animal grouping) and clustering of predictor variables. We argue that there is a compelling need for the scientific community involved in veterinary observational studies to use the STROBE statement, use an amended version of STROBE, or to develop and use reporting guidelines that are specific to veterinary medicine to improve reporting of these studies. Copyright © 2013 Elsevier B.V. All rights reserved.

  13. Back to the Future: What Previous HEA Reauthorizations Might Say about the Next One

    ERIC Educational Resources Information Center

    Madzelan, Dan

    2015-01-01

    For 50 years, the Higher Education Act has been the primary vehicle for advancing federal higher education policy. Many policymakers and interested observers expect its upcoming reauthorization to address three overarching topic areas: college affordability, institutional quality, and student safety. Indeed, previous reauthorizations have…

  14. Observability of global rivers with future SWOT observations

    NASA Astrophysics Data System (ADS)

    Fisher, Colby; Pan, Ming; Wood, Eric

    2017-04-01

    The Surface Water and Ocean Topography (SWOT) mission is designed to provide global observations of water surface elevation and slope from which river discharge can be estimated using a data assimilation system. This mission will provide increased spatial and temporal coverage compared to current altimeters, with an expected accuracy for water level elevations of 10 cm on rivers greater than 100 m wide. Within the 21-day repeat cycle, a river reach will be observed 2-4 times on average. Due to the relationship between the basin orientation and the orbit, these observations are not evenly distributed in time, which will impact the derived discharge values. There is, then, a need for a better understanding of how the mission will observe global river basins. In this study, we investigate how SWOT will observe global river basins and how the temporal and spatial sampling impacts the discharge estimated from assimilation. SWOT observations can be assimilated using the Inverse Streamflow Routing (ISR) model of Pan and Wood [2013] with a fixed interval Kalman smoother. Previous work has shown that the ISR assimilation method can be used to reproduce the spatial and temporal dynamics of discharge within many global basins: however, this performance was strongly impacted by the spatial and temporal availability of discharge observations. In this study, we apply the ISR method to 32 global basins with different geometries and crossing patterns for the future orbit, assimilating theoretical SWOT-retrieved "gauges". Results show that the model performance varies significantly across basins and is driven by the orientation, flow distance, and travel time in each. Based on these properties, we quantify the "observability" of each basin and relate this to the performance of the assimilation. Applying this metric globally to a large variety of basins we can gain a better understanding of the impact that SWOT observations may have across basin scales. By determining the

  15. Responses to A(H1N1)pdm09 Influenza Vaccines in Participants Previously Vaccinated With Seasonal Influenza Vaccine: A Randomized, Observer-Blind, Controlled Study

    PubMed Central

    Roy-Ghanta, Sumita; Van der Most, Robbert; Li, Ping; Vaughn, David W.

    2014-01-01

    Background. Prior receipt of a trivalent seasonal influenza vaccine (TIV) can affect hemagglutination inhibition (HI) antibody responses to pandemic influenza vaccines. We investigated the effect of TIV priming on humoral responses to AS03-adjuvanted and nonadjuvanted A(H1N1)pdm09 vaccines, the role of AS03 on cell-mediated immune (CMI) responses, and vaccine safety. Methods. Healthy adults (aged 19–40 years) were randomized 1:1:1:1 to receive TIV or saline followed 4 months later by 2 doses, 3 weeks apart, of adjuvanted or nonadjuvanted A(H1N1)pdm09 vaccine and followed up to study end (day 507). Pre- and postvaccination responses of HI and neutralizing antibody, CD4+/CD8+ T cells, memory B cells, and plasmablasts were assessed. Results. Ninety-nine of the 133 participants enrolled completed the study. No vaccine-related serious adverse events were recorded. In TIV-primed participants, A(H1N1)pdm09-specific antibody and CD4+ T-cell and memory B-cell responses to the pandemic vaccine tended to be diminished. Vaccine adjuvantation led to increased responses of vaccine-homologous and -heterologous HI and neutralizing antibodies and CD4+ T cells, homologous memory B cells, and plasmablasts. Conclusions. In healthy adults, prior TIV administration decreased humoral and CMI responses to A(H1N1)pdm09 vaccine. Adjuvantation of A(H1N1)pdm09 antigen helped to overcome immune interference between the influenza vaccines. No safety concerns were observed. Registration. Clinical Trials.gov identifier NCT00707967. PMID:24864125

  16. Vertebral artery injuries following cervical spine trauma: a prospective observational study.

    PubMed

    Mueller, Christian-Andreas; Peters, Inga; Podlogar, Martin; Kovacs, Attila; Urbach, Horst; Schaller, Karl; Schramm, Johannes; Kral, Thomas

    2011-12-01

    The purpose of this study was to report on the incidence, diagnosis and clinical manifestation of VAI following cervical spine injuries observed in a prospective observational study with a standardized clinical and radiographical protocol. During a 16-year period, 69 (mean age: 43 ± 20.7 years; 25 female, 44 male) of 599 patients had cervical spine injury suspicious for VAI due to facet luxation and/or fractures extending into the transverse foramen. Diagnosis and management of these patients followed a previously published protocol (Kral in Zentralbl Neurochir 63:153-158, 2002). Digital subtraction angiography (DSA) was performed in all 69 patients. Injury grading of VAI was done according to Biffl et al. (Ann Surg 231:672-681, 2000). All patients with VAI were treated with anticoagulation (heparin followed by ASS) for 6 months. In cases suspicious for VAI, the incidence of VAI detected by DSA was 27.5% (n = 19 of 69 patients). VAI Grade I occurred in 15.8%, Grade II in 26.3%, Grade IV in 52.6% and Grade V in 5.2%. Of 19 patients, 4 (21%) had clinical signs of vertebrobasilar ischemia. Two patients died in hospital after 4 and 21 days respectively. Of 69 patients, 33 (47.8%) with suspected VAI had unstable spine injuries and were treated surgically. In patients with cervical spine fractures or dislocations crossing the course of the vertebral artery, VAI are relatively frequent and may be associated with significant morbidity and mortality. VAI were identified by DSA in 27.5%. Despite anticoagulation therapy, 5.8% became clinically symptomatic and 2.9% died due to cerebrovascular ischemia.

  17. An Observational Study of the Mesoscale Mistral Dynamics

    NASA Astrophysics Data System (ADS)

    Guenard, Vincent; Drobinski, Philippe; Caccia, Jean-Luc; Campistron, Bernard; Bench, Bruno

    2005-05-01

    We investigate the mesoscale dynamics of the mistral through the wind profiler observations of the MAP (autumn 1999) and ESCOMPTE (summer 2001) field campaigns. We show that the mistral wind field can dramatically change on a time scale less than 3 hours. Transitions from a deep to a shallow mistral are often observed at any season when the lower layers are stable. The variability, mainly attributed in summer to the mistral/land-sea breeze interactions on a 10-km scale, is highlighted by observations from the wind profiler network set up during ESCOMPTE. The interpretations of the dynamical mistral structure are performed through comparisons with existing basic theories. The linear theory of R. B. Smith [ Advances in Geophysics, Vol. 31, 1989, Academic Press, 1-41] and the shallow water theory [Schär, C. and Smith, R. B.: 1993a, J. Atmos. Sci. 50, 1373-1400] give some complementary explanations for the deep-to-shallow transition especially for the MAP mistral event. The wave breaking process induces a low-level jet (LLJ) downstream of the Alps that degenerates into a mountain wake, which in turn provokes the cessation of the mistral downstream of the Alps. Both theories indicate that the flow splits around the Alps and results in a persistent LLJ at the exit of the Rhône valley. The LLJ is strengthened by the channelling effect of the Rhône valley that is more efficient for north-easterly than northerly upstream winds despite the north-south valley axis. Summer moderate and weak mistral episodes are influenced by land-sea breezes and convection over land that induce a very complex interaction that cannot be accurately described by the previous theories.

  18. Previous Mental Health Service Utilization and Change in Clients' Depressive Symptoms

    ERIC Educational Resources Information Center

    Boswell, James F.; McAleavey, Andrew A.; Castonguay, Louis G.; Hayes, Jeffrey A.; Locke, Benjamin D.

    2012-01-01

    Although a potentially important factor in case conceptualization and treatment planning, the impact of previous treatment on subsequent counseling response has received little empirical attention. Using archival data, this study aimed to (a) report the prevalence of previous treatment utilization in a counseling population, (b) examine potential…

  19. Low-calorie energy drink improves physiological response to exercise in previously sedentary men: a placebo-controlled efficacy and safety study.

    PubMed

    Lockwood, Christopher M; Moon, Jordan R; Smith, Abbie E; Tobkin, Sarah E; Kendall, Kristina L; Graef, Jennifer L; Cramer, Joel T; Stout, Jeffrey R

    2010-08-01

    Energy drink use has grown despite limited research to support efficacy or safety and amid concerns when combined with exercise. The purpose of this study was to assess the effects of 10 weeks of once-daily energy drink consumption or energy drink consumption with exercise on measures of body composition, cardiorespiratory fitness, strength, mood, and safety in previously sedentary males. Thirty-eight males were randomly assigned to energy drink + exercise (EX-A), energy drink (NEX-A), placebo + exercise (EX-B), or placebo (NEX-B). All participants consumed 1 drink per day for 10 weeks; EX-A and EX-B participated in 10 weeks of resistance and endurance exercise. Testing was performed before (PRE) and after (POST) the 10-week intervention. No significant (p > 0.05) changes were observed for body composition, fitness, or strength in NEX-A; however, significantly greater decreases in fat mass and percentage body fat and increases in VO2peak were observed in EX-A versus EX-B. Ventilatory threshold (VT), minute ventilation, VO2 at VT, and power output at VT improved significantly PRE to POST in EX-A but not in EX-B or nonexercising groups. Clinical markers for hepatic, renal, cardiovascular, and immune function, as determined by PRE and POST blood work revealed no adverse effects in response to the energy drink. Mood was not affected by energy drink use. Absent energy restriction or other dietary controls, chronic ingestion of a once-daily low-calorie energy drink appears ineffective at improving body composition, cardiorespiratory fitness, or strength in sedentary males. However, when combined with exercise, preworkout energy drink consumption may significantly improve some physiological adaptations to combined aerobic and resistance training.

  20. Totally extraperitoneal inguinal hernia repair in patients previously having prostatectomy is feasible, safe, and effective.

    PubMed

    Le Page, Philip; Smialkowski, Ania; Morton, Jonathan; Fenton-Lee, Douglas

    2013-12-01

    The laparoscopic approach to repair of inguinal hernia has proven advantages over open repair. Repair of more technically challenging hernias, such as patients previously receiving prostatectomy, has been less studied and may not have these advantages. We aimed to compare safety, feasibility, and clinical outcomes for repairs in patients who previously underwent prostatectomy to control subjects. We undertook a case-control study using a prospectively collected database. From 2004, all patients were routinely offered totally extraperitoneal laparoscopic repair. All patients who had a history of previous prostatectomy were identified and compared to a matched control group. Both operative and follow-up data were analyzed. Of 987 patients undergoing surgery during this time period, 52 prostatectomy patients were identified (44% open, 44% robotic, 3% laparoscopic) and matched to 102 control subjects. Accounting for bilateral repairs, 203 hernia repairs had been performed. Patients were well matched for age and American Society of Anesthesiologists score. Operative time was longer for prostatectomy patients (mean, 70 vs. 52 min, p < 0.0001); however, this reduced over time when comparing the first and second half prostatectomy patients (77 vs. 63 min, p = 0.144). Overall, there were no intraoperative or major postoperative complications and only one conversion (prostatectomy group). No significant differences were found for rates of minor postoperative complications, length of stay, or recurrence (n = 1, control group). No difference was observed for chronic pain, and all patients in each group reported satisfaction with surgery at contemporary follow-up. In experienced hands, totally extraperitoneal inguinal hernia repair for patients previously having undergone prostatectomy is safe and has equivalent outcomes to patients not having undergone prostatectomy, and is an option to open repair. Understandably, slightly longer operative times may be justified, given the

  1. Plantar pressure and daily cumulative stress in persons affected by leprosy with current, previous and no previous foot ulceration.

    PubMed

    van Schie, Carine H M; Slim, Frederik J; Keukenkamp, Renske; Faber, William R; Nollet, Frans

    2013-03-01

    Not only plantar pressure but also weight-bearing activity affects accumulated mechanical stress to the foot and may be related to foot ulceration. To date, activity has not been accounted for in leprosy. The purpose was to compare barefoot pressure, in-shoe pressure and daily cumulative stress between persons affected by leprosy with and without previous or current foot ulceration. Nine persons with current plantar ulceration were compared to 15 with previous and 15 without previous ulceration. Barefoot peak pressure (EMED-X), in-shoe peak pressure (Pedar-X) and daily cumulative stress (in-shoe forefoot pressure time integral×mean daily strides (Stepwatch™ Activity Monitor)) were measured. Barefoot peak pressure was increased in persons with current and previous compared to no previous foot ulceration (mean±SD=888±222 and 763±335 vs 465±262kPa, p<0.05). In-shoe peak pressure was only increased in persons with current compared to without previous ulceration (mean±SD=412±145 vs 269±70kPa, p<0.05). Daily cumulative stress was not different between groups, although persons with current and previous foot ulceration were less active. Although barefoot peak pressure was increased in people with current and previous plantar ulceration, it did not discriminate between these groups. While in-shoe peak pressure was increased in persons with current ulceration, they were less active, resulting in no difference in daily cumulative stress. Increased in-shoe peak pressure suggests insufficient pressure reducing footwear in persons with current ulceration, highlighting the importance of pressure reducing qualities of footwear. Copyright © 2012 Elsevier B.V. All rights reserved.

  2. Immediacy bias in emotion perception: current emotions seem more intense than previous emotions.

    PubMed

    Van Boven, Leaf; White, Katherine; Huber, Michaela

    2009-08-01

    People tend to perceive immediate emotions as more intense than previous emotions. This immediacy bias in emotion perception occurred for exposure to emotional but not neutral stimuli (Study 1), when emotional stimuli were separated by both shorter (2 s; Studies 1 and 2) and longer (20 min; Studies 3, 4, and 5) delays, and for emotional reactions to pictures (Studies 1 and 2), films (Studies 3 and 4), and descriptions of terrorist threats (Study 5). The immediacy bias may be partly caused by immediate emotion's salience, and by the greater availability of information about immediate compared with previous emotion. Consistent with emotional salience, when people experienced new emotions, they perceived previous emotions as less intense than they did initially (Studies 3 and 5)-a change in perception that did not occur when people did not experience a new immediate emotion (Study 2). Consistent with emotional availability, reminding people that information about emotions naturally decays from memory reduced the immediacy bias by making previous emotions seem more intense (Study 4). Discussed are implications for psychological theory and other judgments and behaviors.

  3. From randomized controlled trials to observational studies.

    PubMed

    Silverman, Stuart L

    2009-02-01

    Randomized controlled trials are considered the gold standard in the hierarchy of research designs for evaluating the efficacy and safety of a treatment intervention. However, their results can have limited applicability to patients in clinical settings. Observational studies using large health care databases can complement findings from randomized controlled trials by assessing treatment effectiveness in patients encountered in day-to-day clinical practice. Results from these designs can expand upon outcomes of randomized controlled trials because of the use of larger and more diverse patient populations with common comorbidities and longer follow-up periods. Furthermore, well-designed observational studies can identify clinically important differences among therapeutic options and provide data on long-term drug effectiveness and safety.

  4. Oxidative stress biomarkers in pediatric sepsis: a prospective observational pilot study.

    PubMed

    Molina, Víctor; von Dessauer, Bettina; Rodrigo, Ramón; Carvajal, Cristian

    2017-11-01

    Oxidative stress is known to participate in the progression of sepsis. Definite data regarding the behavior of oxidative stress biomarkers in pediatric sepsis is still lacking. This study hypothesized that oxidative stress occurs in pediatric sepsis and that the magnitude of the redox derangement is associated with worse clinical progression. Forty-two previously healthy pediatric patients with sepsis and a group of control subjects were included. Oxidative stress and inflammatory activity biomarkers were determined in blood samples. Patients were prospectively followed until their discharge or death. Patients with non-severe and severe sepsis showed higher levels of plasmatic antioxidant capacity, lower erythrocyte thiol index, lower superoxide dismutase and catalase activities, higher glutathione peroxidase activity, and higher plasmatic F 2 -isoprostanes concentration than controls. Patients with severe sepsis had higher NF-kappaB activation than those with non-severe sepsis. Although we observed changes in some biomarkers in patients with worse clinical evolution, the explored biomarkers did not correlate with clinical estimators of outcome. Oxidative stress occurs in pediatric sepsis, resulting in oxidative damage. The explored biomarkers are not useful as outcome predictors in the studied population. The behavior of these biomarkers still needs to be addressed in broader groups of pediatric patients with sepsis.

  5. Iodine-131 induced hepatotoxicity in previously healthy patients with Grave’s disease

    PubMed Central

    2013-01-01

    Objective To describe the association of the rare and serious complication of liver toxicity in previously healthy Grave’s disease (GD) patients after the treatment with radioactive iodine 131I (RAI). Case presentation We report the clinical, laboratory and pathologic findings of 2 cases of severe liver toxicity associated with the treatment with RAI in previously healthy patients with GD. Clinical examination and laboratory investigations excluded viral hepatitis, autoimmune hepatitis, granulomatous disease, primary biliary disease, extrahepatic biliary obstruction, and heart failure. Case 1: A previously healthy 52-years old man reportedly having a typical GD but following RAI treatment, concomitantly developed severe liver toxicity that required 1 week of treatment in hospital. Case 2: A previously healthy 34-years old woman is reported as having a typical GD but developed jaundice following RAI treatment that required several weeks of in hospital treatment in the hepato-biliary department. In both cases, the liver dysfunction resolved after intensive treatment with hepato-protective agents. In this report the therapeutic considerations as well as the pathogenetic possibilities are reviewed. Conclusion To the best of our knowledge, this is the first description of the association observed, which is rare but may be severe and should be considered in any case of thyrotoxicosis where a liver dysfunction develops after the treatment with radioactive iodine 131I. PMID:23497434

  6. Postpartum education and lifestyle changes for preventing type 2 diabetes in Turkish women with previous gestational diabetes: A retrospective study.

    PubMed

    Aluş Tokat, Merlinda; Sancı, Muzafer; Girgeç, Semra; Kulhan, Nur Gözde; Özcan, Çiler Yeygel

    2016-10-01

    Women with previous gestational diabetes mellitus (GDM) have at least sevenfold increased risk for developing type 2 diabetes compared with non-GDM mothers. The risk can be decreased by self-care measures. The aim of this study was to explore the postpartum education and lifestyle changes of Turkish women with previous GDM. This was a retrospective descriptive epidemiological study. A total of 111 women who had given birth within the previous 3-4 years were interviewed by telephone between December 2013 and April 2014. The 83.8% of the women with GDM had not received education related to exercise, while 40.5% received no education regarding the importance of diet. More importantly, while 68.5% had been informed about testing blood glucose levels postpartum, a large majority, 69.3%, did not know for how long they would have had to continue testing their glucose levels. However, 31.3% of those who monitored their glucose levels had glucose intolerance. In terms of lifestyle changes, less than half of the women, 48.6%, had made changes in their diet and the majority, 51.4%, were inactive. Women need access to sustained education and supportive counselling both to motivate and to minimize the risk of type 2 diabetes after GDM. © 2016 John Wiley & Sons Australia, Ltd.

  7. CAMS confirmation of previously reported meteor showers

    NASA Astrophysics Data System (ADS)

    Jenniskens, P.; Nénon, Q.; Gural, P. S.; Albers, J.; Haberman, B.; Johnson, B.; Holman, D.; Morales, R.; Grigsby, B. J.; Samuels, D.; Johannink, C.

    2016-03-01

    Leading up to the 2015 IAU General Assembly, the International Astronomical Union's Working List of Meteor Showers included 486 unconfirmed showers, showers that are not certain to exist. If confirmed, each shower would provide a record of past comet or asteroid activity. Now, we report that 41 of these are detected in the Cameras for Allsky Meteor Surveillance (CAMS) video-based meteor shower survey. They manifest as meteoroids arriving at Earth from a similar direction and orbit, after removing the daily radiant drift due to Earth's motion around the Sun. These showers do exist and, therefore, can be moved to the IAU List of Established Meteor Showers. This adds to 31 previously confirmed showers from CAMS data. For each shower, finding charts are presented based on 230,000 meteors observed up to March of 2015, calculated by re-projecting the drift-corrected Sun-centered ecliptic coordinates into more familiar equatorial coordinates. Showers that are not detected, but should have, and duplicate showers that project to the same Sun-centered ecliptic coordinates, are recommended for removal from the Working List.

  8. [Electronic cigarettes - effects on health. Previous reports].

    PubMed

    Napierała, Marta; Kulza, Maksymilian; Wachowiak, Anna; Jabłecka, Katarzyna; Florek, Ewa

    2014-01-01

    Currently very popular in the market of tobacco products have gained electronic cigarettes (ang. E-cigarettes). These products are considered to be potentially less harmful in compared to traditional tobacco products. However, current reports indicate that the statements of the producers regarding to the composition of the e- liquids not always are sufficient, and consumers often do not have reliable information on the quality of the product used by them. This paper contain a review of previous reports on the composition of e-cigarettes and their impact on health. Most of the observed health effects was related to symptoms of the respiratory tract, mouth, throat, neurological complications and sensory organs. Particularly hazardous effects of the e-cigarettes were: pneumonia, congestive heart failure, confusion, convulsions, hypotension, aspiration pneumonia, face second-degree burns, blindness, chest pain and rapid heartbeat. In the literature there is no information relating to passive exposure by the aerosols released during e-cigarette smoking. Furthermore, the information regarding to the use of these products in the long term are not also available.

  9. A day-to-day comparison study of Seasat scatterometer winds with winds observed from islands in the tropical Pacific

    NASA Technical Reports Server (NTRS)

    Davison, Jerry; Harrison, D. E.

    1989-01-01

    The winds derived from the Seasat-A Satellite Scatterometer (SASS) measurements have been the subject of great interest since the 1978 mission, because of the promise of radically improved wind observations over the world ocean. Due to the early end of the mission, only a few of the planned ground truth validation experiments could be made, and the subsequent lack of sufficient high quality independent wind data for comparison has limited the ability to resolve critical issues regarding the scatterometer's performance and the correct interpretation of its signal. Operational weather observations were made of ocean winds independent of Seasat mission plans during the Seasat mission period; the results are reported of a comparison study using such observations. Previous verification with in situ winds has been primarily in middle latitudes (GOASEX, JASIN, and NDBO buoys); winds observed from nine tropical Pacific islands are compared with nearly contemporaneous measurements taken by SASS during overpasses of the islands.

  10. Improving visual observation skills through the arts to aid radiographic interpretation in veterinary practice: A pilot study.

    PubMed

    Beck, Cathy; Gaunt, Heather; Chiavaroli, Neville

    2017-09-01

    Radiographic interpretation is a perceptual and cognitive skill. Recently core veterinary radiology textbooks have focused on the cognitive (i.e., the clinical aspects of radiographic interpretation) rather than the features of visual observation that improve identification of abnormalities. As a result, the skill of visual observation is underemphasized and thus often underdeveloped by trainees. The study of the arts in medical education has been used to train and improve visual observation and empathy. The use of the arts to improve visual observation skills in Veterinary Science has not been previously described. Objectives of this pilot study were to adapt the existing Visual Arts in Health Education Program for medical and dental students at the University of Melbourne, Australia to third year Doctor of Veterinary Medicine students and evaluate their perceptions regarding the program's effects on visual observation skills and confidence with respect to radiographic interpretation. This adaptation took the form of a single seminar given to third year Doctor of Veterinary Medicine students. Following the seminar, students reported an improved approach to radiographic interpretation and felt they had gained skills which would assist them throughout their career. In the year following the seminar, written reports of the students who attended the seminar were compared with reports from a matched cohort of students who did not attend the seminar. This demonstrated increased identification of abnormalities and greater description of the abnormalities identified. Findings indicated that explicit training in visual observation may be a valuable adjunct to the radiology training of Doctor of Veterinary Medicine students. © 2017 American College of Veterinary Radiology.

  11. SABRE observations of Pi2 pulsations: case studies

    NASA Astrophysics Data System (ADS)

    Bradshaw, E. G.; Lester, M.

    1997-01-01

    The characteristics of substorm-associated Pi2 pulsations observed by the SABRE coherent radar system during three separate case studies are presented. The SABRE field of view is well positioned to observe the differences between the auroral zone pulsation signature and that observed at mid-latitudes. During the first case study the SABRE field of view is initially in the eastward electrojet, equatorward and to the west of the substorm-enhanced electrojet current. As the interval progresses, the western, upward field-aligned current of the substorm current wedge moves westward across the longitudes of the radar field of view. The westward motion of the wedge is apparent in the spatial and temporal signatures of the associated Pi2 pulsation spectra and polarisation sense. During the second case study, the complex field-aligned and ionospheric currents associated with the pulsation generation region move equatorward into the SABRE field of view and then poleward out of it again after the third pulsation in the series. The spectral content of the four pulsations during the interval indicate different auroral zone and mid-latitude signatures. The final case study is from a period of low magnetic activity when SABRE observes a Pi2 pulsation signature from regions equatorward of the enhanced substorm currents. There is an apparent mode change between the signature observed by SABRE in the ionosphere and that on the ground by magnetometers at latitudes slightly equatorward of the radar field of view. The observations are discussed in terms of published theories of the generation mechanisms for this type of pulsation. Different signatures are observed by SABRE depending on the level of magnetic activity and the position of the SABRE field of view relative to the pulsation generation region. A twin source model for Pi2 pulsation generation provides the clearest explanation of the signatures observed Acknowledgements. The authors are grateful to Prof. D. J. Southwood

  12. Empirical Performance of Covariates in Education Observational Studies

    ERIC Educational Resources Information Center

    Wong, Vivian C.; Valentine, Jeffrey C.; Miller-Bains, Kate

    2017-01-01

    This article summarizes results from 12 empirical evaluations of observational methods in education contexts. We look at the performance of three common covariate-types in observational studies where the outcome is a standardized reading or math test. They are: pretest measures, local geographic matching, and rich covariate sets with a strong…

  13. "Lies, damned lies ..." and observational studies in comparative effectiveness research.

    PubMed

    Albert, Richard K

    2013-06-01

    A new federal initiative has allocated $1.1 billion to comparative effectiveness research, and many have emphasized the importance of including observational studies in this effort. The rationale for using observational studies to assess comparative effectiveness is based on concerns that randomized controlled trials (RCTs) are not "real world" because they enroll homogeneous patient populations, measure study outcomes that are not important to patients, use protocols that are overly complex, are conducted in specialized centers, and use study treatments that are not consistent with usual care, and that RCTs are not always feasible because of a lack of equipoise, the need to assess delayed endpoints, and concerns that they take years to complete and are expensive. This essay questions the validity of each of these proposed limitations, summarizes concerns raised about the accuracy of results generated by observational studies, provides some examples of discrepancies between results of observational studies and RCTs that pertain to pulmonary and critical care, and suggests that using observational studies for comparative effectiveness research may increase rather than decrease the cost of health care and may harm patients.

  14. The Effect on Melanoma Risk of Genes Previously Associated With Telomere Length

    PubMed Central

    Bishop, D. Timothy; Taylor, John C.; Hayward, Nicholas K.; Brossard, Myriam; Cust, Anne E.; Dunning, Alison M.; Lee, Jeffrey E.; Moses, Eric K.; Akslen, Lars A.; Andresen, Per A.; Avril, Marie-Françoise; Azizi, Esther; Scarrà, Giovanna Bianchi; Brown, Kevin M.; Dębniak, Tadeusz; Elder, David E.; Friedman, Eitan; Ghiorzo, Paola; Gillanders, Elizabeth M.; Goldstein, Alisa M.; Gruis, Nelleke A.; Hansson, Johan; Harland, Mark; Helsing, Per; Hočevar, Marko; Höiom, Veronica; Ingvar, Christian; Kanetsky, Peter A.; Landi, Maria Teresa; Lang, Julie; Lathrop, G. Mark; Lubiński, Jan; Mackie, Rona M.; Martin, Nicholas G.; Molven, Anders; Montgomery, Grant W.; Novaković, Srdjan; Olsson, Håkan; Puig, Susana; Puig-Butille, Joan Anton; Radford-Smith, Graham L.; Randerson-Moor, Juliette; van der Stoep, Nienke; van Doorn, Remco; Whiteman, David C.; MacGregor, Stuart; Pooley, Karen A.; Ward, Sarah V.; Mann, Graham J.; Amos, Christopher I.; Pharoah, Paul D. P.; Demenais, Florence; Law, Matthew H.; Newton Bishop, Julia A.; Barrett, Jennifer H.

    2014-01-01

    Telomere length has been associated with risk of many cancers, but results are inconsistent. Seven single nucleotide polymorphisms (SNPs) previously associated with mean leukocyte telomere length were either genotyped or well-imputed in 11108 case patients and 13933 control patients from Europe, Israel, the United States and Australia, four of the seven SNPs reached a P value under .05 (two-sided). A genetic score that predicts telomere length, derived from these seven SNPs, is strongly associated (P = 8.92x10-9, two-sided) with melanoma risk. This demonstrates that the previously observed association between longer telomere length and increased melanoma risk is not attributable to confounding via shared environmental effects (such as ultraviolet exposure) or reverse causality. We provide the first proof that multiple germline genetic determinants of telomere length influence cancer risk. PMID:25231748

  15. Prevalence and titers of yellow fever virus neutralizing antibodies in previously vaccinated adults.

    PubMed

    Miyaji, Karina Takesaki; Avelino-Silva, Vivian Iida; Simões, Marisol; Freire, Marcos da Silva; Medeiros, Carlos Roberto de; Braga, Patrícia Emilia; Neves, Maria Angélica Acalá; Lopes, Marta Heloisa; Kallas, Esper Georges; Sartori, Ana Marli Christovam

    2017-04-03

    The World Health Organization (WHO) recommends one single dose of the Yellow Fever (YF) vaccine based on studies of antibody persistency in healthy adults. We assessed the prevalence and titers of YF virus neutralizing antibodies in previously vaccinated persons aged  60 years, in comparison to younger adults. We also evaluated the correlation between antibody titers and the time since vaccination among participants who received one vaccine dose, and the seropositivity among participants vaccinated prior to or within the past 10 years. previously vaccinated healthy persons aged  18 years were included. YF virus neutralizing antibody titers were determined by means of the 50% Plaque Reduction Neutralization Test. 46 persons aged  60 years and 48 persons aged 18 to 59 years were enrolled. There was no significant difference in the prevalence of YF virus neutralizing antibodies between the two groups (p = 0.263). However, titers were significantly lower in the elderly (p = 0.022). There was no correlation between YF virus neutralizing antibody titers and the time since vaccination. There was no significant difference in seropositivity among participants vaccinated prior to or within the past 10 years. the clinical relevance of the observed difference in YF virus neutralizing antibody titers between the two groups is not clear.

  16. STRengthening Analytical Thinking for Observational Studies: the STRATOS initiative

    PubMed Central

    Sauerbrei, Willi; Abrahamowicz, Michal; Altman, Douglas G; le Cessie, Saskia; Carpenter, James

    2014-01-01

    The validity and practical utility of observational medical research depends critically on good study design, excellent data quality, appropriate statistical methods and accurate interpretation of results. Statistical methodology has seen substantial development in recent times. Unfortunately, many of these methodological developments are ignored in practice. Consequently, design and analysis of observational studies often exhibit serious weaknesses. The lack of guidance on vital practical issues discourages many applied researchers from using more sophisticated and possibly more appropriate methods when analyzing observational studies. Furthermore, many analyses are conducted by researchers with a relatively weak statistical background and limited experience in using statistical methodology and software. Consequently, even ‘standard’ analyses reported in the medical literature are often flawed, casting doubt on their results and conclusions. An efficient way to help researchers to keep up with recent methodological developments is to develop guidance documents that are spread to the research community at large. These observations led to the initiation of the strengthening analytical thinking for observational studies (STRATOS) initiative, a large collaboration of experts in many different areas of biostatistical research. The objective of STRATOS is to provide accessible and accurate guidance in the design and analysis of observational studies. The guidance is intended for applied statisticians and other data analysts with varying levels of statistical education, experience and interests. In this article, we introduce the STRATOS initiative and its main aims, present the need for guidance documents and outline the planned approach and progress so far. We encourage other biostatisticians to become involved. PMID:25074480

  17. STRengthening analytical thinking for observational studies: the STRATOS initiative.

    PubMed

    Sauerbrei, Willi; Abrahamowicz, Michal; Altman, Douglas G; le Cessie, Saskia; Carpenter, James

    2014-12-30

    The validity and practical utility of observational medical research depends critically on good study design, excellent data quality, appropriate statistical methods and accurate interpretation of results. Statistical methodology has seen substantial development in recent times. Unfortunately, many of these methodological developments are ignored in practice. Consequently, design and analysis of observational studies often exhibit serious weaknesses. The lack of guidance on vital practical issues discourages many applied researchers from using more sophisticated and possibly more appropriate methods when analyzing observational studies. Furthermore, many analyses are conducted by researchers with a relatively weak statistical background and limited experience in using statistical methodology and software. Consequently, even 'standard' analyses reported in the medical literature are often flawed, casting doubt on their results and conclusions. An efficient way to help researchers to keep up with recent methodological developments is to develop guidance documents that are spread to the research community at large. These observations led to the initiation of the strengthening analytical thinking for observational studies (STRATOS) initiative, a large collaboration of experts in many different areas of biostatistical research. The objective of STRATOS is to provide accessible and accurate guidance in the design and analysis of observational studies. The guidance is intended for applied statisticians and other data analysts with varying levels of statistical education, experience and interests. In this article, we introduce the STRATOS initiative and its main aims, present the need for guidance documents and outline the planned approach and progress so far. We encourage other biostatisticians to become involved. © 2014 The Authors. Statistics in Medicine published by John Wiley & Sons, Ltd.

  18. Effects of anticoagulant therapy on pregnancy outcomes in patients with thrombophilia and previous poor obstetric history.

    PubMed

    Mutlu, Ilknur; Mutlu, Mehmet Firat; Biri, Aydan; Bulut, Berk; Erdem, Mehmet; Erdem, Ahmet

    2015-04-01

    This study investigates the effects of anticoagulant therapy on pregnancy outcomes in 204 patients with thrombophilia and previous poor obstetric outcomes. Patients with poor obstetric history (pre-eclampsia, intrauterine growth retardation, fetal death, placental abruption, recurrent pregnancy loss) and having hereditary thrombophilia were included in this study. Poor obstetric outcomes were observed more frequently in patients who had not taken anticogulant therapy compared with treated group. Live birth rate, gestational age at birth and Apgar scores were significantly higher in the treated group when compared with the untreated group. There were no significant differences in terms of birthweight, mode of delivery and admission rates to the neonatal intensive care unit (NICU). Low-molecular-weight heparin (LMWH) plus acetylsalicylic acid (ASA) had higher gestational age at birth, Apgar scores, live birth rate and a lower abortion rates when compared with controls; in contrast, no significant difference was observed in terms of birthweight, mode of delivery, obstetric complications and admission rates to NICU. There were no significant differences between control group and both LMWH only and ASA only groups in terms of gestational age at birth, Apgar scores, birthweight, mode of delivery, obstetric complications and admission rates to NICU. Only LMWH group had higher live birth rate as compared with control group. The use of only ASA did not seem to affect the perinatal complication rates and outcomes. In conclusion, anticoagulant therapy with both LMWH and ASA seems to provide better obstetric outcomes in pregnant women with thrombophilia and previous poor obstetric outcomes.

  19. A Variational Inverse Model Study of Amazonian Methane Emissions including Observations from the AMAZONICA campaign

    NASA Astrophysics Data System (ADS)

    Wilson, C. J.; Gloor, M.; Chipperfield, M.; Miller, J. B.; Gatti, L.

    2013-12-01

    reproduce these observations. Although there is mostly good agreement between the modelled and observed CH4, we find discrepancies between the two at one site in the east of the region, indicating possible errors surrounding the surface fluxes of methane affecting this site. We also present the results of an inverse modelling study of methane emissions for the year 2010, using INVICAT, which is a new variational inverse model based upon TOMCAT. This study represents the first use of the INVICAT scheme to constrain emissions of an atmospheric trace gas. Similarly to many previous inverse model studies, this top-down study assimilates ground-based flask observations of CH4 from the NOAA ground network. However, in order to provide additional constraints of CH4 emissions in the Amazon region, flask observations taken as part of the AMAZONICA campaign are also assimilated. The results of this inversion provide improved Amazonian and global CH4 emission budgets for the year 2010.

  20. [Preliminary study on detox in outpatient care units with 18 alcoholic patients in Directly Observed Treatment].

    PubMed

    Lloréns Martínez, Ramón; Calatayud Francés, María; Morales Gallús, Esperanza; Añó Cervera, Consol; Adriá Caballero, Librada

    2008-01-01

    Directly Observed Treatment (TOD-DOT) has been tested in different conditions. The objective of this work is to check whether a UCA-CAB (Centre for Addictive Behaviour) can achieve detox and reduce the risk of early relapse (up to 12 weeks) in alcoholic patients. All patients had an established organic addiction and serious withdrawal syndrome, and had undergone multiple previous treatments. Furthermore, they had not managed to abstain for a 3-month consecutive period over the previous 2 years. The aim of the Directly Observed Treatment was to attain detox and reduce relapse by following a multi-method approach: medical, psychological and personal care, based on a brief daily consultation and pharmacological supervision. The results were as follows: Of the 18 patients included in the study, after 12 weeks, 13 (72 %) were still abstinent and 4 (22 %) had relapsed. Thus, 17 (94 %) were still following the treatment, with just one drop-out. We analysed the profiles of the patients abstaining, of those who relapsed (4) and of the one who dropped out. The average CIWA-Ar was 27.05 (21-36). Any value over 20 is considered to indicate serious withdrawal syndrome, though there were no negative events leading to hospitalization. Level of adherence to the treatment (94 %) meant that the most seriously affected patients and those with fewest financial resources could benefit, not only from any auxiliary social schemes, but also from basic health services, permitting them to improve the quality of their everyday life.

  1. An Observational Study of Antibiotic Prescribing Behavior and the Hawthorne Effect

    PubMed Central

    Mangione-Smith, Rita; Elliott, Marc N; McDonald, Laurie; McGlynn, Elizabeth A

    2002-01-01

    Objectives To assess whether prospective, observational study procedures, including questionnaires and audio recording, are associated with different patterns of physician diagnostic decision making and antibiotic prescribing. Data Sources/Setting (1) Survey data from a prospective observational study of treatment patterns for children with acute upper respiratory illnesses (10/96–3/97) and (2) retrospective medical record abstraction data of nonobserved encounters for the same problems occurring during (10/96–3/97) and one year after (10/97–3/98) the observational study period. Ten pediatricians in two community practices were studied. Study Design Patterns of diagnoses recorded in the medical record and antibiotics ordered for visits occurring outside of the observational study (same time period and one year later) were compared with the pattern of diagnoses and antibiotics ordered during the observational study. Data Collection/Extraction Methods For the observational study (10/96–2/97), diagnosis and treatment choices were obtained from questionnaires completed by physicians immediately following the visit. For the nonstudy encounters (10/96–3/97 and 10/97–3/98), data were abstracted from medical records one year after the observational study was completed. Principal Findings The proportion of viral cases in which an antibiotic was prescribed was 29 percentage points lower for the observational study compared to the retrospective analysis (p <.05). In one of two study sites, the proportion of cases assigned a bacterial diagnosis was 29 percentage points lower in the observational study period compared to the retrospective study (p <.05). Conclusions Observational study procedures including questionnaires and audio recording can affect antibiotic prescribing behavior. Future observational studies aimed at examining the frequency of inappropriate antibiotic prescribing should measure and adjust for the Hawthorne effect; without such adjustments, the

  2. Does Observation of Postural Imbalance Induce a Postural Reaction?

    PubMed Central

    Tia, Banty; Saimpont, Arnaud; Paizis, Christos; Mourey, France; Fadiga, Luciano; Pozzo, Thierry

    2011-01-01

    Background Several studies bring evidence that action observation elicits contagious responses during social interactions. However automatic imitative tendencies are generally inhibited and it remains unclear in which conditions mere action observation triggers motor behaviours. In this study, we addressed the question of contagious postural responses when observing human imbalance. Methodology/Principal Findings We recorded participants' body sway while they observed a fixation cross (control condition), an upright point-light display of a gymnast balancing on a rope, and the same point-light display presented upside down. Our results showed that, when the upright stimulus was displayed prior to the inverted one, centre of pressure area and antero-posterior path length were significantly greater in the upright condition compared to the control and upside down conditions. Conclusions/Significance These results demonstrate a contagious postural reaction suggesting a partial inefficiency of inhibitory processes. Further, kinematic information was sufficient to trigger this reaction. The difference recorded between the upright and upside down conditions indicates that the contagion effect was dependent on the integration of gravity constraints by body kinematics. Interestingly, the postural response was sensitive to habituation, and seemed to disappear when the observer was previously shown an inverted display. The motor contagion recorded here is consistent with previous work showing vegetative output during observation of an effortful movement and could indicate that lower level control facilitates contagion effects. PMID:21423622

  3. Newly diagnosed and previously known diabetes mellitus and short-term outcomes in patients with acute myocardial infarction.

    PubMed

    Tian, Li; Wei, Chang; Zhu, Jun; Liu, Lisheng; Liang, Yan; Li, Jiandong; Yang, Yanmin

    2013-12-01

    The prognostic value of diabetes mellitus (DM) on the long-term outcomes of patients after myocardial infarction has been well established. The correlation between DM, including newly diagnosed DM, and short-term outcomes needs to be validated. A total of 5410 ST-segment elevation myocardial infarction (STEMI) patients with typical chest pain onset in the past 12 h were enrolled. Follow-ups were carried out on days 7 and 30 after hospital admission. According to 2013 Standards of Medical Care in Diabetes, the study population was stratified into the following three groups: no diabetes, newly diagnosed diabetes, and previously known diabetes. The primary outcomes of our study were mortality from all causes and major adverse cardiac events (MACE) at days 7 and 30. Patients with previously known diabetes were older and had a higher incidence of previous history of cardiovascular disease compared with the other groups. The 7-day and 30-day mortality was similar between patients without DM and patients with newly diagnosed DM. For both groups, this was significantly lower than that in patients with DM. Similar results were observed for 7-day and 30-day MACE. Multivariable Cox regression analysis indicated that newly diagnosed diabetes did not correlate with 30-day MACE (hazard ratio, 0.901; 95% confidence interval, 0.759-1.069), but that previously known DM correlated with short-term MACE (hazard ratio, 1.211; 95% confidence interval, 1.009-1.453). Previously known DM, but not newly diagnosed DM, was an independent predictor for short-term MACE in patients with STEMI. To reduce the incidence of short-term MACE and the detrimental effects of stress hyperglycemia after STEMI, intensive insulin therapy should be provided to diabetic patients with STEMI.

  4. Outcomes of Induction of Labour in Women with Previous Caesarean Delivery: A Retrospective Cohort Study Using a Population Database

    PubMed Central

    Stock, Sarah J.; Ferguson, Evelyn; Duffy, Andrew; Ford, Ian; Chalmers, James; Norman, Jane E.

    2013-01-01

    Background There is evidence that induction of labour (IOL) around term reduces perinatal mortality and caesarean delivery rates when compared to expectant management of pregnancy (allowing the pregnancy to continue to await spontaneous labour or definitive indication for delivery). However, it is not clear whether IOL in women with a previous caesarean section confers the same benefits. The aim of this study was to describe outcomes of IOL at 39–41 weeks in women with one previous caesarean delivery and to compare outcomes of IOL or planned caesarean delivery to those of expectant management. Methods and Findings We performed a population-based retrospective cohort study of singleton births greater than 39 weeks gestation, in women with one previous caesarean delivery, in Scotland, UK 1981–2007 (n = 46,176). Outcomes included mode of delivery, perinatal mortality, neonatal unit admission, postpartum hemorrhage and uterine rupture. 40.1% (2,969/7,401) of women who underwent IOL 39–41 weeks were ultimately delivered by caesarean. When compared to expectant management IOL was associated with lower odds of caesarean delivery (adjusted odds ratio [AOR] after IOL at 39 weeks of 0.81 [95% CI 0.71–0.91]). There was no significant effect on the odds of perinatal mortality but greater odds of neonatal unit admission (AOR after IOL at 39 weeks of 1.29 [95% CI 1.08–1.55]). In contrast, when compared with expectant management, elective repeat caesarean delivery was associated with lower perinatal mortality (AOR after planned caesarean at 39 weeks of 0.23 [95% CI 0.07–0.75]) and, depending on gestation, the same or lower neonatal unit admission (AOR after planned caesarean at 39 weeks of 0.98 [0.90–1.07] at 40 weeks of 1.08 [0.94–1.23] and at 41 weeks of 0.77 [0.60–1.00]). Conclusions A more liberal policy of IOL in women with previous caesarean delivery may reduce repeat caesarean delivery, but increases the risks of neonatal complications. PMID:23565242

  5. Competition Between Fusarium pseudograminearum and Cochliobolus sativus Observed in Field and Greenhouse Studies.

    PubMed

    Troth, Erin E Gunnink; Johnston, Jeffrey A; Dyer, Alan T

    2018-02-01

    Among root pathogens, one of the most documented antagonisms is the suppression of Cochliobolus sativus by Fusarium (roseum) species. Unfortunately, previous studies involved single isolates of each pathogen and thus, provided no indication of the spectrum of responses that occur across the respective species. To investigate the variability in interactions between Cochliobolus sativus and Fusarium pseudograminearum, field and greenhouse trials were conducted that included monitoring of spring wheat plant health and monitoring of pathogen populations via quantitative real-time polymerase chain reaction. The interactions between two isolates of C. sativus and four isolates of F. pseudograminearum were explored in three geographically distinct wheat fields. To complement field trials and to limit potentially confounding environmental variables that are often associated with field studies, greenhouse trials were performed that investigated the interactions among and between three isolates of C. sativus and four isolates of F. pseudograminearum. Across field locations, C. sativus isolate Cs2344 consistently and significantly reduced Fusarium populations by an average of 20.1%. Similarly, F. pseudograminearum isolate Fp2228 consistently and significantly reduced C. sativus field populations by an average of 30.9%. No interaction was detected in the field between pathogen species with regards to disease or crop losses. Greenhouse results confirmed a powerful (>99%), broadly effective suppression of Fusarium populations by isolate Cs2344. Among greenhouse trials, additional isolate-isolate interactions were observed affecting Fusarium populations. Due to lower C. sativus population sizes in greenhouse trials, significant Fusarium suppression of C. sativus was only detected in one isolate-isolate interaction. This study is the first to demonstrate suppression of Fusarium spp. by C. sativus in field and greenhouse settings. These findings also reveal a complex competitive

  6. A roadside study of observable driver distractions.

    PubMed

    Sullman, Mark J M; Prat, Francesc; Tasci, Duygu Kuzu

    2015-01-01

    This study investigated the prevalence of observable distractions while driving and the effect of drivers' characteristics and time-related variables on their prevalence. Using roadside observation, 2 independent observers collected data at 4 randomly selected locations in St. Albans, UK. Of the 10,984 drivers observed, 16.8% were engaged in a secondary task, with talking to passengers being the most common distraction (8.8%), followed by smoking (1.9%) and talking on a hands-free mobile phone (1.7%). An additional 1.0% were observed talking on a handheld phone, and the rest of the distractions (e.g., texting, drinking) were recorded in less than 1% of the drivers observed. Gender-related differences were found for a number of different distractions (i.e., talking to passengers, drinking, and handheld mobile phone conversations), but age emerged as a significant predictor for most secondary tasks, including talking to passengers, smoking, hands-free mobile phone use, handheld mobile phone use, texting/keying numbers, drinking, and engagement in any type of distraction (all distractions combined). The overall pattern for age was that middle-aged and older drivers were less likely to be distracted than younger drivers. This work provides further evidence of the relatively high rate of distracted driving in the UK. The findings clearly indicate that younger drivers are more likely to drive distracted, which probably contributes to their higher crash rates.

  7. Incidence and risk factors for oxygen desaturation during recovery from modified electroconvulsive therapy: A prospective observational study.

    PubMed

    Surve, Rohini; Bansal, Sonia; Sriganesh, Kamath; Subbakrishna, Doddaballapur Kumaraswamy; Thirthalli, Jagadisha; Umamaheswara Rao, Ganne Sesha

    2015-01-01

    Electroconvulsive therapy (ECT) is an established modality of treatment for severe psychiatric illnesses. Among the various complications associated with ECT, oxygen desaturation is often under reported. None of the previous studies has evaluated the predictive factors for oxygen desaturation during ECT. The objective of this study was to evaluate the incidence of oxygen desaturation during recovery from anesthesia for modified ECT and evaluate its risk factors in a large sample. All patients aged above 15 years who were prescribed a modified ECT for their psychiatric illness over 1 year were prospectively included in this observational study. The association between age, body mass index (BMI), doses of thiopentone and suxamethonium, stimulus current, ECT session number, pre- and post-ECT heart rate and mean arterial pressure, seizure duration, and pre- and post ECT oxygen saturation, was systematically studied. The incidence of oxygen desaturation was 29% (93/316 patients). Seizure duration and BMI were found to be significantly correlated with post ECT desaturation. In this prospective observational study, the incidence of oxygen desaturation during recovery from anesthesia for ECT was high. The study identified obesity and duration of seizure as the independent predictors of this complication. This knowledge is likely to help in identifying and optimizing such patients before subsequent ECT sessions.

  8. An Observational Study of Skilled Memory in Waitresses.

    ERIC Educational Resources Information Center

    Stevens, Joy

    A two-phase study about skilled memory as it is used by waitresses included a participant-observer phase and an observational phase. Participants were three experienced waitresses who had worked at a midtown Manhattan restaurant for 14, 7, and 3 years respectively and a team of 5 confederate customers. Waitresses and customers wore microphones.…

  9. The NOAA Satellite Observing System Architecture Study

    NASA Technical Reports Server (NTRS)

    Volz, Stephen; Maier, Mark; Di Pietro, David

    2016-01-01

    NOAA is beginning a study, the NOAA Satellite Observing System Architecture (NSOSA) study, to plan for the future operational environmental satellite system that will follow GOES and JPSS, beginning about 2030. This is an opportunity to design a modern architecture with no pre-conceived notions regarding instruments, platforms, orbits, etc. The NSOSA study will develop and evaluate architecture alternatives to include partner and commercial alternatives that are likely to become available. The objectives will include both functional needs and strategic characteristics (e.g., flexibility, responsiveness, sustainability). Part of this study is the Space Platform Requirements Working Group (SPRWG), which is being commissioned by NESDIS. The SPRWG is charged to assess new or existing user needs and to provide relative priorities for observational needs in the context of the future architecture. SPRWG results will serve as input to the process for new foundational (Level 0 and Level 1) requirements for the next generation of NOAA satellites that follow the GOES-R, JPSS, DSCOVR, Jason-3, and COSMIC-2 missions.

  10. Survival after postoperative morbidity: a longitudinal observational cohort study.

    PubMed

    Moonesinghe, S R; Harris, S; Mythen, M G; Rowan, K M; Haddad, F S; Emberton, M; Grocott, M P W

    2014-12-01

    Previous studies have suggested that there may be long-term harm associated with postoperative complications. Uncertainty exists however, because of the need for risk adjustment and inconsistent definitions of postoperative morbidity. We did a longitudinal observational cohort study of patients undergoing major surgery. Case-mix adjustment was applied and morbidity was recorded using a validated outcome measure. Cox proportional hazards modelling using time-dependent covariates was used to measure the independent relationship between prolonged postoperative morbidity and longer term survival. Data were analysed for 1362 patients. The median length of stay was 9 days and the median follow-up time was 6.5 yr. Independent of perioperative risk, postoperative neurological morbidity (prevalence 2.9%) was associated with a relative hazard for long-term mortality of 2.00 [P=0.001; 95% confidence interval (CI) 1.32-3.04]. Prolonged postoperative morbidity (prevalence 15.6%) conferred a relative hazard for death in the first 12 months after surgery of 3.51 (P<0.001; 95% CI 2.28-5.42) and for the next 2 yr of 2.44 (P<0.001; 95% CI 1.62-3.65), returning to baseline thereafter. Prolonged morbidity after surgery is associated with a risk of premature death for a longer duration than perhaps is commonly thought; however, this risk falls with time. We suggest that prolonged postoperative morbidity measured in this way may be a valid indicator of the quality of surgical healthcare. Our findings reinforce the importance of research and quality improvement initiatives aimed at reducing the duration and severity of postoperative complications. © The Author 2014. Published by Oxford University Press on behalf of the British Journal of Anaesthesia.

  11. Community Engagement in Observational Human Exposure Studies

    EPA Science Inventory

    Although observational human exposure studies do not deliberately expose participants to chemicals or environmental conditions, merely involving people as research participants and conducting research inside homes raises ethical issues. Community engagement offers a promising st...

  12. Intrinsic scatter of caustic masses and hydrostatic bias: An observational study

    NASA Astrophysics Data System (ADS)

    Andreon, S.; Trinchieri, G.; Moretti, A.; Wang, J.

    2017-10-01

    All estimates of cluster mass have some intrinsic scatter and perhaps some bias with true mass even in the absence of measurement errors for example caused by cluster triaxiality and large scale structure. Knowledge of the bias and scatter values is fundamental for both cluster cosmology and astrophysics. In this paper we show that the intrinsic scatter of a mass proxy can be constrained by measurements of the gas fraction because masses with higher values of intrinsic scatter with true mass produce more scattered gas fractions. Moreover, the relative bias of two mass estimates can be constrained by comparing the mean gas fraction at the same (nominal) cluster mass. Our observational study addresses the scatter between caustic (I.e., dynamically estimated) and true masses, and the relative bias of caustic and hydrostatic masses. For these purposes, we used the X-ray Unbiased Cluster Sample, a cluster sample selected independently from the intracluster medium content with reliable masses: 34 galaxy clusters in the nearby (0.050 < z < 0.135) Universe, mostly with 14 < log M500/M⊙ ≲ 14.5, and with caustic masses. We found a 35% scatter between caustic and true masses. Furthermore, we found that the relative bias between caustic and hydrostatic masses is small, 0.06 ± 0.05 dex, improving upon past measurements. The small scatter found confirms our previous measurements of a highly variable amount of feedback from cluster to cluster, which is the cause of the observed large variety of core-excised X-ray luminosities and gas masses.

  13. Influence of social and built environment features on children walking to school: an observational study.

    PubMed

    Rothman, Linda; To, Teresa; Buliung, Ron; Macarthur, Colin; Howard, Andrew

    2014-03-01

    To estimate the proportion of children living within walking distance who walk to school in Toronto, Canada and identify built and social environmental correlates of walking. Observational counts of school travel mode were done in 2011, at 118 elementary schools. Built environment data were obtained from municipal sources and school field audits and mapped onto school attendance boundaries. The influence of social and built environmental features on walking counts was analyzed using negative binomial regression. The mean proportion observed walking was 67% (standard deviation=14.0). Child population (incidence rate ratio (IRR) 1.36), pedestrian crossover (IRR 1.32), traffic light (IRR 1.19), and intersection densities (IRR 1.03), school crossing guard (IRR 1.14) and primary language other than English (IRR 1.20) were positively correlated with walking. Crossing guard presence reduced the influence of other features on walking. This is the first large observational study examining school travel mode and the environment. Walking proportions were higher than those previously reported in Toronto, with large variability. Associations between population density and several roadway design features and walking were confirmed. School crossing guards may override the influence of roadway features on walking. Results have important implications for policies regarding walking promotion. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

  14. Analytical study of body waves in orthorhombic media and comparison with SKS-phase observations from selected stations

    NASA Astrophysics Data System (ADS)

    Löberich, Eric; Bokelmann, Götz

    2016-04-01

    Anisotropic effects of wave propagation, observed in the Earth, provide interesting applications in basic research and practice, e.g., in reservoir geophysics and other fields. Teleseismic waves often evidence upper mantle anisotropy, as created by aligned olivine grains. While each grain is associated with orthorhombic symmetry, the preferred alignment may lead to a transversely isotropic characteristic. Considering body waves passing through an anisotropic medium, a splitting of shear waves can usually be observed, since their transverse polarization leads to a separation of the two quasi-shear waves. The associated splitting-delay is generated if the related fast and slow seismic velocities differ. Most of the previous shear-wave splitting investigations were based on the common assumption of near-vertical incidence. However, the influence of increasing incidence angles, which may lead to angular dependent splitting-delay and fast polarization orientation, has been pointed out by Davis (2003). Our study investigates the occurrence of these postulated dependences on azimuth and incidence angle (distance), examining splitting observations in SKS-recordings at selected broadband stations (e.g., Djibouti and Red Lake, Ontario).

  15. Economic impact of feeding a phenylalanine-restricted diet to adults with previously untreated phenylketonuria.

    PubMed

    Brown, M C; Guest, J F

    1999-02-01

    The aim of the present study was to estimate the direct healthcare cost of managing adults with previously untreated phenylketonuria (PKU) for one year before any dietary restrictions and for the first year after a phenylalanine- (PHE-) restricted diet was introduced. The resource use and corresponding costs were estimated from medical records and interviews with health care professionals experienced in caring for adults with previously untreated PKU. The mean annual cost of caring for a client being fed an unrestricted diet was estimated to be 83 996 pound silver. In the first year after introducing a PHE-restricted diet, the mean annual cost was reduced by 20 647 pound silver to 63 348 pound silver as a result of a reduction in nursing time, hospitalizations, outpatient clinic visits and medications. However, the economic benefit of the diet depended on whether the clients were previously high or low users of nursing care. Nursing time was the key cost-driver, accounting for 79% of the cost of managing high users and 31% of the management cost for low users. In contrast, the acquisition cost of a PHE-restricted diet accounted for up to 6% of the cost for managing high users and 15% of the management cost for low users. Sensitivity analyses showed that introducing a PHE-restricted diet reduces the annual cost of care, provided that annual nursing time was reduced by more than 8% or more than 5% of clients respond to the diet. The clients showed fewer negative behaviours when being fed a PHE-restricted diet, which may account for the observed reduction in nursing time needed to care for these clients. In conclusion, feeding a PHE-restricted diet to adults with previously untreated PKU leads to economic benefits to the UK's National Health Service and society in general.

  16. Observational Study of Morphological Changes in Medium-mass Evolved Stars

    NASA Astrophysics Data System (ADS)

    Chong, Sze-Ning

    2014-02-01

    Medium-mass (or intermediate-mass) stars refer to main sequence stars with masses ranging from 0.4 to 8 solar masses. These stars are believed to finally evolve into the central stars of planetary nebulae (PNe) and white dwarfs. One of the fascinating aspects of PNe is their diverse morphology. To understand the mechanisms of the morphological changes from spherical circumstellar envelopes (CSEs) of asymptotic giant branch (AGB) stars to those forming highly diversified PNe, it is necessary to investigate the true three-dimensional (3D) morphology of PNe from two-dimensional images, and the short transition phase in-between the two phases should also be explored. "Water Fountain" (WF) sources belong to transition phase objects; they are AGB or post-AGB stars with collimated jets traced by high velocity water maser emissions in their CSEs. This thesis comprises of four chapters. The results can be divided into two major parts. Chapter 1 is the introduction on the related fields with brief reviews of previous observational studies on PNe and the rapidly evolving transition phase objects. Basic theories necessary for understanding the next chapters were also described, including those explaining the commonly observed Hα emission in PNe, the formation of multipolar PNe, the maser emission and the role of shock in circumstellar materials. The first major part of the results, about the morphological classification of multipolar PNe, is presented in Chapter 2. At the beginning of the chapter, the problems on the previous classification methods were pointed out. Then a three-lobed model was introduced. By changing the combination of the orientations of the three pairs of lobes, simulations using the model produced statistical results in classification and quantified the errors of misidentification. Assuming that all PNe observed have the true structure of three lobes, due to projection effect, only 49% of them would be correctly classified. 46% and 5% of them would be

  17. The advances in airglow study and observation by the ground-based airglow observation network over China

    NASA Astrophysics Data System (ADS)

    Xu, Jiyao; Li, Qinzeng; Yuan, Wei; Liu, Xiao; Liu, Weijun; Sun, Longchang

    2017-04-01

    Ground-based airglow observation networks over China used to study airglow have been established, which contains 15 stations. Some new results were obtained using the networks. For OH airglow observations, firstly, an unusual outbreak of Concentric Gravity Wave (CGW) events were observed by the first no-gap network nearly every night during the first half of August 2013. Combination of the ground imager network with satellites provides multilevel observations of the CGWs from the troposphere to the mesopause region. Secondly, three-year OH airglow images (2012-2014) from Qujing (25.6°N, 103.7°E) were used to study how orographic features of the Tibetan Plateau (TP) affect the geographical distributions of gravity wave (GW) sources. We find the orographic forcings have a significant impact on the gravity wave propagation features. Thirdly, ground-based observations of the OH (9-4, 8-3, 6-2, 5-1, 3-0) band airglow over Xinglong (40°2N, 117°4E) in northern China from 2012 to 2014 are used to calculate rotational temperatures. By comparing the ground-based OH rotational temperature with SABER's observations, five Einstein coefficient datasets are evaluated. We find rotational temperatures determined using any of the available Einstein coefficient datasets have systematic errors. We have obtained a set of optimal Einstein coefficients ratios for rotational temperature derivation using three years data from ground-based OH spectra and SABER temperatures. For the OI 630.0 nm airglow observations, we used three-year (2011-2013) observations of thermospheric winds (at 250 km) by Fabry-Perot interferometers at Xinglong to study the climatology of atmospheric planetary wave-type oscillations (PWTOs) with periods of 4-19 days. We found these PWTOs occur more frequently in the months from May to October. They are consistent with the summertime preference of middle-latitude ionospheric electron density oscillations noted in other studies. By using an all-sky airglow imager

  18. Gender, body weight, disease activity, and previous radiotherapy influence the response to pegvisomant.

    PubMed

    Parkinson, Craig; Burman, Pia; Messig, Michael; Trainer, Peter J

    2007-01-01

    To effectively normalize IGF-I in patients with acromegaly, various covariates may affect dosing and plasma concentrations of pegvisomant. We assessed whether sex, age, weight, and previous radiotherapy influence dosing of pegvisomant in patients with active disease. Data from 69 men and 49 women participating in multicenter, open-label trials of pegvisomant were retrospectively evaluated using multiple regression techniques. Sixty-nine subjects (39 men, 30 women) had undergone external beam pituitary radiotherapy. Serum IGF-I was at least 30% above age-related upper limit of normal in all patients at study entry. After a loading dose of pegvisomant (80 mg), patients were commenced on 10 mg/d. Pegvisomant dose was adjusted by 5 mg every eighth week until serum IGF-I was normalized. At baseline, men had significantly higher mean serum IGF-I levels than women despite similar GH levels. After treatment with pegvisomant, IGF-I levels were similar in men and women. A significant correlation between baseline GH, IGF-I, body weight, and the dose of pegvisomant required to normalize serum IGF-I was observed (all P < 0.001). Women required an average of 0.04 mg/kg more pegvisomant than men and a mean weight-corrected dose of 19.2 mg/d to normalize serum IGF-I [14.5 mg/d (men); P < 0.001]. Patients treated with radiotherapy required less pegvisomant to normalize serum IGF-I despite similar baseline GH/IGF-I levels (15.2 vs. 18.5 mg/d for no previous radiotherapy; P = 0.002). Sex, body weight, previous radiotherapy, and baseline GH/IGF-I influence the dose of pegvisomant required to normalize serum IGF-I in patients with active acromegaly.

  19. 14 CFR 60.17 - Previously qualified FSTDs.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false Previously qualified FSTDs. 60.17 Section 60.17 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRMEN FLIGHT SIMULATION TRAINING DEVICE INITIAL AND CONTINUING QUALIFICATION AND USE § 60.17 Previously...

  20. 14 CFR 60.17 - Previously qualified FSTDs.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false Previously qualified FSTDs. 60.17 Section 60.17 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRMEN FLIGHT SIMULATION TRAINING DEVICE INITIAL AND CONTINUING QUALIFICATION AND USE § 60.17 Previously...

  1. 14 CFR 60.17 - Previously qualified FSTDs.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Previously qualified FSTDs. 60.17 Section 60.17 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRMEN FLIGHT SIMULATION TRAINING DEVICE INITIAL AND CONTINUING QUALIFICATION AND USE § 60.17 Previously...

  2. 14 CFR 60.17 - Previously qualified FSTDs.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Previously qualified FSTDs. 60.17 Section 60.17 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRMEN FLIGHT SIMULATION TRAINING DEVICE INITIAL AND CONTINUING QUALIFICATION AND USE § 60.17 Previously...

  3. 14 CFR 60.17 - Previously qualified FSTDs.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Previously qualified FSTDs. 60.17 Section 60.17 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRMEN FLIGHT SIMULATION TRAINING DEVICE INITIAL AND CONTINUING QUALIFICATION AND USE § 60.17 Previously...

  4. 49 CFR 173.23 - Previously authorized packaging.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Previously authorized packaging. 173.23 Section... REQUIREMENTS FOR SHIPMENTS AND PACKAGINGS Preparation of Hazardous Materials for Transportation § 173.23 Previously authorized packaging. (a) When the regulations specify a packaging with a specification marking...

  5. Estimating sensitivity and specificity for technology assessment based on observer studies.

    PubMed

    Nishikawa, Robert M; Pesce, Lorenzo L

    2013-07-01

    The goal of this study was to determine the accuracy and precision of using scores from a receiver operating characteristic rating scale to estimate sensitivity and specificity. We used data collected in a previous study that measured the improvements in radiologists' ability to classify mammographic microcalcification clusters as benign or malignant with and without the use of a computer-aided diagnosis scheme. Sensitivity and specificity were estimated from the rating data from a question that directly asked the radiologists their biopsy recommendations, which was used as the "truth," because it is the actual recall decision, thus it is their subjective truth. By thresholding the rating data, sensitivity and specificity were estimated for different threshold values. Because of interreader and intrareader variability, estimated sensitivity and specificity values for individual readers could be as much as 100% in error when using rating data compared to using the biopsy recommendation data. When pooled together, the estimates using thresholding the rating data were in good agreement with sensitivity and specificity estimated from the recommendation data. However, the statistical power of the rating data estimates was lower. By simply asking the observer his or her explicit recommendation (eg, biopsy or no biopsy), sensitivity and specificity can be measured directly, giving a more accurate description of empirical variability and the power of the study can be maximized. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

  6. Fundamental Properties of Co-moving Stars Observed by Gaia

    NASA Astrophysics Data System (ADS)

    Bochanski, John J.; Faherty, Jacqueline K.; Gagné, Jonathan; Nelson, Olivia; Coker, Kristina; Smithka, Iliya; Desir, Deion; Vasquez, Chelsea

    2018-04-01

    We have estimated fundamental parameters for a sample of co-moving stars observed by Gaia and identified by Oh et al. We matched the Gaia observations to the 2MASS and Wide-Field Infrared Survey Explorer catalogs and fit MIST isochrones to the data, deriving estimates of the mass, radius, [Fe/H], age, distance, and extinction to 9754 stars in the original sample of 10606 stars. We verify these estimates by comparing our new results to previous analyses of nearby stars, examining fiducial cluster properties, and estimating the power-law slope of the local present-day mass function. A comparison to previous studies suggests that our mass estimates are robust, while metallicity and age estimates are increasingly uncertain. We use our calculated masses to examine the properties of binaries in the sample and show that separation of the pairs dominates the observed binding energies and expected lifetimes.

  7. 22 CFR 40.91 - Certain aliens previously removed.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Certain aliens previously removed. 40.91... IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Aliens Previously Removed § 40.91 Certain aliens previously removed. (a) 5-year bar. An alien who has been found inadmissible, whether as a result...

  8. 22 CFR 40.91 - Certain aliens previously removed.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Certain aliens previously removed. 40.91... IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Aliens Previously Removed § 40.91 Certain aliens previously removed. (a) 5-year bar. An alien who has been found inadmissible, whether as a result...

  9. 22 CFR 40.91 - Certain aliens previously removed.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Certain aliens previously removed. 40.91... IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Aliens Previously Removed § 40.91 Certain aliens previously removed. (a) 5-year bar. An alien who has been found inadmissible, whether as a result...

  10. 22 CFR 40.91 - Certain aliens previously removed.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Certain aliens previously removed. 40.91... IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Aliens Previously Removed § 40.91 Certain aliens previously removed. (a) 5-year bar. An alien who has been found inadmissible, whether as a result...

  11. 22 CFR 40.91 - Certain aliens previously removed.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Certain aliens previously removed. 40.91... IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Aliens Previously Removed § 40.91 Certain aliens previously removed. (a) 5-year bar. An alien who has been found inadmissible, whether as a result...

  12. An observational study of the ozone dilution effect: Ozone transport in the austral spring stratosphere

    NASA Technical Reports Server (NTRS)

    Atkinson, Roger J.; Plumb, R. Alan

    1994-01-01

    In a previous observational analysis, Atkinson et al (1989) ascribed a sudden decrease in Southern Hemisphere midlatitude total ozone during December 1987 to an 'ozone dilution effect' brought about by the breakup of the polar stratospheric vortex at that time. A question alluded to but unanswered by that study was the degree to which the observed total ozone decrease might have been caused by the quasi-horizontal equatorward transport of 'ozone hold' air from within the vortex, and to what degree by the vertical advection from lower levels of air naturally low in ozone, a dynamical adjustment process which must accompany the equatorward outbreak of a discrete high-latitude airmass. In the present study, analyses of Ertel potential vorticity, TOMS total ozone, and SAGE and ozone sonde vertical profile data are employed using a novel technique to examine the 1987 event in greater detail, to answer this question. Recent progress is then reported in refining the technique and extending the investigation to examine the dynamical evolution of the austral spring stratosphere during other recent years, to shed more light on the precise nature, frequency, and severity of such 'ozone dilution' events, and the effect that this process may have on long term ozone behavior in the Southern Hemisphere.

  13. A statistical study of EMIC waves observed by Cluster. 1. Wave properties. EMIC Wave Properties

    DOE PAGES

    Allen, R. C.; Zhang, J. -C.; Kistler, L. M.; ...

    2015-07-23

    Electromagnetic ion cyclotron (EMIC) waves are an important mechanism for particle energization and losses inside the magnetosphere. In order to better understand the effects of these waves on particle dynamics, detailed information about the occurrence rate, wave power, ellipticity, normal angle, energy propagation angle distributions, and local plasma parameters are required. Previous statistical studies have used in situ observations to investigate the distribution of these parameters in the magnetic local time versus L-shell (MLT-L) frame within a limited magnetic latitude (MLAT) range. In our study, we present a statistical analysis of EMIC wave properties using 10 years (2001–2010) of datamore » from Cluster, totaling 25,431 min of wave activity. Due to the polar orbit of Cluster, we are able to investigate EMIC waves at all MLATs and MLTs. This allows us to further investigate the MLAT dependence of various wave properties inside different MLT sectors and further explore the effects of Shabansky orbits on EMIC wave generation and propagation. Thus, the statistical analysis is presented in two papers. OUr paper focuses on the wave occurrence distribution as well as the distribution of wave properties. The companion paper focuses on local plasma parameters during wave observations as well as wave generation proxies.« less

  14. Complications of local anaesthesia. An observational study.

    PubMed

    Brand, H S; Bekker, W; Baart, J A

    2009-11-01

    Local anaesthesia is increasingly used by dental hygienists. As little is known about the incidence of adverse effects during and after the administration of local anaesthetics, we evaluated side-effects associated with local anaesthesia. A prospective observational study was conducted using standard criteria among a group of 103 patients receiving mandibular block anaesthesia. Physical reactions like clenching fists (14.5%), moaning (12.6%) and turning pale (7.8%) were frequently observed. Patients (3.8%) showed a painful reaction because of needle contact with a nerve or the periosteum. Systemic complications were not observed. After the injection, 41.7% said they felt tense during the administration; 4.9% of the patients reported swallowing problems and 3.9% a tachycardia. These results suggest that administration of local anaesthesia has a small risk of adverse events. Complications, if they occur, seem minor and transient in nature.

  15. Is email a reliable means of contacting authors of previously published papers? A study of the Emergency Medicine Journal for 2001.

    PubMed

    O'Leary, F

    2003-07-01

    To determine whether it is possible to contact authors of previously published papers via email. A cross sectional study of the Emergency Medicine Journal for 2001. 118 articles were included in the study. The response rate from those with valid email addresses was 73%. There was no statistical difference between the type of email address used and the address being invalid (p=0.392) or between the type of article and the likelihood of a reply (p=0.197). More responses were obtained from work addresses when compared with Hotmail addresses (86% v 57%, p=0.02). Email is a valid means of contacting authors of previously published articles, particularly within the emergency medicine specialty. A work based email address may be a more valid means of contact than a Hotmail address.

  16. Mindfulness-based cognitive therapy may reduce thought suppression in previously suicidal participants: findings from a preliminary study.

    PubMed

    Hepburn, Silvia R; Crane, Catherine; Barnhofer, Thorsten; Duggan, Danielle S; Fennell, Melanie J V; Williams, J Mark G

    2009-06-01

    Thought suppression is a strategy aimed at mental control that may paradoxically increase the frequency of unwanted thoughts. This preliminary study examined effects of mindfulness-based cognitive therapy (MBCT) on thought suppression and depression in individuals with past depression and suicidality. In a randomized controlled trial design, 68 participants were allocated to an MBCT group or a treatment-as-usual waitlist control. Measures of thought suppression and depression were taken pre- and post-treatment. MBCT did not reduce thought suppression as measured by the White Bear Suppression Inventory, but significantly reduced self-reported attempts to suppress in the previous week. Preliminary evidence suggests that MBCT for suicidality may reduce thought suppression, but differential effects on thought suppression measures warrant further studies.

  17. A prospective observational study of pigmented naevi changes in psoriasis patients on biologic therapy.

    PubMed

    Choi, Seohee Deanne; D'Souza, Mario I; Menzies, Scott W; Weninger, Wolfgang

    2018-05-23

    Patients on biologic therapy are thought to be at increased risk of developing non-melanoma skin cancers and melanomas. It is unknown whether biologic therapy alters the natural history of melanocytic naevi. Therefore, a prospective observational study was conducted to determine whether psoriasis patients on biologic therapy develop changes in naevi. Clinical and dermoscopic assessment of all melanocytic naevi was performed in 45 psoriasis patients on biologic therapy versus a control cohort of 43 subjects, using sequential digital dermoscopic imaging and total body photography. The mean follow-up period was 1.5 years. The study and control patients had comparable age, gender, previous and family history of non-melanoma skin cancers and melanomas, as well as previous sun exposure and total number of naevi. The number of naevi with major dermoscopic changes was 3% in the study and 1.9% in the control group, with an adjusted incidence rate ratio of 1.45 (95% confidence interval 0.90-2.33; P = 0.125). The rate of minor changes was 15.9% in the study group versus 19.4% in the control (adjusted incidence rate ratio 0.77, 95% confidence interval 0.57-1.08; P = 0.14). There were six new dysplastic naevi in 4/45 biologic patients and four in 4/43 controls; however, the difference was not significant (relative risk 0.96, 95% confidence interval -0.12 to 0.12; P = 0.95). There were no melanomas in either group. Over a mean follow-up period of 1.5 years there was no evidence of significantly different changes in naevi or development of new dysplastic naevi in psoriasis patients on biologic treatment compared to controls. © 2018 The Australasian College of Dermatologists.

  18. Recovery in patients with major depressive disorder (MDD): results of a 6-month, multinational, observational study.

    PubMed

    Novick, Diego; Montgomery, William; Vorstenbosch, Ellen; Moneta, Maria Victoria; Dueñas, Héctor; Haro, Josep Maria

    2017-01-01

    Not all individuals treated for major depressive disorder (MDD) achieve recovery. This observational study examined the recovery rates in MDD patients and the patient characteristics associated with achieving recovery in a naturalistic clinical setting. Recovery was defined as having both clinical and functional remission. Data for this post hoc analysis were taken from a 24-week prospective, observational study that involved 1,549 MDD patients. Clinical remission was assessed using the 16-item Quick Inventory of Depressive Symptomatology Self-Report and functional remission through the Sheehan Disability Scale and no days of reduced productivity in the previous week. Generalized estimating equation regression models were used to examine the baseline factors associated with recovery during follow-up. Clinical and functional remission was achieved in 70.6% and 56.1% of the MDD patients, respectively. MDD patients who achieved recovery (52.1%) were significantly less likely to have impaired levels of functioning, concurrent medical or psychiatric conditions, low levels of education, or nonadherence to therapy at follow-up. The level of functioning during the index episode seems to be a better predictor of recovery than symptom severity. Therefore, the level of functioning should be considered while determining recovery from depression.

  19. Performing both propensity score and instrumental variable analyses in observational studies often leads to discrepant results: a systematic review.

    PubMed

    Laborde-Castérot, Hervé; Agrinier, Nelly; Thilly, Nathalie

    2015-10-01

    Propensity score (PS) and instrumental variable (IV) are analytical techniques used to adjust for confounding in observational research. More and more, they seem to be used simultaneously in studies evaluating health interventions. The present review aimed to analyze the agreement between PS and IV results in medical research published to date. Review of all published observational studies that evaluated a clinical intervention using simultaneously PS and IV analyses, as identified in MEDLINE and Web of Science. Thirty-seven studies, most of them published during the previous 5 years, reported 55 comparisons between results from PS and IV analyses. There was a slight/fair agreement between the methods [Cohen's kappa coefficient = 0.21 (95% confidence interval: 0.00, 0.41)]. In 23 cases (42%), results were nonsignificant for one method and significant for the other, and IV analysis results were nonsignificant in most situations (87%). Discrepancies are frequent between PS and IV analyses and can be interpreted in various ways. This suggests that researchers should carefully consider their analytical choices, and readers should be cautious when interpreting results, until further studies clarify the respective roles of the two methods in observational comparative effectiveness research. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Ghosts in the machine: memory interference from the previous trial.

    PubMed

    Papadimitriou, Charalampos; Ferdoash, Afreen; Snyder, Lawrence H

    2015-01-15

    Previous memoranda can interfere with the memorization or storage of new information, a concept known as proactive interference. Studies of proactive interference typically use categorical memoranda and match-to-sample tasks with categorical measures such as the proportion of correct to incorrect responses. In this study we instead train five macaques in a spatial memory task with continuous memoranda and responses, allowing us to more finely probe working memory circuits. We first ask whether the memoranda from the previous trial result in proactive interference in an oculomotor delayed response task. We then characterize the spatial and temporal profile of this interference and ask whether this profile can be predicted by an attractor network model of working memory. We find that memory in the current trial shows a bias toward the location of the memorandum of the previous trial. The magnitude of this bias increases with the duration of the memory period within which it is measured. Our simulations using standard attractor network models of working memory show that these models easily replicate the spatial profile of the bias. However, unlike the behavioral findings, these attractor models show an increase in bias with the duration of the previous rather than the current memory period. To model a bias that increases with current trial duration we posit two separate memory stores, a rapidly decaying visual store that resists proactive interference effects and a sustained memory store that is susceptible to proactive interference. Copyright © 2015 the American Physiological Society.

  1. Ghosts in the machine: memory interference from the previous trial

    PubMed Central

    Ferdoash, Afreen; Snyder, Lawrence H.

    2014-01-01

    Previous memoranda can interfere with the memorization or storage of new information, a concept known as proactive interference. Studies of proactive interference typically use categorical memoranda and match-to-sample tasks with categorical measures such as the proportion of correct to incorrect responses. In this study we instead train five macaques in a spatial memory task with continuous memoranda and responses, allowing us to more finely probe working memory circuits. We first ask whether the memoranda from the previous trial result in proactive interference in an oculomotor delayed response task. We then characterize the spatial and temporal profile of this interference and ask whether this profile can be predicted by an attractor network model of working memory. We find that memory in the current trial shows a bias toward the location of the memorandum of the previous trial. The magnitude of this bias increases with the duration of the memory period within which it is measured. Our simulations using standard attractor network models of working memory show that these models easily replicate the spatial profile of the bias. However, unlike the behavioral findings, these attractor models show an increase in bias with the duration of the previous rather than the current memory period. To model a bias that increases with current trial duration we posit two separate memory stores, a rapidly decaying visual store that resists proactive interference effects and a sustained memory store that is susceptible to proactive interference. PMID:25376781

  2. Observational constraint on Pluto's atmospheric CO with ASTE

    NASA Astrophysics Data System (ADS)

    Iino, Takahiro; Hirahara, Yasuhiro; Hidemori, Takehiro; Tsukagoshi, Takashi; Nakajima, Taku; Nakamoto, Satoru; Kato, Chihaya

    2016-02-01

    To confirm the previous observational results of Pluto's atmospheric CO in the J = 2-1 rotational transition, we conducted a new observation of CO (J = 3-2) in Pluto's atmosphere in 2014 August with the Atacama Submillimeter Telescope Experiment 10 m single-dish telescope. In contrast to the previous observational result obtained with the James Clerk Maxwell Telescope in 2009 and 2010 by using the J = 2-1 transition, no emission structure was observed near the rest frequency in our attempt. Possible explanations for the nondetection result of the J = 3-2 transition are discussed.

  3. 18 CFR 154.302 - Previously submitted material.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Previously submitted material. 154.302 Section 154.302 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... Filed With Changes § 154.302 Previously submitted material. (a) If all, or any portion, of the...

  4. 18 CFR 154.302 - Previously submitted material.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Previously submitted material. 154.302 Section 154.302 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... Filed With Changes § 154.302 Previously submitted material. (a) If all, or any portion, of the...

  5. 18 CFR 154.302 - Previously submitted material.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Previously submitted material. 154.302 Section 154.302 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... Filed With Changes § 154.302 Previously submitted material. (a) If all, or any portion, of the...

  6. 18 CFR 154.302 - Previously submitted material.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Previously submitted material. 154.302 Section 154.302 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... Filed With Changes § 154.302 Previously submitted material. (a) If all, or any portion, of the...

  7. Immunogenicity and safety of tetravalent dengue vaccine in 2-11 year-olds previously vaccinated against yellow fever: randomized, controlled, phase II study in Piura, Peru.

    PubMed

    Lanata, Claudio F; Andrade, Teresa; Gil, Ana I; Terrones, Cynthia; Valladolid, Omar; Zambrano, Betzana; Saville, Melanie; Crevat, Denis

    2012-09-07

    In a randomized, placebo-controlled, monocenter, observer blinded study conducted in an area where dengue is endemic, we assessed the safety and immunogenicity of a recombinant, live, attenuated, tetravalent dengue vaccine candidate (CYD-TDV) in 2-11 year-olds with varying levels of pre-existing yellow-fever immunity due to vaccination 1-7 years previously. 199 children received 3 injections of CYD-TDV (months 0, 6 and 12) and 99 received placebo (months 0 and 6) or pneumococcal polysaccharide vaccine (month 12). One month after the third dengue vaccination, serotype specific neutralizing antibody GMTs were in the range of 178-190 (1/dil) (versus 16.7-38.1 in the control group), a 10-20 fold-increase from baseline, and 94% of vaccines were seropositive to all four serotypes (versus 39% in the control group). There were no vaccine-related SAEs. The observed reactogenicity profile was consistent with phase I studies, with severity grade 1-2 injection site pain, headache, malaise and fever most frequently reported and no increase after subsequent vaccinations. Virologically confirmed dengue cases were seen after completion of the 3 doses: 1 in the CYD-TDV group (N=199), and 3 in the control group (N=99). A 3-dose regimen of CYD-TDV had a good safety profile in 2-11 year olds with a history of YF vaccination and elicited robust antibody responses that were balanced against the four serotypes. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. In-Hospital Recruitment to Observational Studies of Stroke

    ERIC Educational Resources Information Center

    Pickering, Ruth M.; Kunkel, Dorit; Fitton, Carolyn; Ashburn, Ann; Jenkinson, Damian

    2010-01-01

    The objective of this study was to examine recruitment in three observational follow-up studies of patients with stroke, focusing on reasons for nonparticipation and the role of potential factors in explaining recruitment rates. It comprised secondary analysis of the three studies. Recruitment rates varied between the studies. Between 10 and 50%…

  9. Spitzer Observations of GRB Hosts: A Legacy Approach

    NASA Astrophysics Data System (ADS)

    Perley, Daniel; Tanvir, Nial; Hjorth, Jens; Berger, Edo; Laskar, Tanmoy; Michalowski, Michal; Chary, Ranga-Ram; Fynbo, Johan; Levan, Andrew

    2012-09-01

    The host galaxies of long-duration GRBs are drawn from uniquely broad range of luminosities and redshifts. Thus they offer the possibility of studying the evolution of star-forming galaxies without the limitations of other luminosity-selected samples, which typically are increasingly biased towards the most massive systems at higher redshift. However, reaping the full benefits of this potential requires careful attention to the selection biases affecting host identification. To this end, we propose observations of a Legacy sample of 70 GRB host galaxies (an additional 70 have already been observed by Spitzer), in order to constrain the mass and luminosity function in GRB-selected galaxies at high redshift, including its dependence on redshift and on properties of the afterglow. Crucially, and unlike previous Spitzer surveys, this sample is carefully designed to be uniform and free of optical selection biases that have caused previous surveys to systematically under-represent the role of luminous, massive hosts. We also propose to extend to larger, more powerfully constraining samples the study of two science areas where Spitzer observations have recently shown spectacular success: the hosts of dust-obscured GRBs (which promise to further our understanding of the connection between GRBs and star-formation in the most luminous galaxies), and the evolution of the mass-metallicity relation at z>2 (for which GRB host observations provide particularly powerful constraints on high-z chemical evolution).

  10. Resuscitative Hyperkalemia in Noncrush Trauma: A Prospective, Observational Study

    DTIC Science & Technology

    2006-12-01

    Resuscitative Hyperkalemia in Noncrush Trauma: A Prospective, Observational Study Robert M. Perkins,*† Matthew C. Aboudara,* Kevin C. Abbott,*† and...Surgical Research, San Antonio, Texas The trauma patient is exposed to physiologic processes and life-saving interventions that predispose to hyperkalemia ...in the care of the massively traumatized patient may or may not increase the risk for hyperkalemia . This prospective, observational study was

  11. Tire pressure special study : vehicle observation data

    DOT National Transportation Integrated Search

    2001-08-01

    Twenty seven percent of passenger cars with : regular passenger car tires have at least one : tire that is underinflated by 8 psi or more. : Tire Pressure Special Study: Vehicle : Observation Data is the third in a series of : research notes co...

  12. Dietary fat intake and risk of epithelial ovarian cancer: a meta-analysis of 6,689 subjects from 8 observational studies.

    PubMed

    Huncharek, M; Kupelnick, B

    2001-01-01

    The etiology of epithelial ovarian cancer is unknown. Prior work suggests that high dietary fat intake is associated with an increased risk of this tumor, although this association remains speculative. A meta-analysis was performed to evaluate this suspected relationship. Using previously described methods, a protocol was developed for a meta-analysis examining the association between high vs. low dietary fat intake and the risk of epithelial ovarian cancer. Literature search techniques, study inclusion criteria, and statistical procedures were prospectively defined. Data from observational studies were pooled using a general variance-based meta-analytic method employing confidence intervals (CI) previously described by Greenland. The outcome of interest was a summary relative risk (RRs) reflecting the risk of ovarian cancer associated with high vs. low dietary fat intake. Sensitivity analyses were performed when necessary to evaluate any observed statistical heterogeneity. The literature search yielded 8 observational studies enrolling 6,689 subjects. Data were stratified into three dietary fat intake categories: total fat, animal fat, and saturated fat. Initial tests for statistical homogeneity demonstrated that hospital-based studies accounted for observed heterogeneity possibly because of selection bias. Accounting for this, an RRs was calculated for high vs. low total fat intake, yielding a value of 1.24 (95% CI = 1.07-1.43), a statistically significant result. That is, high total fat intake is associated with a 24% increased risk of ovarian cancer development. The RRs for high saturated fat intake was 1.20 (95% CI = 1.04-1.39), suggesting a 20% increased risk of ovarian cancer among subjects with these dietary habits. High vs. low animal fat diet gave an RRs of 1.70 (95% CI = 1.43-2.03), consistent with a statistically significant 70% increased ovarian cancer risk. High dietary fat intake appears to represent a significant risk factor for the development of

  13. Validity of the Autism Spectrum Disorder Observation for Children (ASD-OC)

    ERIC Educational Resources Information Center

    Neal, Daniene; Matson, Johnny L.; Hattier, Megan A.

    2014-01-01

    The Autism Spectrum Disorder Observation for Children (ASD-OC) is a 45-item observation scale used to assess autistic symptomatology. The reliability of this measure has been established in previous research; therefore, the purpose of this study is to evaluate its validity among a sample of children (1-15 years). The large correlation between the…

  14. Doxorubicin and ifosfamide combination chemotherapy in previously treated acute leukemia in adults: a Southwest Oncology Group pilot study.

    PubMed

    Ryan, D H; Bickers, J N; Vial, R H; Hussein, K; Bottomley, R; Hewlett, J S; Wilson, H E; Stuckey, W J

    1980-01-01

    The Southwest Oncology Group did a limited institutional pilot study of the combination of doxorubicin and ifosfamide in the treatment of previously treated adult patients with acute leukemia. Thirty-four patients received one or two courses of the combination. All patients had received prior chemotherapy and 32 had received prior anthracycline chemotherapy. Three patients died before their responses could be fully evaluated. Fourteen patients achieved complete remission (41%) and one patient achieved partial remission. The complete remission rate was 27% for patients with acute myeloblastic leukemia (myelomonoblastic leukemia, monoblastic leukemia, and erythroleukemia) and 89% for patients with acute lymphocytic and undifferentiated leukemia (ALL). Toxic effects included severe hematologic reactions in 33 of 34 patients, hematuria in six patients, altered sensorium in one patient, and congestive heart failure in one patient. The safety of the combination was established and toxic side effects of this therapy were tolerable. The 89% complete remission rate for previously treated patients with ALL suggests that the combination of doxorubicin and ifosfamide may be particularly effective in ALL.

  15. Active-comparator design and new-user design in observational studies

    PubMed Central

    Yoshida, Kazuki; Solomon, Daniel H.; Kim, Seoyoung C.

    2015-01-01

    SUMMARY Over the past decade, an increasing number of observational studies have examined the effectiveness or safety of rheumatoid arthritis treatments. However, unlike randomized controlled trials (RCTs), observational studies of drug effects face methodological challenges including confounding by indication. Two design principles - active comparator design and new user design can help mitigate such challenges in observational studies. To improve validity of study findings, observational studies should be designed in such a way that makes them more closely approximate RCTs. The active comparator design compares the drug of interest to another commonly used agent for the same indication, rather than a ‘non-user’ group. This principle helps select treatment groups similar in treatment indications (both measured and unmeasured characteristics). The new user design includes a cohort of patients from the time of treatment initiation, so that it can assess patients’ pretreatment characteristics and capture all events occurring anytime during follow-up. PMID:25800216

  16. Combining complexity measures of EEG data: multiplying measures reveal previously hidden information

    PubMed Central

    Burns, Thomas; Rajan, Ramesh

    2015-01-01

    Many studies have noted significant differences among human electroencephalograph (EEG) results when participants or patients are exposed to different stimuli, undertaking different tasks, or being affected by conditions such as epilepsy or Alzheimer's disease. Such studies often use only one or two measures of complexity and do not regularly justify their choice of measure beyond the fact that it has been used in previous studies. If more measures were added to such studies, however, more complete information might be found about these reported differences. Such information might be useful in confirming the existence or extent of such differences, or in understanding their physiological bases. In this study we analysed publically-available EEG data using a range of complexity measures to determine how well the measures correlated with one another. The complexity measures did not all significantly correlate, suggesting that different measures were measuring unique features of the EEG signals and thus revealing information which other measures were unable to detect. Therefore, the results from this analysis suggests that combinations of complexity measures reveal unique information which is in addition to the information captured by other measures of complexity in EEG data. For this reason, researchers using individual complexity measures for EEG data should consider using combinations of measures to more completely account for any differences they observe and to ensure the robustness of any relationships identified. PMID:26594331

  17. Combining complexity measures of EEG data: multiplying measures reveal previously hidden information.

    PubMed

    Burns, Thomas; Rajan, Ramesh

    2015-01-01

    Many studies have noted significant differences among human electroencephalograph (EEG) results when participants or patients are exposed to different stimuli, undertaking different tasks, or being affected by conditions such as epilepsy or Alzheimer's disease. Such studies often use only one or two measures of complexity and do not regularly justify their choice of measure beyond the fact that it has been used in previous studies. If more measures were added to such studies, however, more complete information might be found about these reported differences. Such information might be useful in confirming the existence or extent of such differences, or in understanding their physiological bases. In this study we analysed publically-available EEG data using a range of complexity measures to determine how well the measures correlated with one another. The complexity measures did not all significantly correlate, suggesting that different measures were measuring unique features of the EEG signals and thus revealing information which other measures were unable to detect. Therefore, the results from this analysis suggests that combinations of complexity measures reveal unique information which is in addition to the information captured by other measures of complexity in EEG data. For this reason, researchers using individual complexity measures for EEG data should consider using combinations of measures to more completely account for any differences they observe and to ensure the robustness of any relationships identified.

  18. Understanding the Transition Experiences of Previously Detained Adolescents with Disabilities

    ERIC Educational Resources Information Center

    Logan-Friend, Jocelyn

    2018-01-01

    The purpose of this study was to explore the perceptions and lived experiences of previously detained adolescents with disabilities in order to better understand the influence these experiences may have on their postsecondary outcomes. This study employed a phenomenological approach through a three interview series to further understand the lived…

  19. An observational study of socioeconomic and clinical gradients among diabetes patients hospitalized for avoidable causes: evidence of underlying health disparities in China?

    PubMed

    Chen, Brian; Eggleston, Karen; Li, Hong; Shah, Nilay; Wang, Jian

    2014-01-30

    Diabetes is an ambulatory care sensitive condition that can generally be managed in outpatient settings with little or no need for inpatient care. As a preliminary step to investigate whether health disparities can be detected in the inpatient setting in China, we study how diabetic patients hospitalized without prior primary care contact or with greater severity of illness differ from other diabetic inpatients along socioeconomic and clinical dimensions. We conduct an observational study using three years of clinical data for more than 1,800 adult patients with diabetes at two tertiary hospitals in East China. Univariate analysis and probit regression are used to characterize the differences in socioeconomic and clinical factors between patients hospitalized for diabetes with no prior primary care contact and those hospitalized with previous treatment experience. Secondarily, we use ordinary least squares regression to estimate the socioeconomic and clinical differences associated with poor serum glucose control at admission. We find that compared with patients hospitalized after prior treatment experience, inpatients with no previous primary care contact for diabetes have worse clinical laboratory values, are more likely to be young and male, to have lower education attainment, and to have poorer blood sugar control. Insurance, urban residence, and previous use of diabetic medication are in turn negatively correlated with HbA1c levels upon admission. Among hospitalized diabetic patients, socioeconomic factors such as lower education attainment, rural residence and lack of full insurance are associated with avoidable hospitalizations or worse indicators of health. Although we cannot definitively rule out selection bias, these findings are consistent with health disparities observable even at the inpatient level. Future studies should study the underlying mechanism by which traditionally vulnerable groups are more likely to be hospitalized for avoidable causes and

  20. Chasing the observational signatures of seed black holes at z > 7: candidate observability

    NASA Astrophysics Data System (ADS)

    Valiante, Rosa; Schneider, Raffaella; Zappacosta, Luca; Graziani, Luca; Pezzulli, Edwige; Volonteri, Marta

    2018-05-01

    Observing the light emitted by the first accreting black holes (BHs) would dramatically improve our understanding of the formation of quasars at z > 6, possibly unveiling the nature of their supermassive black hole (SMBH) seeds. In previous works, we explored the relative role of the two main competing BH seed formation channels, Population III remnants (low-mass seeds) and direct collapse BHs (high-mass seeds), investigating the properties of their host galaxies in a cosmological context. Building on this analysis, we predict here the spectral energy distribution and observational features of low- and high-mass BH seeds selected among the progenitors of a z ˜ 6 SMBH. We derive the processed emission from both accreting BHs and stars by using the photoionization code CLOUDY, accounting for the evolution of metallicity and dust-to-gas mass ratio in the interstellar medium of the host galaxies, as predicted by the cosmological data-constrained model GAMETE/QSODUST. We show how future missions like James Webb Space Telescope (JWST) and Advanced Telescope for High Energy Astrophysics (ATHENA) will be able to detect the light coming from SMBH progenitors already at z ˜ 16. We build upon previous complementary studies and propose a method based on the combined analysis of near-infrared colours, IR excess (IRX), and UV continuum slopes (i.e. colour-colour and IRX-β diagrams) to distinguish growing seed BH host galaxies from starburst-dominated systems in JWST surveys. Sources selected through this criterion would be the best target for follow-up X-ray observations.

  1. Rhabdomyolysis in Ebola Virus Disease. Results of an Observational Study in a Treatment Center in Guinea.

    PubMed

    Cournac, Jean Marie; Karkowski, Ludovic; Bordes, Julien; Aletti, Marc; Duron, Sandrine; Janvier, Frédéric; Foissaud, Vincent; Savini, Hélène; de Greslan, Thierry; Rousseau, Claire; Billhot, Magali; Gagnon, Nicolas; Mac Nab, Christine; Dubrous, Philippe; Moroge, Sophie; Broto, Helene; Cotte, Jean; Maugey, Nancy; Cordier, Pierre-Yves; Sagui, Emmanuel; Merens, Audrey; Rapp, Christophe; Quentin, Benoit; Granier, Hervé; Carmoi, Thierry; Cellarier, Gilles

    2016-01-01

    The pathogenesis of Ebola virus disease (EVD) remains unclear. The sporadic nature of Ebola outbreaks and their occurrence in resource-limited settings have precluded the acquisition of extensive clinical and laboratory data. Rhabdomyolysis during EVD has been suggested to occur in previous studies showing increased aspartate aminotransferase-alanine aminotransferase ratios, but, to date, has not been confirmed with creatine kinase (CK) assays. We performed an observational study of 38 patients admitted to an Ebola treatment center from January to April 2015. CK values from patients with confirmed EVD were compared with those in patients without confirmed EVD. A panel of other analyses were also performed. In patients with EVD, characteristics were compared between survivors and nonsurvivors. High levels of CK were more frequent in patients with EVD than in those without (P = .002), and rhabdomyolysis was more frequent (59% vs 19%, respectively; P = .03). CK levels >5000 U/L were observed in 36% of patients with EVD. Also in patients with EVD, fatal outcome was significantly associated with higher creatinine and bilirubin levels, international normalized ratio, and viral load. Rhabdomyolysis is a frequent disorder in EVD and seems to be more common than in other viral infections. It may contribute to the renal failure observed in nonsurviving patients. More studies are needed to determine the impact of rhabdomyolysis on EVD outcome. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  2. Globally Gridded Satellite observations for climate studies

    USGS Publications Warehouse

    Knapp, K.R.; Ansari, S.; Bain, C.L.; Bourassa, M.A.; Dickinson, M.J.; Funk, Chris; Helms, C.N.; Hennon, C.C.; Holmes, C.D.; Huffman, G.J.; Kossin, J.P.; Lee, H.-T.; Loew, A.; Magnusdottir, G.

    2011-01-01

    Geostationary satellites have provided routine, high temporal resolution Earth observations since the 1970s. Despite the long period of record, use of these data in climate studies has been limited for numerous reasons, among them that no central archive of geostationary data for all international satellites exists, full temporal and spatial resolution data are voluminous, and diverse calibration and navigation formats encumber the uniform processing needed for multisatellite climate studies. The International Satellite Cloud Climatology Project (ISCCP) set the stage for overcoming these issues by archiving a subset of the full-resolution geostationary data at ~10-km resolution at 3-hourly intervals since 1983. Recent efforts at NOAA's National Climatic Data Center to provide convenient access to these data include remapping the data to a standard map projection, recalibrating the data to optimize temporal homogeneity, extending the record of observations back to 1980, and reformatting the data for broad public distribution. The Gridded Satellite (GridSat) dataset includes observations from the visible, infrared window, and infrared water vapor channels. Data are stored in Network Common Data Format (netCDF) using standards that permit a wide variety of tools and libraries to process the data quickly and easily. A novel data layering approach, together with appropriate satellite and file metadata, allows users to access GridSat data at varying levels of complexity based on their needs. The result is a climate data record already in use by the meteorological community. Examples include reanalysis of tropical cyclones, studies of global precipitation, and detection and tracking of the intertropical convergence zone.

  3. Tonic or Phasic Stimulation of Dopaminergic Projections to Prefrontal Cortex Causes Mice to Maintain or Deviate from Previously Learned Behavioral Strategies

    PubMed Central

    Ellwood, Ian T.; Patel, Tosha; Wadia, Varun; Lee, Anthony T.; Liptak, Alayna T.

    2017-01-01

    Dopamine neurons in the ventral tegmental area (VTA) encode reward prediction errors and can drive reinforcement learning through their projections to striatum, but much less is known about their projections to prefrontal cortex (PFC). Here, we studied these projections and observed phasic VTA–PFC fiber photometry signals after the delivery of rewards. Next, we studied how optogenetic stimulation of these projections affects behavior using conditioned place preference and a task in which mice learn associations between cues and food rewards and then use those associations to make choices. Neither phasic nor tonic stimulation of dopaminergic VTA–PFC projections elicited place preference. Furthermore, substituting phasic VTA–PFC stimulation for food rewards was not sufficient to reinforce new cue–reward associations nor maintain previously learned ones. However, the same patterns of stimulation that failed to reinforce place preference or cue–reward associations were able to modify behavior in other ways. First, continuous tonic stimulation maintained previously learned cue–reward associations even after they ceased being valid. Second, delivering phasic stimulation either continuously or after choices not previously associated with reward induced mice to make choices that deviated from previously learned associations. In summary, despite the fact that dopaminergic VTA–PFC projections exhibit phasic increases in activity that are time locked to the delivery of rewards, phasic activation of these projections does not necessarily reinforce specific actions. Rather, dopaminergic VTA–PFC activity can control whether mice maintain or deviate from previously learned cue–reward associations. SIGNIFICANCE STATEMENT Dopaminergic inputs from ventral tegmental area (VTA) to striatum encode reward prediction errors and reinforce specific actions; however, it is currently unknown whether dopaminergic inputs to prefrontal cortex (PFC) play similar or distinct

  4. Predicting fruit consumption: the role of habits, previous behavior and mediation effects

    PubMed Central

    2014-01-01

    Background This study assessed the role of habits and previous behavior in predicting fruit consumption as well as their additional predictive contribution besides socio-demographic and motivational factors. In the literature, habits are proposed as a stable construct that needs to be controlled for in longitudinal analyses that predict behavior. The aim of this study is to provide empirical evidence for the inclusion of either previous behavior or habits. Methods A random sample of 806 Dutch adults (>18 years) was invited by an online survey panel of a private research company to participate in an online study on fruit consumption. A longitudinal design (N = 574) was used with assessments at baseline and after one (T2) and two months (T3). Multivariate linear regression analysis was used to assess the differential value of habit and previous behavior in the prediction of fruit consumption. Results Eighty percent of habit strength could be explained by habit strength one month earlier, and 64% of fruit consumption could be explained by fruit consumption one month earlier. Regression analyses revealed that the model with motivational constructs explained 41% of the behavioral variance at T2 and 38% at T3. The addition of previous behavior and habit increased the explained variance up to 66% at T2 and to 59% at T3. Inclusion of these factors resulted in non-significant contributions of the motivational constructs. Furthermore, our findings showed that the effect of habit strength on future behavior was to a large extent mediated by previous behavior. Conclusions Both habit and previous behavior are important as predictors of future behavior, and as educational objectives for behavior change programs. Our results revealed less stability for the constructs over time than expected. Habit strength was to a large extent mediated by previous behavior and our results do not strongly suggest a need for the inclusion of both constructs. Future research needs to assess

  5. Tracking the complex absorption in NGC 2110 with two Suzaku observations

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

    Rivers, Elizabeth; Markowitz, Alex; Rothschild, Richard

    2014-05-10

    We present spectral analysis of two Suzaku observations of the Seyfert 2 galaxy, NGC 2110. This source has been known to show complex, variable absorption which we study in depth by analyzing these two observations set 7 yr apart and by comparing them to previously analyzed observations with the XMM-Newton and Chandra observatories. We find that there is a relatively stable, full-covering absorber with a column density of ∼3× 10{sup 22} cm{sup –2}, with an additional patchy absorber that is likely variable in both column density and covering fraction over timescales of years, consistent with clouds in a patchy torusmore » or in the broad line region. We model a soft emission line complex, likely arising from ionized plasma and consistent with previous studies. We find no evidence for reflection from an accretion disk in this source with contribution from neither relativistically broadened Fe Kα line emission, nor from a Compton reflection hump.« less

  6. HERschel Observations of Edge-on Spirals (HEROES). III. Dust energy balance study of IC 2531

    NASA Astrophysics Data System (ADS)

    Mosenkov, Aleksandr V.; Allaert, Flor; Baes, Maarten; Bianchi, Simone; Camps, Peter; De Geyter, Gert; De Looze, Ilse; Fritz, Jacopo; Gentile, Gianfranco; Hughes, Thomas M.; Lewis, Fraser; Verstappen, Joris; Verstocken, Sam; Viaene, Sébastien

    2016-07-01

    We investigate the dust energy balance for the edge-on galaxy IC 2531, one of the seven galaxies in the HEROES sample. We perform a state-of-the-art radiative transfer modelling based, for the first time, on a set of optical and near-infrared galaxy images. We show that by taking into account near-infrared imaging in the modelling significantly improves the constraints on the retrieved parameters of the dust content. We confirm the result from previous studies that including a young stellar population in the modelling is important to explain the observed stellar energy distribution. However, the discrepancy between the observed and modelled thermal emission at far-infrared wavelengths, the so-called dust energy balance problem, is still present: the model underestimates the observed fluxes by a factor of about two. We compare two different dust models, and find that dust parameters, and thus the spectral energy distribution in the infrared domain, are sensitive to the adopted dust model. In general, the THEMIS model reproduces the observed emission in the infrared wavelength domain better than the popular BARE-GR-S model. Our study of IC 2531 is a pilot case for detailed and uniform radiative transfer modelling of the entire HEROES sample, which will shed more light on the strength and origins of the dust energy balance problem. Herschel is an ESA space observatory with science instruments provided by European-led Principal Investigator consortia and with important participation from NASA.The reduced images (as FITS files) are only available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (http://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/592/A71

  7. Positivity effect in healthy aging in observational but not active feedback-learning.

    PubMed

    Bellebaum, Christian; Rustemeier, Martina; Daum, Irene

    2012-01-01

    The present study investigated the impact of healthy aging on the bias to learn from positive or negative performance feedback in observational and active feedback learning. In active learning, a previous study had already shown a negative learning bias in healthy seniors older than 75 years, while no bias was found for younger seniors. However, healthy aging is accompanied by a 'positivity effect', a tendency to primarily attend to stimuli with positive valence. Based on recent findings of dissociable neural mechanisms in active and observational feedback learning, the positivity effect was hypothesized to influence older participants' observational feedback learning in particular. In two separate experiments, groups of young (mean age 27) and older participants (mean age 60 years) completed an observational or active learning task designed to differentially assess positive and negative learning. Older but not younger observational learners showed a significant bias to learn better from positive than negative feedback. In accordance with previous findings, no bias was found for active learning. This pattern of results is discussed in terms of differences in the neural underpinnings of active and observational learning from performance feedback.

  8. Comparative genomics of grass EST libraries reveals previously uncharacterized splicing events in crop plants.

    PubMed

    Chuang, Trees-Juen; Yang, Min-Yu; Lin, Chuang-Chieh; Hsieh, Ping-Hung; Hung, Li-Yuan

    2015-02-05

    Crop plants such as rice, maize and sorghum play economically-important roles as main sources of food, fuel, and animal feed. However, current genome annotations of crop plants still suffer false-positive predictions; a more comprehensive registry of alternative splicing (AS) events is also in demand. Comparative genomics of crop plants is largely unexplored. We performed a large-scale comparative analysis (ExonFinder) of the expressed sequence tag (EST) library from nine grass plants against three crop genomes (rice, maize, and sorghum) and identified 2,879 previously-unannotated exons (i.e., novel exons) in the three crops. We validated 81% of the tested exons by RT-PCR-sequencing, supporting the effectiveness of our in silico strategy. Evolutionary analysis reveals that the novel exons, comparing with their flanking annotated ones, are generally under weaker selection pressure at the protein level, but under stronger pressure at the RNA level, suggesting that most of the novel exons also represent novel alternatively spliced variants (ASVs). However, we also observed the consistency of evolutionary rates between certain novel exons and their flanking exons, which provided further evidence of their co-occurrence in the transcripts, suggesting that previously-annotated isoforms might be subject to erroneous predictions. Our validation showed that 54% of the tested genes expressed the newly-identified isoforms that contained the novel exons, rather than the previously-annotated isoforms that excluded them. The consistent results were steadily observed across cultivated (Oryza sativa and O. glaberrima) and wild (O. rufipogon and O. nivara) rice species, asserting the necessity of our curation of the crop genome annotations. Our comparative analyses also inferred the common ancestral transcriptome of grass plants and gain- and loss-of-ASV events. We have reannotated the rice, maize, and sorghum genomes, and showed that evolutionary rates might serve as an indicator

  9. Whole-genome sequencing to determine Neisseria gonorrhoeae transmission: an observational study

    PubMed Central

    Cole, Kevin; Cole, Michelle J; Cresswell, Fiona; Dean, Gillian; Dave, Jayshree; Thomas, Daniel Rh; Foster, Kirsty; Waldram, Alison; Wilson, Daniel J; Didelot, Xavier; Grad, Yonatan H; Crook, Derrick W; Peto, Tim EA; Walker, A Sarah

    2016-01-01

    Background New approaches are urgently required to address increasing rates of gonorrhoea and the emergence and global spread of antibiotic-resistant Neisseria gonorrhoeae. Whole genome sequencing (WGS) can be applied to study transmission and track resistance. Methods We performed WGS on 1659 isolates from Brighton, UK, and 217 additional isolates from other UK locations. We included WGS data (n=196) from the USA. Estimated mutation rates, plus diversity observed within patients across anatomical sites and probable transmission pairs, were used to fit a coalescent model to determine the number of single nucleotide polymorphisms (SNPs) expected between sequences related by direct/indirect transmission, depending on the time between samples. Findings We detected extensive local transmission. 281/1061(26%) Brighton cases were indistinguishable (0 SNPs) to ≥1 previous case(s), and 786(74%) had evidence of a sampled direct or indirect Brighton source. There was evidence of sustained transmission of some lineages. We observed multiple related samples across geographic locations. Of 1273 infections in Brighton, 225(18%) were linked to another case from elsewhere in the UK, and 115(9%) to a case from the USA. Four lineages initially identified in Brighton could be linked to 70 USA sequences, including 61 from a lineage carrying the mosaic penA XXXIV associated with reduced cefixime susceptibility. Interpretation We present a WGS-based tool for genomic contact tracing of N. gonorrhoeae and demonstrate local, national and international transmission. WGS can be applied across geographical boundaries to investigate gonorrhoea transmission and to track antimicrobial resistance. Funding Oxford NIHR Health Protection Research Unit and Biomedical Research Centre. PMID:27427203

  10. Upon Further Review: V. An Examination of Previous Lightcurve Analysis from the Palmer Divide Observatory

    NASA Astrophysics Data System (ADS)

    Warner, Brian D.

    2011-01-01

    Updated results are given for nine asteroids previously reported from the Palmer Divide Observatory (PDO). The original images were re-measured to obtain new data sets using the latest version of MPO Canopus photometry software, analysis tools, and revised techniques for linking multiple observing runs covering several days to several weeks. Results that were previously not reported or were moderately different were found for 1659 Punkajarju, 1719 Jens, 1987 Kaplan, 2105 Gudy, 2961 Katsurahama, 3285 Ruth Wolfe, 3447 Burckhalter, 7816 Hanoi, and (34817) 2000 SE116. This is one in a series of papers that will examine results obtained during the initial years of the asteroid lightcurve program at PDO.

  11. Global Distribution of Extreme Precipitation and High-Impact Landslides in 2010 Relative to Previous Years

    NASA Technical Reports Server (NTRS)

    Kirschbaum, Dalia; Adler, Robert; Adler, David; Peters-Lidard, Christa; Huffman, George

    2012-01-01

    It is well known that extreme or prolonged rainfall is the dominant trigger of landslides worldwide. While research has evaluated the spatiotemporal distribution of extreme rainfall and landslides at local or regional scales using in situ data, few studies have mapped rainfall-triggered landslide distribution globally due to the dearth of landslide data and consistent precipitation information. This study uses a newly developed Global Landslide Catalog (GLC) and a 13-year satellite-based precipitation record from TRMM data. For the first time, these two unique products provide the foundation to quantitatively evaluate the co-occurrence of precipitation and landslides globally. Evaluation of the GLC indicates that 2010 had a large number of high-impact landslide events relative to previous years. This study considers how variations in extreme and prolonged satellite-based rainfall are related to the distribution of landslides over the same time scales for three active landslide areas: Central America, the Himalayan Arc, and central-eastern China. Several test statistics confirm that TRMM rainfall generally scales with the observed increase in landslide reports and fatal events for 2010 and previous years over each region. These findings suggest that the co-occurrence of satellite precipitation and landslide reports may serve as a valuable indicator for characterizing the spatiotemporal distribution of landslide-prone areas in order to establish a global rainfall-triggered landslide climatology. This study characterizes the variability of satellite precipitation data and reported landslide activity at the globally scale in order to improve landslide cataloging, forecasting and quantify potential triggering sources at daily, monthly and yearly time scales.

  12. Workplace Education Initiative: Case Studies and Observations.

    ERIC Educational Resources Information Center

    Astrein, Bruce; And Others

    Seven workplace education projects funded in the first year of the Massachusetts Workplace Education Initiative are reported. This report includes both general observations and specific information in case studies of the projects. Overall information is provided on students served, the importance of partnerships, the emphasis on…

  13. Sunburn and sun-protective behaviors among adults with and without previous nonmelanoma skin cancer: a population-based study

    PubMed Central

    Fischer, Alexander H.; Wang, Timothy S.; Yenokyan, Gayane; Kang, Sewon; Chien, Anna L.

    2016-01-01

    Background Individuals with previous nonmelanoma skin cancer (NMSC) are at increased risk for subsequent skin cancer, and should therefore limit UV exposure. Objective To determine whether individuals with previous NMSC engage in better sun protection than those with no skin cancer history. Methods We pooled self-reported data (2005 and 2010 National Health Interview Surveys) from US non-Hispanic white adults (758 with and 34,161 without previous NMSC). We calculated adjusted prevalence odds ratios (aPOR) and 95% confidence intervals (95% CI), taking into account the complex survey design. Results Individuals with previous NMSC versus no history of NMSC had higher rates of frequent use of shade (44.3% versus 27.0%; aPOR=1.41; 1.16–1.71), long sleeves (20.5% versus 7.7%; aPOR=1.55; 1.21–1.98), a wide-brimmed hat (26.1% versus 10.5%; aPOR=1.52; 1.24–1.87), and sunscreen (53.7% versus 33.1%; aPOR=2.11; 95% CI=1.73–2.59), but did not have significantly lower odds of recent sunburn (29.7% versus 40.7%; aPOR=0.95; 0.77–1.17). Among subjects with previous NMSC, recent sunburn was inversely associated with age, sun avoidance, and shade but not sunscreen. Limitations Self-reported cross-sectional data and unavailable information quantifying regular sun exposure. Conclusion Physicians should emphasize sunburn prevention when counseling patients with previous NMSC, especially younger adults, focusing on shade and sun avoidance over sunscreen. PMID:27198078

  14. Task Equivalence for Model and Human-Observer Comparisons in SPECT Localization Studies

    NASA Astrophysics Data System (ADS)

    Sen, Anando; Kalantari, Faraz; Gifford, Howard C.

    2016-06-01

    While mathematical model observers are intended for efficient assessment of medical imaging systems, their findings should be relevant for human observers as the primary clinical end users. We have investigated whether pursuing equivalence between the model and human-observer tasks can help ensure this goal. A localization receiver operating characteristic (LROC) study tested prostate lesion detection in simulated In-111 SPECT imaging with anthropomorphic phantoms. The test images were 2D slices extracted from reconstructed volumes. The iterative ordered sets expectation-maximization (OSEM) reconstruction algorithm was used with Gaussian postsmoothing. Variations in the number of iterations and the level of postfiltering defined the test strategies in the study. Human-observer performance was compared with that of a visual-search (VS) observer, a scanning channelized Hotelling observer, and a scanning channelized nonprewhitening (CNPW) observer. These model observers were applied with precise information about the target regions of interest (ROIs). ROI knowledge was a study variable for the human observers. In one study format, the humans read the SPECT image alone. With a dual-modality format, the SPECT image was presented alongside an anatomical image slice extracted from the density map of the phantom. Performance was scored by area under the LROC curve. The human observers performed significantly better with the dual-modality format, and correlation with the model observers was also improved. Given the human-observer data from the SPECT study format, the Pearson correlation coefficients for the model observers were 0.58 (VS), -0.12 (CH), and -0.23 (CNPW). The respective coefficients based on the human-observer data from the dual-modality study were 0.72, 0.27, and -0.11. These results point towards the continued development of the VS observer for enhancing task equivalence in model-observer studies.

  15. Adalimumab for maintenance therapy for one year in Crohn's disease: results of a Latin American single-center observational study.

    PubMed

    Kotze, Paulo Gustavo; Abou-Rejaile, Vinícius Rezende; Uiema, Luciana Aparecida; Olandoski, Marcia; Sartor, Maria Cristina; Miranda, Eron Fábio; Kotze, Lorete Maria da Silva; Saad-Hossne, Rogério

    2014-01-01

    Adalimumab is a fully-human antibody that inhibits TNF alpha, with a significant efficacy for long-term maintenance of remission. Studies with this agent in Latin American Crohn's disease patients are scarce. The objective of this study was to outline clinical remission rates after 12 months of adalimumab therapy for Crohn's disease patients. Retrospective, single-center, observational study of a Brazilian case series of Crohn's disease patients under adalimumab therapy. Variables analyzed: demographic data, Montreal classification, concomitant medication, remission rates after 1, 4, 6 and 12 months. Remission was defined as Harvey-Bradshaw Index ≤ 4, and non-responder-imputation and last-observation-carried-forward analysis were used. The influence of infliximab on remission rates was analyzed by Fischer and Chi-square tests (P<0.05). Fifty patients, with median age of 35 years at therapy initiation, were included. Remission rates after 12 months of therapy were 54% under non-responder-imputation and 88% under last-observation-carried-forward analysis. After 12 months, remission on patients with previous infliximab occurred in 69.23% as compared to 94.59% in infliximab-naïve patients (P = 0.033). Adalimumab was effective in maintaining clinical remission after 12 months of therapy, with an adequate safety profile, and was also more effective in infliximab naïve patients.

  16. Cheilitis in acne vulgaris patients with no previous use of systemic retinoid products.

    PubMed

    Balighi, Kamran; Daneshpazhooh, Maryam; Lajevardi, Vahideh; Talebi, Shahin; Azizpour, Arghavan

    2017-08-01

    Isotretinoin is commonly used in the treatment of acne vulgaris. While one of the more common side-effects is cheilitis, we have observed an increased incidence of cheilitis prior to the commencement of systemic isotretinoin. The aim of this study was to assess the prevalence of cheilitis among acne vulgaris patients. A non-interventional cross-sectional study of patients with acne vulgaris. Patients with previous use of systemic retinoids were excluded. The patients were examined for signs and symptoms of cheilitis. Of a total of 400 patients, 134 (34%) had evidence of cheilitis at initial presentation. Two-thirds (63%) were female (P < 0.001). The distribution of the cheilitis was as follows; 55% on the lower lip, 30% on both lips, and 16% on the upper lip. Over a quarter (27%) of patients with cheilitis had acne excorie, compared with only 8% of patients with no signs of cheilitis. Our findings suggest that cheilitis is quite common among acne vulgaris patients even before treatment with isotretinoin. © 2016 The Australasian College of Dermatologists.

  17. High-Density Lipoprotein Cholesterol and Cause-Specific Mortality in Individuals Without Previous Cardiovascular Conditions: The CANHEART Study.

    PubMed

    Ko, Dennis T; Alter, David A; Guo, Helen; Koh, Maria; Lau, Geoffrey; Austin, Peter C; Booth, Gillian L; Hogg, William; Jackevicius, Cynthia A; Lee, Douglas S; Wijeysundera, Harindra C; Wilkins, John T; Tu, Jack V

    2016-11-08

    The prognostic importance of high-density lipoprotein cholesterol (HDL-C) as a specific risk factor for cardiovascular (CV) disease has been challenged by recent clinical trials and genetic studies. This study sought to reappraise the association of HDL-C level with CV and non-CV mortality using a "big data" approach. An observational cohort study was conducted using the CANHEART (Cardiovascular Health in Ambulatory Care Research Team) dataset, which was created by linking together 17 different individual-level data sources. People were included if they were between 40 and 105 years old on January 1, 2008, living in Ontario, Canada, without previous CV conditions or severe comorbidities, and had an outpatient fasting cholesterol measurement in the year prior to the inception date. The primary outcome was cause-specific mortality. A total of 631,762 individuals were included. The mean age of our cohort was 57.2 years, 55.4% were women, and mean HDL-C level was 55.2 mg/dl. There were 17,952 deaths during a mean follow-up of 4.9 ± 0.4 years. The overall all-cause mortality rate was 8.1 per 1,000 person-years for men and 6.6 per 1,000 person-years for women. Individuals with lower HDL-C levels were more likely to have low incomes, unhealthy lifestyle, higher triglycerides levels, other cardiac risk factors, and medical comorbidities. Individuals with lower HDL-C levels were independently associated with higher risk of CV, cancer, and other mortality compared with individuals in the reference ranges of HDL-C levels. In addition, individuals with higher HDL levels (>70 mg/dl in men, >90 mg/dl in women) had increased hazard of non-CV mortality. Complex associations exist between HDL-C levels and sociodemographic, lifestyle, comorbidity factors, and mortality. HDL-C level is unlikely to represent a CV-specific risk factor given similarities in its associations with non-CV outcomes. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  18. Coronal Loop Evolution Observed with AIA and Hi-C

    NASA Technical Reports Server (NTRS)

    Mulu-Moore, Fana; Winebarger, A.; Cirtain, J.; Kobayashi, K.; Korreck, K.; Golub, L.; Kuzin. S.; Walsh, R.; DeForest, C.; DePontieu, B.; hide

    2012-01-01

    Despite much progress toward understanding the dynamics of the solar corona, the physical properties of coronal loops are not yet fully understood. Recent investigations and observations from different instruments have yielded contradictory results about the true physical properties of coronal loops. In the past, the evolution of loops has been used to infer the loop substructure. With the recent launch of High Resolution Coronal Imager (Hi-C), this inference can be validated. In this poster we discuss the first results of loop analysis comparing AIA and Hi-C data. We find signatures of cooling in a pixel selected along a loop structure in the AIA multi-filter observations. However, unlike previous studies, we find that the cooling time is much longer than the draining time. This is inconsistent with previous cooling models.

  19. Temporal observations of bright soil exposures at Gusev crater, Mars

    USGS Publications Warehouse

    Rice, M.S.; Bell, J.F.; Cloutis, E.A.; Wray, J.J.; Herkenhoff, K. E.; Sullivan, R.; Johnson, J. R.; Anderson, R.B.

    2011-01-01

    The Mars Exploration Rover Spirit has discovered bright soil deposits in its wheel tracks that previously have been confirmed to contain ferric sulfates and/or opaline silica. Repeated Pancam multispectral observations have been acquired at four of these deposits to monitor spectral and textural changes over time during exposure to Martian surface conditions. Previous studies suggested that temporal spectral changes occur because of mineralogic changes (e.g., phase transitions accompanying dehydration). In this study, we present a multispectral and temporal analysis of eight Pancam image sequences at the Tyrone exposure, three at the Gertrude Weise exposure, two at the Kit Carson exposure, and ten at the Ulysses exposure that have been acquired as of sol 2132 (1 January 2010). We compare observed variations in Pancam data to spectral changes predicted by laboratory experiments for the dehydration of ferric sulfates. We also present a spectral analysis of repeated Mars Reconnaissance Orbiter HiRISE observations spanning 32 sols and a textural analysis of Spirit Microscopic Imager observations of Ulysses spanning 102 sols. At all bright soil exposures, we observe no statistically significant spectral changes with time that are uniquely diagnostic of dehydration and/or mineralogic phase changes. However, at Kit Carson and Ulysses, we observe significant textural changes, including slumping within the wheel trench, movement of individual grains, disappearance of fines, and dispersal of soil clods. All observed textural changes are consistent with aeolian sorting and/or minor amounts of air fall dust deposition.

  20. Observational Learning of Academic and Social Behaviors during Small-Group Direct Instruction

    ERIC Educational Resources Information Center

    Ledford, Jennifer R.; Wolery, Mark

    2015-01-01

    Many studies have shown that small-group direct instruction is effective and efficient for teaching students with and without disabilities, although relatively few studies have been conducted with heterogeneous groups of preschool participants. In addition, previous studies have primarily assessed whether observational learning occurred for…

  1. Previous Knee Injury and Health-Related Quality of Life in Collegiate Athletes.

    PubMed

    Lam, Kenneth C; Thomas, Steven St; Valier, Alison R Snyder; McLeod, Tamara C Valovich; Bay, R Curtis

    2017-06-02

      Patient-rated outcome measures (PROMs) capture changes that are important and meaningful to patients, such as health-related quality of life (HRQOL). Although group differences in HRQOL have been reported, little is known about the effect of injury history on HRQOL in collegiate athletes.   To determine whether knee-specific function (International Knee Documentation Committee Subjective Knee Evaluation Form [IKDC]) and HRQOL (Short Form 12 [SF-12]) differs in collegiate athletes based on sex and the severity of a previous knee injury.   Cross-sectional study.   Athletic training facilities.   Healthy collegiate athletes (n = 263) were grouped based on self-report of a previous knee injury: severe (n = 47), mild (n = 40), and no (n = 176) knee injury.   Participants completed the IKDC and SF-12 during their preparticipation examinations.   Generalized linear models were used to assess interactions and main effects of all scores.   An interaction effect was observed for the SF-12 role physical subscale (P = .02), with men in the mild- and severe-injury groups reporting worse scores than men with no injury history. We noted a main effect for injury group for the IKDC total score (P < .001) and SF-12 physical functioning (P = .04) and role emotional (P = .04) subscales, with the severe-injury group reporting worse scores than the mild- and no-injury groups. No main effects of sex were reported (P > .05).   Despite returning to full participation, collegiate athletes who previously sustained severe knee injuries tended to report worse knee-specific function and less ability to complete activities due to physical health. In addition, individuals with a history of severe knee injury tended to report more emotional concerns than athletes with a history of mild or no knee injury. Region-specific PROMs may be more sensitive in detecting deficits than generic PROMs after return to full participation. Researchers should investigate the role of PROMs

  2. Teacher Effectiveness and Causal Inference in Observational Studies

    ERIC Educational Resources Information Center

    Rose, Roderick A.

    2013-01-01

    An important target of education policy is to improve overall teacher effectiveness using evidence-based policies. Randomized control trials (RCTs), which randomly assign study participants or groups of participants to treatment and control conditions, are not always practical or possible and observational studies using rigorous quasi-experimental…

  3. Previous dropout from diabetic care as a predictor of patients' willingness to use mobile applications for self-management: A cross-sectional study.

    PubMed

    Yamaguchi, Satoko; Waki, Kayo; Tomizawa, Nobuko; Waki, Hironori; Nannya, Yasuhito; Nangaku, Masaomi; Kadowaki, Takashi; Ohe, Kazuhiko

    2017-07-01

    Preventing dropout is crucial in managing diabetes. Accordingly, we investigated whether patients who had dropped out of diabetic care are suitable candidates for the use of mobile technologies - such as smartphone applications - to support self-management (mHealth), which might help prevent dropout. We carried out a cross-sectional study in Tokyo, Japan. Patients aged 20 years or older who were clinically diagnosed as diabetic and who regularly visited the outpatient unit at the University of Tokyo Hospital were recruited between August 2014 and March 2015. Data were collected through face-to-face structured interviews, physical measurements and medical records. Participants were asked whether they were willing to use mHealth after being shown DialBetics - an mHealth application for diabetics - as an example, and about their history of dropout and previous mHealth experience. Data were analyzed by multivariate logistic regression models. Of 307 patients with type 1 and type 2 diabetes, 34 (11.1%) had previously dropped out from diabetic care. Multivariate analysis identified previous mHealth experience as a negative predictor of dropout (odds ratio 0.211, P = 0.023). Of those 34 patients, 27 (79.4%) expressed willingness to use mHealth, a significantly higher percentage than for those who had never dropped out (51.5%, P = 0.002). After adjusting for confounders, history of dropout remained a strong predictor of willingness (odds ratio 3.870, P = 0.004). Patients who previously dropped out of diabetic care are suitable candidates for mHealth. Future studies must evaluate whether mHealth is effective for preventing repeated dropout and improving glycemic control among this population. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

  4. Observing position and movements in hydrotherapy: a pilot study.

    PubMed

    Stark, Mary Ann; Rudell, Barb; Haus, George

    2008-01-01

    To observe and describe the positions and movements women choose while immersed in water during the first stage of labor. Descriptive, observational pilot study. A rural community hospital that provided hydrotherapy in labor. Women (N = 7) who intended to use hydrotherapy in labor were recruited prenatally from a midwife-managed practice. For 15 minutes of each hour during the first stage of labor, position and movements of the participants were observed and recorded on a laptop computer. The observational tool was developed for this study from a review of the literature and interviews with nursing experts; 435 observations were recorded. Women were free to choose when and how long to use hydrotherapy and had no restriction on their positions and movements. Only 3 of the 7 participants labored in the tub. Women demonstrated a greater range of positions and movements in the tub than in bed, both throughout labor and during late first-stage labor (7-10 cm of dilatation). Women had more contractions and made more rhythmic movements while in the tub than in bed. Hydrotherapy may encourage upright positions and movements that facilitate labor progress and coping, helping women avoid unnecessary interventions.

  5. Perspective: An Extension of the STROBE Statement for Observational Studies in Nutritional Epidemiology (STROBE-nut): Explanation and Elaboration

    PubMed Central

    Berg, Christina; Forsum, Elisabet; Larsson, Christel; Sonestedt, Emily; Åkesson, Agneta; Lachat, Carl; Hawwash, Dana; Kolsteren, Patrick; Byrnes, Graham; De Keyzer, Willem; Van Camp, John; Cade, Janet E; Greenwood, Darren C; Slimani, Nadia; Cevallos, Myriam; Egger, Matthias; Huybrechts, Inge; Wirfält, Elisabet

    2017-01-01

    Nutritional epidemiology is an inherently complex and multifaceted research area. Dietary intake is a complex exposure and is challenging to describe and assess, and links between diet, health, and disease are difficult to ascertain. Consequently, adequate reporting is necessary to facilitate comprehension, interpretation, and generalizability of results and conclusions. The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement is an international and collaborative initiative aiming to enhance the quality of reporting of observational studies. We previously presented a checklist of 24 reporting recommendations for the field of nutritional epidemiology, called “the STROBE-nut.” The STROBE-nut is an extension of the general STROBE statement, intended to complement the STROBE recommendations to improve and standardize the reporting in nutritional epidemiology. The aim of the present article is to explain the rationale for, and elaborate on, the STROBE-nut recommendations to enhance the clarity and to facilitate the understanding of the guidelines. Examples from the published literature are used as illustrations, and references are provided for further reading. PMID:28916567

  6. Potentially Inappropriate Antihypertensive Prescriptions to Elderly Patients: Results of a Prospective, Observational Study.

    PubMed

    Márquez, Paola H Ponte; Torres, Olga H; San-José, Anonio; Vidal, Xavier; Agustí, Antonia; Formiga, Francesc; López-Soto, Alfonso; Ramírez-Duque, Nieves; Fernández-Moyano, Antonio; Garcia-Moreno, Juana; Arroyo, Juan A; Ruiz, Domingo

    2017-06-01

    Previous studies of antihypertensive treatment of older patients have focused on blood pressure control, cardiovascular risk or adherence, whereas data on inappropriate antihypertensive prescriptions to older patients are scarce. The aim of the study was to assess inappropriate antihypertensive prescriptions to older patients. An observational, prospective multicentric study was conducted to assess potentially inappropriate prescription of antihypertensive drugs, in patients aged 75 years and older with arterial hypertension (HTN), in the month prior to hospital admission, using four instruments: Beers, Screening Tool of Older Person's Prescriptions (STOPP), Screening Tool to Alert Doctors to the Right Treatment (START) and Assessing Care of Vulnerable Elders 3 (ACOVE-3). Primary care and hospital electronic records were reviewed for HTN diagnoses, antihypertensive treatment and blood pressure readings. Of 672 patients, 532 (median age 85 years, 56% female) had HTN. 21.6% received antihypertensive monotherapy, 4.7% received no hypertensive treatment, and the remainder received a combination of antihypertensive therapies. The most frequently prescribed antihypertensive drugs were diuretics (53.5%), angiotensin-converting enzyme inhibitors (ACEIs) (41%), calcium antagonists (32.2%), angiotensin receptor blockers (29.7%) and beta-blockers (29.7%). Potentially inappropriate prescription was observed in 51.3% of patients (27.8% overprescription and 35% underprescription). The most frequent inappropriately prescribed drugs were calcium antagonists (overprescribed), ACEIs and beta-blockers (underprescribed). ACEI and beta-blocker underprescriptions were independently associated with heart failure admissions [beta-blockers odds ratio (OR) 0.53, 95% confidence interval (CI) 0.39-0.71, p < 0.001; ACEIs OR 0.50, 95% CI 0.36-0.70, p < 0.001]. Potentially inappropriate prescription was detected in more than half of patients receiving antihypertensive treatment

  7. Advanced Earth Observation System Instrumentation Study (aeosis)

    NASA Technical Reports Server (NTRS)

    White, R.; Grant, F.; Malchow, H.; Walker, B.

    1975-01-01

    Various types of measurements were studied for estimating the orbit and/or attitude of an Earth Observation Satellite. An investigation was made into the use of known ground targets in the earth sensor imagery, in combination with onboard star sightings and/or range and range rate measurements by ground tracking stations or tracking satellites (TDRSS), to estimate satellite attitude, orbital ephemeris, and gyro bias drift. Generalized measurement equations were derived for star measurements with a particular type of star tracker, and for landmark measurements with a multispectral scanner being proposed for an advanced Earth Observation Satellite. The use of infra-red horizon measurements to estimate the attitude and gyro bias drift of a geosynchronous satellite was explored.

  8. Observer Agreement for Measurements in Videolaryngostroboscopy.

    PubMed

    Brunings, Jan Wouter; Vanbelle, Sophie; Akkermans, Annemarie; Heemskerk, Nienke M M; Kremer, Bernd; Stokroos, Robert J; Baijens, Laura W J

    2017-11-06

    This study evaluated the levels of intraobserver and interobserver agreement for measurements of visuoperceptual variables in videolaryngostroboscopic examinations and compared the observers' behavior during independent versus consensus panel rating. This is a retrospective study. This study was conducted in a single-center tertiary care facility. Sixty-four patients with dysphonia of heterogeneous etiology were included. All subjects underwent a standardized videolaryngostroboscopic examination. Two experienced and trained observers scored exactly the same examinations, first independently and then on a consensus panel. Specific visuoperceptual variables and the clinical diagnosis (as recommended by the Committee on Phoniatrics and the Phonosurgery Committee of the European Laryngological Society and advised by the American Speech-Language-Hearing Association) were scored. Descriptive and kappa statistics were used. In general, intraobserver agreement was better than agreement between observers for measurements of several variables. The intrapanel observer agreement levels were slightly higher than the intraobserver agreement levels on the independent rating task. When rating on the consensus panel, the observers deviated considerably from the scores they had previously given on the independent rating task. Observer agreement in videolaryngostroboscopic assessment has important implications not only for the diagnosis and treatment of dysphonic patients but also for the interpretation of the results of scientific studies using videolaryngostroboscopic outcome parameters. The identification of factors that can influence the levels of observer agreement can provide a better understanding of the rating process and its limitations. The results of this study suggest that future research could achieve better agreement levels by rating the visuoperceptual variables in a panel setting. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  9. Spectroscopic Observations of the Mass Donor Star in SS 433

    NASA Astrophysics Data System (ADS)

    Hillwig, T. C.; Gies, D. R.

    2008-03-01

    The microquasar SS 433 is an interacting massive binary consisting of an evolved mass donor and a compact companion that ejects relativistic jets. The mass donor was previously identified through spectroscopic observations of absorption lines in the blue part of the spectrum that showed Doppler shifts associated with orbital motion and strength variations related to the orbital modulation of the star-to-disk flux ratio and to disk obscuration. However, subsequent observations revealed other absorption features that lacked these properties and that were probably formed in the disk gas outflow. We present follow-up observations of SS 433 at orbital and precession phases identical to those from several previous studies, with the goals of confirming the detection of the mass donor spectrum and providing more reliable masses for the two system components. We show that the absorption features present as well as those previously observed almost certainly belong to the mass donor star, and find revised masses of 12.3 ± 3.3 and 4.3 ± 0.8 M⊙ for the mass donor and compact object, respectively. Based on observations obtained at the Gemini Observatory, which is operated by the Association of Universities for Research in Astronomy, Inc., under a cooperative agreement with the NSF on behalf of the Gemini partnership: the National Science Foundation (US), the Science and Technology Facilities Council (UK), the National Research Council (Canada), CONICYT (Chile), the Australian Research Council (Australia), CNPq (Brazil), and SECYT (Argentina).

  10. Observations of EMIC Triggered Emissions off the Magnetic Equatorial Plane

    NASA Astrophysics Data System (ADS)

    Grison, B.; Breuillard, H.; Santolik, O.; Cornilleau-Wehrlin, N.

    2016-12-01

    On 19/08/2005 Cluster spacecraft had their perigee close to the dayside of the Earth magnetic equatorial plane, at about 14 hours Magnetic Local Time. The spacecraft crossed the equator from the southern hemisphere toward the northern hemisphere. In the Southern hemisphere, at about -23° magnetic latitude (MLAT) and at distance of 5.25 Earth Radii from Earth, Cluster 3 observes an EMIC triggered emission between the He+ and the proton local gyrofrequencies. The magnetic waveform (STAFF instrument data) is transformed into the Fourier space for a study based on single value decomposition (SVD) analysis. The emission lasts about 30s. The emission frequency rises from 1Hz up to 1.9Hz. The emission polarization is left-hand, its coherence value is high and the propagation angle is field aligned (lower than 30º). The Poynting flux orientation could not be established. Based on previous study results, these properties are indicative of an observation in vicinity of the source region of the triggered emission. From our knowledge this is the first time that EMIC triggered emission are observed off the magnetic equator. In order to identify the source region we study two possibilities: a source region at higher latitudes than the observations (and particles orbiting in "Shabansky" orbits) and a source region close to the magnetic equatorial plane, as reported in previous studies. We propose to identify the source region from ray tracing analysis and to compare the observed propagation angle in several frequency ranges to the ray tracing results.

  11. Seat belt and mobile phone use among vehicle drivers in the city of Doha, Qatar: an observational study.

    PubMed

    Mahfoud, Ziyad R; Cheema, Sohaila; Alrouh, Hekmat; Al-Thani, Mohammed Hamad; Al-Thani, Al Anoud Mohammed; Mamtani, Ravinder

    2015-09-22

    In Qatar traffic injuries and fatalities are of serious concern. Mobile phone use whilst driving has been associated with increased risk of vehicular collisions and injuries. Seat belt use has been demonstrated to save lives and reduce the severity of road traffic injuries. Whereas previously published studies may have looked at all front passengers, this study aims to obtain reliable estimates of the prevalence of seat belt and mobile phone use among vehicle drivers in the city of Doha, Qatar. Additionally, we aim to investigate the association of these behaviors with other variables namely gender, time of the day and type of vehicle. An observational study on 2,011 vehicles was conducted in 2013. Data were collected at ten sites within Doha city over a two-week period. Two trained observers surveyed each car and recorded observations on a data collection form adapted from a form used in a 2012 Oklahoma observational study. Associations were assessed using the Chi-squared test or Fisher's exact test. A p-value of .05 or less was considered statistically significant. Overall, 1,463 (72.7 %) drivers were found using a seat belt (95 % CI: 70.8-74.7 %) and 150 (7.5 %) their mobile phones (95 % CI: 6.3-8.6 %) during the observation period. Mobile phone use was significantly associated with not using a seat belt and driving a sport utility vehicle. Significantly lower rates of seat belt use were observed in the early morning and late afternoon. No gender differences were observed. Seatbelt use in Doha was found to be similar to countries in the region but lower than those in western countries. Also, studies from other high-income locations, reported lower rates of mobile phone use while driving than in Doha. Despite road traffic crashes being one of the leading causes of death in Qatar, three out of 10 drivers in Doha, Qatar, do not use a seat belt and about one in 12 use a mobile phone while driving. More efforts, in the form of awareness campaigns and increased law

  12. Neural Repetition Effects in the Medial Temporal Lobe Complex are Modulated by Previous Encoding Experience

    PubMed Central

    Greene, Ciara M.; Soto, David

    2012-01-01

    It remains an intriguing question why the medial temporal lobe (MTL) can display either attenuation or enhancement of neural activity following repetition of previously studied items. To isolate the role of encoding experience itself, we assessed neural repetition effects in the absence of any ongoing task demand or intentional orientation to retrieve. Experiment 1 showed that the hippocampus and surrounding MTL regions displayed neural repetition suppression (RS) upon repetition of past items that were merely attended during an earlier study phase but this was not the case following re-occurrence of items that had been encoded into working memory (WM). In this latter case a trend toward neural repetition enhancement (RE) was observed, though this was highly variable across individuals. Interestingly, participants with a higher degree of neural RE in the MTL complex displayed higher memory sensitivity in a later, surprise recognition test. Experiment 2 showed that massive exposure at encoding effected a change in the neural architecture supporting incidental repetition effects, with regions of the posterior parietal and ventral-frontal cortex in addition to the hippocampus displaying neural RE, while no neural RS was observed. The nature of encoding experience therefore modulates the expression of neural repetition effects in the MTL and the neocortex in the absence of memory goals. PMID:22829892

  13. Recovery in patients with major depressive disorder (MDD): results of a 6-month, multinational, observational study

    PubMed Central

    Novick, Diego; Montgomery, William; Vorstenbosch, Ellen; Moneta, Maria Victoria; Dueñas, Héctor; Haro, Josep Maria

    2017-01-01

    Not all individuals treated for major depressive disorder (MDD) achieve recovery. This observational study examined the recovery rates in MDD patients and the patient characteristics associated with achieving recovery in a naturalistic clinical setting. Recovery was defined as having both clinical and functional remission. Data for this post hoc analysis were taken from a 24-week prospective, observational study that involved 1,549 MDD patients. Clinical remission was assessed using the 16-item Quick Inventory of Depressive Symptomatology Self-Report and functional remission through the Sheehan Disability Scale and no days of reduced productivity in the previous week. Generalized estimating equation regression models were used to examine the baseline factors associated with recovery during follow-up. Clinical and functional remission was achieved in 70.6% and 56.1% of the MDD patients, respectively. MDD patients who achieved recovery (52.1%) were significantly less likely to have impaired levels of functioning, concurrent medical or psychiatric conditions, low levels of education, or nonadherence to therapy at follow-up. The level of functioning during the index episode seems to be a better predictor of recovery than symptom severity. Therefore, the level of functioning should be considered while determining recovery from depression. PMID:29184393

  14. No Previous Public Services Required

    ERIC Educational Resources Information Center

    Taylor, Kelley R.

    2009-01-01

    In 2007, the Supreme Court heard a case that involved the question of whether a school district could be required to reimburse parents who unilaterally placed their child in private school when the child had not previously received special education and related services in a public institution ("Board of Education v. Tom F."). The…

  15. Is the Universe More Transparent to Gamma Rays than Previously Thought?

    NASA Technical Reports Server (NTRS)

    Stecker, Floyd W.; Scully, Sean T.

    2009-01-01

    The MAGIC collaboration has recently reported the detection of the strong gamma-ray blazar 3C279 during a 1-2 day flare. They have used their spectral observations to draw conclusions regarding upper limits on the opacity of the Universe to high energy gamma-rays and, by implication, upper limits on the extragalactic mid-infrared background radiation. In this paper we examine the effect of gamma-ray absorption by the extragalactic infrared radiation on intrinsic spectra for this blazar and compare our results with the observational data on 3C279. We find agreement with our previous results, contrary to the recent assertion of the MAGIC group that the Universe is more transparent to gamma-rays than our calculations indicate. Our analysis indicates that in the energy range between approx. 80 and approx. 500 GeV, 3C279 has a best-fit intrinsic spectrum with a spectral index approx. 1.78 using our fast evolution model and approx. 2.19 using our baseline model. However, we also find that spectral indices in the range of 1.0 to 3.0 are almost as equally acceptable as the best fit spectral indices. Assuming the same intrinsic spectral index for this flare as for the 1991 flare from 3C279 observed by EGRET, viz., 2.02, which lies between our best fit indeces, we estimate that the MAGIC flare was approx.3 times brighter than the EGRET flare observed 15 years earlier.

  16. Cassini/CIRS Observations of Saturn’s Polar Vortices from Proximal Orbit Observations

    NASA Astrophysics Data System (ADS)

    Achterberg, Richard; Bjoraker, Gordon L.; Hesman, Brigette E.; Flasar, F. Michael

    2017-10-01

    The proximal orbit phase of the Cassini mission, with periapses inside the inner edge of the rings, has allowed observations of Saturn’s atmosphere with unprecedented spatial resolution. During the periapse periods on 26 April and 29 June 2017, the Composite Infrared Spectrometer (CIRS) performed scans over both the north and south poles with a spatial resolution better than 0.2° of latitude, over a factor of 4 better resolution than previous observations. A further observation of the south pole is planned on 20 Aug 2017.Previous thermal infrared observations of Saturn’s poles [1,2] showed a compact hot spot in the upper troposphere at each pole, roughly coincident with the hurricane-like polar vortex seen in visible imaging [3]. Preliminary results from the proximal orbit scans of the north pole, near summer solstice, show that in the upper troposphere, the meridional temperature gradient increases sharply at about 89°N, with the temperature increasing by ~5K between 89°N and the pole, with the temperature gradient persisting all the way to the pole within the spatial resolution of the observation. In the northern stratosphere, the polar hot spot is broader than in the troposphere, extending to ~86°N at 4 mbar, and disappearing into the general meridional gradient at 1 mbar.[1] G. S. Orton and P. A. Yanamadra-Fisher, Science 307, 696[2] L. N. Fletcher et al., Science, 319, 79[3] U. A. Dyudina et al., Icarus, 202, 240.

  17. ESO Large Program on physical studies of Trans-Neptunian objects and Centaurs: Final results of the visible spectrophotometric observations

    NASA Astrophysics Data System (ADS)

    Fornasier, S.; Doressoundiram, A.; Tozzi, G. P.; Barucci, M. A.; Boehnhardt, H.; de Bergh, C.; Delsanti, A.; Davies, J.; Dotto, E.

    2004-07-01

    The Large Program on physical studies of TNOs and Centaurs, started at ESO Cerro Paranal on April 2001, has recently been concluded. This project was devoted to the investigation of the surface properties of these icy bodies through photometric and spectroscopic observations. In this paper we present the latest results on these pristine bodies obtained from the spectrophotometric investigation in the visible range. The newly obtained spectrophotometric data on 3 Centaurs and 5 TNOs, coming from 2 observing runs at the Very Large Telescope (VLT), show a large variety of spectral characteristics, comprising both gray and red objects in the two different populations. A very broad and weak absorption feature, centered around 7000 Å , has been revealed in the spectrum of the gray TNO 2003 AZ84. This absorption is very similar to a feature observed on low albedo main belt asteroids and attributed to the action of the aqueous alteration process on minerals. This process was previously also claimed as the most plausible explanation for some peculiar visible absorption bands observed on 2000 EB173 and 2000 GN171 in the framework of the Large Program (Lazzarin et al. \\cite{Lazzarin03}; de Bergh et al. \\cite{Bergh04}). This detection seems to reinforce the hypothesis that aqueous alteration might have taken place also at such large heliocentric distances. We also report the results of a spectroscopic investigation performed outside the Large Program on the very interesting TNO 2000 GN171 during part of its rotational period. This object, previously observed twice in the framework of the Large Program, had shown during the early observations a very peculiar absorption band tentatively attributed to aqueous alteration processes. As this feature was not confirmed in a successive spectrum, we recently repeated the investigations of 2000 GN171, finding out that it has an heterogeneous composition. Finally an analysis of the visible spectral slopes is reported for all the data

  18. GM1 antibodies in post-polio syndrome and previous paralytic polio.

    PubMed

    Farbu, E; Rekand, T; Tysnes, O-B; Aarli, J A; Gilhus, N E; Vedeler, C A

    2003-06-01

    We studied the relationship between post-polio syndrome (PPS) and GM1 antibodies, since such antibodies have been associated with PPS and motor neuron disorders. Sera from 144 patients with previous poliomyelitis (105 paralytic, 22 nonparalytic and 17 PPS), 60 with previous Guillain-Barré syndrome, 44 with amyotrophic lateral sclerosis (ALS) and 22 healthy blood donors were analyzed with ELISA for GM1 IgM, IgG and IgA antibodies. GM1 antibodies were present in 14% of the PPS patients, but the prevalence did not differ significantly from that of the other groups. Our study does not support the hypothesis that GM1 antibodies are involved in the pathogenesis of PPS.

  19. Determining root correspondence between previously and newly detected objects

    DOEpatents

    Paglieroni, David W.; Beer, N Reginald

    2014-06-17

    A system that applies attribute and topology based change detection to networks of objects that were detected on previous scans of a structure, roadway, or area of interest. The attributes capture properties or characteristics of the previously detected objects, such as location, time of detection, size, elongation, orientation, etc. The topology of the network of previously detected objects is maintained in a constellation database that stores attributes of previously detected objects and implicitly captures the geometrical structure of the network. A change detection system detects change by comparing the attributes and topology of new objects detected on the latest scan to the constellation database of previously detected objects.

  20. Space observations for global and regional studies of the biosphere

    NASA Technical Reports Server (NTRS)

    Cihlar, J.; Li, Z.; Chen, J.; Sellers, P.; Hall, F.

    1994-01-01

    The capability to make space-based measurements of Earth at high spatial and temporal resolutions, which would not otherwise be economically or practically feasible, became available just in time to contribute to scientific understanding of the interactive processes governing the total Earth system. Such understanding has now become essential in order to take practical steps which would counteract or mitigate the pervasive impact of the growing human population on the future habitability of the Earth. The paper reviews the rationale for using space observations for studies of climate and terrestrial ecosystems at global and regional scales, as well as the requirements for such observations for studies of climate and ecosystem dynamics. The present status of these developments is reported along with initiatives under way to advance the use of satellite observations for Earth system studies. The most important contribution of space observations is the provision of physical or biophysical parameters for models representing various components of the Earth system. Examples of such parameters are given for climatic and ecosystem studies.

  1. Observational studies and the difficult quest for causality: lessons from vaccine effectiveness and impact studies.

    PubMed

    Lipsitch, Marc; Jha, Ayan; Simonsen, Lone

    2016-12-01

    Although randomized placebo-controlled trials (RCT) are critical to establish efficacy of vaccines at the time of licensure, important remaining questions about vaccine effectiveness (VE)-used here to include individual-level measures and population-wide impact of vaccine programmes-can only be answered once the vaccine is in use, from observational studies. However, such studies are inherently at risk for bias. Using a causal framework and illustrating with examples, we review newer approaches to detecting and avoiding confounding and selection bias in three major classes of observational study design: cohort, case-control and ecological studies. Studies of influenza VE, especially in seniors, are an excellent demonstration of the challenges of detecting and reducing such bias, and so we use influenza VE as a running example. We take a fresh look at the time-trend studies often dismissed as 'ecological'. Such designs are the only observational study design that can measure the overall effect of a vaccination programme [indirect (herd) as well as direct effects], and are in fact already an important part of the evidence base for several vaccines currently in use. Despite the great strides towards more robust observational study designs, challenges lie ahead for evaluating best practices for achieving robust unbiased results from observational studies. This is critical for evaluation of national and global vaccine programme effectiveness. © The Author 2016; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

  2. User-friendly tools on handheld devices for observer performance study

    NASA Astrophysics Data System (ADS)

    Matsumoto, Takuya; Hara, Takeshi; Shiraishi, Junji; Fukuoka, Daisuke; Abe, Hiroyuki; Matsusako, Masaki; Yamada, Akira; Zhou, Xiangrong; Fujita, Hiroshi

    2012-02-01

    ROC studies require complex procedures to select cases from many data samples, and to set confidence levels in each selected case to generate ROC curves. In some observer performance studies, researchers have to develop software with specific graphical user interface (GUI) to obtain confidence levels from readers. Because ROC studies could be designed for various clinical situations, it is difficult task for preparing software corresponding to every ROC studies. In this work, we have developed software for recording confidence levels during observer studies on tiny personal handheld devices such as iPhone, iPod touch, and iPad. To confirm the functions of our software, three radiologists performed observer studies to detect lung nodules by using public database of chest radiograms published by Japan Society of Radiological Technology. The output in text format conformed to the format for the famous ROC kit from the University of Chicago. Times required for the reading each case was recorded very precisely.

  3. Upper limits from hard X-ray observations of five BL Lacertae objects

    NASA Technical Reports Server (NTRS)

    Bezler, M.; Gruber, D. E.; Rothschild, R. E.

    1988-01-01

    Results are presented from hard X-ray observations of the five brightest X-ray BL Lacertae objects: PKS 0548-322, Mrk 421 (=1101+384), 2A 1219+305, Mrk 501 (=1652+398), and PKS 2155-304. The observations covered the energy range 15-165 keV from August 1977 to December 1978. The results are compared with previous studies.

  4. Novel jet observables from machine learning

    NASA Astrophysics Data System (ADS)

    Datta, Kaustuv; Larkoski, Andrew J.

    2018-03-01

    Previous studies have demonstrated the utility and applicability of machine learning techniques to jet physics. In this paper, we construct new observables for the discrimination of jets from different originating particles exclusively from information identified by the machine. The approach we propose is to first organize information in the jet by resolved phase space and determine the effective N -body phase space at which discrimination power saturates. This then allows for the construction of a discrimination observable from the N -body phase space coordinates. A general form of this observable can be expressed with numerous parameters that are chosen so that the observable maximizes the signal vs. background likelihood. Here, we illustrate this technique applied to discrimination of H\\to b\\overline{b} decays from massive g\\to b\\overline{b} splittings. We show that for a simple parametrization, we can construct an observable that has discrimination power comparable to, or better than, widely-used observables motivated from theory considerations. For the case of jets on which modified mass-drop tagger grooming is applied, the observable that the machine learns is essentially the angle of the dominant gluon emission off of the b\\overline{b} pair.

  5. An Observational Study of Cataclysmic Variable Evolution

    NASA Astrophysics Data System (ADS)

    Araujo-Betancor, Sofia

    2004-03-01

    In this thesis I present an observational study of the evolution of Cataclysmic Variables (CVs). Disrupted magnetic braking has been the standard paradigm of CV evolution for the past twenty years. Unfortunately, some of its predictions are in strong disagreement with the observations. In recent years, a number of additions/alternatives to the standard model have been proposed. Yet, none have been able to explain all of the features observed in the currently known CV population. The work presented in this thesis is based mainly on a large-scale search for CVs. The primary aim of this project is to resolve the disagreement between theory and observations by eliminating the observational biases of the present CV sample. Here, I use two complementary approaches to search for CVs: (1) from the spectroscopic appearance in the Hamburg Quasar Survey (HQS), and (2) by using a combination of ROSAT and 2MASS archival data. So far, we have discovered 52 new CVs in the HQS and 11 new CVs (the majority of them magnetic) and 1 pre-CV in the ROSAT/2MASS. Follow-up observations of two newly discovered HQS CVs, 1RXS J062518.2+733433 and HS 2331+3905, resulted in the classification of the first as an Intermediate Polar, with P_orb = 283.0 min and P_spin = 19.8 min, and the second as a short orbital period system, P_orb = 81.0 min, harbouring a white dwarf pulsator. In addition, we found that the dominant ~3.5 h radial velocity variation of HS 2331+3905 does not correspond to the orbital period of the system, contrary to all other CVs. Despite its novel selection criterion, the HQS does not provide many short-period CVs -- even though tests with the known CVs included in the survey have shown that it is very sensitive to those objects. The biggest surprise in the new HQS sample is the discovery of many new SW Sex stars. The clustering of SW Sex stars in the 3-4 h period range is probably an important feature in the evolution of CVs that we currently do not understand at all. To

  6. A review of data sharing statements in observational studies published in the BMJ: A cross-sectional study

    PubMed Central

    McDonald, Laura; Schultze, Anna; Simpson, Alex; Graham, Sophie; Wasiak, Radek; Ramagopalan, Sreeram V.

    2017-01-01

    In order to understand the current state of data sharing in observational research studies, we reviewed data sharing statements of observational studies published in a general medical journal, the British Medical Journal. We found that the majority (63%) of observational studies published between 2015 and 2017 included a statement that implied that data used in the study could not be shared. If the findings of our exploratory study are confirmed, room for improvement in the sharing of real-world or observational research data exists. PMID:29167735

  7. Adverse events, bone mineral density and discontinuation associated with generic alendronate among postmenopausal women previously tolerant of brand alendronate: a retrospective cohort study

    PubMed Central

    2010-01-01

    Background A rise in gastrointestinal (GI) adverse events (AEs) and a decline in bone mineral density (BMD) was observed in patients previously tolerant to brand alendronate shortly after generic versions were introduced in July 2005 to the Canadian market. The objective of our study was to quantify changes in AE rates and BMD scores, as well as associated alendronate discontinuation among patients before and after switch from brand to generic alendronate. Methods A chart review of postmenopausal women 50 years of age and older between 2003 and 2007 was conducted in two specialized tertiary care referral centers. Patients on alendronate both before and after July 2005 were included. The change in the number of AEs, changes in BMD and associated alendronate discontinuation was compared before and after the switch from brand to generic alendronate. Results 301 women with an average age of 67.6 years (standard deviation (SD) = 9.5) had a total of 47 AEs between July 2003 and December 2007 that resulted in discontinuation of the medication. There was a significant increase in the rate of AEs per patient-months-at-risk from 0.0001 before to 0.0044 after October 2005 (p < 0.001). The most common AEs were GI in nature (stomach pain, GI upset, nausea, and reflux). In addition, 23 patients discontinued alendronate due to BMD reduction after January 2006. In these patients, BMD scores were significantly reduced from their prior BMD measures (change of -0.0534, p < 0.001 for spine BMD and change of -0.0338, p = 0.01 for femur BMD). Among patients who discontinued due to BMD reduction, BMD was stable in the period prior to January 2006 (change of -0.0066, p = 0.5 for spine BMD and change of 0.0011, p = 0.9 for femur BMD); however, testing for reduction after January 2006 in BMD measures (one-sided T-test) revealed there was a significant reduction in BMD scores for both anatomic sites (change of -0.0321, p = .005 for spine, change of -0.0205, p = 0.05 for femur). Conclusions

  8. Female Sexual Dysfunction in the Late Postpartum Period Among Women with Previous Gestational Diabetes Mellitus.

    PubMed

    Sargin, Mehmet Akif; Yassa, Murat; Taymur, Bilge Dogan; Taymur, Bulent; Akca, Gizem; Tug, Niyazi

    2017-04-01

    To compare the status of female sexual dysfunction (FSD) between women with a history of previous gestational diabetes mellitus (GDM) and those with follow-up of a healthy pregnancy, using the female sexual function index (FSFI) questionnaire. Cross-sectional study. Department of Obstetrics and Gynecology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey, from September to December 2015. Healthy sexually active adult parous females were included. Participants were asked to complete the validated Turkish versions of the FSFI and Hospital Anxiety and Depression Scale (HADS) questionnaires. Student's t-test was used for two-group comparisons of normally distributed variables and quantitative data. Mann-Whitney U-test was used for two-group comparisons of non-normally distributed variables. Pearson's chi-squared test, the Fisher-FreemanHalton test, Fisher's exact test, and Yates' continuity correction test were used for comparison of qualitative data. The mean FSFI scores of the 179 participants was 23.50 ±3.94. FSFI scores and scores of desire, arousal, lubrication, orgasm, satisfaction, and pain were not statistically significantly different (p>0.05), according to a history of GDM and types of FSD (none, mild, severe). HADS scores and anxiety and depression types did not statistically significantly differ according to the history of GDM (p>0.05). An association could not be found in FSFI scores between participants with both the history of previous GDM and with healthy pregnancy; subclinical sexual dysfunction may be observed in the late postpartum period among women with a history of previous GDM. This may adversely affect their sexual health.

  9. Milky Way Past Was More Turbulent Than Previously Known

    NASA Astrophysics Data System (ADS)

    2004-04-01

    Results of 1001 observing nights shed new light on our Galaxy [1] Summary A team of astronomers from Denmark, Switzerland and Sweden [2] has achieved a major breakthrough in our understanding of the Milky Way, the galaxy in which we live. After more than 1,000 nights of observations spread over 15 years, they have determined the spatial motions of more than 14,000 solar-like stars residing in the neighbourhood of the Sun. For the first time, the changing dynamics of the Milky Way since its birth can now be studied in detail and with a stellar sample sufficiently large to allow a sound analysis. The astronomers find that our home galaxy has led a much more turbulent and chaotic life than previously assumed. PR Photo 10a/04: Distribution on the sky of the observed stars. PR Photo 10b/04: Stars in the solar neigbourhood and the Milky Way galaxy (artist's view). PR Video Clip 04/04: The motions of the observed stars during the past 250 million years. Unknown history Home is the place we know best. But not so in the Milky Way - the galaxy in which we live. Our knowledge of our nearest stellar neighbours has long been seriously incomplete and - worse - skewed by prejudice concerning their behaviour. Stars were generally selected for observation because they were thought to be "interesting" in some sense, not because they were typical. This has resulted in a biased view of the evolution of our Galaxy. The Milky Way started out just after the Big Bang as one or more diffuse blobs of gas of almost pure hydrogen and helium. With time, it assembled into the flattened spiral galaxy which we inhabit today. Meanwhile, generation after generation of stars were formed, including our Sun some 4,700 million years ago. But how did all this really happen? Was it a rapid process? Was it violent or calm? When were all the heavier elements formed? How did the Milky Way change its composition and shape with time? Answers to these and many other questions are 'hot' topics for the

  10. Quantifying the influence of previously burned areas on suppression effectiveness and avoided exposure: A case study of the Las Conchas Fire

    Treesearch

    Matthew P. Thompson; Patrick Freeborn; Jon D. Rieck; Dave Calkin; Julie W. Gilbertson-Day; Mark A. Cochrane; Michael S. Hand

    2016-01-01

    We present a case study of the Las Conchas Fire (2011) to explore the role of previously burned areas (wildfires and prescribed fires) on suppression effectiveness and avoided exposure. Methodological innovations include characterisation of the joint dynamics of fire growth and suppression activities, development of a fire line effectiveness framework, and...

  11. Temporal observations of bright soil exposures at Gusev crater, Mars

    USGS Publications Warehouse

    Rice, M.S.; Bell, J.F.; Cloutis, E.A.; Wray, J.J.; Herkenhoff, K. E.; Sullivan, R.; Johnson, J. R.; Anderson, R.B.

    2011-01-01

    The Mars Exploration Rover Spirit has discovered bright soil deposits in its wheel tracks that previously have been confirmed to contain ferric sulfates and/or opaline silica. Repeated Pancam multispectral observations have been acquired at four of these deposits to monitor spectral and textural changes over time during exposure to Martian surface conditions. Previous studies suggested that temporal spectral changes occur because of mineralogic changes (e.g., phase transitions accompanying dehydration). In this study, we present a multispectral and temporal analysis of eight Pancam image sequences at the Tyrone exposure, three at the Gertrude Weise exposure, two at the Kit Carson exposure, and ten at the Ulysses exposure that have been acquired as of sol 2132 (1 January 2010). We compare observed variations in Pancam data to spectral changes predicted by laboratory experiments for the dehydration of ferric sulfates. We also present a spectral analysis of repeated Mars Reconnaissance Orbiter HiRISE observations spanning 32 sols and a textural analysis of Spirit Microscopic Imager observations of Ulysses spanning 102 sols. At all bright soil exposures, we observe no statistically significant spectral changes with time that are uniquely diagnostic of dehydration and/or mineralogic phase changes. However, at Kit Carson and Ulysses, we observe significant textural changes, including slumping within the wheel trench, movement of individual grains, disappearance of fines, and dispersal of soil clods. All observed textural changes are consistent with aeolian sorting and/or minor amounts of air fall dust deposition. Copyright 2011 by the American Geophysical Union.

  12. Evaluation of questionnaire-based information on previous physical work loads. Stockholm MUSIC 1 Study Group. Musculoskeletal Intervention Center.

    PubMed

    Torgén, M; Winkel, J; Alfredsson, L; Kilbom, A

    1999-06-01

    The principal aim of the present study was to evaluate questionnaire-based information on past physical work loads (6-year recall). Effects of memory difficulties on reproducibility were evaluated for 82 subjects by comparing previously reported results on current work loads (test-retest procedure) with the same items recalled 6 years later. Validity was assessed by comparing self-reports in 1995, regarding work loads in 1989, with worksite measurements performed in 1989. Six-year reproducibility, calculated as weighted kappa coefficients (k(w)), varied between 0.36 and 0.86, with the highest values for proportion of the workday spent sitting and for perceived general exertion and the lowest values for trunk and neck flexion. The six-year reproducibility results were similar to previously reported test-retest results for these items; this finding indicates that memory difficulties was a minor problem. The validity of the questionnaire responses, expressed as rank correlations (r(s)) between the questionnaire responses and workplace measurements, varied between -0.16 and 0.78. The highest values were obtained for the items sitting and repetitive work, and the lowest and "unacceptable" values were for head rotation and neck flexion. Misclassification of exposure did not appear to be differential with regard to musculoskeletal symptom status, as judged by the calculated risk estimates. The validity of some of these self-administered questionnaire items appears sufficient for a crude assessment of physical work loads in the past in epidemiologic studies of the general population with predominantly low levels of exposure.

  13. Salvage brachytherapy for local recurrences of prostate cancer treated previously with radiotherapy.

    PubMed

    Gawkowska-Suwinska, Marzena; Fijałkowski, Marek; Białas, Brygida; Szlag, Marta; Kellas-Ślęczka, Sylwia; Nowicka, Elżbieta; Behrendt, Katarzyna; Plewicki, Grzegorz; Smolska-Ciszewska, Beata; Giglok, Monika; Zajusz, Aleksander; Owczarek, Grzegorz

    2009-12-01

    The aim of the study was to analyze early effects and toxicity of salvage high dose rate brachytherapy for local recurrences of adenocarcinoma of the prostate after external beam radiotherapy (EBRT). In MCS Memorial Institute of Oncology in Gliwice a research programme on salvage HDR brachytherapy for local recurrences of prostate cancer treated previously with EBRT has been ongoing since February 2008. The treatment consisted of 3 fractions of 10 Gy each given every 14 days. Maximal urethral doses were constrained to be ≤ 120% of the prescribed dose. Maximal bladder and rectum doses were constrained to be ≤ 70% of the prescribed dose. Fifteen eligible patients were treated and analyzed from February 2008. All patients completed the treatment without major complications. The most common early complications were: macroscopic haematuria, pain in lower part of the abdomen, and transient dysuria. During the first week after the procedure a transient increase in IPSS score was noticed. The Foley catheter was removed on day 2 to 5. No complications after spinal anaesthesia were observed. Acute toxicity according to EORTC/RTOG was low. For bladder EORTC/RTOG score ranged from 0 to 2. Only in two patients grade 1 toxicity for rectum was observed. The follow-up ranged from 3 to 9 months. In one patient grade 2 rectal toxicity was observed, and one had urethral stricture. Other patients did not have any other significant late toxicity of the treatment. Two patients developed bone metastases. Salvage brachytherapy for localized prostate cancer (3 × 10 Gy every 14 days) seems to be a safe and well tolerated procedure. A significant decline in prostate-specific antigen (PSA) level is seen in patients with hormone-responsive cancer. Long-term efficiency and toxicity of the procedure are yet to be established.

  14. Individual and institutional factors associated with functional disability in nursing home residents: An observational study with multilevel analysis.

    PubMed

    Serrano-Urrea, Ramón; Gómez-Rubio, Virgilio; Palacios-Ceña, Domingo; Fernández-de-Las-Peñas, César; García-Meseguer, María José

    2017-01-01

    High prevalence of functional limitations has been previously observed in nursing homes. Disability may depend not only on the characteristics of the residents but also on the facility characteristics. The aims of this study were: 1, to describe the prevalence of functional disability in older people living in Spanish nursing homes; and 2, to analyze the relationships between individual and nursing home characteristics and residents' functional disability. A cross-sectional study with data collected from 895 residents in 34 nursing homes in the province of Albacete (Spain) was conducted. Functional status was assessed by the Barthel Index. Taking into account both levels of data (individual and institutional characteristics) we resorted to a multilevel analysis in order to take different sources of variability in the data. The prevalence of functional disability of the total sample was 79.8%. The best fitting multilevel model showed that female gender, older age, negative self-perception of health, and living in private nursing homes were factors significantly associated with functional disability. After separating individual and institutional effects, the institutions showed significant differences. In line with previous findings, our study found high levels of functional dependence among institutionalized elders. Gender, age, self-perception of health, and institution ownership were associated with functional status. Disentangling individual and institutional effects by means of multilevel models can help evaluate the quality of the residences.

  15. Overview of the Ocean Observer Satellite Study

    NASA Astrophysics Data System (ADS)

    Cunningham, J. D.; McGuire, J. P.; Pichel, W. G.; Gerber, A. J.

    2002-12-01

    A two-year study of ocean satellite remote sensing requirements and instrument/satellite options is nearing completion. This Ocean Observer Study was sponsored by the U.S. Dept. of Commerce/Dept. of Defense/National Aeronautics and Space Administration Integrated Program Office, whose mission is to develop the future U.S. National Polar-Orbiting Operational Environmental Satellite System (NPOESS). A comprehensive Ocean Observer User Requirements Document has been drafted by a team of over 150 government, academic, and private sector scientists, engineers, and administrators. Included are requirements for open and coastal ocean surface, cryospheric, hydrologic, and some land/hazard and atmospheric boundary layer parameters. This document was then used as input to the instrument and satellite study (conducted by the Jet Propulsion Laboratory) which produced five different instrument/satellite configuration options designed to address the maximum number of requirements which will not be met with the already-approved NPOESS instruments. Instruments studied include a synthetic aperture radar (SAR), an altimeter, and a hyper-spectral coastal infrared/visible imager. After analyzing the alternatives, it appears that one of the best options is a two-satellite system consisting of (1) an altimeter mission in the Topex/Poseidon orbit carrying both wide-swath and delayed doppler altimeters, and (2) a multi-polarization, multi-frequency, multi-mode interferometric SAR mission including a coastal imager in a polar sun-synchronous orbit. This paper summarizes the user requirements process, briefly describes the notional satellite configuration, and presents some of the capabilities of the instruments.

  16. Radiation energy budget studies using collocated AVHRR and ERBE observations

    NASA Technical Reports Server (NTRS)

    Ackerman, Steven A.; Inoue, Toshiro

    1994-01-01

    Changes in the energy balance at the top of the atmosphere are specified as a function of atmospheric and surface properties using observations from the Advanced Very High Resolution Radiometer (AVHRR) and the Earth Radiation Budget Experiment (ERBE) scanner. By collocating the observations from the two instruments, flown on NOAA-9, the authors take advantage of the remote-sensing capabilities of each instrument. The AVHRR spectral channels were selected based on regions that are strongly transparent to clear sky conditions and are therefore useful for characterizing both surface and cloud-top conditions. The ERBE instruments make broadband observations that are important for climate studies. The approach of collocating these observations in time and space is used to study the radiative energy budget of three geographic regions: oceanic, savanna, and desert.

  17. Driving performance while using cell phones: an observational study.

    PubMed

    Rosenbloom, Tova

    2006-01-01

    Through spontaneous driving observations, this study sought to examine the impact of using a hands-free cell phone while driving on speed and safe gap keeping behaviors. The study also examined the association between the measure of disturbance created by using a cell phone and the driver's awareness of the disturbance. Twenty-three male adults were observed while driving for an hour and a half each; drivers were unaware of being observed. During the session, each of the participants received a phone call, initiated by an associate of the observer. The experiment was divided into two periods during which the experimental parameters were monitored: 10 minutes during conversation on a cell phone and 10 minutes of non-conversation on a hands-free cell phone. After the experiment, the driver was questioned concerning the extent to which his/her driving was disturbed by the cell phone conversation. T-test for matched samples revealed that the gaps between the drivers' cars and those in front of them diminished when drivers were engaged in the cell phone conversations. Repeated measures ANOVA revealed that drivers that had short conversations did not change their speed, while drivers who were engaged in long (over 16 minutes) conversations drove faster. No effect of drivers' awareness toward cell phone-related disturbance on actual driving behavior monitored in the present study was found.

  18. Applying Squeaky-Wheel Optimization Schedule Airborne Astronomy Observations

    NASA Technical Reports Server (NTRS)

    Frank, Jeremy; Kuerklue, Elif

    2004-01-01

    We apply the Squeaky Wheel Optimization (SWO) algorithm to the problem of scheduling astronomy observations for the Stratospheric Observatory for Infrared Astronomy, an airborne observatory. The problem contains complex constraints relating the feasibility of an astronomical observation to the position and time at which the observation begins, telescope elevation limits, special use airspace, and available fuel. Solving the problem requires making discrete choices (e.g. selection and sequencing of observations) and continuous ones (e.g. takeoff time and setting up observations by repositioning the aircraft). The problem also includes optimization criteria such as maximizing observing time while simultaneously minimizing total flight time. Previous approaches to the problem fail to scale when accounting for all constraints. We describe how to customize SWO to solve this problem, and show that it finds better flight plans, often with less computation time, than previous approaches.

  19. 49 CFR 236.1031 - Previously approved PTC systems.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Previously approved PTC systems. 236.1031 Section 236.1031 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD....1005 and 236.1007 and otherwise conform to this subpart. (d) Previous approval or recognition of a...

  20. Synchrony and motor mimicking in chimpanzee observational learning

    PubMed Central

    Fuhrmann, Delia; Ravignani, Andrea; Marshall-Pescini, Sarah; Whiten, Andrew

    2014-01-01

    Cumulative tool-based culture underwrote our species' evolutionary success, and tool-based nut-cracking is one of the strongest candidates for cultural transmission in our closest relatives, chimpanzees. However the social learning processes that may explain both the similarities and differences between the species remain unclear. A previous study of nut-cracking by initially naïve chimpanzees suggested that a learning chimpanzee holding no hammer nevertheless replicated hammering actions it witnessed. This observation has potentially important implications for the nature of the social learning processes and underlying motor coding involved. In the present study, model and observer actions were quantified frame-by-frame and analysed with stringent statistical methods, demonstrating synchrony between the observer's and model's movements, cross-correlation of these movements above chance level and a unidirectional transmission process from model to observer. These results provide the first quantitative evidence for motor mimicking underlain by motor coding in apes, with implications for mirror neuron function. PMID:24923651

  1. Synchrony and motor mimicking in chimpanzee observational learning.

    PubMed

    Fuhrmann, Delia; Ravignani, Andrea; Marshall-Pescini, Sarah; Whiten, Andrew

    2014-06-13

    Cumulative tool-based culture underwrote our species' evolutionary success, and tool-based nut-cracking is one of the strongest candidates for cultural transmission in our closest relatives, chimpanzees. However the social learning processes that may explain both the similarities and differences between the species remain unclear. A previous study of nut-cracking by initially naïve chimpanzees suggested that a learning chimpanzee holding no hammer nevertheless replicated hammering actions it witnessed. This observation has potentially important implications for the nature of the social learning processes and underlying motor coding involved. In the present study, model and observer actions were quantified frame-by-frame and analysed with stringent statistical methods, demonstrating synchrony between the observer's and model's movements, cross-correlation of these movements above chance level and a unidirectional transmission process from model to observer. These results provide the first quantitative evidence for motor mimicking underlain by motor coding in apes, with implications for mirror neuron function.

  2. Theoretical and Observational Studies of Meteor Interactions with the Ionosphere

    DTIC Science & Technology

    2006-06-01

    within an order of magnitude. The histograms of scattering mass, calculated from data collected at the ALTAIR rada are contained in Figure 1 . These...RTO-MP-IST-056 12 - 1 UNCLASSIFIED/UNLIMITED UNCLASSIFIED/UNLIMITED Theoretical and Observational Studies of Meteor Interactions with the...Observational Studies of Meteor Interactions with the Ionosphere. In Characterising the Ionosphere (pp. 12- 1 – 12-12). Meeting Proceedings RTO-MP-IST-056

  3. An observational study of secondary task engagement while driving on urban streets in Iranian Safe Communities.

    PubMed

    Torkamannejad Sabzevari, Javad; Nabipour, Amir Reza; Khanjani, Narges; Molaei Tajkooh, Ali; Sullman, Mark J M

    2016-11-01

    In Iran the prevalence of traffic injuries and death from vehicle collisions are high. Driver engagement in non-driving-related tasks has been previously identified as an important contributing factor to crashes. Therefore, the objective of the present study was to investigate the prevalence of drivers' engagement in potentially distracting activities in Kashmar, Khalilabad and Bardaskan, which are three Iranian International Safe Communities. Observations took place at 12 randomly selected roadside locations in each city, which were comprised of six main streets and six side streets. In total 7979 drivers were observed. The prevalence rates of potentially distracting activities in Kashmar, Khalilabad and Bardaskan were 24.3%, 26% and 24.9%, respectively. In both Kashmar and Khalilabad the most frequently observed secondary tasks were drivers talking to passengers (10.6% and 11.5%, respectively) followed by mobile phone use (3.4% and 4.0%, respectively). Although in Bardaskan the most commonly observed secondary task was also talking to passengers (12.7%), the second most common was reaching for an object (3.2%). In all three cities younger drivers were significantly more likely to be observed engaged in a secondary task while driving. Furthermore, involvement in secondary tasks while driving was significantly higher amongst females and those driving on a working day. The percentage of drivers identified as potentially distracted in these three Safe Communities was worryingly high. Thus, interventions should be integrated into the WHO Safe Community network in these cities, including: education regarding the risks associated with engaging in secondary activities while driving, law enforcement, tougher legislation, periodic assessment, raising public awareness, as well as attracting political and social support. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Recent evolution of antibiotic resistance in the anaerobes as compared to previous decades.

    PubMed

    Boyanova, Lyudmila; Kolarov, Rossen; Mitov, Ivan

    2015-02-01

    Evolution of antibiotic resistance in the anaerobes was reviewed using recent data covering 2000-2013 as compared to previous years. All studies reported growing moxifloxacin resistance in Bacteroides/Parabacteroides spp. in Europe and USA and in Clostridium difficile in Europe. In half or more studies, the resistance rates in Bacteroides/Parabacteroides spp. to amoxicillin-clavulanate or ampicillin-sulbactam and clindamycin rose. In some studies, an increase in resistance was found in Bacteroides/Parabacteroides spp. to cefoxitin/cefotetan and carbapenems, in Prevotella spp. to penicillins, in anaerobic cocci to clindamycin and in Bacteroides/Parabacteroides spp. and C. difficile to metronidazole. Decreasing resistance was also observed, e.g. in Bacteroides/Parabacteroides spp. to cephalosporins, in Prevotella spp. and C. difficile to tetracyclines and in C. difficile to rifampin. No resistance changes were found to tigecycline, in Bacteroides/Parabacteroides spp. to chloramphenicol and in C. difficile to vancomycin. Factors influencing the resistance were the species, ribotype, country, hospital centre, antibiotic consumption and specimen type. In conclusion, the antibiotic resistance changes in the anaerobes are diverse and dynamic. Regular national surveys of resistance and both anaerobic microbiology and susceptibility testing of the isolates become more and more valuable. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. 44 CFR 402.5 - Forwarding commodities previously shipped.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... previously shipped. 402.5 Section 402.5 Emergency Management and Assistance DEPARTMENT OF COMMERCE AND DEPARTMENT OF TRANSPORTATION SHIPMENTS ON AMERICAN FLAG SHIPS AND AIRCRAFT (T-1, INT. 1) § 402.5 Forwarding commodities previously shipped. Order T-1 applies to transportation on or discharge from ships documented...

  6. 44 CFR 402.5 - Forwarding commodities previously shipped.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... previously shipped. 402.5 Section 402.5 Emergency Management and Assistance DEPARTMENT OF COMMERCE AND DEPARTMENT OF TRANSPORTATION SHIPMENTS ON AMERICAN FLAG SHIPS AND AIRCRAFT (T-1, INT. 1) § 402.5 Forwarding commodities previously shipped. Order T-1 applies to transportation on or discharge from ships documented...

  7. 44 CFR 402.5 - Forwarding commodities previously shipped.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... previously shipped. 402.5 Section 402.5 Emergency Management and Assistance DEPARTMENT OF COMMERCE AND DEPARTMENT OF TRANSPORTATION SHIPMENTS ON AMERICAN FLAG SHIPS AND AIRCRAFT (T-1, INT. 1) § 402.5 Forwarding commodities previously shipped. Order T-1 applies to transportation on or discharge from ships documented...

  8. 44 CFR 402.5 - Forwarding commodities previously shipped.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... previously shipped. 402.5 Section 402.5 Emergency Management and Assistance DEPARTMENT OF COMMERCE AND DEPARTMENT OF TRANSPORTATION SHIPMENTS ON AMERICAN FLAG SHIPS AND AIRCRAFT (T-1, INT. 1) § 402.5 Forwarding commodities previously shipped. Order T-1 applies to transportation on or discharge from ships documented...

  9. Does previous use affect litter box appeal in multi-cat households?

    PubMed

    Ellis, J J; McGowan, R T S; Martin, F

    2017-08-01

    It is commonly assumed that cats actively avoid eliminated materials (especially in multi-cat homes), suggesting regular litter box cleaning as the best defense against out-of-box elimination. The relationship between previous use and litter box appeal to familiar subsequent users is currently unknown. The purpose of this study was to investigate the relationship between previous litter box use and the identity of the previous user, type of elimination, odor, and presence of physical/visual obstructions in a multi-cat household scenario. Cats preferred a clean litter box to a dirty one, but the identity of the previous user had no impact on preferences. While the presence of odor from urine and/or feces did not impact litter box preferences, the presence of odorless faux-urine and/or feces did - with the presence of faux-feces being preferred over faux-urine. Results suggest neither malodor nor chemical communication play a role in litter box preferences, and instead emphasize the importance of regular removal of physical/visual obstructions as the key factor in promoting proper litter box use. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  10. Frequency of placenta previa in previously scarred and non scarred uterus.

    PubMed

    Majeed, Tayyaba; Waheed, Fatima; Mahmood, Zahid; Saba, Kanwal; Mahmood, Hamis; Bukhari, Mulazim Hussain

    2015-01-01

    To determine the frequency of placenta Previa in patients coming to a tertiary care unit with previously scarred and non-scarred uterus. A descriptive cross sectional study was carried on 114 cases who underwent caesarean sections (37 cases out of 645 cases with non scarred uterus and 77 cases from 721 cases with scarred uterus) in the department of obstetrics and gynecology Lady Willingdon Hospital from January 2008- December 2011. Most patients (47.36%) were between 26-30 years age group, presented with gestational age between 36-40 weeks (70.17%), were mostly G2-4, while frequency of placenta Previa in non-scarred uterus was 32.45% (37 cases), and frequency in previously scarred uterus was 67.54% (77 cases). Major degree Previa was found in 88 cases (77.19%). There were 5.70% cases of placenta Previa from non-scarred uteruses and 10.67% cases of placenta Previa (10.67%) from already scarred uteruses. Stratification revealed a higher trend of the morbidity with the increase in number of previous caesarean sections. A significantly higher frequency of placenta Previa was found among patients coming to a tertiary care hospital with previously scarred uterus.

  11. Pleomorphic dermal sarcoma: a more aggressive neoplasm than previously estimated.

    PubMed

    Tardío, Juan C; Pinedo, Fernando; Aramburu, José A; Suárez-Massa, Dolores; Pampín, Ana; Requena, Luis; Santonja, Carlos

    2016-02-01

    Pleomorphic dermal sarcoma (PDS) is a rare neoplasm sharing pathological features with atypical fibroxanthoma, but adding tumor necrosis, invasion beyond superficial subcutis or vascular or perineural infiltration. Although its metastatic risk has been estimated to be less than 5%, its real outcome is presently uncertain because of its rarity and to the lack of homogeneous criteria used in reported cases. Retrospective clinicopathological study of 18 cases of PDS. The lesions presented as tumors or plaques (size: 7-70 mm) on the head of elderly patients (median: 81 years), without a gender predominance. Histopathologically, they consisted of spindle cells arranged in a fascicular pattern, containing pleomorphic epithelioid and giant multinucleated cells in varying proportions, and usually exhibiting numerous mitotic figures and infiltrative tumor margins. No immunoexpression for cytokeratins, S100 protein, desmin or CD34 was observed. Necrosis and venous invasion were found in three tumors each (17%). Follow-up was available in 15 cases (median: 33 months). Three patients (20%) had local recurrences, all with incomplete primary surgical resections. Three patients (20%) developed distant metastases in the skin, regional lymph nodes and/or lungs and died from the disease. Our data suggest that PDS may be a more aggressive neoplasm than previously estimated. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Particle-Laden Leidenfrost Droplets: Final-Stage Observations

    NASA Astrophysics Data System (ADS)

    Fang, Zecong; Xu, Jie

    2015-03-01

    Little interest has been paid to the final stage of a Leidenfrost droplet until a recent study by Celestini et al [Phys. Rev. Lett. 109, 034501 (2012)] reporting an unexpected take-off phenomenon of micrometer sized pure liquid droplets (Rl < R study, we first report an unexpected observation on millimeter sized water Leidenfrost droplets (R >Ri), which behave quite differently from the previous study. While an originally micrometer sized Leidenfrost droplet takes off due to breakdown of lubrication regime, and hovers above its vapor layer until disappearing in the final stage of evaporation, an originally millimetric Leidenfrost drop is observed to hover and oscillate, taking off and falling back consecutively. We further report another interesting observation on water droplets containing micrometric glass beads. These droplets spontaneously organize and buckle together during evaporation. In addition to oscillation just like pure droplets, these particle-laden drops create an unexpected explosive shoot-up at the end of evaporation.

  13. Prevention of congenital Chagas disease by Benznidazole treatment in reproductive-age women. An observational study.

    PubMed

    Álvarez, María G; Vigliano, Carlos; Lococo, Bruno; Bertocchi, Graciela; Viotti, Rodolfo

    2017-10-01

    Since the decline in new cases of infection by insect/vector, congenital Chagas disease has become more relevant in the transmission of Chagas disease. Treatment with benznidazole significantly reduces the parasitemia, which constitutes an important factor linked to vertical transmission. The objective of this study was to evaluate whether treatment with benznidazole previously administered to women of childbearing age can prevent or reduce the incidence of new cases of congenital Chagas disease. An historical cohort study that included all women in reproductive age (15-45 years) assisted in our center was designed. We included 67 mothers with chronic Chagas disease; 35 women had not been treated prior to pregnancy, 15 had been treated prior to pregnancy and 17 gave birth prior and after treatment with benznidazole. Eight mothers gave birth to 16 children with congenital Chagas disease (8/67, 12%). The prevalence of congenital Chagas was 16/114 (14%) children born to untreated mothers and 0/42 (0%) children born to benznidazole- treated mothers, p=0.01. No significant differences were observed in clinical, serologic, epidemiological or socioeconomic baseline variables between mothers with and without children born with congenital Chagas. A 32% conversion rate to negative serology was observed in benznidazole-treated women after long-term follow up. Antiparasitic treatment administered to women in reproductive age can prevent the occurrence of congenital Chagas disease. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. 2 CFR 225.45 - Relationship to previous issuance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 2 Grants and Agreements 1 2011-01-01 2011-01-01 false Relationship to previous issuance. 225.45 Section 225.45 Grants and Agreements Office of Management and Budget Guidance for Grants and Agreements... INDIAN TRIBAL GOVERNMENTS (OMB CIRCULAR A-87) § 225.45 Relationship to previous issuance. (a) The...

  15. 2 CFR 230.45 - Relationship to previous issuance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 2 Grants and Agreements 1 2010-01-01 2010-01-01 false Relationship to previous issuance. 230.45 Section 230.45 Grants and Agreements OFFICE OF MANAGEMENT AND BUDGET CIRCULARS AND GUIDANCE Reserved COST PRINCIPLES FOR NON-PROFIT ORGANIZATIONS (OMB CIRCULAR A-122) § 230.45 Relationship to previous issuance. (a...

  16. Association between previous enterobiasis and current wheezing: evaluation of 1018 children.

    PubMed

    Bahceciler, Nerin N; Ozdemir, Cevdet; Kucukosmanoglu, Ercan; Arikan, Cigdem; Over, Ufuk; Karavelioglu, Salim; Akkoc, Tunc; Yazi, Didem; Yesil, Ozlem; Soysal, Ahmet; Bakir, Mustafa; Barlan, Isil B

    2007-01-01

    The aim of this study was to investigate the association between parasitosis and allergy. We surveyed all children aged 4-12 years living in poor hygienic conditions in a shantytown of Istanbul. After obtaining data from the International Study of Asthma and Allergies in Childhood (ISAAC) and an additional questionnaire, performing a skin-prick test (SPT), and determining total IgE, stool and perianal tape specimens were obtained from 1018 participating children. The prevalence of past episodes of wheezing, current wheezing, asthma, and rhinitis was 31, 14.6, 10.7, and 26.2%, respectively. Parasitosis was present in 49.1%, Enterobius vermicularis (23.3%), being the most common. A history of treatment for enterobiasis was present in 37%. Comparison of children with and without current enterobiasis revealed no significant difference in allergic manifestations and SPT results, except for serum total IgE level (p = 0.018), whereas children with previous enterobiasis were more likely to have current wheezing (p = 0.012). Current wheezers were more likely to have previous enterobiasis (p = 0.01) and a higher maternal employment level (p = 0.036) when compared with those without. According to logistic regression analysis, covariables significantly positively related with current wheezing were previous enterobiasis (p = 0.003) and being < or =5 years of age (p = 0.043), whereas being the first child of the family (p = 0.043) was negatively related. A previous infection with E. vermicularis was found to potentiate current wheezing in a population living in a shantytown in Istanbul.

  17. Observing the variation of asteroid thermal inertia with heliocentric distance

    NASA Astrophysics Data System (ADS)

    Rozitis, B.; Green, S. F.; MacLennan, E.; Emery, J. P.

    2018-06-01

    Thermal inertia is a useful property to characterize a planetary surface, since it can be used as a qualitative measure of the regolith grain size. It is expected to vary with heliocentric distance because of its dependence on temperature. However, no previous investigation has conclusively observed a change in thermal inertia for any given planetary body. We have addressed this by using NEOWISE data and the Advanced Thermophysical Model to study the thermophysical properties of the near-Earth asteroids (1036) Ganymed, (1580) Betulia, and (276 049) 2002 CE26 as they moved around their highly eccentric orbits. We confirm that the thermal inertia values of Ganymed and 2002 CE26 do vary with heliocentric distance, although the degree of variation observed depends on the spectral emissivity assumed in the thermophysical modelling. We also confirm that the thermal inertia of Betulia did not change for three different observations obtained at the same heliocentric distance. Depending on the spectral emissivity, the variations for Ganymed and 2002 CE26 are potentially more extreme than that implied by theoretical models of heat transfer within asteroidal regoliths, which might be explained by asteroids having thermal properties that also vary with depth. Accounting for this variation reduces a previously observed trend of decreasing asteroid thermal inertia with increasing size, and suggests that the surfaces of small and large asteroids could be much more similar than previously thought. Furthermore, this variation can affect Yarkovsky orbital drift predictions by a few tens of per cent.

  18. Laboratory polarization and permittivity measurements to interpret dust polarimetric observations and in-situ radar studies. Significance for Rosetta mission at 67P/Churyumov-Gerasimenko

    NASA Astrophysics Data System (ADS)

    Levasseur-Regourd, Anny-Chantal; Brouet, Yann; Hadamcik, Edith; Heggy, Essam; Hines, Dean; Lasue, Jérémie; Renard, Jean-Baptiste

    2015-08-01

    Polarimetric astronomical observations on dust clouds and regolithic surfaces require laboratory simulations on samples to provide information on properties (size distribution, porosity, refractive index) of the scattering media. Similarly, in-situ radar investigations in the solar system require laboratory studies on samples to infer physical properties (e.g. porosity, ice/dust ratio) of sub-surfaces and interiors. Recent developments are illustrated with present studies related to the Rosetta mission, which begun its rendezvous with comet 67P/Churyumov-Gerasimeko (C-G) and landed the Philae module on its nucleus in 2014.We will summarize laboratory simulations with the PROGRA2 suite of instruments that study (in the visible to near IR domain) the polarimetric properties of dust samples in microgravity conditions or on surfaces [1], with emphasis on the interpretation of polarimetric observations of C-G, during its previous perihelion passages from Earth observatories, and currently from HST [2,3]. The presence of large dust particles in the pre-perihelion coma previously inferred from remote observations agrees with Rosetta ground truth [4]. We will also present measurements on the permittivity (in the millimeter to meter domain) of various dust samples, with emphasis on porous samples [5,6]. Results provide constraints on the properties of the subsurface and interior of C-G, as explored by MIRO on Rosetta and CONSERT on Philae.Such studies are relevant for the interpretation of polarimetric observations of other dust clouds (e.g. debris disks, interplanetary dust cloud, clouds in planetary atmospheres) and surfaces (e.g. planets, moons), as well as for those of other radar characterization studies (e.g. Mars, moons, asteroids).[1] Levasseur-Regourd et al. In Polarization of stars and planetary systems, Cambridge UP, in press 2015.[2] Hadamcik et al. A&A 517 2010.[3] Hines and Levasseur-Regourd, PSS submitted 2015.[4] Schulz et al. Nature 518 2015.[5] Heggy et al

  19. 2 CFR 1.215 - Relationship to previous issuances.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 2 Grants and Agreements 1 2013-01-01 2013-01-01 false Relationship to previous issuances. 1.215... ABOUT TITLE 2 OF THE CODE OF FEDERAL REGULATIONS AND SUBTITLE A Introduction toSubtitle A § 1.215... title 2 of the CFR. Specifically: Guidance in * * * On * * * Previously was in * * * (a) Chapter I, part...

  20. 2 CFR 1.215 - Relationship to previous issuances.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false Relationship to previous issuances. 1.215... ABOUT TITLE 2 OF THE CODE OF FEDERAL REGULATIONS AND SUBTITLE A Introduction to Subtitle A § 1.215... title 2 of the CFR. Specifically: Guidance in * * * On * * * Previously was in * * * (a) Chapter I, part...

  1. 2 CFR 1.215 - Relationship to previous issuances.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 2 Grants and Agreements 1 2012-01-01 2012-01-01 false Relationship to previous issuances. 1.215... ABOUT TITLE 2 OF THE CODE OF FEDERAL REGULATIONS AND SUBTITLE A Introduction to Subtitle A § 1.215... title 2 of the CFR. Specifically: Guidance in * * * On * * * Previously was in * * * (a) Chapter I, part...

  2. 2 CFR 220.40 - Relationship to previous issuance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 2 Grants and Agreements 1 2011-01-01 2011-01-01 false Relationship to previous issuance. 220.40 Section 220.40 Grants and Agreements Office of Management and Budget Guidance for Grants and Agreements... INSTITUTIONS (OMB CIRCULAR A-21) § 220.40 Relationship to previous issuance. (a) The guidance in this part...

  3. 2 CFR 230.45 - Relationship to previous issuance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 2 Grants and Agreements 1 2011-01-01 2011-01-01 false Relationship to previous issuance. 230.45 Section 230.45 Grants and Agreements Office of Management and Budget Guidance for Grants and Agreements... ORGANIZATIONS (OMB CIRCULAR A-122) § 230.45 Relationship to previous issuance. (a) The guidance in this part...

  4. 2 CFR 1.215 - Relationship to previous issuances.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 2 Grants and Agreements 1 2010-01-01 2010-01-01 false Relationship to previous issuances. 1.215 Section 1.215 Grants and Agreements ABOUT TITLE 2 OF THE CODE OF FEDERAL REGULATIONS AND SUBTITLE A Introduction toSubtitle A § 1.215 Relationship to previous issuances. Although some of the guidance was...

  5. Academic success or failure in nursing students: results of a retrospective observational study.

    PubMed

    Lancia, Loreto; Petrucci, Cristina; Giorgi, Fabio; Dante, Angelo; Cifone, Maria Grazia

    2013-12-01

    Nursing student academic failure is a phenomenon of growing international interest, not only because of its economic impact but also because it negatively affects the availability of future nurses in different healthcare systems. To recruit the students with the highest probability of academic success, an open challenge for universities is to recruit students who have previously demonstrated superior scholastic aptitudes that appear to be associated with a greater likelihood of academic success. Documenting the relationship between the selection methods used when selecting nursing students and academic failure will contribute to the international debate concerning the optimisation of the selection strategies. The principal aim of this study was to investigate the role in predicting nursing student academic success of (1) the upper-secondary diploma grades and (2) the score obtained by students in the nursing degree program admission test. A retrospective observational study was conducted. Five cohorts of nursing students, matriculated in consecutive academic years from 2004 to 2008, in an Italian bachelor's degree program were observed retrospectively. Overall, 61.2% of the 1006 considered students concluded their degree within the legal duration allowed for the nursing degree. Students who failed were those who had lowest grades associated with their upper-secondary diploma coursework (p=0.000) and were male (p=0.000). The grades associated with the upper-secondary diploma coursework, unlike the admission test score, correlates positively with the final degree grade and the average value of degree program examination scores. No correlation was found between the upper-secondary diploma coursework grades and the scores obtained in the test for the nursing degree program admission test (r=-0.037). These results suggest that upper-secondary diploma coursework grades are a parameter that should receive great consideration, especially in cases where there are planned

  6. The reporting of observational research studies in dermatology journals: a literature-based study.

    PubMed

    Langan, Sinéad; Schmitt, Jochen; Coenraads, Pieter-Jan; Svensson, Ake; von Elm, Erik; Williams, Hywel

    2010-05-01

    To assess the quality of reporting in observational studies in dermatology. Five dermatology journals-the Archives of Dermatology, the British Journal of Dermatology, the Journal of the American Academy of Dermatology, the Journal of Investigative Dermatology, and Acta Dermato-Venereologica. Cohort, case-control, and cross-sectional studies published as original articles during the period January 2005 through December 2007. Studies were identified with a literature search of PubMed combining the journal title and the term epidemiological studies (free text) and by hand searching all of the issues of each journal to identify relevant articles. All articles were extracted by 2 reviewers independently using standardized checklists based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations. The number and proportion of reported STROBE items were analyzed for each article. The proportion of studies with good reporting for each item was also assessed. A total of 138 articles were included and analyzed. Reporting quality was very mixed. Key areas that were infrequently reported included sample size calculations (n = 10 [7%]), missing data (n = 8 [6%]), losses to follow-up (n = 17 [12%]), and statistical methods (n = 19 [14%]). Only 13 studies (9%) explained the role of funders in the research. The quality of reporting was similar across study designs for "critical" questions with the exception of reporting of participant details, which was better reported in cohort studies (96%) compared with cross-sectional (80%) and case-control (70%) studies. It is difficult to judge the quality of dermatological research unless it is reported well. This study has identified a clear need to improve the quality of reporting of observational studies in dermatology. We recommend that dermatology journals adopt the STROBE criteria.

  7. Characterizing Musculoskeletal Injury among Aeromedical Evacuation Personnel: An Observational Study

    DTIC Science & Technology

    2016-09-28

    three phases: a sampling study, laboratory observations, and field observations. In Phase I, 43 active duty AECMs volunteered to complete a...was administered via SurveyMonkey to volunteers from the USAFSAM Education and Training Department and the four active duty AE squadrons. The

  8. Scientific and Ethical Approaches for Observational Exposure Studies

    EPA Science Inventory

    Researchers conduct observational human exposure studies to understand how and the extent to which people come into contact with chemicals and environmental stressors in their everyday lives, through the air they breathe, the food and liquids they consume, and the things they tou...

  9. 2 CFR 1.215 - Relationship to previous issuances.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 2 Grants and Agreements 1 2011-01-01 2011-01-01 false Relationship to previous issuances. 1.215... ABOUT TITLE 2 OF THE CODE OF FEDERAL REGULATIONS AND SUBTITLE A Introduction toSubtitle A § 1.215... title 2 of the CFR. Specifically: Guidance in * * * On * * * Previously was in * * * (a) Chapter I, part...

  10. 44 CFR 402.5 - Forwarding commodities previously shipped.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Forwarding commodities previously shipped. 402.5 Section 402.5 Emergency Management and Assistance DEPARTMENT OF COMMERCE AND DEPARTMENT OF TRANSPORTATION SHIPMENTS ON AMERICAN FLAG SHIPS AND AIRCRAFT (T-1, INT. 1) § 402.5 Forwarding commodities previously shipped. Order T-1...

  11. Sunburn and sun-protective behaviors among adults with and without previous nonmelanoma skin cancer (NMSC): A population-based study.

    PubMed

    Fischer, Alexander H; Wang, Timothy S; Yenokyan, Gayane; Kang, Sewon; Chien, Anna L

    2016-08-01

    Individuals with previous nonmelanoma skin cancer (NMSC) are at increased risk for subsequent skin cancer, and should therefore limit ultraviolet exposure. We sought to determine whether individuals with previous NMSC engage in better sun protection than those with no skin cancer history. We pooled self-reported data (2005 and 2010 National Health Interview Surveys) from US non-Hispanic white adults (758 with and 34,161 without previous NMSC). We calculated adjusted prevalence odds ratios (aPOR) and 95% confidence intervals (CI), taking into account the complex survey design. Individuals with previous NMSC versus no history of NMSC had higher rates of frequent use of shade (44.3% vs 27.0%; aPOR 1.41; 95% CI 1.16-1.71), long sleeves (20.5% vs 7.7%; aPOR 1.55; 95% CI 1.21-1.98), a wide-brimmed hat (26.1% vs 10.5%; aPOR 1.52; 95% CI 1.24-1.87), and sunscreen (53.7% vs 33.1%; aPOR 2.11; 95% CI 1.73-2.59), but did not have significantly lower odds of recent sunburn (29.7% vs 40.7%; aPOR 0.95; 95% CI 0.77-1.17). Among those with previous NMSC, recent sunburn was inversely associated with age, sun avoidance, and shade but not sunscreen. Self-reported cross-sectional data and unavailable information quantifying regular sun exposure are limitations. Physicians should emphasize sunburn prevention when counseling patients with previous NMSC, especially younger adults, focusing on shade and sun avoidance over sunscreen. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  12. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration

    PubMed Central

    Vandenbroucke, Jan P; von Elm, Erik; Altman, Douglas G; Gøtzsche, Peter C; Mulrow, Cynthia D; Pocock, Stuart J; Poole, Charles; Schlesselman, James J; Egger, Matthias

    2007-01-01

    Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www.strobe-statement.org/) should be helpful resources to improve reporting of observational research. PMID:17941715

  13. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration.

    PubMed

    Vandenbroucke, Jan P; von Elm, Erik; Altman, Douglas G; Gøtzsche, Peter C; Mulrow, Cynthia D; Pocock, Stuart J; Poole, Charles; Schlesselman, James J; Egger, Matthias

    2014-12-01

    Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www.strobe-statement.org/) should be helpful resources to improve reporting of observational research. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. The evolution of avian wing shape and previously unrecognized trends in covert feathering

    PubMed Central

    Wang, Xia; Clarke, Julia A.

    2015-01-01

    Avian wing shape has been related to flight performance, migration, foraging behaviour and display. Historically, linear measurements of the feathered aerofoil and skeletal proportions have been used to describe this shape. While the distribution of covert feathers, layered over the anterior wing, has long been assumed to contribute to aerofoil properties, to our knowledge no previous studies of trends in avian wing shape assessed their variation. Here, these trends are explored using a geometric–morphometric approach with landmarks describing the wing outline as well as the extent of dorsal and ventral covert feathers for 105 avian species. We find that most of the observed variation is explained by phylogeny and ecology but shows only a weak relationship with previously described flight style categories, wing loading and an investigated set of aerodynamic variables. Most of the recovered variation is in greater primary covert feather extent, followed by secondary feather length and the shape of the wing tip. Although often considered a plastic character strongly linked to flight style, the estimated ancestral wing morphology is found to be generally conservative among basal parts of most major avian lineages. The radiation of birds is characterized by successive diversification into largely distinct areas of morphospace. However, aquatic taxa show convergence in feathering despite differences in flight style, and songbirds move into a region of morphospace also occupied by basal taxa but at markedly different body sizes. These results have implications for the proposed inference of flight style in extinct taxa. PMID:26446812

  15. The evolution of avian wing shape and previously unrecognized trends in covert feathering.

    PubMed

    Wang, Xia; Clarke, Julia A

    2015-10-07

    Avian wing shape has been related to flight performance, migration, foraging behaviour and display. Historically, linear measurements of the feathered aerofoil and skeletal proportions have been used to describe this shape. While the distribution of covert feathers, layered over the anterior wing, has long been assumed to contribute to aerofoil properties, to our knowledge no previous studies of trends in avian wing shape assessed their variation. Here, these trends are explored using a geometric-morphometric approach with landmarks describing the wing outline as well as the extent of dorsal and ventral covert feathers for 105 avian species. We find that most of the observed variation is explained by phylogeny and ecology but shows only a weak relationship with previously described flight style categories, wing loading and an investigated set of aerodynamic variables. Most of the recovered variation is in greater primary covert feather extent, followed by secondary feather length and the shape of the wing tip. Although often considered a plastic character strongly linked to flight style, the estimated ancestral wing morphology is found to be generally conservative among basal parts of most major avian lineages. The radiation of birds is characterized by successive diversification into largely distinct areas of morphospace. However, aquatic taxa show convergence in feathering despite differences in flight style, and songbirds move into a region of morphospace also occupied by basal taxa but at markedly different body sizes. These results have implications for the proposed inference of flight style in extinct taxa. © 2015 The Author(s).

  16. Observed Free-Play Patterns of Children with ADHD and Their Real-Life Friends.

    PubMed

    Normand, Sébastien; Soucisse, Marie Michèle; Melançon, Marie Pier Vézina; Schneider, Barry H; Lee, Matthew D; Maisonneuve, Marie-France

    2018-04-26

    Previous observational studies conducted in highly structured, analog situations indicate that children with Attention-Deficit/Hyperactivity Disorder (ADHD) mismanage their relationships with same-age peers and friends. Such structured situations may not, however, fully represent the true nature of children's play, which is typically characterized by free choice, intrinsic motivation, and spontaneity. The unique objective of the current observational study was to describe how 87 children with ADHD and 46 comparison (76% boys) aged 7-13 years behave when interacting with their real-life dyadic friends during an unstructured, free-play situation. Results indicate that dyads comprising one referred child with ADHD and an invited friend ("ADHD dyads") engaged in less cooperative play, displayed less companionship, and showed less sensitivity to friends than comparison dyads. ADHD dyads also engaged in more conflict and exhibited significantly more negative affect than comparison dyads. These findings complement and extend, possibly with somewhat enhanced ecological validity, results obtained in previous studies on the friendships of children with ADHD featuring closed-field observations and questionnaire methodology.

  17. Potential protective effect of lactation against incidence of type 2 diabetes mellitus in women with previous gestational diabetes mellitus: A systematic review and meta-analysis.

    PubMed

    Tanase-Nakao, Kanako; Arata, Naoko; Kawasaki, Maki; Yasuhi, Ichiro; Sone, Hirohito; Mori, Rintaro; Ota, Erika

    2017-05-01

    Lactation may protect women with previous gestational diabetes mellitus (GDM) from developing type 2 diabetes mellitus, but the results of existing studies are inconsistent, ranging from null to beneficial. We aimed to conduct a systematic review to gather available evidence. Databases MEDLINE, CINAHL, PubMed, and EMBASE were searched on December 15, 2015, without restriction of language or publication year. A manual search was also conducted. We included observational studies (cross-sectional, case-control, and cohort study) with information on lactation and type 2 diabetes mellitus incidence among women with previous GDM. We excluded case studies without control data. Data synthesis was conducted by random-effect meta-analysis. Fourteen reports of 9 studies were included. Overall risk of bias using RoBANS ranged from low to unclear. Longer lactation for more than 4 to 12 weeks postpartum had risk reduction of type 2 diabetes mellitus compared with shorter lactation (OR 0.77, 95% CI 0.01-55.86; OR 0.56, 95% CI 0.35-0.89; OR 0.22, 95% CI 0.13-0.36; type 2 diabetes mellitus evaluation time < 2 y, 2-5 y, and >5 y, respectively). Exclusive lactation for more than 6 to 9 weeks postpartum also had lower risk of type 2 diabetes mellitus compared with exclusive formula (OR 0.42, 95% CI 0.22-0.81). The findings support the evidence that longer and exclusive lactation may be beneficial for type 2 diabetes mellitus prevention in women with previous GDM. However, the evidence relies only on observational studies. Therefore, further studies are required to address the true causal effect. © 2017 The Authors. Diabetes/Metabolism Research and Reviews Published by John Wiley & Sons Ltd.

  18. Fathers' challenging parenting behavior prevents social anxiety development in their 4-year-old children: a longitudinal observational study.

    PubMed

    Majdandžić, Mirjana; Möller, Eline L; de Vente, Wieke; Bögels, Susan M; van den Boom, Dymphna C

    2014-02-01

    Recent models on parenting propose different roles for fathers and mothers in the development of child anxiety. Specifically, it is suggested that fathers' challenging parenting behavior, in which the child is playfully encouraged to push her limits, buffers against child anxiety. In this longitudinal study, we explored whether the effect of challenging parenting on children's social anxiety differed between fathers and mothers. Fathers and mothers from 94 families were separately observed with their two children (44 % girls), aged 2 and 4 years at Time 1, in three structured situations involving one puzzle task and two games. Overinvolved and challenging parenting behavior were coded. Child social anxiety was measured by observing the child's response to a stranger at Time 1, and half a year later at Time 2, and by parental ratings. In line with predictions, father's challenging parenting behavior predicted less subsequent observed social anxiety of the 4-year-old child. Mothers' challenging behavior, however, predicted more observed social anxiety of the 4-year-old. Parents' overinvolvement at Time 1 did not predict change in observed social anxiety of the 4-year-old child. For the 2-year-old child, maternal and paternal parenting behavior did not predict subsequent social anxiety, but early social anxiety marginally did. Parent-rated social anxiety was predicted by previous parental ratings of social anxiety, and not by parenting behavior. Challenging parenting behavior appears to have favorable effects on observed 4-year-old's social anxiety when displayed by the father. Challenging parenting behavior emerges as an important focus for future research and interventions.

  19. Preliminary Checklist for Reporting Observational Studies in Sports Areas: Content Validity.

    PubMed

    Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana; Anguera, M Teresa; Losada, José L; Portell, Mariona; Lozano-Lozano, José A

    2018-01-01

    Observational studies are based on systematic observation, understood as an organized recording and quantification of behavior in its natural context. Applied to the specific area of sports, observational studies present advantages when comparing studies based on other designs, such as the flexibility for adapting to different contexts and the possibility of using non-standardized instruments as well as a high degree of development in specific software and data analysis. Although the importance and usefulness of sports-related observational studies have been widely shown, there is no checklist to report these studies. Consequently, authors do not have a guide to follow in order to include all of the important elements in an observational study in sports areas, and reviewers do not have a reference tool for assessing this type of work. To resolve these issues, this article aims to develop a checklist to measure the quality of sports-related observational studies based on a content validity study. The participants were 22 judges with at least 3 years of experience in observational studies, sports areas, and methodology. They evaluated a list of 60 items systematically selected and classified into 12 dimensions. They were asked to score four aspects of each item on 5-point Likert scales to measure the following dimensions: representativeness, relevance, utility, and feasibility. The judges also had an open-format section for comments. The Osterlind index was calculated for each item and for each of the four aspects. Items were considered appropriate when obtaining a score of at least 0.5 in the four assessed aspects. After considering these inclusion criteria and all of the open-format comments, the resultant checklist consisted of 54 items grouped into the same initial 12 dimensions. Finally, we highlight the strengths of this work. We also present its main limitation: the need to apply the resultant checklist to obtain data and, thus, increase quality indicators of

  20. Preliminary Checklist for Reporting Observational Studies in Sports Areas: Content Validity

    PubMed Central

    Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana; Anguera, M. Teresa; Losada, José L.; Portell, Mariona; Lozano-Lozano, José A.

    2018-01-01

    Observational studies are based on systematic observation, understood as an organized recording and quantification of behavior in its natural context. Applied to the specific area of sports, observational studies present advantages when comparing studies based on other designs, such as the flexibility for adapting to different contexts and the possibility of using non-standardized instruments as well as a high degree of development in specific software and data analysis. Although the importance and usefulness of sports-related observational studies have been widely shown, there is no checklist to report these studies. Consequently, authors do not have a guide to follow in order to include all of the important elements in an observational study in sports areas, and reviewers do not have a reference tool for assessing this type of work. To resolve these issues, this article aims to develop a checklist to measure the quality of sports-related observational studies based on a content validity study. The participants were 22 judges with at least 3 years of experience in observational studies, sports areas, and methodology. They evaluated a list of 60 items systematically selected and classified into 12 dimensions. They were asked to score four aspects of each item on 5-point Likert scales to measure the following dimensions: representativeness, relevance, utility, and feasibility. The judges also had an open-format section for comments. The Osterlind index was calculated for each item and for each of the four aspects. Items were considered appropriate when obtaining a score of at least 0.5 in the four assessed aspects. After considering these inclusion criteria and all of the open-format comments, the resultant checklist consisted of 54 items grouped into the same initial 12 dimensions. Finally, we highlight the strengths of this work. We also present its main limitation: the need to apply the resultant checklist to obtain data and, thus, increase quality indicators of

  1. Evaluating the Impact of Database Heterogeneity on Observational Study Results

    PubMed Central

    Madigan, David; Ryan, Patrick B.; Schuemie, Martijn; Stang, Paul E.; Overhage, J. Marc; Hartzema, Abraham G.; Suchard, Marc A.; DuMouchel, William; Berlin, Jesse A.

    2013-01-01

    Clinical studies that use observational databases to evaluate the effects of medical products have become commonplace. Such studies begin by selecting a particular database, a decision that published papers invariably report but do not discuss. Studies of the same issue in different databases, however, can and do generate different results, sometimes with strikingly different clinical implications. In this paper, we systematically study heterogeneity among databases, holding other study methods constant, by exploring relative risk estimates for 53 drug-outcome pairs and 2 widely used study designs (cohort studies and self-controlled case series) across 10 observational databases. When holding the study design constant, our analysis shows that estimated relative risks range from a statistically significant decreased risk to a statistically significant increased risk in 11 of 53 (21%) of drug-outcome pairs that use a cohort design and 19 of 53 (36%) of drug-outcome pairs that use a self-controlled case series design. This exceeds the proportion of pairs that were consistent across databases in both direction and statistical significance, which was 9 of 53 (17%) for cohort studies and 5 of 53 (9%) for self-controlled case series. Our findings show that clinical studies that use observational databases can be sensitive to the choice of database. More attention is needed to consider how the choice of data source may be affecting results. PMID:23648805

  2. Evaluation of internal noise methods for Hotelling observers

    NASA Astrophysics Data System (ADS)

    Zhang, Yani; Pham, Binh T.; Eckstein, Miguel P.

    2005-04-01

    Including internal noise in computer model observers to degrade model observer performance to human levels is a common method to allow for quantitatively comparisons of human and model performance. In this paper, we studied two different types of methods for injecting internal noise to Hotelling model observers. The first method adds internal noise to the output of the individual channels: a) Independent non-uniform channel noise, b) Independent uniform channel noise. The second method adds internal noise to the decision variable arising from the combination of channel responses: a) internal noise standard deviation proportional to decision variable's standard deviation due to the external noise, b) internal noise standard deviation proportional to decision variable's variance caused by the external noise. We tested the square window Hotelling observer (HO), channelized Hotelling observer (CHO), and Laguerre-Gauss Hotelling observer (LGHO). The studied task was detection of a filling defect of varying size/shape in one of four simulated arterial segment locations with real x-ray angiography backgrounds. Results show that the internal noise method that leads to the best prediction of human performance differs across the studied models observers. The CHO model best predicts human observer performance with the channel internal noise. The HO and LGHO best predict human observer performance with the decision variable internal noise. These results might help explain why previous studies have found different results on the ability of each Hotelling model to predict human performance. Finally, the present results might guide researchers with the choice of method to include internal noise into their Hotelling models.

  3. Pregnancy outcome after induction of labor in women with previous cesarean section.

    PubMed

    Ashwal, Eran; Hiersch, Liran; Melamed, Nir; Ben-Zion, Maya; Brezovsky, Alex; Wiznitzer, Arnon; Yogev, Yariv

    2015-03-01

    As conflicting data exist concerning the safety of induction of labor (IoL) in women with previous single lower segment cesarean section (CS), we aimed to assess pregnancy outcome following IoL in such patient population. All singleton pregnancies with previous single CS which underwent IoL during 2008-2012 were included (study group). Their pregnancy outcome was compared to those pregnancies with previous single CS that admitted with spontaneous onset of labor (control group). Overall, 1898 pregnancies were eligible, of them, 259 underwent IoL, and 1639 were admitted with spontaneous onset of labor. Parity, gestational age at delivery and birthweight were similar. Women in the study group were more likely to undergo CS mainly due to labor dystocia (8.1 versus 3.7%, p < 0.01). The rate of CS due to non-reassuring fetal heart rate was similar. No difference was found in the rate of uterine rupture/dehiscence. Short-term neonatal outcome was similar between the groups. On multivariable logistic regression analysis, IoL was not independently associated with uterine rupture (OR 1.33, 95% C.I 0.46-3.84, p = 0.59). Our data suggest that IoL in women with one previous low segment CS neither increases the risk of uterine rupture nor adversely affects immediate neonatal outcome.

  4. Does previous abdominal surgery affect the course and outcomes of laparoscopic bariatric surgery?

    PubMed

    Major, Piotr; Droś, Jakub; Kacprzyk, Artur; Pędziwiatr, Michał; Małczak, Piotr; Wysocki, Michał; Janik, Michał; Walędziak, Maciej; Paśnik, Krzysztof; Hady, Hady Razak; Dadan, Jacek; Proczko-Stepaniak, Monika; Kaska, Łukasz; Lech, Paweł; Michalik, Maciej; Duchnik, Michał; Kaseja, Krzysztof; Pastuszka, Maciej; Stepuch, Paweł; Budzyński, Andrzej

    2018-03-26

    Global experiences in general surgery suggest that previous abdominal surgery may negatively influence different aspects of perioperative care. As the incidence of bariatric procedures has recently increased, it is essential to assess such correlations in bariatric surgery. To assess whether previous abdominal surgery influences the course and outcomes of laparoscopic bariatric surgery. Seven referral bariatric centers in Poland. We conducted a retrospective analysis of 2413 patients; 1706 patients who underwent laparoscopic sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) matched the inclusion criteria. Patients with no history of abdominal surgery were included as group 1, while those who had undergone at least 1 abdominal surgery were included as group 2. Group 2 had a significantly prolonged median operation time for RYGB (P = .012), and the longest operation time was observed in patients who had previously undergone surgeries in both the upper and lower abdomen (P = .002). Such a correlation was not found in SG cases (P = .396). Groups 1 and 2 had similar rates of intraoperative adverse events and postoperative complications (P = .562 and P = .466, respectively). Group 2 had a longer median duration of hospitalization than group 1 (P = .034), while the readmission rate was similar between groups (P = .079). There was no significant difference between groups regarding the influence of the long-term effects of bariatric treatment on weight loss (percentage of follow-up was 55%). Previous abdominal surgery prolongs the operative time of RYGB and the duration of postoperative hospitalization, but does not affect the long-term outcomes of bariatric treatment. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  5. Observational studies of regions of massive star formation

    NASA Astrophysics Data System (ADS)

    Cooper, Heather Danielle Blythe

    2013-03-01

    Massive stars have a profound influence on their surroundings. However, relatively little is known about their formation. The study of massive star formation is hindered by a lack of observational evidence, primarily due to difficulties observing massive stars at early stages in their development. The Red MSX Source survey (RMS survey) is a valuable tool with which to address these issues. Near-infrared H- and K-band spectra were taken for 247 candidate massive young stellar objects (MYSOs), selected from the RMS survey. 195 (∼80%) of the targets are YSOs, of which 131 are massive YSOs (LBOL>5E3L⊙, M>8 M⊙). This is the largest spectroscopic study of massive YSOs to date. This study covers minimally obscured objects right through to very red, dusty sources. Almost all YSOs show some evidence for emission lines, though there is a wide variety of observed properties, with HI, H2 Fe II, and CO among the most commonly observed lines. Evidence for disks and outflows was frequently seen. Comparisons of Brγ and H2 emission with low mass YSOs suggest that the emission mechanism for these lines is the same for low-, intermediate-, and high-mass YSOs, i.e. high-mass YSOs appear to resemble scaled-up versions of low-mass YSOs. It was found that the YSOs form an evolutionary sequence, based on their spectra, consistent with the existing theoretical models. Type I YSOs have strong H2 emission, no ionized lines, and are redder than the other two subtypes. As such, these are considered to be the youngest sources. The Type III sources are bluest, and therefore considered to be the oldest subtype. They have strong H I lines and fluorescent Fe II 1.6878 μm emission. They may also have weak H2 emission. Type III sources may even be beginning to form a mini-H II region. XSHOOTER data from 10 Herbig Be stars were analysed. The evidence suggests that winds and disks are common among Herbig stars, as they are among their main sequence classical Be star counterparts. Line

  6. Osteoporosis therapies: evidence from health-care databases and observational population studies.

    PubMed

    Silverman, Stuart L

    2010-11-01

    Osteoporosis is a well-recognized disease with severe consequences if left untreated. Randomized controlled trials are the most rigorous method for determining the efficacy and safety of therapies. Nevertheless, randomized controlled trials underrepresent the real-world patient population and are costly in both time and money. Modern technology has enabled researchers to use information gathered from large health-care or medical-claims databases to assess the practical utilization of available therapies in appropriate patients. Observational database studies lack randomization but, if carefully designed and successfully completed, can provide valuable information that complements results obtained from randomized controlled trials and extends our knowledge to real-world clinical patients. Randomized controlled trials comparing fracture outcomes among osteoporosis therapies are difficult to perform. In this regard, large observational database studies could be useful in identifying clinically important differences among therapeutic options. Database studies can also provide important information with regard to osteoporosis prevalence, health economics, and compliance and persistence with treatment. This article describes the strengths and limitations of both randomized controlled trials and observational database studies, discusses considerations for observational study design, and reviews a wealth of information generated by database studies in the field of osteoporosis.

  7. [Tetanus after cat scratch and bites in a previously immunized patient].

    PubMed

    Fica, Alberto; Gaínza, Daniela; Ortigosa, Pablo

    2017-04-01

    Tetanus is declining due to vaccination, professional labor management and appropriate wound care. Tetanus cases have been reported despite immunization. We report the case of a previously healthy 21 years old female patient that presented a mild generalized tetanus requiring admission after mild and recurrent cat scratch and bites. She had received six vaccine shots during childhood, and a booster dose five years earlier after a rabbit bite. Symptoms appeared seven weeks after the last contact, and included headache, muscle spasms and mild opisthotonus. Laboratory evaluation, including CSF analysis and microbiological investigation, as well as imaging studies were all normal. The patient received 6,000 IU of human antitoxin immunoglobulin. No autonomic manifestations or respiratory compromise were registered. Symptoms resolved rapidly and she was discharge after seven days with an order to complete a tetanus toxoid immunization schedule with three doses. Tetanus is possible in urban settings with a declining epidemiologic curve of disease in previously immunized patients. Severity of disease is modulated by previous vaccination.

  8. A cross-sectional study of tuberculosis drug resistance among previously treated patients in a tertiary hospital in Accra, Ghana: public health implications of standardized regimens.

    PubMed

    Forson, Audrey; Kwara, Awewura; Kudzawu, Samuel; Omari, Michael; Otu, Jacob; Gehre, Florian; de Jong, Bouke; Antonio, Martin

    2018-04-02

    Mycobacterium tuberculosis drug resistance is a major challenge to the use of standardized regimens for tuberculosis (TB) therapy, especially among previously treated patients. We aimed to investigate the frequency and pattern of drug resistance among previously treated patients with smear-positive pulmonary tuberculosis at the Korle-Bu Teaching Hospital Chest Clinic, Accra. This was a cross-sectional survey of mycobacterial isolates from previously treated patients referred to the Chest Clinic Laboratory between October 2010 and October 2013. The Bactec MGIT 960 system for mycobactrerial culture and drug sensitivity testing (DST) was used for sputum culture of AFB smear-positive patients with relapse, treatment failure, failure of smear conversion, or default. Descriptive statistics were used to summarize patient characteristics, and frequency and patterns of drug resistance. A total of 112 isolates were studied out of 155 from previously treated patients. Twenty contaminated (12.9%) and 23 non-viable isolates (14.8%) were excluded. Of the 112 studied isolates, 53 (47.3%) were pan-sensitive to all first-line drugs tested Any resistance (mono and poly resistance) to isoniazid was found in 44 isolates (39.3%) and any resistance to streptomycin in 43 (38.4%). Thirty-one (27.7%) were MDR-TB. Eleven (35.5%) out of 31 MDR-TB isolates were pre-XDR. MDR-TB isolates were more likely than non-MDR isolates to have streptomycin and ethambutol resistance. The main findings of this study were the high prevalence of MDR-TB and streptomycin resistance among previously treated TB patients, as well as a high prevalence of pre-XDR-TB among the MDR-TB patients, which suggest that first-line and second-line DST is essential to aid the design of effective regimens for these groups of patients in Ghana.

  9. A new stratified risk assessment tool for whiplash injuries developed from a prospective observational study

    PubMed Central

    Kasch, Helge; Kongsted, Alice; Qerama, Erisela; Bach, Flemming W; Bendix, Tom; Jensen, Troels Staehelin

    2013-01-01

    Objectives An initial stratification of acute whiplash patients into seven risk-strata in relation to 1-year work disability as primary outcome is presented. Design The design was an observational prospective study of risk factors embedded in a randomised controlled study. Setting Acute whiplash patients from units, general practitioners in four Danish counties were referred to two research centres. Participants During a 2-year inclusion period, acute consecutive whiplash-injured (age 18–70 years, rear-end or frontal-end car accident and WAD (whiplash-associated disorders) grades I–III, symptoms within 72 h, examination prior to 10 days postinjury, capable of written/spoken Danish, without other injuries/fractures, pre-existing significant somatic/psychiatric disorder, drug/alcohol abuse and previous significant pain/headache). 688 (438 women and 250 men) participants were interviewed and examined by a study nurse after 5 days; 605 were completed after 1 year. A risk score which included items of initial neck pain/headache intensity, a number of non-painful complaints and active neck mobility was applied. The primary outcome parameter was 1-year work disability. Results The risk score and number of sick-listing days were related (Kruskal-Wallis, p<0.0001). In stratum 1, less than 4%, but in stratum 7, 68% were work-disabled after 1 year. Early work assessment (p<0.0001), impact of the event questionnaire (p<0.0006), psychophysical pain measures being McGill pain questionnaire parameters (p<0.0001), pressure pain algometry (p<0.0001) and palpation (p<0.0001) showed a significant relationship with risk stratification. Analysis Findings confirm previous studies reporting intense neck pain/headache and distress as predictors for work disability after whiplash. Neck-mobility was a strong predictor in this study; however, it was a more inconsistent predictor in other studies. Conclusions Application of the risk assessment score and use of the risk strata

  10. Characterization and complete genome sequence of a previously uncharacterized panicovirus from Bermuda grass detected by high throughput sequencing

    USDA-ARS?s Scientific Manuscript database

    Bermuda grass samples were examined by transmission electron microscopy and 28-30 nm spherical virus particles were observed. Total RNA from these plants was subjected to high throughput sequencing (HTS). The nearly full genome sequence of a previously uncharacterized Panicovirus was identified from...

  11. Copernicus observations of Betelgeuse and Antares

    NASA Technical Reports Server (NTRS)

    Bernat, A. P.; Lambert, D. L.

    1976-01-01

    The Mg II h and k lines were observed strongly in emission by Copernicus scans of the M supergiants alpha Ori and alpha Sco. The striking symmetry in the k line as contrasted with the symmetric h line, as observed previously was confirmed. Estimates of absolute chromospheric fluxes were obtained. Measured values for the widths of the h and k lines do not follow a Wilson-Bappu relationship. Upper limits determined for other chromospheric lines of alpha Ori tend to exclude the existence of extensive and/or hot regions surrounding this supergiant. Observed weakening by fluorescence of the Fe L 4307 A line is good evidence that the Mn I and Fe I resonance transitions overlying the Mg II k-line profile are responsible for the strong asymmetry of this line in the two stars. However, quantitative study shows that the absorption provided by the cool circumstellar shells is insufficient to provide the observed asymmetry. Additional absorption may be provided by a cool turbulent region at the top of the chromosphere.

  12. Frequency of placenta previa in previously scarred and non scarred uterus

    PubMed Central

    Majeed, Tayyaba; Waheed, Fatima; Mahmood, Zahid; Saba, Kanwal; Mahmood, Hamis; Bukhari, Mulazim Hussain

    2015-01-01

    Objective: To determine the frequency of placenta Previa in patients coming to a tertiary care unit with previously scarred and non-scarred uterus. Methods: A descriptive cross sectional study was carried on 114 cases who underwent caesarean sections (37 cases out of 645 cases with non scarred uterus and 77 cases from 721 cases with scarred uterus) in the department of obstetrics and gynecology Lady Willingdon Hospital from January 2008– December 2011. Results: Most patients (47.36%) were between 26-30 years age group, presented with gestational age between 36-40 weeks (70.17%), were mostly G2-4, while frequency of placenta Previa in non-scarred uterus was 32.45% (37 cases), and frequency in previously scarred uterus was 67.54% (77 cases). Major degree Previa was found in 88 cases (77.19%). There were 5.70% cases of placenta Previa from non-scarred uteruses and 10.67% cases of placenta Previa (10.67%) from already scarred uteruses. Stratification revealed a higher trend of the morbidity with the increase in number of previous caesarean sections. Conclusion: A significantly higher frequency of placenta Previa was found among patients coming to a tertiary care hospital with previously scarred uterus. PMID:26101491

  13. Human Papilloma Virus Identification in Breast Cancer Patients with Previous Cervical Neoplasia.

    PubMed

    Lawson, James S; Glenn, Wendy K; Salyakina, Daria; Clay, Rosemary; Delprado, Warick; Cheerala, Bharathi; Tran, Dinh D; Ngan, Christopher C; Miyauchi, Shingo; Karim, Martha; Antonsson, Annika; Whitaker, Noel J

    2015-01-01

    Women with human papilloma virus (HPV)-associated cervical neoplasia have a higher risk of developing breast cancer than the general female population. The purpose of this study was to (i) identify high-risk HPVs in cervical neoplasia and subsequent HPV positive breast cancers which developed in the same patients and (ii) determine if these HPVs were biologically active. A range of polymerase chain reaction and immunohistochemical techniques were used to conduct a retrospective cohort study of cervical precancers and subsequent breast cancers in the same patients. The same high-risk HPV types were identified in both the cervical and breast specimens in 13 (46%) of 28 patients. HPV type 18 was the most prevalent. HPVs appeared to be biologically active as demonstrated by the expression of HPV E7 proteins and the presence of HPV-associated koilocytes. The average age of these patients diagnosed with breast cancer following prior cervical precancer was 51 years, as compared to 60 years for all women with breast cancer (p for difference = 0.001). These findings indicate that high-risk HPVs can be associated with cervical neoplasia and subsequent young age breast cancer. However, these associations are unusual and are a very small proportion of breast cancers. These outcomes confirm and extend the observations of two similar previous studies and offer one explanation for the increased prevalence of serious invasive breast cancer among young women.

  14. Are Common Skin Diseases among Norwegian Dermatological Outpatients Associated with Psychological Problems Compared with Controls? An Observational Study.

    PubMed

    Balieva, Flora; Lien, Lars; Kupfer, Jörg; Halvorsen, Jon Anders; Dalgard, Florence

    2016-02-01

    Dermatological disease has been shown to be associated with psychological comorbidity. The aim of this observational study is to describe the distribution of skin disease and the prevalence of depression, anxiety and stress among Norwegian dermatological outpatients. Thirteen percent of outpatients had clinical anxiety compared with 3.7% of healthy controls, and 5.8% had clinical depression compared with 0.9% of controls. Adjusted odds ratio for clinical anxiety was 4.53 in patients compared with controls, and for clinical depression 6.25, which is much higher than previously described in a larger European study. Patients with tumours had less depression. Chronic inflammatory skin conditions had an especially high impact on patient's psychological wellbeing and should not be undervalued relative to, for instance, skin cancer in health strategies. These results argue strongly for including skin disease prevention and treatment in future health strategies.

  15. Ozone Lidar Observations for Air Quality Studies

    NASA Technical Reports Server (NTRS)

    Wang, Lihua; Newchurch, Mike; Kuang, Shi; Burris, John F.; Huang, Guanyu; Pour-Biazar, Arastoo; Koshak, William; Follette-Cook, Melanie B.; Pickering, Kenneth E.; McGee, Thomas J.; hide

    2015-01-01

    Tropospheric ozone lidars are well suited to measuring the high spatio-temporal variability of this important trace gas. Furthermore, lidar measurements in conjunction with balloon soundings, aircraft, and satellite observations provide substantial information about a variety of atmospheric chemical and physical processes. Examples of processes elucidated by ozone-lidar measurements are presented, and modeling studies using WRF-Chem, RAQMS, and DALES/LES models illustrate our current understanding and shortcomings of these processes.

  16. Strategies GeoCape Intelligent Observation Studies @ GSFC

    NASA Technical Reports Server (NTRS)

    Cappelaere, Pat; Frye, Stu; Moe, Karen; Mandl, Dan; LeMoigne, Jacqueline; Flatley, Tom; Geist, Alessandro

    2015-01-01

    This presentation provides information a summary of the tradeoff studies conducted for GeoCape by the GSFC team in terms of how to optimize GeoCape observation efficiency. Tradeoffs include total ground scheduling with simple priorities, ground scheduling with cloud forecast, ground scheduling with sub-area forecast, onboard scheduling with onboard cloud detection and smart onboard scheduling and onboard image processing. The tradeoffs considered optimzing cost, downlink bandwidth and total number of images acquired.

  17. On Deviations between Observed and Theoretically Estimated Values on Additivity-Law Failures

    NASA Astrophysics Data System (ADS)

    Nayatani, Yoshinobu; Sobagaki, Hiroaki

    The authors have reported in the previous studies that the average observed results are about a half of the corresponding predictions on the experiments with large additivity-law failures. One of the reasons of the deviations is studied and clarified by using the original observed data on additivity-law failures in the Nakano experiment. The conclusion from the observations and their analyses clarified that it was essentially difficult to have a good agreement between the average observed results and the corresponding theoretical predictions in the experiments with large additivity-law failures. This is caused by a kind of unavoidable psychological pressure existing in subjects participated in the experiments. We should be satisfied with the agreement in trend between them.

  18. Prevalence and Characteristics of Work Anxiety in Medical Rehabilitation Patients: A Cross-Sectional Observation Study.

    PubMed

    Muschalla, Beate; Jöbges, Michael

    2018-01-01

    To investigate frequency, type, and characteristics of work anxieties in patients with somatic illness. Cross-sectional observation study. Neurology, orthopedic, and cardiology rehabilitation clinics. Patients (N=1610; age, 18-65y) with work anxieties. Not applicable. Patients who scored high on at least 2 of 9 items in the work-anxiety screening questionnaire and who reported impairment were investigated with a differential diagnostic interview on work anxieties and with the Mini-International Neuropsychiatric Interview on non-work-related common mental disorders. Patients also filled out a self-rating questionnaire on their subjective symptom load and sociodemographic data. Approximately 20% to 27% of the investigated inpatients in somatic rehabilitation (altogether n=393) received a work-anxiety diagnosis. Patients with orthopedic illness report highest work anxiety and have previous longest sick leave (20.6wk in the past 12mo). Patients with orthopedic illness suffer from work-related adjustment disorder with anxiety, social anxieties, and workplace phobias, whereas patients with cardiac illness are more often affected by hypochondriac anxieties. Anxieties of insufficiency and worrying occur equally in all indications. About a quarter of patients in somatic rehabilitation are in need of additional diagnostic attention owing to work anxieties. Differential diagnostic of work anxiety is needed for initiating adequate therapeutic action. Somatic rehabilitation physicians should be aware of work anxieties in their patients, especially in patients with orthopedic illness with previous long-term sick leave. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. ADAPTIVE MATCHING IN RANDOMIZED TRIALS AND OBSERVATIONAL STUDIES

    PubMed Central

    van der Laan, Mark J.; Balzer, Laura B.; Petersen, Maya L.

    2014-01-01

    SUMMARY In many randomized and observational studies the allocation of treatment among a sample of n independent and identically distributed units is a function of the covariates of all sampled units. As a result, the treatment labels among the units are possibly dependent, complicating estimation and posing challenges for statistical inference. For example, cluster randomized trials frequently sample communities from some target population, construct matched pairs of communities from those included in the sample based on some metric of similarity in baseline community characteristics, and then randomly allocate a treatment and a control intervention within each matched pair. In this case, the observed data can neither be represented as the realization of n independent random variables, nor, contrary to current practice, as the realization of n/2 independent random variables (treating the matched pair as the independent sampling unit). In this paper we study estimation of the average causal effect of a treatment under experimental designs in which treatment allocation potentially depends on the pre-intervention covariates of all units included in the sample. We define efficient targeted minimum loss based estimators for this general design, present a theorem that establishes the desired asymptotic normality of these estimators and allows for asymptotically valid statistical inference, and discuss implementation of these estimators. We further investigate the relative asymptotic efficiency of this design compared with a design in which unit-specific treatment assignment depends only on the units’ covariates. Our findings have practical implications for the optimal design and analysis of pair matched cluster randomized trials, as well as for observational studies in which treatment decisions may depend on characteristics of the entire sample. PMID:25097298

  20. Observer Use of Standardized Observation Protocols in Consequential Observation Systems

    ERIC Educational Resources Information Center

    Bell, Courtney A.; Yi, Qi; Jones, Nathan D.; Lewis, Jennifer M.; McLeod, Monica; Liu, Shuangshuang

    2014-01-01

    Evidence from a handful of large-scale studies suggests that although observers can be trained to score reliably using observation protocols, there are concerns related to initial training and calibration activities designed to keep observers scoring accurately over time (e.g., Bell, et al, 2012; BMGF, 2012). Studies offer little insight into how…

  1. Polarimetric Observations of the Lunar Surface

    NASA Astrophysics Data System (ADS)

    Kim, S.

    2017-12-01

    Polarimetric images contain valuable information on the lunar surface such as grain size and porosity of the regolith, from which one can estimate the space weathering environment on the lunar surface. Surprisingly, polarimetric observation has never been conducted from the lunar orbit before. A Wide-Angle Polarimetric Camera (PolCam) has been recently selected as one of three Korean science instruments onboard the Korea Pathfinder Lunar Orbiter (KPLO), which is aimed to be launched in 2019/2020 as the first Korean lunar mission. PolCam will obtain 80 m-resolution polarimetric images of the whole lunar surface between -70º and +70º latitudes at 320, 430 and 750 nm bands for phase angles up to 115º. I will also discuss previous polarimetric studies on the lunar surface based on our ground-based observations.

  2. Hypernovae: Observational aspects

    NASA Astrophysics Data System (ADS)

    Danziger, I. J.

    2001-05-01

    Following the discovery of a supernova SN 1998bw very probably associated with the γ-ray burst source GRB980425 the term ``hypernova'' has been re-defined to embrace SNe of high energy associated with GRB's. Here we discuss in some detail the observed and inferred properties of SN 1998bw and its relation to other previously observed SNe to which it may be related. A brief account is given of other relatively nearby SNe where a possible association with GRB's has been suggested ex post facto. There are also cases where less direct but suggestive evidence for a SN/GRB association has been adduced for well observed GRB events and their associated afterglow. These are also referred to. Our conclusion is that observationally we are still near the beginning of understanding which types of SNe give rise to GRB's and how frequently they occur. Nevertheless objects such as SN1998bw surely give rise to young supernova remnants with high velocity oxygen-enriched filaments. .

  3. Linking Indigenous Knowledge and Observed Climate Change Studies

    NASA Technical Reports Server (NTRS)

    Alexander, Chief Clarence; Bynum, Nora; Johnson, Liz; King, Ursula; Mustonen, Tero; Neofotis, Peter; Oettle, Noel; Rosenzweig, Cynthia; Sakakibara, Chie; Shadrin, Chief Vyacheslav; hide

    2010-01-01

    We present indigenous knowledge narratives and explore their connections to documented temperature and other climate changes and observed climate change impact studies. We then propose a framework for enhancing integration of these indigenous narratives of observed climate change with global assessments. Our aim is to contribute to the thoughtful and respectful integration of indigenous knowledge with scientific data and analysis, so that this rich body of knowledge can inform science, and so that indigenous and traditional peoples can use the tools and methods of science for the benefit of their communities if they choose to do so. Enhancing ways of understanding such connections are critical as the Intergovernmental Panel on Climate Change Fifth Assessment process gets underway.

  4. The association between previous and future severe exacerbations of chronic obstructive pulmonary disease: Updating the literature using robust statistical methodology.

    PubMed

    Sadatsafavi, Mohsen; Xie, Hui; Etminan, Mahyar; Johnson, Kate; FitzGerald, J Mark

    2018-01-01

    There is minimal evidence on the extent to which the occurrence of a severe acute exacerbation of COPD that results in hospitalization affects the subsequent disease course. Previous studies on this topic did not generate causally-interpretable estimates. Our aim was to use corrected methodology to update previously reported estimates of the associations between previous and future exacerbations in these patients. Using administrative health data in British Columbia, Canada (1997-2012), we constructed a cohort of patients with at least one severe exacerbation, defined as an episode of inpatient care with the main diagnosis of COPD based on international classification of diseases (ICD) codes. We applied a random-effects 'joint frailty' survival model that is particularly developed for the analysis of recurrent events in the presence of competing risk of death and heterogeneity among individuals in their rate of events. Previous severe exacerbations entered the model as dummy-coded time-dependent covariates, and the model was adjusted for several observable patient and disease characteristics. 35,994 individuals (mean age at baseline 73.7, 49.8% female, average follow-up 3.21 years) contributed 34,271 severe exacerbations during follow-up. The first event was associated with a hazard ratio (HR) of 1.75 (95%CI 1.69-1.82) for the risk of future severe exacerbations. This risk decreased to HR = 1.36 (95%CI 1.30-1.42) for the second event and to 1.18 (95%CI 1.12-1.25) for the third event. The first two severe exacerbations that occurred during follow-up were also significantly associated with increased risk of all-cause mortality. There was substantial heterogeneity in the individual-specific rate of severe exacerbations. Even after adjusting for observable characteristics, individuals in the 97.5th percentile of exacerbation rate had 5.6 times higher rate of severe exacerbations than those in the 2.5th percentile. Using robust statistical methodology that controlled

  5. Abstract processing and observer vantage perspective in dysphoria.

    PubMed

    Hart-Smith, Ly; Moulds, Michelle L

    2018-05-07

    processing and observer vantage perspective have been associated with negative consequences in depression. We investigated the relationship between mode of processing and vantage perspective bidirectionally in high and low dysphoric individuals, using abstract and concrete descriptions of experimenter-provided everyday actions. When vantage perspective was manipulated and processing mode was measured (Study 1a), participants who adopted a field perspective did not differ from those who adopted an observer perspective in their preference for abstract descriptions, irrespective of dysphoria status. When processing mode was manipulated and vantage perspective was measured (Study 1b), participants provided with abstract descriptions had a greater tendency to adopt an observer perspective than those provided with concrete descriptions, irrespective of dysphoria status. These results were replicated in larger online samples (Studies 2a and 2b). Together, they indicate a unidirectional causal relationship, whereby processing mode causally influences vantage perspective, in contrast to the bidirectional relationship previously reported in an unselected sample (Libby, Shaeffer, & Eibach, 2009). Further, these findings demonstrate that abstract processing increases the likelihood of adopting an observer perspective, and support targeting abstract processing in the treatment of depression to address the negative consequences associated with both abstract processing and recalling/imagining events from an observer perspective. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  6. A photometric study of globular clusters observed by the APOGEE survey

    NASA Astrophysics Data System (ADS)

    Mészáros, Szabolcs; García-Hernández, D. A.; Cassisi, Santi; Monelli, Matteo; Szigeti, László; Dell'Agli, Flavia; Derekas, Alíz; Masseron, Thomas; Shetrone, Matthew; Stetson, Peter; Zamora, Olga

    2018-04-01

    In this paper, we describe the photometric and spectroscopic properties of multiple populations in seven northern globular clusters. In this study, we employ precise ground-based photometry from the private collection of Stetson, space photometry from the Hubble Space Telescope (HST), literature abundances of Na and O, and Apache Point Observatory Galactic Evolution Experiment (APOGEE) survey abundances for Mg, Al, C, and N. Multiple populations are identified by their position in the CU, B, I -Vpseudo colour-magnitude diagram (pseudo-CMD) and confirmed with their chemical composition determined using abundances. We confirm the expectation from previous studies that the red giant branches (RGBs) in all seven clusters are split and the different branches have different chemical compositions. The Mg-Al anticorrelations were well explored by the APOGEE and Gaia-ESO surveys for most globular clusters, some clusters showing bimodal distributions, while others continuous distributions. Even though the structure (i.e. bimodal versus continuous) of Mg-Al can greatly vary, the Al-rich and Al-poor populations do not seem to have very different photometric properties, agreeing with theoretical calculations. There is no one-to-one correspondence between the Mg-Al anticorrelation shape (bimodal versus continuous) and the structure of the RGB seen in the HST pseudo-CMDs, with the HST photometric information usually implying more complex formation/evolution histories than the spectroscopic ones. We report on finding two second-generation horizontal branch (HB) stars in M5, and five second-generation asymptotic giant branch (AGB) stars in M92, which is the most metal-poor cluster to date in which second-generation AGB stars have been observed.

  7. An Observational Study of Print Literacy in Canadian Preschool Classrooms

    ERIC Educational Resources Information Center

    Lynch, Jacqueline

    2011-01-01

    The purpose of this study was to examine the role of print literacy in preschool classrooms. There were seven preschool teachers working in central Canada who were observed over three sessions. The process of analytic induction was used to formulate categories based on interviews, classroom observations and documents. The following categories were…

  8. The hypertensive response to intubation. Do researchers acknowledge previous work?

    PubMed

    Smith, A J; Goodman, N W

    1997-01-01

    To see whether investigators of a circumscribed research topic, the haemodynamic response to orotracheal intubation, review and cite previous work. A 1989 editorial about the response was critical to investigators for measuring physiology but not outcome; for nonetheless making recommendations; for studying only patients not at risk; and for implying patients are at risk when this is not certain. A systemic Medline search was made for English language reports published during or after 1990, and their citation lists read for missed reports. All retrieved papers were read for citation of the editorial and for acknowledgement of its criticisms. Citations were tabulated, and cross-referenced between papers, to see whether blocks of citations had been obtained from other investigators' reports. Eighty-one full reports, from 48 groups of investigators, were obtained. The 1989 editorial was cited twice. All studies included physiological measurements, but none reported long-term outcome. There was no comment on the need to know outcome in 39 reports. Pre-existing risk factors were exclusions in 65 studies. In 56 papers, complications of the response were given as the reason for the study; in 41 of these papers only healthy subjects were studied. In total, 249 references about the response were identified from the 81 papers. There was no obvious evidence that citations were obtained from others' papers. Recognised deficiencies in research method were not acknowledged. When submitting work for publication, investigators should provide evidence of how they searched for previous work.

  9. Changes in Health and Fitness in Firefighter Recruits: An Observational Cohort Study.

    PubMed

    Cornell, David J; Gnacinski, Stacy L; Meyer, Barbara B; Ebersole, Kyle T

    2017-11-01

    To observe longitudinal changes in health and fitness among firefighter recruits. Body composition, aerobic capacity, muscular power, muscular strength, and muscular endurance measures were longitudinally collected among 27 male firefighter recruits (mean ± SD, age = 29.9 ± 4.1 yr; height, 179.8 ± 4.6 cm; body mass, 87.2 ± 9.7 kg) at the beginning (W1) and end (W14) of their firefighter training academy, as well as at the end of their probationary period (W38). Repeated-measures multivariate analyses of variance (RM MANOVA) identified significant changes across time among measures of body composition (F10,17 = 30.390, Λ = 0.053, P < 0.001), aerobic capacity (F6,21 = 55.111, Λ = 0.060, P < 0.001), muscular power (F8,17 = 2.785, Λ = 0.433, P = 0.036), muscular strength (F6,20 = 34.908, Λ = 0.087, P < 0.001), and muscular endurance (F4,23 = 25.983, Λ = 0.181, P < 0.001). Follow-up post hoc analyses indicated that all measures, except muscular power, significantly improved from W1 to W14 (P < 0.05). However, significant decrements in many of these measures were also observed from W14 to W38 (P < 0.05). The results of the current study suggest that measures of health and fitness among firefighter recruits significantly improved throughout the firefighter training academy (W1 to W14). However, many of these positive physiological adaptations are lost before these recruits finish their probationary period as active-duty firefighters (W14 to W38). These results highlight the importance of developing exercise programming that is designed for the active-duty firefighter cohort population to maintain the beneficial adaptations in health and fitness previously created during the firefighter training academy.

  10. Current antiviral practice and course of Hepatitis B virus infection in inflammatory arthritis: a multicentric observational study (A + HBV study).

    PubMed

    Kalyoncu, Umut; Emmungil, Hakan; Onat, Ahmet Mesut; Yılmaz, Sedat; Kaşifoglu, Timuçin; Akar, Servet; İnanç, Nevsun; Yıldız, Fatih; Küçükşahin, Orhan; Karadağ, Ömer; Mercan, Rıdvan; Bes, Cemal; Yazısız, Veli; Yılmazer, Barış; Özmen, Mustafa; Erten, Şükran; Şenel, Soner; Yazıcı, Ayten; Taşçılar, Koray; Kalfa, Melike; Kiraz, Sedat; Kısacık, Bünyamin; Pehlivan, Yavuz; Kılıç, Levent; Şimşek, İsmail; Çefle, Ayşe; Akkoç, Nurullah; Direskeneli, Haner; Erken, Eren; Turgay, Murat; Öztürk, Mehmet Akif; Soy, Mehmet; Aksu, Kenan; Dinç, Ayhan; Ertenli, İhsan

    2015-12-01

    The reactivation of hepatitis B virus (HBV) infection is a well-known event in hepatitis B surface antigen (HbsAg)-positive patients receiving immunosuppressive therapy. The objective of this study was to assess the antiviral practice and course of HBV infection in inflammatory arthritis. Nineteen rheumatology centers participated in this retrospective study. HbsAg-positive patients who were taking disease-modifying antirheumatic drugs and who were being tested for HBV viral load at a minimum of two different time points were included. The case report form (CRF) consisted of demographic data, rheumatic diseases, treatment profiles, transaminase levels, viral hepatitis serological markers, and HBV viral load. The reactivation of HBV was defined as the abrupt rise in HBV replication by an increase in serum HBV DNA levels in a patient with a previously inactive HBV infection. In total, the data of 101 (female 50.5%) patients were included (76 patients with inactive HBV carriers and 25 patients with chronic HBV infection). The mean age of patients was 44±12 years, and the mean follow-up duration was 31±22 months. Of the 101 patients, 70 (69.3%) received antiviral treatment. HBV reactivation was detected in 13 of 76 (17.1%) patients with inactive HBV carriers. HBV reactivation was observed less frequently, not although significantly, in those patients receiving antiviral prophylaxis compared with those not receiving prophylaxis [5/41 (12.2%) vs. 8/33 (24.2%), p=0.17]. Forty-two patients (31 patients had inactive HBV carriers) were using anti-tumor necrosis factor agents. HBV reactivation was detected in 6 of the 31 (19.3%) patients. Twenty-five patients had chronic hepatitis, and five (20%) of them had not received antiviral prophylaxis. HBV viral loads were persistently elevated in 7 (28%) of 25 patients (three patients under and four patients not under antiviral treatment). HBV reactivation was observed in approximately 17% of patients under immunosuppressive

  11. Current antiviral practice and course of Hepatitis B virus infection in inflammatory arthritis: a multicentric observational study (A + HBV study)

    PubMed Central

    Kalyoncu, Umut; Emmungil, Hakan; Onat, Ahmet Mesut; Yılmaz, Sedat; Kaşifoglu, Timuçin; Akar, Servet; İnanç, Nevsun; Yıldız, Fatih; Küçükşahin, Orhan; Karadağ, Ömer; Mercan, Rıdvan; Bes, Cemal; Yazısız, Veli; Yılmazer, Barış; Özmen, Mustafa; Erten, Şükran; Şenel, Soner; Yazıcı, Ayten; Taşçılar, Koray; Kalfa, Melike; Kiraz, Sedat; Kısacık, Bünyamin; Pehlivan, Yavuz; Kılıç, Levent; Şimşek, İsmail; Çefle, Ayşe; Akkoç, Nurullah; Direskeneli, Haner; Erken, Eren; Turgay, Murat; Öztürk, Mehmet Akif; Soy, Mehmet; Aksu, Kenan; Dinç, Ayhan; Ertenli, İhsan

    2015-01-01

    Objective The reactivation of hepatitis B virus (HBV) infection is a well-known event in hepatitis B surface antigen (HbsAg)-positive patients receiving immunosuppressive therapy. The objective of this study was to assess the antiviral practice and course of HBV infection in inflammatory arthritis. Material and Methods Nineteen rheumatology centers participated in this retrospective study. HbsAg-positive patients who were taking disease-modifying antirheumatic drugs and who were being tested for HBV viral load at a minimum of two different time points were included. The case report form (CRF) consisted of demographic data, rheumatic diseases, treatment profiles, transaminase levels, viral hepatitis serological markers, and HBV viral load. The reactivation of HBV was defined as the abrupt rise in HBV replication by an increase in serum HBV DNA levels in a patient with a previously inactive HBV infection. Results In total, the data of 101 (female 50.5%) patients were included (76 patients with inactive HBV carriers and 25 patients with chronic HBV infection). The mean age of patients was 44±12 years, and the mean follow-up duration was 31±22 months. Of the 101 patients, 70 (69.3%) received antiviral treatment. HBV reactivation was detected in 13 of 76 (17.1%) patients with inactive HBV carriers. HBV reactivation was observed less frequently, not although significantly, in those patients receiving antiviral prophylaxis compared with those not receiving prophylaxis [5/41 (12.2%) vs. 8/33 (24.2%), p=0.17]. Forty-two patients (31 patients had inactive HBV carriers) were using anti-tumor necrosis factor agents. HBV reactivation was detected in 6 of the 31 (19.3%) patients. Twenty-five patients had chronic hepatitis, and five (20%) of them had not received antiviral prophylaxis. HBV viral loads were persistently elevated in 7 (28%) of 25 patients (three patients under and four patients not under antiviral treatment). Conclusion HBV reactivation was observed in

  12. Preseason Perceived Physical Capability and Previous Injury.

    PubMed

    Sciascia, Aaron; Haegele, Lauren E; Lucas, Jean; Uhl, Timothy L

    2015-09-01

    Patient opinion about the ability to perform athletic maneuvers is important after injury; however, prospective assessment of self-perceived physical capability for athletes before the beginning of a season is lacking. To perform a descriptive analysis of knee, shoulder, and elbow self-perceived measures of physical capability specific to athletics and to compare the measures between athletes with and without a history of injury. Cross-sectional study. Preparticipation physical examinations. A total of 738 collegiate athletes (486 men, 251 women; age = 19 ± 1 years) were administered questionnaires after receiving medical clearance to participate in their sports. Of those athletes, 350 reported a history of injury. Athletes self-reported a history of knee, shoulder, or elbow injury. Perceived physical capability of the 3 joints was evaluated using the Knee Injury and Osteoarthritis Outcome Score Sport and Recreation Function and Knee-Related Quality of Life subscales and the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score. We conducted nonparametric analysis to determine if scores differed between athletes with and without a history of injury. Median values for the Knee Injury and Osteoarthritis Outcome Score Sports and Recreation Function and Knee-Related Quality of Life subscales and the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score for all athletes were 100. Median values for perceived physical capability of athletes with a history of injury were 3 to 12 points lower for each questionnaire before the start of the season (P < .001). Our study provided descriptive values for individual perceived knee, shoulder, and elbow physical capability of collegiate athletes participating in 19 sports. Athletes who did not report previous injuries perceived their physical capabilities to be nearly perfect, which could set the goal for these athletes to return to participation after injury. Athletes reporting previous injuries perceived less physical

  13. The NRAO Observing for University Classes Program

    NASA Astrophysics Data System (ADS)

    Cannon, John M.; Van Moorsel, Gustaaf A.

    2017-01-01

    The NRAO "Observing for University Classes" program is a tremendous resource for instructors of courses in observational astronomy. As a service to the astronomical and educational communities, the NRAO offers small amounts of observing time on the Very Large Array (VLA) and the Very Long Baseline Array to such instructors. The data can be used by students and faculty to demonstrate radio astronomy theory with modern data products. Further, the results may lead to publication; this is a unique opportunity for faculty members to integrate research into the classroom. Previous experience with NRAO facilities is required for instructors; individuals without radio astronomy experience can take advantage of other NRAO educational opportunities (e.g., the Synthesis Imaging Workshop) prior to using the program. No previous experience with radio astronomy data is required for students; this is the primary target audience of the program. To demonstrate concept, this poster describes three different VLA observing programs that have been completed using the "Observing for University Classes" resource at Macalester College; undergraduate students have published the results of all three of these programs. Other recent "Observing for University Classes" programs are also described.

  14. Changes in dental plaque following hospitalisation in a critical care unit: an observational study.

    PubMed

    Sachdev, Mishal; Ready, Derren; Brealey, David; Ryu, Jung; Bercades, Georgia; Nagle, Janette; Borja-Boluda, Susana; Agudo, Elisa; Petrie, Aviva; Suvan, Jean; Donos, Nikos; Singer, Mervyn; Needleman, Ian

    2013-09-04

    Previous research has suggested that deterioration in oral health can occur following hospitalisation. The impact of such deterioration could increase the risk of oral disease, reduce quality of life and increase the potential for healthcare-associated infections (HCAI) such as healthcare-associated pneumonia (HAP). However, the strength of the evidence is limited by, amongst other factors, the few observational studies published that assess oral health longitudinally. In view of the microbiological component of oral diseases and HCAIs, the objective of this study was to investigate the microbiological changes in dental plaque following hospitalisation in a Critical Care Unit (CCU): (1) total number of cultivable bacteria and (2) presence and changes in specific HAP pathogens. We conducted a prospective, longitudinal observational study in the CCU of University College Hospital, London. Study participants were recruited within 24 hours of admission. Dental plaque samples were collected from up to six sites per patient. The primary outcome was microbiological change from baseline to seven days with additional analysis for participants still present at day 14. 50 patients were recruited with 36 available for review at one week, with early discharge accounting for much of the loss to follow-up. The median total viable count of the plaque microbiota at baseline was 4.40 × 105 cfu/ml and increased at week one to 3.44 × 106 cfu/ml. The total viable microbe counts increased by a median of 2.26 × 106 cfu/ml from baseline to week one (95% CI: 3.19 × 106, 1.24 × 107) and this was statistically significant (P < 0.01). Specific HAP bacteria were detected in 26% of participants sampled, although accounted for a relatively low proportion of the total viable bacteria. Total bacterial count of dental plaque increases during hospitalisation in CCU. This finding, together with the colonisation of dental plaque by HAP bacteria strengthens the evidence for a deterioration in oral

  15. Changes in dental plaque following hospitalisation in a critical care unit: an observational study

    PubMed Central

    2013-01-01

    Introduction Previous research has suggested that deterioration in oral health can occur following hospitalisation. The impact of such deterioration could increase the risk of oral disease, reduce quality of life and increase the potential for healthcare-associated infections (HCAI) such as healthcare-associated pneumonia (HAP). However, the strength of the evidence is limited by, amongst other factors, the few observational studies published that assess oral health longitudinally. In view of the microbiological component of oral diseases and HCAIs, the objective of this study was to investigate the microbiological changes in dental plaque following hospitalisation in a Critical Care Unit (CCU): (1) total number of cultivable bacteria and (2) presence and changes in specific HAP pathogens. Methods We conducted a prospective, longitudinal observational study in the CCU of University College Hospital, London. Study participants were recruited within 24 hours of admission. Dental plaque samples were collected from up to six sites per patient. The primary outcome was microbiological change from baseline to seven days with additional analysis for participants still present at day 14. Results 50 patients were recruited with 36 available for review at one week, with early discharge accounting for much of the loss to follow-up. The median total viable count of the plaque microbiota at baseline was 4.40 × 105 cfu/ml and increased at week one to 3.44 × 106 cfu/ml. The total viable microbe counts increased by a median of 2.26 × 106 cfu/ml from baseline to week one (95% CI: 3.19 × 106, 1.24 × 107) and this was statistically significant (P < 0.01). Specific HAP bacteria were detected in 26% of participants sampled, although accounted for a relatively low proportion of the total viable bacteria. Conclusion Total bacterial count of dental plaque increases during hospitalisation in CCU. This finding, together with the colonisation of dental plaque by HAP bacteria strengthens

  16. Management of augmentation of restless legs syndrome with rotigotine: a 1-year observational study.

    PubMed

    Trenkwalder, Claudia; Canelo, Monica; Lang, Michael; Schroeder, Hanna; Kelling, Daniela; Berkels, Reinhard; Schollmayer, Erwin; Heidbrede, Tanja; Benes, Heike

    2017-02-01

    The aim of this study is to assess the effect of switching to rotigotine transdermal patch on severity of restless legs syndrome (RLS) in patients who experienced acute augmentation with previous oral dopaminergics. In this 13-month observational study, adults with moderate-to-severe RLS and augmentation were switched to rotigotine per the physician's independent decision. Assessments included Clinical Global Impression severity score (CGI-1); (primary), treatment regimen for switching (secondary), RLS-6, International RLS Study Group Rating Scale (IRLS), and augmentation severity rating scale (ASRS). A total of 99 patients received rotigotine, of whom 46 completed observational period, and 43 were assessed for effectiveness. A total of 5 patients switched to rotigotine after a >1-day drug holiday, 23 switched overnight, 9 had an overlapping switch, and 6 received ongoing oral dopaminergics with rotigotine for ≥28 days. Of the 99 patients, 57 took concomitant RLS medications (excluding switching medications) on at least 1 day. At the final visit, median change in CGI-1 (Hodges-Lehman estimate [95% CI]) was -2.0 (-2.5, -1.50); 37 of the 43 patients improved by ≥1 CGI-1 category, and 16 of 43 were responders (≥50% improvement). RLS-6 and IRLS scores also improved. Patients had median ASRS of 0 at the final visit indicating "no worsening/occurrence of augmentation." ASRS item 1 showed a shift in mean time of symptom onset (24-h clock) from 12:38 (baseline) to 18:25 (final visit). Most common reasons for withdrawal of rotigotine were adverse events (26 patients) and lack of efficacy (14 patients). Switching from oral therapies to rotigotine was effective in improving RLS symptoms in 37 of the 43 patients (from the original population of 99 patients) who remained in the study over 13 months. ClinicalTrials.govNCT01386944. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. The chronic obstructive pulmonary disease assessment test improves the predictive value of previous exacerbations for poor outcomes in COPD.

    PubMed

    Miravitlles, Marc; García-Sidro, Patricia; Fernández-Nistal, Alonso; Buendía, María Jesús; Espinosa de Los Monteros, María José; Esquinas, Cristina; Molina, Jesús

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) exacerbations have a negative impact on the quality of life of patients and the evolution of the disease. We have investigated the prognostic value of several health-related quality of life questionnaires to predict the appearance of a composite event (new ambulatory or emergency exacerbation, hospitalization, or death) over a 1-year follow-up. This was a multicenter, prospective, observational study. Patients completed four questionnaires after recovering from an exacerbation (COPD Assessment Test [CAT], a Clinical COPD Questionnaire [CCQ], COPD Severity Score [COPDSS], and Airways Questionnaire [AQ20]). Patients were followed-up until the appearance of the composite event or for 1 year, whichever came first. A total of 497 patients were included in the study. The majority of them were men (89.7%), with a mean age of 68.7 (SD 9.2) years, and a forced expiratory volume in 1 second of 47.1% (SD 17.5%). A total of 303 (61%) patients experienced a composite event. Patients with an event had worse mean scores of all questionnaires at baseline compared to patients without event: CAT=12.5 vs 11.3 (P=0.028); CCQ=2.2 vs 1.9 (P=0.013); COPDSS=12.3 vs 10.9 (P=0.001); AQ20=8.3 vs 7.5 (P=0.048). In the multivariate analysis, only previous history of exacerbations and CAT score ≥13.5 were significant risk factors for the composite event. A CAT score ≥13.5 increased the predictive value of previous exacerbations with an area under the receiver operating characteristic curve of 0.864 (95% CI: 0.829-0.899; P=0.001). The predictive value of previous exacerbations significantly increased only in one of the four trialled questionnaires, namely in the CAT questionnaire. However, previous history of exacerbations was the strongest predictor of the composite event.

  18. Statistical analysis of MMS observations of energetic electron escape observed at/beyond the dayside magnetopause

    NASA Astrophysics Data System (ADS)

    Cohen, Ian J.; Mauk, Barry H.; Anderson, Brian J.; Westlake, Joseph H.; Sibeck, David G.; Turner, Drew L.; Fennell, Joseph F.; Blake, J. Bern; Jaynes, Allison N.; Leonard, Trevor W.; Baker, Daniel N.; Spence, Harlan E.; Reeves, Geoff D.; Giles, Barbara J.; Strangeway, Robert J.; Torbert, Roy B.; Burch, James L.

    2017-09-01

    Observations from the Energetic Particle Detector (EPD) instrument suite aboard the Magnetospheric Multiscale (MMS) spacecraft show that energetic (greater than tens of keV) magnetospheric particle escape into the magnetosheath occurs commonly across the dayside. This includes the surprisingly frequent observation of magnetospheric electrons in the duskside magnetosheath, an unexpected result given assumptions regarding magnetic drift shadowing. The 238 events identified in the 40 keV electron energy channel during the first MMS dayside season that exhibit strongly anisotropic pitch angle distributions indicating monohemispheric field-aligned streaming away from the magnetopause. A review of the extremely rich literature of energetic electron observations beyond the magnetopause is provided to place these new observations into historical context. Despite the extensive history of such research, these new observations provide a more comprehensive data set that includes unprecedented magnetic local time (MLT) coverage of the dayside equatorial magnetopause/magnetosheath. These data clearly highlight the common escape of energetic electrons along magnetic field lines concluded to have been reconnected across the magnetopause. While these streaming escape events agree with prior studies which show strong correlation with geomagnetic activity (suggesting a magnetotail source) and occur most frequently during periods of southward IMF, the high number of duskside events is unexpected and previously unobserved. Although the lowest electron energy channel was the focus of this study, the events reported here exhibit pitch angle anisotropies indicative of streaming up to 200 keV, which could represent the magnetopause loss of >1 MeV electrons from the outer radiation belt.

  19. Observer Rated Sleepiness and Real Road Driving: An Explorative Study

    PubMed Central

    Anund, Anna; Fors, Carina; Hallvig, David; Åkerstedt, Torbjörn; Kecklund, Göran

    2013-01-01

    The aim of the present study was to explore if observer rated sleepiness (ORS) is a feasible method for quantification of driver sleepiness in field studies. Two measures of ORS were used: (1) one for behavioural signs based on facial expression, body gestures and body movements labelled B-ORS, and (2) one based on driving performance e.g. if swerving and other indicators of impaired driving occurs, labelled D-ORS. A limited number of observers sitting in the back of an experimental vehicle on a motorway about 2 hours repeatedly 3 times per day (before lunch, after lunch, at night) observed 24 participant’s sleepiness level with help of the two observer scales. At the same time the participant reported subjective sleepiness (KSS), EOG was recorded (for calculation of blink duration) and several driving measure were taken and synchronized with the reporting. Based on mixed model Anova and correlation analysis the result showed that observer ratings of sleepiness based on drivers’ impaired performance and behavioural signs are sensitive to extend the general pattern of time awake, circadian phase and time of driving. The detailed analysis of the subjective sleepiness and ORS showed weak correspondence on an individual level. Only 16% of the changes in KSS were predicted by the observer. The correlation between the observer ratings based on performance (D-ORS) and behavioural signs (B-ORS) are high (r = .588), and the B-ORS shows a moderately strong association (r = .360) with blink duration. Both ORS measures show an association (r>0.45) with KSS, whereas the association with driving performance is weak. The results show that the ORS-method detects the expected general variations in sleepy driving in field studies, however, sudden changes in driver sleepiness on a detailed level as 5 minutes is usually not detected; this holds true both when taking into account driving behaviour or driver behavioural signs. PMID:23724094

  20. Identifying Conditions That Support Causal Inference in Observational Studies in Education: Empirical Evidence from within Study Comparisons

    ERIC Educational Resources Information Center

    Hallberg, Kelly

    2013-01-01

    This dissertation is a collection of three papers that employ empirical within study comparisons (WSCs) to identify conditions that support causal inference in observational studies. WSC studies empirically estimate the extent to which a given observational study reproduces the result of a randomized clinical trial (RCT) when both share the same…

  1. IRAS observations of young stellar objects in the Corona Australis dark cloud

    NASA Technical Reports Server (NTRS)

    Wilking, Bruce A.; Greene, Thomas P.; Lada, Charles J.; Meyer, Michael R.; Young, Erick T.

    1992-01-01

    The young stellar object (YSO) population associated with the dark cloud complex in Corona Australis is studied by synthesizing IRAS data with newly obtained near-IR and mid-IR photometry and previously published optical/IR data. Twenty-four YSOs in the Cr A complex are identified. The observed range of spectral energy distribution shapes and bolometric luminosities are consistent with those observed in other dark clouds. The duration and efficiency of star formation are found to be similar to the Rho Ophiuchi IR cluster. The low number of YSOs compared to other dark clouds is understood by a reevaluation of the molecular mass of the R Cr A cloud which shows it to be much less massive than previously assumed.

  2. Observational learning by individuals with autism: a review of teaching strategies.

    PubMed

    Plavnick, Joshua B; Hume, Kara A

    2014-05-01

    Observational learning is the process used to explain the acquisition of novel behaviors or performance of previously acquired behaviors under novel conditions after observing the behavior of another person and the consequences that follow the behavior. Many learners with autism do not attend to environmental stimuli at a level sufficient to learn a range of prosocial behaviors through observation of others. Modeling, group or dyadic instruction, and explicit observation training can improve the extent to which individuals with autism learn through observation. This article reviews previous research that involved observational learning by individuals with autism and outlines future research that could benefit instructional practices.

  3. The construction of power in family medicine bedside teaching: a video observation study.

    PubMed

    Rees, Charlotte E; Ajjawi, Rola; Monrouxe, Lynn V

    2013-02-01

    Bedside teaching is essential for helping students develop skills, reasoning and professionalism, and involves the learning triad of student, patient and clinical teacher. Although current rhetoric espouses the sharing of power, the medical workplace is imbued with power asymmetries. Power is context-specific and although previous research has explored some elements of the enactment and resistance of power within bedside teaching, this exploration has been conducted within hospital rather than general practice settings. Furthermore, previous research has employed audio-recorded rather than video-recorded observation and has therefore focused on language and para-language at the expense of non-verbal communication and human-material interaction. A qualitative design was adopted employing video- and audio-recorded observations of seven bedside teaching encounters (BTEs), followed by short individual interviews with students, patients and clinical teachers. Thematic and discourse analyses of BTEs were conducted. Power is constructed by students, patients and clinical teachers throughout different BTE activities through the use of linguistic, para-linguistic and non-verbal communication. In terms of language, participants construct power through the use of questions, orders, advice, pronouns and medical/health belief talk. With reference to para-language, participants construct power through the use of interruption and laughter. In terms of non-verbal communication, participants construct power through physical positioning and the possession or control of medical materials such as the stethoscope. Using this paper as a trigger for discussion, we encourage students and clinical teachers to reflect critically on how their verbal and non-verbal communication constructs power in bedside teaching. Students and clinical teachers need to develop their awareness of what power is, how it can be constructed and shared, and what it means for the student

  4. Observed cloud reflectivities and liquid water paths: An update

    NASA Technical Reports Server (NTRS)

    Coakley, James A., Jr.; Snider, Jack B.

    1990-01-01

    The FIRE microwave radiometer observations of liquid water path from San Nicolas Island and simultaneous NOAA AVHRR observations of cloud reflectivity were used to test a relationship between cloud liquid water path and cloud reflectivity that is often used in general circulation climate models (Stephens, 1978). The results of attempts to improve the data analysis which was described at the previous FIRE Science Team Workshop and elsewhere (Coakley and Snider, 1989) are reported. The improvements included the analysis of additional satellite passes over San Nicolas and sensitivity studies to estimate the effects on the observed reflectivities due to: (1) nonzero surface reflectivities beneath the clouds; (2) the anisotropy of the reflected radiances observed by the AVHRR; (3) small scale spatial structure in the liquid water path; and (4) adjustments to the calibration of AVHRR.

  5. High-Throughput Sequencing for Detection of Subpopulations of Bacteria Not Previously Associated with Artisanal Cheeses

    PubMed Central

    Quigley, Lisa; O'Sullivan, Orla; Beresford, Tom P.; Ross, R. Paul; Fitzgerald, Gerald F.

    2012-01-01

    Here, high-throughput sequencing was employed to reveal the highly diverse bacterial populations present in 62 Irish artisanal cheeses and, in some cases, associated cheese rinds. Using this approach, we revealed the presence of several genera not previously associated with cheese, including Faecalibacterium, Prevotella, and Helcococcus and, for the first time, detected the presence of Arthrobacter and Brachybacterium in goats' milk cheese. Our analysis confirmed many previously observed patterns, such as the dominance of typical cheese bacteria, the fact that the microbiota of raw and pasteurized milk cheeses differ, and that the level of cheese maturation has a significant influence on Lactobacillus populations. It was also noted that cheeses containing adjunct ingredients had lower proportions of Lactococcus species. It is thus apparent that high-throughput sequencing-based investigations can provide valuable insights into the microbial populations of artisanal foods. PMID:22685131

  6. High-throughput sequencing for detection of subpopulations of bacteria not previously associated with artisanal cheeses.

    PubMed

    Quigley, Lisa; O'Sullivan, Orla; Beresford, Tom P; Ross, R Paul; Fitzgerald, Gerald F; Cotter, Paul D

    2012-08-01

    Here, high-throughput sequencing was employed to reveal the highly diverse bacterial populations present in 62 Irish artisanal cheeses and, in some cases, associated cheese rinds. Using this approach, we revealed the presence of several genera not previously associated with cheese, including Faecalibacterium, Prevotella, and Helcococcus and, for the first time, detected the presence of Arthrobacter and Brachybacterium in goats' milk cheese. Our analysis confirmed many previously observed patterns, such as the dominance of typical cheese bacteria, the fact that the microbiota of raw and pasteurized milk cheeses differ, and that the level of cheese maturation has a significant influence on Lactobacillus populations. It was also noted that cheeses containing adjunct ingredients had lower proportions of Lactococcus species. It is thus apparent that high-throughput sequencing-based investigations can provide valuable insights into the microbial populations of artisanal foods.

  7. Are patients with thrombophilia and previous venous thromboembolism at higher risk to arterial thrombosis?

    PubMed

    Linnemann, Birgit; Schindewolf, Marc; Zgouras, Dimitrios; Erbe, Matthias; Jarosch-Preusche, Marie; Lindhoff-Last, Edelgard

    2008-01-01

    Whether thrombophilic disorders, which are established risk factors for venous thromboembolism (VTE), also increase the risk of arterial thrombosis is still unknown. We analyzed data from 1081 consecutive patients (649 F/432 M, 16-93 years of age) with previous VTE registered in the MAISTHRO (MAin-ISar-THROmbosis) database with regard to arterial thrombotic events and contributing risk factors. Screening for thrombophilia included testing for factor V Leiden and prothrombin G20210A mutation, antiphospholipid antibodies and activities of factor VIII, protein C, protein S and antithrombin. Of the entire study cohort, 40 patients (3.7%) had a prior myocardial infarction (MI), and 41 (3.8%) suffered a stroke. Other arterial thrombotic events were rare. Elevated factor VIII levels were more prevalent in MI patients than in controls (44.4 vs. 25.9%, p=0.044), but after adjusting for the traditional cardiovascular risk factors, this relationship was no longer significant. We observed a higher rate of lupus anticoagulant in MI patients with an adjusted odds ratio of 3.3 (95%CI 0.84-12.8, p=0.090). No difference in any other tested thrombophilia was observed in patients with MI or stroke relative to those without. The cumulative incidence of arterial thrombotic events in VTE patients is low, and the inherited thrombophilias do not seem to substantially increase the risk of arterial thrombosis.

  8. Vitality Forms Processing in the Insula during Action Observation: A Multivoxel Pattern Analysis

    PubMed Central

    Di Cesare, Giuseppe; Valente, Giancarlo; Di Dio, Cinzia; Ruffaldi, Emanuele; Bergamasco, Massimo; Goebel, Rainer; Rizzolatti, Giacomo

    2016-01-01

    Observing the style of an action done by others allows the observer to understand the cognitive state of the agent. This information has been defined by Stern “vitality forms”. Previous experiments showed that the dorso-central insula is selectively active both during vitality form observation and execution. In the present study, we presented participants with videos showing hand actions performed with different velocities and asked them to judge either their vitality form (gentle, neutral, rude) or their velocity (slow, medium, fast). The aim of the present study was to assess, using multi-voxel pattern analysis, whether vitality forms and velocities of observed goal-directed actions are differentially processed in the insula, and more specifically whether action velocity is encoded per se or it is an element that triggers neural populations of the insula encoding the vitality form. The results showed that, consistently across subjects, in the dorso-central sector of the insula there were voxels selectively tuned to vitality forms, while voxel tuned to velocity were rare. These results indicate that the dorso-central insula, which previous data showed to be involved in the vitality form processing, contains voxels specific for the action style processing. PMID:27375461

  9. Vitality Forms Processing in the Insula during Action Observation: A Multivoxel Pattern Analysis.

    PubMed

    Di Cesare, Giuseppe; Valente, Giancarlo; Di Dio, Cinzia; Ruffaldi, Emanuele; Bergamasco, Massimo; Goebel, Rainer; Rizzolatti, Giacomo

    2016-01-01

    Observing the style of an action done by others allows the observer to understand the cognitive state of the agent. This information has been defined by Stern "vitality forms". Previous experiments showed that the dorso-central insula is selectively active both during vitality form observation and execution. In the present study, we presented participants with videos showing hand actions performed with different velocities and asked them to judge either their vitality form (gentle, neutral, rude) or their velocity (slow, medium, fast). The aim of the present study was to assess, using multi-voxel pattern analysis, whether vitality forms and velocities of observed goal-directed actions are differentially processed in the insula, and more specifically whether action velocity is encoded per se or it is an element that triggers neural populations of the insula encoding the vitality form. The results showed that, consistently across subjects, in the dorso-central sector of the insula there were voxels selectively tuned to vitality forms, while voxel tuned to velocity were rare. These results indicate that the dorso-central insula, which previous data showed to be involved in the vitality form processing, contains voxels specific for the action style processing.

  10. Association between previous splenectomy and gastric dilatation-volvulus in dogs: 453 cases (2004-2009).

    PubMed

    Sartor, Angela J; Bentley, Adrienne M; Brown, Dorothy C

    2013-05-15

    To evaluate the association between previous splenectomy and gastric dilatation-volvulus (GDV) in dogs. Multi-institutional retrospective case-control study. Animals-151 dogs treated surgically for GDV and 302 control dogs with no history of GDV. Computerized records of dogs evaluated via exploratory laparotomy or abdominal ultrasonography were searched, and dogs with GDV and dogs without GDV (control dogs) were identified. Two control dogs were matched with respect to age, body weight, sex, neuter status, and breed to each dog with GDV. Data were collected on the presence or absence of the spleen for both dogs with GDV and control dogs. Conditional logistic regression analysis was used to investigate the association of previous splenectomy with GDV. 6 (4%) dogs in the GDV group and 3 (1%) dogs in the control group had a history of previous splenectomy. The odds of GDV in dogs with a history of previous splenectomy in this population of dogs were 5.3 times those of dogs without a history of previous splenectomy (95% confidence interval, 1.1 to 26.8). For the patients in the present study, there was an increased odds of GDV in dogs with a history of splenectomy. Prophylactic gastropexy may be considered in dogs undergoing a splenectomy, particularly if other risk factors for GDV are present.

  11. Competition between Free-Floating Plants Is Strongly Driven by Previously Experienced Phosphorus Concentrations in the Water Column.

    PubMed

    Peeters, Edwin T H M; Neefjes, Rozemarijn E M; Zuidam, Bastiaan G van

    2016-01-01

    Nutrients can determine the outcome of the competition between different floating plant species. The response of floating plants to current phosphorus levels may be affected by previously experienced phosphorus concentrations because some species have the ability to store excess phosphorus for later use. This might have an impact on their competition. Here, we investigate the effect of previous and actual phosphorus concentrations on the growth rate of free-floating plant species (Azolla filiculoides, Lemna minor/gibba and Ricciocarpus natans)and the effect of phosphorus history on the competition between L. minor/gibba and A. filiculoides and between L. minor/gibba and R. natans. As expected, plant growth was lower when previously kept at low instead of high phosphorus concentrations. Growth of L. minor/gibba and A. filiculoides with a phosphorus rich history was comparable for low and high actual phosphorus concentrations, however, internal phosphorus concentrations were significantly lower with low actual phosphorus concentration. This indicates that both species perform luxury phosphorus uptake. Furthermore, internal P concentration in Azolla and Lemna increased within two weeks after a period of P deficit without a strong increase in growth. A. filiculoides in a mixture with L. minor/gibba grew faster than its monoculture. Morphological differences may explain why A. filiculoides outcompeted L. minor/gibba and these differences may be induced by phosphorus concentrations in the past. Growth of L. minor/gibba was only reduced by the presence of A. filiculoides with a high phosphorus history. Growth of L. minor/gibba and R. natans in mixtures was positively affected only when they had a high phosphorus history themselves and their competitor a low phosphorus history. These observations clearly indicate that phosphorus history of competing plants is important for understanding the outcome of the competition. Therefore, actual and previously experienced phosphorus

  12. Satellite-borne study of seismic phenomena by low frequency magnetic field observations

    NASA Astrophysics Data System (ADS)

    Schwingenschuh, Konrad; Magnes, Werner; Xuhui, Shen; Wang, Jindong; Pollinger, Andreas; Hagen, Christian; Prattes, Gustav; Eichelberger, Hans-Ulrich; Wolbang, Daniel; Boudjada, Mohammed Y.; Besser, Bruno P.; Rozhnoi, Alexander A.; Zhang, Tielong

    2015-04-01

    A combined scalar-vector magnetic field experiment will be flown on the upcoming CSES mission (China Seismo-Electromagnetic Satellite). Magnetic field data from DC to 30 Hz will be measured with an accuracy of about 10 pT. A fluxgate instrument will provide the 3 magnetic field components and a new type of an optically pumped magnetometer [see Pollinger, 2010] will measure the magnitude of the ambient magnetic field. The satellite will operate in a Sun synchronous polar orbit at an altitude of about 500 km and with an inclination of 97°. We present a model of magnetic field fluctuations in the upper ionosphere based on previous satellite observations and on a model of the lithospheric-atmospheric-ionospheric coupling. Pollinger et al., CDSM-a new scalar magnetometer, EGU General Assembly 2010

  13. Job tenure and work injuries: a multivariate analysis of the relation with previous experience and differences by age

    PubMed Central

    2013-01-01

    Background One of the consequences of the increasing flexibility in contemporary labour markets is that individuals change jobs more frequently than in the past. Indeed, in many cases, through collecting a lot of contracts, individuals work in the same economic sector or even in the same company, doing the same job in the same way as existing colleagues. A very long literature has established that newly hired workers – whatever the contract type – are more likely to be injured than those with longer job tenures. The objectives of this paper are: 1) to study the relationship between job tenure and injury risk taking into account past experience as a possible confounder; and 2) to evaluate how the effects of past experience and job tenure are modified by age. Methods Using a longitudinal national database, we considered only job contracts starting in 1998–2003 held by men working as blue collars or apprentices in the non-agricultural private sector. We calculated injury rates stratified by job tenure and age. Multivariate analyses were adjusted for background variables and previous experience accrued in the same economic sector of the current job. Results In the study period 58,271 workers who had experienced 10,260 injuries were observed. These people worked on 115,277 contracts in the six years observed (1.98 contracts per worker). Injury rates decrease with job tenure; the trend is the same in each age group; young workers have both the highest injury rate (9.20; CI 95%: 8.95-9.45) and the highest decrease with job tenure. Previous experience is associated with a decreasing injury rate in all age groups and for all job tenures. Multivariate analyses show that, even after checking for previous experience, workers with job tenure of less than 6 months show always higher relative risks compared with job tenure > 2 years: relative risk is 41% higher among under-thirty workers; it is 22% higher among people over forty. Previous experience is protective

  14. The accuracy of colonoscopic localisation of colorectal tumours: a prospective, multi-centred observational study.

    PubMed

    Johnstone, M S; Moug, S J

    2014-05-01

    Colonoscopy is essential for accurate pre-operative colorectal tumour localisation, but its accuracy for localisation remains undetermined due to limitations of previous work. This study aimed to establish the accuracy of colonoscopic localisation and to determine how frequently inaccuracy results in altered surgical management. A prospective, multi-centred, powered observational study recruited 79 patients with colorectal tumours that underwent curative surgical resection. Patient and colonoscopic factors were recorded. Pre-operative colonoscopic and radiological lesion localisations were compared to intra-operative localisation using pre-defined anatomical bowel segments to determine accuracy, with changes in planned surgical management documented. Colonoscopy accurately located the colorectal tumour in 64/79 patients (81%). Five out of 15 inaccurately located patients required on-table alteration in planned surgical management. Pre-operative imaging was unable to visualise the primary tumour in 23.1% of cases, a finding that was more prevalent amongst bowel screener patients compared to symptomatic patients (45.8% vs. 13%; p = 0.003). Colonoscopic lesion localisation is inaccurate in 19.0% of cases and occurred throughout the colon with a change in on-table surgical management in 6.3%. With CT unable to visualise lesions in just under a quarter of cases, particularly in the screening population, preoperative localisation is heavily reliant on colonoscopy.

  15. Participation in population-based case-control studies: does the observed decline vary by socio-economic status?

    PubMed

    Mazloum, Marie; Bailey, Helen D; Heiden, Tamika; Armstrong, Bruce K; de Klerk, Nicholas; Milne, Elizabeth

    2012-05-01

    An Australian study of childhood leukaemia (Aus-ALL) previously reported that control participation was positively associated with socio-economic status (SES). A similar study of childhood brain tumours (Aus-CBT) was carried out 4 years later, and this paper compares control participation and its relationship with SES in the two studies. To assess the representativeness of controls in terms of SES, the addresses of controls were linked to Australian Bureau of Statistics Census 2006 Collection Districts (CDs), and hence to area-based indices of SES. Independent sample t-tests and chi-squared tests were used to compare the SES indices of CDs where Aus-CBT controls lived with those where Aus-ALL controls lived and with those of all CDs where Australian families lived. The overall percentage of eligible families who agreed to participate was lower in Aus-CBT (53.9%) than in Aus-ALL (70.3%). Control families in both studies were of higher SES than the general population, while the distribution of SES among recruited controls was similar in both studies. These findings provide some reassurance that the observed decline in research participation over time may not be associated with an increasingly unrepresentative participant population. © 2012 Blackwell Publishing Ltd.

  16. ON ESTIMATING FORCE-FREENESS BASED ON OBSERVED MAGNETOGRAMS

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

    Zhang, X. M.; Zhang, M.; Su, J. T., E-mail: xmzhang@nao.cas.cn

    It is a common practice in the solar physics community to test whether or not measured photospheric or chromospheric vector magnetograms are force-free, using the Maxwell stress as a measure. Some previous studies have suggested that magnetic fields of active regions in the solar chromosphere are close to being force-free whereas there is no consistency among previous studies on whether magnetic fields of active regions in the solar photosphere are force-free or not. Here we use three kinds of representative magnetic fields (analytical force-free solutions, modeled solar-like force-free fields, and observed non-force-free fields) to discuss how measurement issues such asmore » limited field of view (FOV), instrument sensitivity, and measurement error could affect the estimation of force-freeness based on observed magnetograms. Unlike previous studies that focus on discussing the effect of limited FOV or instrument sensitivity, our calculation shows that just measurement error alone can significantly influence the results of estimates of force-freeness, due to the fact that measurement errors in horizontal magnetic fields are usually ten times larger than those in vertical fields. This property of measurement errors, interacting with the particular form of a formula for estimating force-freeness, would result in wrong judgments of the force-freeness: a truly force-free field may be mistakenly estimated as being non-force-free and a truly non-force-free field may be estimated as being force-free. Our analysis calls for caution when interpreting estimates of force-freeness based on measured magnetograms, and also suggests that the true photospheric magnetic field may be further away from being force-free than it currently appears to be.« less

  17. Perturbation of lipids and glucose metabolism associated with previous 2,4-D exposure: a cross-sectional study of NHANES III data, 1988-1994

    EPA Science Inventory

    Background Results from previous population studies showed that mortality rates from acute myocardial infarction and type-2 diabetes during the 1980s and 1990s in rural, agricultural counties of Minnesota, Montana, North and South Dakota, were higher in counties with a higher le...

  18. Analysis of the isoprene chemistry observed during the New England Air Quality Study (NEAQS) 2002 intensive experiment

    NASA Astrophysics Data System (ADS)

    Roberts, James M.; Marchewka, Mathew; Bertman, Steven B.; Goldan, Paul; Kuster, William; de Gouw, Joost; Warneke, Carsten; Williams, Eric; Lerner, Brian; Murphy, Paul; Apel, Eric; Fehsenfeld, Fred C.

    2006-12-01

    Isoprene and its first and second generation photochemical products, methyl vinyl ketone (MVK), methacrolein (MACR), and peroxymethacrylic nitric anhydride (MPAN), were measured off the coast of New England during the 2002 New England Air Quality Study (NEAQS) on board the NOAA Research Vessel Ronald H. Brown. The results of these measurements were analyzed using a simple sequential reaction model that has been used previously to examine regional oxidant chemistry. The highest isoprene impact was observed in air masses that had passed over an area of high isoprene emission WSW of Boston. The relative concentrations of isoprene and its first generation products show that the photochemistry is consistently "older" than the isoprene photochemistry observed at continental sites. The sequential reaction model was also applied to the aldehyde-PANs (Peroxycarboxylic nitric anhydride) system, and the resulting PPN (peroxypropionic nitric anhydride)/propanal and PAN (peroxyacetic nitric anhydride)/acetaldehyde relationships were consistent with additional sources of PAN in this environment, e.g., isoprene photochemistry. This isoprene source was estimated to result in approximately 1.6 to 4 times more PAN in this environment relative to that produced from anthropogenic VOCs (volatile organic compounds) alone.

  19. Results of Observational Studies: Analysis of Findings from the Nurses’ Health Study

    PubMed Central

    Tai, Vicky; Grey, Andrew; Bolland, Mark J.

    2014-01-01

    Background The role of observational studies in informing clinical practice is debated, and high profile examples of discrepancies between the results of observational studies and randomised controlled trials (RCTs) have intensified that debate. We systematically reviewed findings from the Nurses’ Health Study (NHS), one of the longest and largest observational studies, to assess the number and strength of the associations reported and to determine if they have been confirmed in RCTs. Methods We reviewed NHS publication abstracts from 1978–2012, extracted information on associations tested, and graded the strength of the reported effect sizes. We searched PubMed for RCTs or systematic reviews for 3 health outcomes commonly reported in NHS publications: breast cancer, ischaemic heart disease (IHD) and osteoporosis. NHS results were compared with RCT results and deemed concordant when the difference in effect sizes between studies was ≤0.15. Findings 2007 associations between health outcomes and independent variables were reported in 1053 abstracts. 58.0% (1165/2007) were statistically significant, and 22.2% (445/2007) were neutral (no association). Among the statistically significant results that reported a numeric odds ratio (OR) or relative risk (RR), 70.5% (706/1002) reported a weak association (OR/RR 0.5–2.0), 24.5% (246/1002) a moderate association (OR/RR 0.25–0.5 or 2.0–4.0) and 5.0% (50/1002) a strong association (OR/RR ≤0.25 or ≥4.0). 19 associations reported in NHS publications for breast cancer, IHD and osteoporosis have been tested in RCTs, and the concordance between NHS and RCT results was low (≤25%). Conclusions NHS publications contain a large number of analyses, the majority of which reported statistically significant but weak associations. Few of these associations have been tested in RCTs, and where they have, the agreement between NHS results and RCTs is poor. PMID:25330007

  20. Clinical activity of fulvestrant in metastatic breast cancer previously treated with endocrine therapy and/or chemotherapy.

    PubMed

    Heo, Mi Hwa; Kim, Hee Kyung; Lee, Hansang; Kim, Ji-Yeon; Ahn, Jin-Seok; Im, Young-Hyuck; Park, Yeon Hee

    2018-03-16

    We conducted a retrospective analysis of the clinical activity of fulvestrant in postmenopausal women with hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC) previously treated with endocrine therapy and/or chemotherapy. We reviewed the medical records of all patients with MBC treated at Samsung Medical Center between January 2009 and August 2016. Patients received fulvestrant 250 mg intramuscularly every 28 days (from January 2009 to November 2010) or 500 mg intramuscularly every 28 days (from December 2010 to August 2016). Tumor responses were assessed every 8 weeks and at the end of treatment, as well as when disease progression was suspected. A total of 84 patients were included in this study. A median of two previous endocrine treatments had been performed; 79% of the patients had received two or more endocrine treatments. Forty-five patients (54%) had been treated with chemotherapy for MBC before the fulvestrant treatment course. Visceral metastasis was found in 49 patients (58%). The estimated median progression-free survival and overall survival were 4.4 months (95% confidence interval [CI], 3.4 to 5.5) and 32.5 months (95% CI, 17.6 to 47.4), respectively. The disease control rate was 40.5% (95% CI, 30.5 to 51.5); partial response was observed in 16% of the patients and stable disease was observed in 25% of the patients. The most frequently reported adverse reactions were mild-to-moderate grade myalgia (10.5% of the patients), injection site pain (7%), and fatigue (7%). Fulvestrant was generally well tolerated. Fulvestrant showed encouraging clinical activity and favorable feasibility in postmenopausal women with MBC who had been treated with multiple endocrine therapies and/or cytotoxic chemotherapies.

  1. Landslide Monitoring Using Insar Time-Series and GPS Observations, Case Study: Shabkola Landslide in Northern Iran

    NASA Astrophysics Data System (ADS)

    Mirzaee, S.; Motagh, M.; Akbari, B.

    2017-05-01

    Shabkola is a village located in Mazandaran province of northern Iran that suffers from the mass movement happening in the upstream. Deforestation and changes to land use are the main reasons for the soil instability in this region, which together with steep slope, relatively high precipitation rate and natural erosion has led to such a condition. The area of mass movement is approximately 90 hectares which is a big threat for people living in the region. In this study, we have utilized two different geodetic techniques including InSAR time-series analysis and GPS measurements to assess slope stability in Shabkola. The SAR dataset includes 19 ALOS/PALSAR images spanning from July 2007 to February 2011 while GPS observations are collected in 5 campaigns from September 2011 to May 2014. Displacement as much as approximately 11.7 m in slope direction was detected by GPS observations for the 2011-2014 time period. Most of the slope geometry is in north-south direction, for which the sensitivity of InSAR for displacement detection is low. However, ALOS PALSAR data analysis revealed a previously unknown landslide, covered by dense vegetation in the northern part of main Shabkola landslide, showing line-of-sight velocity of approximately 2cm/year in the time period 2007-2011.

  2. Optimal temperature for malaria transmission is dramaticallylower than previously predicted

    USGS Publications Warehouse

    Mordecai, Eerin A.; Paaijmans, Krijin P.; Johnson, Leah R.; Balzer, Christian; Ben-Horin, Tal; de Moor, Emily; McNally, Amy; Pawar, Samraat; Ryan, Sadie J.; Smith, Thomas C.; Lafferty, Kevin D.

    2013-01-01

    The ecology of mosquito vectors and malaria parasites affect the incidence, seasonal transmission and geographical range of malaria. Most malaria models to date assume constant or linear responses of mosquito and parasite life-history traits to temperature, predicting optimal transmission at 31 °C. These models are at odds with field observations of transmission dating back nearly a century. We build a model with more realistic ecological assumptions about the thermal physiology of insects. Our model, which includes empirically derived nonlinear thermal responses, predicts optimal malaria transmission at 25 °C (6 °C lower than previous models). Moreover, the model predicts that transmission decreases dramatically at temperatures > 28 °C, altering predictions about how climate change will affect malaria. A large data set on malaria transmission risk in Africa validates both the 25 °C optimum and the decline above 28 °C. Using these more accurate nonlinear thermal-response models will aid in understanding the effects of current and future temperature regimes on disease transmission.

  3. Factors associated with successful matching to dermatology residency programs by reapplicants and other applicants who previously graduated from medical school.

    PubMed

    Stratman, Erik J; Ness, Rachel M

    2011-02-01

    To identify factors associated with and not associated with successful matching and matriculation (hereinafter "matching") to dermatology residency programs for applicants who previously graduated from medical school and to distinguish which factors are within applicants' control. Observational cohort study. Six accredited academic dermatology residency training programs in the United States. A total of 221 residency applicants who previously graduated from medical school and who applied through standardized electronic application to 1 or more of the participating residency training programs. Matriculation to a dermatology residency program by August 2008 following the 2006 residency application period. Forty-six of 221 former medical school graduates included in this study matched to a dermatology residency program. Factors strongly associated with matching included United States Medical Licensing Examination Step 3 score; submission of letters written by dermatologists from institutions that train dermatology residents; completion of preliminary medicine internships rather than transitional or other internship types; listing of research experience; publishing of medical manuscripts; and completion of non-Accreditation Council for Graduate Medical Examination dermatology fellowships. Factors not associated with increased matching included volunteer work; PhD status; sex; number of posters or presentations at dermatology conferences; quality of journal publications; and first authorship. Most successful applicants limited personal statements to 1 page and did not mention previously failing to match. The study sample represented at least 86% of such nontraditional applicants who matched in 2006. For candidates seeking to match into dermatology residency programs after graduating from medical school, there are factors within their control that are associated with higher rates of match success. This study provides evidence to assist mentors who counsel such candidates

  4. A Survey of Patients' Preoperative Need for Information About Postoperative Pain-Effect of Previous Surgery Experience.

    PubMed

    Mavridou, Paraskevi; Manataki, Adamantia; Arnaoutoglou, Elena; Damigos, Dimitrios

    2017-10-01

    The aim of this study was to determine the kind of information patients need preoperatively about postoperative pain (POP) and whether this is affected by previous surgery experience. A descriptive study design using preoperative questionnaires. Questionnaires with fixed questions related to POP and its management were distributed preoperatively to consenting, consecutive surgical patients. Patients were divided into two groups: patients with previous surgery experience (group A) and patients without previous surgery experience (group B). Of the patients who participated in the study, 94.2% wanted information about POP and 77.8% of them believe that they will feel calmer if they get the information they need. The patients' biggest concern relates to pain management issues after discharge. Next, in order of preference is information about the analgesics that they need to take. The patients want to be informed primarily with a personal interview (59.4%). Previous surgery experience has no effect on patients' needs for information. Most of the patients want to be informed about the management of the POP after being discharged. It is remarkable that patients who had previous surgery experience need the same information with those who had no previous surgery. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  5. Standardized observation of neighbourhood disorder: does it work in Canada?

    PubMed Central

    2010-01-01

    Background There is a growing body of evidence that where you live is important to your health. Despite numerous previous studies investigating the relationship between neighbourhood deprivation (and structure) and residents' health, the precise nature of this relationship remains unclear. Relatively few investigations have relied on direct observation of neighbourhoods, while those that have were developed primarily in US settings. Evaluation of the transferability of such tools to other contexts is an important first step before applying such instruments to the investigation of health and well-being. This study evaluated the performance of a systematic social observational (SSO) tool (adapted from previous studies of American and British neighbourhoods) in a Canadian urban context. Methods This was a mixed-methods study. Quantitative SSO ratings and qualitative descriptions of 176 block faces were obtained in six Toronto neighbourhoods (4 low-income, and 2 middle/high-income) by trained raters. Exploratory factor analysis was conducted with the quantitative SSO ratings. Content analysis consisted of independent coding of qualitative data by three members of the research team to yield common themes and categories. Results Factor analysis identified three factors (physical decay/disorder, social accessibility, recreational opportunities), but only 'physical decay/disorder' reflected previous findings in the literature. Qualitative results (based on raters' fieldwork experiences) revealed the tool's shortcomings in capturing important features of the neighbourhoods under study, and informed interpretation of the quantitative findings. Conclusions This study tested the performance of an SSO tool in a Canadian context, which is an important initial step before applying it to the study of health and disease. The tool demonstrated important shortcomings when applied to six diverse Toronto neighbourhoods. The study's analyses challenge previously held assumptions (e

  6. Observations of disconnection of open coronal magnetic structures

    NASA Technical Reports Server (NTRS)

    Mccomas, D. J.; Phillips, J. L.; Hundhausen, A. J.; Burkepile, J. T.

    1991-01-01

    The solar maximum mission coronagraph/polarimeter observations are surveyed for evidence of magnetic disconnection of previously open magnetic structures and several sequences of images consistent with this interpretation are identified. Such disconnection occurs when open field lines above helmet streamers reconnect, in contrast to previously suggested disconnections of CMEs into closed plasmoids. In this paper a clear example of open field disconnection is shown in detail. The event, on June 27, 1988, is preceded by compression of a preexisting helmet streamer and the open coronal field around it. The compressed helmet streamer and surrounding open field region detach in a large U-shaped structure which subsequently accelerates outward from the sun. The observed sequence of events is consistent with reconnection across the heliospheric current sheet and the creation of a detached U-shaped magnetic structure. Unlike CMEs, which may open new magnetic flux into interplanetary space, this process could serve to close off previously open flux, perhaps helping to maintain the roughly constant amount of open magnetic flux observed in interplanetary space.

  7. Generalizability and decision studies to inform observational and experimental research in classroom settings.

    PubMed

    Bottema-Beutel, Kristen; Lloyd, Blair; Carter, Erik W; Asmus, Jennifer M

    2014-11-01

    Attaining reliable estimates of observational measures can be challenging in school and classroom settings, as behavior can be influenced by multiple contextual factors. Generalizability (G) studies can enable researchers to estimate the reliability of observational data, and decision (D) studies can inform how many observation sessions are necessary to achieve a criterion level of reliability. We conducted G and D studies using observational data from a randomized control trial focusing on social and academic participation of students with severe disabilities in inclusive secondary classrooms. Results highlight the importance of anchoring observational decisions to reliability estimates from existing or pilot data sets. We outline steps for conducting G and D studies and address options when reliability estimates are lower than desired.

  8. Observed touch on a non-human face is not remapped onto the human observer's own face.

    PubMed

    Beck, Brianna; Bertini, Caterina; Scarpazza, Cristina; Làdavas, Elisabetta

    2013-01-01

    Visual remapping of touch (VRT) is a phenomenon in which seeing a human face being touched enhances detection of tactile stimuli on the observer's own face, especially when the observed face expresses fear. This study tested whether VRT would occur when seeing touch on monkey faces and whether it would be similarly modulated by facial expressions. Human participants detected near-threshold tactile stimulation on their own cheeks while watching fearful, happy, and neutral human or monkey faces being concurrently touched or merely approached by fingers. We predicted minimal VRT for neutral and happy monkey faces but greater VRT for fearful monkey faces. The results with human faces replicated previous findings, demonstrating stronger VRT for fearful expressions than for happy or neutral expressions. However, there was no VRT (i.e. no difference between accuracy in touch and no-touch trials) for any of the monkey faces, regardless of facial expression, suggesting that touch on a non-human face is not remapped onto the somatosensory system of the human observer.

  9. Observed Touch on a Non-Human Face Is Not Remapped onto the Human Observer's Own Face

    PubMed Central

    Beck, Brianna; Bertini, Caterina; Scarpazza, Cristina; Làdavas, Elisabetta

    2013-01-01

    Visual remapping of touch (VRT) is a phenomenon in which seeing a human face being touched enhances detection of tactile stimuli on the observer's own face, especially when the observed face expresses fear. This study tested whether VRT would occur when seeing touch on monkey faces and whether it would be similarly modulated by facial expressions. Human participants detected near-threshold tactile stimulation on their own cheeks while watching fearful, happy, and neutral human or monkey faces being concurrently touched or merely approached by fingers. We predicted minimal VRT for neutral and happy monkey faces but greater VRT for fearful monkey faces. The results with human faces replicated previous findings, demonstrating stronger VRT for fearful expressions than for happy or neutral expressions. However, there was no VRT (i.e. no difference between accuracy in touch and no-touch trials) for any of the monkey faces, regardless of facial expression, suggesting that touch on a non-human face is not remapped onto the somatosensory system of the human observer. PMID:24250781

  10. 75 FR 3237 - Proposed Collection; Comment Request; Women's Health Initiative Observational Study

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-20

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Proposed Collection; Comment Request; Women's Health Initiative Observational Study SUMMARY: In compliance with the requirement of... Initiative (WHI) Observational Study. Type of Information Collection Request: Revision OMB 0925- 0414. Need...

  11. The Unruh effect for eccentric uniformly rotating observers

    NASA Astrophysics Data System (ADS)

    Ramezani-Aval, H.

    It is common to use Galilean rotational transformation (GRT) to investigate the Unruh effect for uniformly rotating observers. However, the rotating observer in this subject is an eccentric observer while GRT is only valid for centrally rotating observers. Thus, the reliability of the results of applying GRT to the study of the Unruh effect might be considered as questionable. In this work, the rotational analog of the Unruh effect is investigated by employing two relativistic rotational transformations corresponding to the eccentric rotating observer, and it is shown that in both cases, the detector response function is nonzero. It is also shown that although consecutive Lorentz transformations cannot give a frame within which the canonical construction can be carried out, the expectation value of particle number operator in canonical approach will be zero if we use modified Franklin transformation. These conclusions reinforce the claim that correspondence between vacuum states defined via canonical field theory and a detector is broken for rotating observers. Some previous conclusions are commented on and some controversies are also discussed.

  12. Genome-wide association study for birth weight in Nellore cattle points to previously described orthologous genes affecting human and bovine height

    PubMed Central

    2013-01-01

    Background Birth weight (BW) is an economically important trait in beef cattle, and is associated with growth- and stature-related traits and calving difficulty. One region of the cattle genome, located on Bos primigenius taurus chromosome 14 (BTA14), has been previously shown to be associated with stature by multiple independent studies, and contains orthologous genes affecting human height. A genome-wide association study (GWAS) for BW in Brazilian Nellore cattle (Bos primigenius indicus) was performed using estimated breeding values (EBVs) of 654 progeny-tested bulls genotyped for over 777,000 single nucleotide polymorphisms (SNPs). Results The most significant SNP (rs133012258, PGC = 1.34 × 10-9), located at BTA14:25376827, explained 4.62% of the variance in BW EBVs. The surrounding 1 Mb region presented high identity with human, pig and mouse autosomes 8, 4 and 4, respectively, and contains the orthologous height genes PLAG1, CHCHD7, MOS, RPS20, LYN, RDHE2 (SDR16C5) and PENK. The region also overlapped 28 quantitative trait loci (QTLs) previously reported in literature by linkage mapping studies in cattle, including QTLs for birth weight, mature height, carcass weight, stature, pre-weaning average daily gain, calving ease, and gestation length. Conclusions This study presents the first GWAS applying a high-density SNP panel to identify putative chromosome regions affecting birth weight in Nellore cattle. These results suggest that the QTLs on BTA14 associated with body size in taurine cattle (Bos primigenius taurus) also affect birth weight and size in zebu cattle (Bos primigenius indicus). PMID:23758625

  13. An observational study of defensible space in the neighbourhood park

    NASA Astrophysics Data System (ADS)

    Marzukhi, M. A.; Afiq, M. A.; Zaki, S. Ahmad; Ling, O. H. L.

    2018-02-01

    The planning of neighborhood park is important to provide space for interaction, leisure, and recreation among residents in any neighbourhood area. However, on an almost daily basis, newspapers report inappropriate incidents such as snatch theft, robbery and street attack that occurred in the neighborhood park. These cases reflect the significance of physical planning and design of neighborhood park that directly affect the safety and comfort of the users. Thus, this study attempts to engage with the defensible space concept in ensuring the security elements be applied in the planning of the recreational area. This study adopts a qualitative method form of research that is retrofitted to an observational study. The observational study is significant for revealing the condition of a neighbourhood park in the ‘real-world,’ in which direct observation is conducted on Taman Tasik Puchong Perdana. The observer focused on four elements or variables of defensible space concept including the provision of facilities in the neighborhood park, territoriality, surveillance, image and milieu. The findings revealed that the planning of Taman Tasik Puchong Perdana does not deliberate the defensible space elements, which may contribute to the crime activities in the park. In these circumstances, the planning of neighbourhood park needs to include proposals for the implementation of defensible space in response to the challenges underpinned by crime problems. Besides, the awareness among the residents needs to be emphasized with the support from local authorities and other organizations to manage and sustain the safety environment in the neighborhood park.

  14. New precise astrometric observations of Nereid in 2012-2017

    NASA Astrophysics Data System (ADS)

    Yu, Y.; Qiao, R. C.; Yan, D.; Cheng, X.; Xi, X. J.; Tang, K.; Luo, H.

    2018-03-01

    Nereid is one of the most distinctive natural satellites that we know in the Solar system. The orbit of Nereid is highly eccentric and inclined with respect to the equator of its primary, Neptune. Studying Nereid is one of the inspiring ways to acquire better knowledge of the Solar system. Due to its faintness, the ground-based observations of Nereid have been limited and the observation precisions in the past were generally not high. A total of 150 new observed positions of Nereid in the period 2012-2017 were collected by the 0.8 m reflecting telescope at Xinglong station of National Astronomical Observatory and the 2.4 m reflecting telescope at Lijiang station of Yunnan Astronomical Observatory. Thanks to the high-quality reference catalogue Gaia DR1 and suitable processing methods for images, the precision of our new observations of Nereid is 2-3 times higher than those of the previous observations, and the dispersions of our observations are better than 70 mas.

  15. A New Lagrangian Relaxation Method Considering Previous Hour Scheduling for Unit Commitment Problem

    NASA Astrophysics Data System (ADS)

    Khorasani, H.; Rashidinejad, M.; Purakbari-Kasmaie, M.; Abdollahi, A.

    2009-08-01

    Generation scheduling is a crucial challenge in power systems especially under new environment of liberalization of electricity industry. A new Lagrangian relaxation method for unit commitment (UC) has been presented for solving generation scheduling problem. This paper focuses on the economical aspect of UC problem, while the previous hour scheduling as a very important issue is studied. In this paper generation scheduling of present hour has been conducted by considering the previous hour scheduling. The impacts of hot/cold start-up cost have been taken in to account in this paper. Case studies and numerical analysis presents significant outcomes while it demonstrates the effectiveness of the proposed method.

  16. [Effect of previous experience in reacting to a danger signal on "open field" behavior in the rat].

    PubMed

    Poltyreva, T E; Petrov, E S

    1983-01-01

    Modification of rats behaviour in an "hopen field" test was investigated, induced by an acoustic stimulus, previously subjected to conditioning in a shuttle chamber in experiments with possibility and impossibility of avoidance from electrical shock. It has been established that presentation of a stimulus having the meaning of a danger signal, in a new situation, significantly suppresses investigating behaviour of rats, whereas the stimulus which had not been subjected to conditioning exerts no marked effect on behaviour. The greatest suppression was observed in rats with "learned helplessness". This fact suggests that the degree of suppression of the behaviour in an open field in response to a danger signal, depends on the animal's previous experience in reacting to this signal.

  17. Proactive interference from items previously stored in visual working memory.

    PubMed

    Makovski, Tal; Jiang, Yuhong V

    2008-01-01

    This study investigates the fate of information that was previously stored in visual working memory but that is no longer needed. Previous research has found inconsistent results, with some showing effective release of irrelevant information and others showing proactive interference. Using change detection tasks of colors or shapes, we show that participants tend to falsely classify a changed item as "no change" if it matches one of the memory items on the preceding trial. The interference is spatially specific: Memory for the preceding trial interferes more if it matches the feature value and the location of a test item than if it does not. Interference results from retaining information in visual working memory, since it is absent when items on the preceding trials are passively viewed, or are attended but not memorized. We conclude that people cannot fully eliminate unwanted visual information from current working memory tasks.

  18. Strontium ranelate effect on bone mineral density is modified by previous bisphosphonate treatment.

    PubMed

    Brun, Lucas R; Galich, Ana M; Vega, Eduardo; Salerni, Helena; Maffei, Laura; Premrou, Valeria; Costanzo, Pablo R; Sarli, Marcelo A; Rey, Paula; Larroudé, María S; Moggia, María S; Brance, María L; Sánchez, Ariel

    2014-01-01

    The aim of this study was to evaluate the effect of strontium ranelate (SrR) on bone mineral density (BMD) and bone turnover markers after 1 year of treatment. Additionally, the effect of SrR in bisphosphonate-naïve patients (BP-naïve) compared to patients previously treated with bisphosphonates (BP-prior) was analyzed. This retrospective study included 482 postmenopausal women treated with SrR (2 g/day) for 1 year in ten Argentine centers; 41 patients were excluded due to insufficient data, while 441 were included. Participants were divided according to previous bisphosphonate treatment in two groups: BP-naïve (n = 87) and BP-prior (n = 350). Data are expressed as mean ± SEM. After 1 year of treatment with SrR the bone formation markers total alkaline phosphatase and osteocalcin were increased (p < 0.0001), while the bone resorption marker s-CTX was decreased (p = 0.0579). Also increases in BMD at the lumbar spine (LS, 3.73%), femoral neck (FN, 2.00%) and total hip (TH, 1.54%) [p < 0.0001] were observed. These increments were significant (p < 0.0001) both among BP-naïve and BP-prior patients. Interestingly, the change in BMD after 1 year of SrR treatment was higher in BP-naïve patients: LS: BP-naïve = 4.58 ± 0.62%; BP-prior = 3.45 ± 0.28% (p = 0.078). FN: BP-naïve = 2.79 ± 0.56%; BP-prior = 2.13 ± 0.29% (p = 0.161). TH: BP-naïve = 3.01 ± 0.55%; BP-prior = 1.22 ± 0.27% (p = 0.0006). SrR treatment increased BMD and bone formation markers and decreased a bone resorption marker in the whole group, with better response in BP-naïve patients.

  19. Impulsivity Moderates the Relationship between Previous Quit Failure and Cue-induced Craving

    PubMed Central

    Erblich, Joel; Michalowski, Alexandra

    2015-01-01

    Introduction Poor inhibitory control has been shown to be an important predictor of relapse to a number of drugs, including nicotine. Indeed, smokers who exhibit higher levels of impulsivity are thought to have impaired regulation of urges to smoke, and previous research has suggested that impulsivity may moderate cue-induced cigarette cravings. To that end, we conducted a study to evaluate the interplay between failed smoking cessation, cue-induced craving, and impulsivity. Methods Current smokers (n=151) rated their cigarette cravings before and after laboratory to exposure to smoking cues, and completed questionnaires assessing impulsivity and previous failed quit attempts. Results Findings indicated that shorter duration of previous failed quit attempts was related to higher cue-induced cigarette craving, especially among smokers with higher levels of impulsivity. Conclusions Results underscore the importance of considering trait impulsivity as a factor in better understanding the management of cue-induced cravings. PMID:26183443

  20. Multi-Wavelength Interferometric Observations of YSO Disks

    NASA Astrophysics Data System (ADS)

    Ragland, Sam; Akeson, R.; Armandroff, T.; Colavita, M.; Cotton, W.; Danchi, W.; Hillenbrand, L.; Millan-Gabet, R.; Ridgway, S. T.; Traub, W.; Wizinowich, P.

    2010-01-01

    We initiated a multi-color interferometric study of YSO disks in the K, L and N bands using the Keck Interferometer. The initial results on two Herbig Ae/Be stars will be presented. Our observations are sensitive to the radial distribution of temperature in the inner region of the YSO disks. The geometric models show that the apparent size increases linearly with wavelength, suggesting that the disk is extended with a temperature gradient. We will discuss our results in conjunction with the previous measurements of these targets.

  1. Previous exposure to dietary phytase reduces the endogenous energy losses from precision-fed chickens.

    PubMed

    Pirgozliev, V; Acamovic, T; Bedford, M R

    2009-09-01

    1. A precision feeding experiment was conducted with broiler chickens, which were previously fed on diets with or without phytase, to study the effects of previous exposure to dietary phytase supplementation on the excretions of endogenous energy, nitrogen, amino acids and minerals. 2. Female Ross 308 broiler chickens, which had previously received one of 4 experimental diets (low P maize/soy diets (control, D), D + 250 international units of phytase per kg diet (FTU), D + 500 FTU and D + 2500 FTU) were used in the study. All birds were starved and then given 50 ml of glucose solution at 44 d of age. The birds were allocated to individual metabolism cages in a randomised block design with 8 replicates of each of the 4 dietary treatments. 3. Chickens which had been previously fed on diets supplemented with phytase excreted 32% less energy and 28% less dry matter per kg metabolic body weight (W(075)) from endogenous sources, compared to birds fed the unsupplemented diet. 4. Birds previously given phytase supplemented diets excreted 60% less sodium than those given the control diet, but there was no effect on all other minerals investigated. There was no effect of diet on the excretion of endogenous N, sialic acid or amino acids. 5. The results showed that the effects of feeding chickens on diets with supplementary phytase may continue for a few days after the diets are withdrawn. This suggests that previous exposure to phytase may alter the nutritive value of follow-on diets, which may be a commercially important effect.

  2. 75 FR 76056 - FEDERAL REGISTER CITATION OF PREVIOUS ANNOUNCEMENT:

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-07

    ... SECURITIES AND EXCHANGE COMMISSION Sunshine Act Meeting FEDERAL REGISTER CITATION OF PREVIOUS ANNOUNCEMENT: STATUS: Closed meeting. PLACE: 100 F Street, NE., Washington, DC. DATE AND TIME OF PREVIOUSLY ANNOUNCED MEETING: Thursday, December 9, 2010 at 2 p.m. CHANGE IN THE MEETING: Time change. The closed...

  3. A statistical study of sporadic sodium layer observed by Sodium lidar at Hefei (31.8° N, 117.3° E)

    NASA Astrophysics Data System (ADS)

    Dou, X.-K.; Xue, X.-H.; Chen, T.-D.; Wan, W.-X.; Cheng, X.-W.; Li, T.; Chen, C.; Qiu, S.; Chen, Z.-Y.

    2009-06-01

    Sodium lidar observations of sporadic sodium layers (SSLs) during the past 3 years at a mid-latitude location (Hefei, China, 31.8° N, 117.3° E) are reported in this paper. From 64 SSL events detected in about 900 h of observation, an SSL occurrence rate of 1 event every 14 h at our location was obtained. This result, combined with previous studies, reveals that the SSL occurrence can be relatively frequent at some mid-latitude locations. Statistical analysis of main parameters for the 64 SSL events was performed. By examining the corresponding data from an ionosonde, a considerable correlation was found with a Pearson coefficient of 0.66 between seasonal variations of SSL and those of sporadic E (Es) during nighttime, which was in line with the research by Nagasawa and Abo (1995). From comparison between observations from the University of Science and Technology of China (USTC) lidar and from Wuhan Institute of Physics and Mathematics (WIPM) lidar (Wuhan, China, 31° N, 114° E), the minimum horizontal range for some events was estimated to be over 500 km.

  4. Natural attenuation is enhanced in previously contaminated and coniferous forest soils.

    PubMed

    Kauppi, Sari; Romantschuk, Martin; Strömmer, Rauni; Sinkkonen, Aki

    2012-01-01

    Prevalence of organic pollutants or their natural analogs in soil is often assumed to lead to adaptation in the bacterial community, which results in enhanced bioremediation if the soil is later contaminated. In this study, the effects of soil type and contamination history on diesel oil degradation and bacterial adaptation were studied. Mesocosms of mineral and organic forest soil (humus) were artificially treated with diesel oil, and oil hydrocarbon concentrations (GC-FID), bacterial community composition (denaturing gradient gel electrophoresis, DGGE), and oil hydrocarbon degraders (DGGE + sequencing of 16S rRNA genes) were monitored for 20 weeks at 16°C. Degradation was advanced in previously contaminated soils as compared with pristine soils and in coniferous organic forest soil as compared with mineral soil. Contamination affected bacterial community composition especially in the pristine mineral soil, where diesel addition increased the number of strong bands in the DGGE gel. Sequencing of cloned 16S rRNA gene fragments and DGGE bands showed that potential oil-degrading bacteria were found in mineral and organic soils and in both pristine and previously contaminated mesocosms. Fast oil degradation was not associated with the presence of any particular bacterial strain in soil. We demonstrate at the mesocosm scale that previously contaminated and coniferous organic soils are superior environments for fast oil degradation as compared with pristine and mineral soil environments. These results may be utilized in preventing soil pollution and planning soil remediation.

  5. Generalizability and Decision Studies to Inform Observational and Experimental Research in Classroom Settings

    ERIC Educational Resources Information Center

    Bottema-Beutel, Kristen; Lloyd, Blair; Carter, Erik W.; Asmus, Jennifer M.

    2014-01-01

    Attaining reliable estimates of observational measures can be challenging in school and classroom settings, as behavior can be influenced by multiple contextual factors. Generalizability (G) studies can enable researchers to estimate the reliability of observational data, and decision (D) studies can inform how many observation sessions are…

  6. Multiwavelength Observations of Volatiles in Comets

    NASA Technical Reports Server (NTRS)

    Milam, Stefanie N.; Charnley, Steven B.; Kuan, Yi-Jehng; Chuang, Yo-Ling; DiSanti, Michael A.; Bonev, Boncho P.; Remijan, Anthony J.

    2011-01-01

    Recently, there have been complimentary observations from multiple facilities to try to unravel the chemical complexity of comets. Incorporating results from various techniques, including: single-dish millimeter wavelength observations, interferometers, and/or IR spectroscopy, one can gain further insight into the abundances, production rates, distributions, and formation mechanisms of molecules in these objects [I]. Such studies have provided great detail towards molecules with a-typical chemistries, such as H2CO [2]. We report spectral observations of C/2006 M4 (SWAN), C/2007 N3 (Lulin), and C/2009 RI (McNaught) with the Arizona Radio Observatory's SMT and 12-m telescopes, as well as the NRAO Greenbank telescope and IRTFCSHELL. Multiple parent volatiles (HCN, CH3OH, CO, CH4, C2H6, and H2O) plus two photodissociation products (CS and OH) have been detected in these objects. We will present a comparison of molecular abundances in these comets to those observed in others, supporting a long-term effort of building a comet taxonomy based on composition. Previous work has revealed a range of abundances of parent species (from "organics-poor" to "organics-rich") with respect to water among comets [3,4,5], however the statistics are stiII poorly constrained and interpretations of the observed compositional diversity are uncertain.

  7. [Changes in mammographic features of breast cancer--comparison with previous films].

    PubMed

    Matsunaga, T; Hagiwara, K; Kimura, K; Kusama, M

    1992-11-25

    Mammographic features of 87 breast cancer patients were studied in comparison with their previous survey films. Changes in the mammographic features included microcalicification (28 cases), tumor shadow (35 cases) and intratumorous microcalicifications (6 cases). Seven cases had several extremely faint calcifications on the previous films, and three of six cases with clustered and scattered microcalcifications that extended over an entire breast quadrant had increased in number, density and extent. Eight cases in which clustered microcalcifications had increased in number, density and extent suggested a relationship between the increase in the extent of microcalcifications and length of time between visits. In most cases with tumor shadow, a slight localized increase in mammary gland density, irregular margins and straightened trabeculae were overlooked because of breast density.

  8. Improved staff procedure skills lead to improved managment skills: an observational study in an educational setting.

    PubMed

    Rüter, Anders; Vikstrom, Tore

    2009-01-01

    Good staff procedure skills in a management group during incidents and disasters are believed to be a prerequisite for good management of the situation. However, this has not been demonstrated scientifically. Templates for evaluation results from performance indicators during simulation exercises have previously been tested. The aim of this study was to demonstrate the possibility that these indicators can be used as a tool for studying the relationship between good management skills and good staff procedure skills. Good and structured work (staff procedure skills) in a hospital management group during simulation exercises in disaster medicine is related to good and timely decisions (good management skills). Results from 29 consecutive simulation exercises in which staff procedure skills and management skills were evaluated using quantitative measurements were included. The statistical analysis method used was simple linear regression with staff procedure skills as the response variable and management skills as the predictor variable. An overall significant relationship was identified between staff procedure skills and management skills (p(2)0.05). This study suggests that there is a relationship between staff procedure skills and management skills in the educational setting used. Future studies are needed to demonstrate if this also can be observed during actual incidents.

  9. 5 CFR 532.405 - Use of highest previous rate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Use of highest previous rate. 532.405 Section 532.405 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PREVAILING RATE SYSTEMS Pay Administration § 532.405 Use of highest previous rate. (a)(1) Subject to the...

  10. 28 CFR 10.5 - Incorporation of papers previously filed.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Incorporation of papers previously filed... CARRYING ON ACTIVITIES WITHIN THE UNITED STATES Registration Statement § 10.5 Incorporation of papers previously filed. Papers and documents already filed with the Attorney General pursuant to the said act and...

  11. 28 CFR 10.5 - Incorporation of papers previously filed.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Incorporation of papers previously filed... CARRYING ON ACTIVITIES WITHIN THE UNITED STATES Registration Statement § 10.5 Incorporation of papers previously filed. Papers and documents already filed with the Attorney General pursuant to the said act and...

  12. Previous land use alters plant allocation and growth in forest herbs

    Treesearch

    Jennifer M. Fraterrigo; Monica G. Turner; Scott M. Pearson

    2006-01-01

    Former human practices can persistently influence forest ecosystems, particularly by altering the distribution and abundance of vegetation. Previous research has focused on the role of colonization success in governing plant community patterns in abandoned forests, but few studies have explored how changes in the performance of adult plants may contribute to...

  13. Learning from Texts: Activation of Information from Previous Texts during Reading

    ERIC Educational Resources Information Center

    Beker, Katinka; Jolles, Dietsje; Lorch, Robert F., Jr.; van den Broek, Paul

    2016-01-01

    Learning often involves integration of information from multiple texts. The aim of the current study was to determine whether relevant information from previously read texts is spontaneously activated during reading, allowing for integration between texts (experiment 1 and 2), and whether this process is related to the representation of the texts…

  14. 27 CFR 26.55 - Previously approved formulas.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... BUREAU, DEPARTMENT OF THE TREASURY ALCOHOL LIQUORS AND ARTICLES FROM PUERTO RICO AND THE VIRGIN ISLANDS Formulas for Products From Puerto Rico § 26.55 Previously approved formulas. Any formula approved on Form...

  15. 27 CFR 26.55 - Previously approved formulas.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... BUREAU, DEPARTMENT OF THE TREASURY LIQUORS LIQUORS AND ARTICLES FROM PUERTO RICO AND THE VIRGIN ISLANDS Formulas for Products From Puerto Rico § 26.55 Previously approved formulas. Any formula approved on Form...

  16. 27 CFR 26.55 - Previously approved formulas.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... BUREAU, DEPARTMENT OF THE TREASURY ALCOHOL LIQUORS AND ARTICLES FROM PUERTO RICO AND THE VIRGIN ISLANDS Formulas for Products From Puerto Rico § 26.55 Previously approved formulas. Any formula approved on Form...

  17. 27 CFR 26.55 - Previously approved formulas.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... BUREAU, DEPARTMENT OF THE TREASURY LIQUORS LIQUORS AND ARTICLES FROM PUERTO RICO AND THE VIRGIN ISLANDS Formulas for Products From Puerto Rico § 26.55 Previously approved formulas. Any formula approved on Form...

  18. 27 CFR 26.55 - Previously approved formulas.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... BUREAU, DEPARTMENT OF THE TREASURY LIQUORS LIQUORS AND ARTICLES FROM PUERTO RICO AND THE VIRGIN ISLANDS Formulas for Products From Puerto Rico § 26.55 Previously approved formulas. Any formula approved on Form...

  19. Assessing the reporting of categorised quantitative variables in observational epidemiological studies.

    PubMed

    Mabikwa, Onkabetse V; Greenwood, Darren C; Baxter, Paul D; Fleming, Sarah J

    2017-03-14

    One aspect to consider when reporting results of observational studies in epidemiology is how quantitative risk factors are analysed. The STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines recommend that researchers describe how they handle quantitative variables when analysing data. For categorised quantitative variables, the authors are required to provide reasons and justifications informing their practice. We investigated and assessed the practices and reporting of categorised quantitative variables in epidemiology. The assessment was based on five medical journals that publish epidemiological research. Observational studies published between April and June 2015 and investigating the relationships between quantitative exposures (or risk factors) and the outcomes were considered for assessment. A standard form was used to collect the data, and the reporting patterns amongst eligible studies were quantified and described. Out of 61 articles assessed for eligibility, 23 observational studies were included in the assessment. Categorisation of quantitative exposures occurred in 61% of these studies and reasons informing the practice were rarely provided. Only one article explained the choice of categorisation in the analysis. Transformation of quantitative exposures into four or five groups was common and dominant amongst studies using equally spaced categories. Dichotomisation was not popular; the practice featured in one article. Overall, the majority (86%) of the studies preferred ordered or arbitrary group categories. Other criterions used to decide categorical boundaries were based on established guidelines such as consensus statements and WHO standards. Categorisation of continuous variables remains a dominant practice in epidemiological studies. The reasons informing the practice of categorisation within published work are limited and remain unknown in most articles. The existing STROBE guidelines could provide stronger

  20. Sensitivity analysis of observed reflectivity to ice particle surface roughness using MISR satellite observations

    NASA Astrophysics Data System (ADS)

    Bell, A.; Hioki, S.; Wang, Y.; Yang, P.; Di Girolamo, L.

    2016-12-01

    Previous studies found that including ice particle surface roughness in forward light scattering calculations significantly reduces the differences between observed and simulated polarimetric and radiometric observations. While it is suggested that some degree of roughness is desirable, the appropriate degree of surface roughness to be assumed in operational cloud property retrievals and the sensitivity of retrieval products to this assumption remains uncertain. In an effort to extricate this ambiguity, we will present a sensitivity analysis of space-borne multi-angle observations of reflectivity, to varying degrees of surface roughness. This process is two fold. First, sampling information and statistics of Multi-angle Imaging SpectroRadiometer (MISR) sensor data aboard the Terra platform, will be used to define the most coming viewing observation geometries. Using these defined geometries, reflectivity will be simulated for multiple degrees of roughness using results from adding-doubling radiative transfer simulations. Sensitivity of simulated reflectivity to surface roughness can then be quantified, thus yielding a more robust retrieval system. Secondly, sensitivity of the inverse problem will be analyzed. Spherical albedo values will be computed by feeding blocks of MISR data comprising cloudy pixels over ocean into the retrieval system, with assumed values of surface roughness. The sensitivity of spherical albedo to the inclusion of surface roughness can then be quantified, and the accuracy of retrieved parameters can be determined.

  1. Assessment of the quality of reporting observational studies in the pediatric dental literature.

    PubMed

    Butani, Yogita; Hartz, Arthur; Levy, Steven; Watkins, Catherine; Kanellis, Michael; Nowak, Arthur

    2006-01-01

    The purpose of this assessment was to evaluate reporting of observational studies in the pediatric dental literature. This assessment included the following steps: (1) developing a model for reporting information in clinical dentistry studies; (2) identifying treatment comparisons in pediatric dentistry that were evaluated by at least 5 observational studies; (3) abstracting from these studies any data indicated by applying the reporting model; and (4) comparing available data elements to the desired data elements in the reporting model. The reporting model included data elements related to: (1) patients; (2) providers; (3) treatment details; and (4) study design. Two treatment comparisons in pediatric dentistry were identified with 5 or more observational studies: (1) stainless steel crowns vs amalgams (10 studies); and (2) composite restorations vs amalgam (5 studies). Results from studies comparing the same treatments varied substantially. Data elements from the reporting model that could have explained some of the variation were often reported inadequately or not at all. Reporting of observational studies in the pediatric dental literature may be inadequate for an informed interpretation of the results. Models similar to that used in this study could be used for developing standards for the conduct and reporting of observational studies in pediatric dentistry.

  2. Management of Pulmonary Nodules by Community Pulmonologists: A Multicenter Observational Study.

    PubMed

    Tanner, Nichole T; Aggarwal, Jyoti; Gould, Michael K; Kearney, Paul; Diette, Gregory; Vachani, Anil; Fang, Kenneth C; Silvestri, Gerard A

    2015-12-01

    Pulmonary nodules (PNs) are a common reason for referral to pulmonologists. The majority of data for the evaluation and management of PNs is derived from studies performed in academic medical centers. Little is known about the prevalence and diagnosis of PNs, the use of diagnostic testing, or the management of PNs by community pulmonologists. This multicenter observational record review evaluated 377 patients aged 40 to 89 years referred to 18 geographically diverse community pulmonary practices for intermediate PNs (8-20 mm). Study measures included the prevalence of malignancy, procedure/test use, and nodule pretest probability of malignancy as calculated by two previously validated models. The relationship between calculated pretest probability and management decisions was evaluated. The prevalence of malignancy was 25% (n = 94). Nearly one-half of the patients (46%, n = 175) had surveillance alone. Biopsy was performed on 125 patients (33.2%). A total of 77 patients (20.4%) underwent surgery, of whom 35% (n = 27) had benign disease. PET scan was used in 141 patients (37%). The false-positive rate for PET scan was 39% (95% CI, 27.1%-52.1%). Pretest probability of malignancy calculations showed that 9.5% (n = 36) were at a low risk, 79.6% (n = 300) were at a moderate risk, and 10.8% (n = 41) were at a high risk of malignancy. The rate of surgical resection was similar among the three groups (17%, 21%, 17%, respectively; P = .69). A substantial fraction of intermediate-sized nodules referred to pulmonologists ultimately prove to be lung cancer. Despite advances in imaging and nonsurgical biopsy techniques, invasive sampling of low-risk nodules and surgical resection of benign nodules remain common, suggesting a lack of adherence to guidelines for the management of PNs.

  3. Effect of Several Negative Rounds of Human Papillomavirus and Cytology Co-testing on Safety Against Cervical Cancer: An Observational Cohort Study.

    PubMed

    Castle, Philip E; Kinney, Walter K; Xue, Xiaonan; Cheung, Li C; Gage, Julia C; Zhao, Fang-Hui; Fetterman, Barbara; Poitras, Nancy E; Lorey, Thomas S; Wentzensen, Nicolas; Katki, Hormuzd A; Schiffman, Mark

    2018-01-02

    Current U.S. cervical cancer screening and management guidelines do not consider previous screening history, because data on multiple-round human papillomavirus (HPV) and cytology "co-testing" have been unavailable. To measure cervical cancer risk in routine practice after successive negative screening co-tests at 3-year intervals. Observational cohort study. Integrated health care system (Kaiser Permanente Northern California, Oakland, California). 990 013 women who had 1 or more co-tests from 2003 to 2014. 3- and 5-year cumulative detection of (risk for) cervical intraepithelial neoplasia grade 3, adenocarcinoma in situ, and cervical cancer (≥CIN3) in women with different numbers of negative co-tests, overall and within subgroups defined by previous co-test results or baseline age. Five-year ≥CIN3 risks decreased after each successive negative co-test screening round (0.098%, 0.052%, and 0.035%). Five-year ≥CIN3 risks for an HPV-negative co-test, regardless of the cytology result, nearly matched the performance (reassurance) of a negative co-test for each successive round of screening (0.114%, 0.061%, and 0.041%). By comparison, ≥CIN3 risks for the cytology-negative co-test, regardless of the HPV result, also decreased with each successive round, but 3-year risks were as high as 5-year risks after an HPV-negative co-test (0.199%, 0.065%, and 0.043%). No interval cervical cancer cases were diagnosed after the second negative co-test. Independently, ≥CIN3 risks decreased with age. Length of previous screening interval did not influence future ≥CIN3 risks. Interval-censored observational data. After 1 or more negative cervical co-tests (or HPV tests), longer screening intervals (every 5 years or more) might be feasible and safe. National Cancer Institute Intramural Research Program.

  4. PDE5 inhibitor treatment persistence and adherence in Brazilian men: post-hoc analyses from a 6-month, prospective, observational study.

    PubMed

    Cairoli, Carlos; Reyes, Luis Antonio; Henneges, Carsten; Sorsaburu, Sebastian

    2014-01-01

    Characterize persistence and adherence to phosphodiesterase type - 5 inhibitor (PDE5I) on-demand therapy over 6 months among Brazilian men in an observational, non-interventional study of Latin American men naïve to PDE5Is with erectile dysfunction (ED). Men were prescribed PDE5Is per routine clinical practice. Persistence was defined as using ≥ 1 dose during the previous 4 - weeks, and adherence as following dosing instructions for the most recent dose, assessed using the Persistence and Adherence Questionnaire. Other measures included the Self - Esteem and Relationship (SEAR) Questionnaire, and International Index of Erectile Function (IIEF). Multivariate logistic regression was used to identify factors associated with persistence/adherence. 104 Brazilian men were enrolled; mean age by treatment was 53 to 59 years, and most presented with moderate ED (61.7%). The prescribed PDE5I was sildenafil citrate for 50 (48.1%), tadalafil for 36 (34.6%), vardenafil for 15 (14.4%), and lodenafil for 3 patients (2.9%). Overall treatment persistence was 69.2% and adherence was 70.2%; both were numerically higher with tadalafil (75.0%) versus sildenafil or vardenafil (range 60.0% to 68.0%). Potential associations of persistence and/or adherence were observed with education level, ED etiology, employment status, and coronary artery disease. Improvements in all IIEF domain scores, and both SEAR domain scores were observed for all treatments. Study limitations included the observational design, brief duration, dependence on patient self - reporting, and limited sample size. Approximately two-thirds of PDE5I-naive, Brazilian men with ED were treatment persistent and adherent after 6 months. Further study is warranted to improve long-term outcomes of ED treatment.

  5. A new concept of the anatomy of the thoracic oesophagus: the meso-oesophagus. Observational study during thoracoscopic esophagectomy.

    PubMed

    Cuesta, Miguel A; Weijs, Teus J; Bleys, Ronald L A W; van Hillegersberg, Richard; van Berge Henegouwen, Mark I; Gisbertz, Suzanne S; Ruurda, Jelle P; Straatman, Jennifer; Osugi, Harushi; van der Peet, Donald L

    2015-09-01

    During thoracoscopic oesophageal surgery, we observed not previously described fascia-like structures. Description of similar structures in rectal cancer surgery was of paramount importance in improving the quality of resection. Therefore, we aimed to describe a new comprehensive concept of the surgical anatomy of the thoracic oesophagus with definition of the meso-oesophagus. We retrospectively evaluated 35 consecutive unedited videos of thoracoscopic oesophageal resections for cancer, to determine the surgical anatomy of the oesophageal fascia's vessels and lymphatic drainage. The resulting concept was validated in a prospective study, including 20 patients at three different centres. Additional confirmation was sought by a histologic study of a cadaver's thorax. A thin layer of connective tissue around the infracarinal oesophagus, involving the lymph nodes at the level of the carina, was observed during thoracoscopic esophagectomy in 32 of the 35 patients included in the retrospective study and in 19 of the 20 patients included in the prospective study. A thick fascia-like structure from the upper thoracic aperture to the lower thoracic aperture was visualized in all patients. This fascia is encountered between the descending aorta and left aspect of the infracarinal oesophagus. Above the carina it expands on both sides of the oesophagus to lateral mediastinal structures. This fascia contains oesophageal vessels, lymph vessels and nodes and nerves. The histologic study confirmed these findings. Here we described the concept of the "meso-oesophagus". Applying the description of the meso-oesophagus will create a better understanding of the oesophageal anatomy, leading to more adequate and reproducible surgery.

  6. Studies of Accreting Neutron Stars with RXTE Cycle 4 Observations: III: TOO Observations of Atoll Sources

    NASA Technical Reports Server (NTRS)

    Paciesas, William S.

    2002-01-01

    NASA Grant NAG 5-9244 provided funds for the research projects 'ASM-Triggered TOO Observations of Kilohertz Oscillations in Five Atoll Sources' and 'Further Measurements of the Kilohertz Oscillations in 4U 1705-44' approved under the Rossi X-ray Timing Explorer (RXTE) Guest Observer Program Cycle 4 and funded under the 1999 NASA Astrophysics Data Program. The principal investigator of the observing time proposals was Dr. E. C. Ford (U. of Amsterdam). The grant was funded for one year beginning 3/15/2000. The original ADP proposal was submitted by Prof. Jan van Paradijs, who passed away in 1999 before the funds were distributed. Prof. Wilham S. Padesas administered the grant during the period of performance. In spite of a wealth of observational data on the kHz QPO in low-mass X-ray binaries (LMXBs), the interpretation of this phenomenon is currently uncertain because the pairs of kHz QPO peaks and the oscillations seen in some Type I X-ray bursts are almost, but not quite, connected by a simple beat frequency relation. Further systematic studies of systems with known QPOs are required in order to better understand the phenomenon. The proposals were intended to contribute to a solution to this confusion by observing the sources as they vary over a wide range of X-ray flux. RXTE target-of-opportunity observations of six transient atoll sources, 4U 0614+09, KS 1732-260, Ser X-1, 4U 1702-42, 4U 1820-30 and 4U 1705-44 were to be performed at various flux levels based on ASM measurements.

  7. Learning Curves Among All Patients Undergoing Transcatheter Aortic Valve Implantation in Germany: A Retrospective Observational Study.

    PubMed

    Kaier, Klaus; Reinecke, Holger; Schmoor, Claudia; Frankenstein, Lutz; Vach, Werner; Hehn, Philip; Zirlik, Andreas; Bode, Christoph; Zehender, Manfred; Reinöhl, Jochen

    2017-05-15

    Transcatheter aortic valve implantation (TAVI) is a rapidly evolving technique for therapy of aortic stenosis. Previous studies report learning curves with respect to in-hospital mortality and clinical complications. We aim to determine whether observed improvements of in-hospital outcomes after TAVI are the result of improvements in procedures or due to a change in the patient population, and whether improvements differ between the transfemoral (TF) and the transapical (TA) approach. Data was analyzed using risk-adjusted regression analyses in order to track the development of clinical outcomes of all isolated TAVI procedures performed in Germany from 2008 to 2013 (N=32.436) in all German hospitals performing TAVI. Measurements include in-hospital mortality, stroke, bleeding, and mechanical ventilation. Unadjusted mortality rates decrease over time for both TA-TAVI and TF-TAVI. Reductions in mortality were smaller for TA-TAVI than for TF-TAVI. These trends could also be observed for risk-adjusted (standardized) mortality rates, indicating that time trends and differences between TA-TAVI (around 7% in 2013) and TF-TAVI (around 4% in 2013) cannot be explained by changes in the risk factor composition of the patient populations. Bleeding complications decreased for both access routes. Both unadjusted and standardized bleeding rates were substantially higher for TA-TAVI. In addition, TA-TAVI procedures were associated with an increased likelihood of requiring >48h of mechanical ventilation. Observed improvements in TAVI-related in-hospital mortality are not due to a change in patient population. The results indicate the superiority of a TF-first approach. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  8. Aseptic cure of pulmonary paracoccidioidomycosis can be achieved after a previous subcutaneous immunization of susceptible but not resistant mice.

    PubMed

    Arruda, Celina; Vaz, Celidéia A C; Calich, Vera L G

    2007-05-01

    The murine model of paracoccidioidomycosis, the most important South American endemic mycosis, mimics the human disease: resistance is associated with preserved cellular immunity while T-cell anergy is related with susceptibility. In the present study we asked whether a previous s.c. infection which induces strong cellular immunity would protect mice against a lethal pulmonary challenge. It was found that susceptible but not resistant mice developed immunoprotection and aseptic cure of infection. Immunoprotection led to reversal of DTH anergy, increased levels of antibodies and pulmonary IL-12, IL-2 and IL-4 indicating a balanced type 1/type 2 response. On the contrary, no marked differences in A/Sn infection and immunity were observed. Depletion experiments showed that immunoprotection required the cooperative action of CD4(+) and CD8(+) T cells in association with IFN-gamma and IL-12. Altogether, these observations demonstrated that susceptible hosts can develop sterilizing immunity and defined the main immunological requirements to control secondary paracoccidioidomycosis.

  9. Cautionary tales in the interpretation of observational studies of effects of clinical interventions.

    PubMed

    Scott, I A; Attia, J

    2017-02-01

    Observational studies of the effectiveness of clinical interventions are proliferating as more 'real-world' clinical data (so called 'big data') are gathered from clinical registries, administrative datasets and electronic health records. While well-conducted randomised controlled trials (RCT) remain the scientific standard in assessing the efficacy of clinical interventions, well-designed observational studies may add to the evidence base of effectiveness in situations where RCT are of limited value or very difficult to perform. Rather than dismissing observational studies, we need to determine what circumstances may justify doing an observational study and when the study is sufficiently rigorous to be considered reasonably trustworthy. This article proposes criteria by which users of the literature might make such determinations. © 2016 Royal Australasian College of Physicians.

  10. Regulatory considerations in the design of comparative observational studies using propensity scores.

    PubMed

    Yue, Lilly Q

    2012-01-01

    In the evaluation of medical products, including drugs, biological products, and medical devices, comparative observational studies could play an important role when properly conducted randomized, well-controlled clinical trials are infeasible due to ethical or practical reasons. However, various biases could be introduced at every stage and into every aspect of the observational study, and consequently the interpretation of the resulting statistical inference would be of concern. While there do exist statistical techniques for addressing some of the challenging issues, often based on propensity score methodology, these statistical tools probably have not been as widely employed in prospectively designing observational studies as they should be. There are also times when they are implemented in an unscientific manner, such as performing propensity score model selection for a dataset involving outcome data in the same dataset, so that the integrity of observational study design and the interpretability of outcome analysis results could be compromised. In this paper, regulatory considerations on prospective study design using propensity scores are shared and illustrated with hypothetical examples.

  11. Use of a Differential Observing Response to Expand Restricted Stimulus Control

    ERIC Educational Resources Information Center

    Walpole, Carrie Wallace; Roscoe, Eileen M.; Dube, William V.

    2007-01-01

    This study extends previous work on the use of differential observing responses (DOR) to remediate atypically restricted stimulus control. A participant with autism had high matching-to-sample accuracy scores with printed words that had no letters in common (e.g., "cat," "lid," "bug") but poor accuracy with words that had two letters in common…

  12. Folic acid supplementation and preterm birth: results from observational studies.

    PubMed

    Mantovani, Elena; Filippini, Francesca; Bortolus, Renata; Franchi, Massimo

    2014-01-01

    Folic acid (FA) supplementation is recommended worldwide in the periconceptional period for the prevention of neural tube defects. Due to its involvement in a number of cellular processes, its role in other pregnancy outcomes such as miscarriage, recurrent miscarriage, low birth weight, preterm birth (PTB), preeclampsia, abruptio placentae, and stillbirth has been investigated. PTB is a leading cause of perinatal mortality and morbidity; therefore its association with FA supplementation is of major interest. The analysis of a small number of randomized clinical trials (RCTs) has not found a beneficial role of FA in reducing the rate of PTBs. The aim of this review was to examine the results from recent observational studies about the effect of FA supplementation on PTB. We carried out a search on Medline and by manual search of the observational studies from 2009 onwards that analyzed the rate of PTB in patients who received supplementation with FA before and/or throughout pregnancy. The results from recent observational studies suggest a slight reduction of PTBs that is not consistent with the results from RCTs. Further research is needed to better understand the role of FA supplementation before and during pregnancy in PTB.

  13. Impulsivity moderates the relationship between previous quit failure and cue-induced craving.

    PubMed

    Erblich, Joel; Michalowski, Alexandra

    2015-12-01

    Poor inhibitory control has been shown to be an important predictor of relapse to a number of drugs, including nicotine. Indeed, smokers who exhibit higher levels of impulsivity are thought to have impaired regulation of urges to smoke, and previous research has suggested that impulsivity may moderate cue-induced cigarette cravings. To that end, we conducted a study to evaluate the interplay between failed smoking cessation, cue-induced craving, and impulsivity. Current smokers (n=151) rated their cigarette cravings before and after laboratory to exposure to smoking cues, and completed questionnaires assessing impulsivity and previous failed quit attempts. Findings indicated that shorter duration of previous failed quit attempts was related to higher cue-induced cigarette craving, especially among smokers with higher levels of impulsivity. Results underscore the importance of considering trait impulsivity as a factor in better understanding the management of cue-induced cravings. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Does previous healthcare experience increase success in physician assistant training?

    PubMed

    Hegmann, Theresa; Iverson, Katie

    2016-06-01

    Healthcare experience is used by many physician assistant (PA) programs to rank applicants. Despite a large healthcare literature base evaluating admissions factors, little information is available on the relationship of healthcare experience and educational outcomes. We aimed to test whether previous healthcare experience is associated with increased success during the clinical portion of the PA educational process. Hours of direct healthcare experience reported on Central Application Service for Physician Assistants applications for 124 students in the classes of 2009 through 2013 were associated with a calculated average preceptor evaluation score for each student and with average standardized-patient examination scores for a subset of students. Average student age was 28.7 years and median healthcare experience was 2,257 hours (range 390-16,400). Previous healthcare experience was not significantly correlated with preceptor evaluations or standardized-patient examination scores. This 5-year single institution pilot study did not support the hypothesis that healthcare experience is associated with improved clinical year outcomes.

  15. AIDS-related health behavior: coping, protection motivation, and previous behavior.

    PubMed

    Van der Velde, F W; Van der Pligt, J

    1991-10-01

    The purpose of this study was to examine Rogers' protection motivation theory and aspects of Janis and Mann's conflict theory in the context of AIDS-related health behavior. Subjects were 84 heterosexual men and women and 147 homosexual men with multiple sexual partners; LISREL's path-analysis techniques were used to evaluate the goodness of fit of the structural equation models. Protection motivation theory did fit the data but had considerably more explanatory power for heterosexual than for homosexual subjects (49 vs. 22%, respectively). When coping styles were added, different patterns of findings were found among both groups. Adding variables such as social norms and previous behavior increased the explained variance to 73% for heterosexual subjects and to 44% for homosexual subjects. It was concluded that although protection motivation theory did fit the data fairly adequately, expanding the theory with other variables--especially those related to previous behavior--could improve our understanding of AIDS-related health behavior.

  16. Study of the footprints of short-term variation in XCO2 observed by TCCON sites using NIES and FLEXPART atmospheric transport models

    NASA Astrophysics Data System (ADS)

    Belikov, Dmitry A.; Maksyutov, Shamil; Ganshin, Alexander; Zhuravlev, Ruslan; Deutscher, Nicholas M.; Wunch, Debra; Feist, Dietrich G.; Morino, Isamu; Parker, Robert J.; Strong, Kimberly; Yoshida, Yukio; Bril, Andrey; Oshchepkov, Sergey; Boesch, Hartmut; Dubey, Manvendra K.; Griffith, David; Hewson, Will; Kivi, Rigel; Mendonca, Joseph; Notholt, Justus; Schneider, Matthias; Sussmann, Ralf; Velazco, Voltaire A.; Aoki, Shuji

    2017-01-01

    The Total Carbon Column Observing Network (TCCON) is a network of ground-based Fourier transform spectrometers (FTSs) that record near-infrared (NIR) spectra of the sun. From these spectra, accurate and precise observations of CO2 column-averaged dry-air mole fractions (denoted XCO2) are retrieved. TCCON FTS observations have previously been used to validate satellite estimations of XCO2; however, our knowledge of the short-term spatial and temporal variations in XCO2 surrounding the TCCON sites is limited. In this work, we use the National Institute for Environmental Studies (NIES) Eulerian three-dimensional transport model and the FLEXPART (FLEXible PARTicle dispersion model) Lagrangian particle dispersion model (LPDM) to determine the footprints of short-term variations in XCO2 observed by operational, past, future and possible TCCON sites. We propose a footprint-based method for the collocation of satellite and TCCON XCO2 observations and estimate the performance of the method using the NIES model and five GOSAT (Greenhouse Gases Observing Satellite) XCO2 product data sets. Comparison of the proposed approach with a standard geographic method shows a higher number of collocation points and an average bias reduction up to 0.15 ppm for a subset of 16 stations for the period from January 2010 to January 2014. Case studies of the Darwin and Reunion Island sites reveal that when the footprint area is rather curved, non-uniform and significantly different from a geographical rectangular area, the differences between these approaches are more noticeable. This emphasises that the collocation is sensitive to local meteorological conditions and flux distributions.

  17. An artificial network model for estimating the network structure underlying partially observed neuronal signals.

    PubMed

    Komatsu, Misako; Namikawa, Jun; Chao, Zenas C; Nagasaka, Yasuo; Fujii, Naotaka; Nakamura, Kiyohiko; Tani, Jun

    2014-01-01

    Many previous studies have proposed methods for quantifying neuronal interactions. However, these methods evaluated the interactions between recorded signals in an isolated network. In this study, we present a novel approach for estimating interactions between observed neuronal signals by theorizing that those signals are observed from only a part of the network that also includes unobserved structures. We propose a variant of the recurrent network model that consists of both observable and unobservable units. The observable units represent recorded neuronal activity, and the unobservable units are introduced to represent activity from unobserved structures in the network. The network structures are characterized by connective weights, i.e., the interaction intensities between individual units, which are estimated from recorded signals. We applied this model to multi-channel brain signals recorded from monkeys, and obtained robust network structures with physiological relevance. Furthermore, the network exhibited common features that portrayed cortical dynamics as inversely correlated interactions between excitatory and inhibitory populations of neurons, which are consistent with the previous view of cortical local circuits. Our results suggest that the novel concept of incorporating an unobserved structure into network estimations has theoretical advantages and could provide insights into brain dynamics beyond what can be directly observed. Copyright © 2014 Elsevier Ireland Ltd and the Japan Neuroscience Society. All rights reserved.

  18. AMR Studies of Star Formation: Simulations and Simulated Observations

    NASA Astrophysics Data System (ADS)

    Offner, Stella; McKee, C. F.; Klein, R. I.

    2009-01-01

    Molecular clouds are typically observed to be approximately virialized with gravitational and turbulent energy in balance, yielding a star formation rate of a few percent. The origin and characteristics of the observed supersonic turbulence are poorly understood, and without continued energy injection the turbulence is predicted to decay within a cloud dynamical time. Recent observations and analytic work have suggested a strong connection between the initial stellar mass function, the core mass function, and turbulence characteristics. The role of magnetic fields in determining core lifetimes, shapes, and kinematic properties remains hotly debated. Simulations are a formidable tool for studying the complex process of star formation and addressing these puzzles. I present my results modeling low-mass star formation using the ORION adaptive mesh refinement (AMR) code. I investigate the properties of forming cores and protostars in simulations in which the turbulence is driven to maintain virial balance and where it is allowed to decay. I will discuss simulated observations of cores in dust emission and in molecular tracers and compare to observations of local star-forming clouds. I will also present results from ORION cluster simulations including flux-limited diffusion radiative transfer and show that radiative feedback, even from low-mass stars, has a significant effect on core fragmentation, disk properties, and the IMF. Finally, I will discuss the new simulation frontier of AMR multigroup radiative transfer.

  19. [Risk factors for infection in total knee artrhoplasty, including previously unreported intraoperative fracture and deep venous thrombosis].

    PubMed

    de Dios, M; Cordero-Ampuero, J

    2015-01-01

    To carry out a statistical analysis on the significant risk factors for deep late infection (prosthetic joint infection, PJI) in patients with a knee arthroplasty (TKA). A retrospective observational case-control study was conducted on a case series of 32 consecutive knee infections, using an analysis of all the risk factors reported in the literature. A control series of 100 randomly selected patients operated in the same Department of a University General Hospital during the same period of time, with no sign of deep infection in their knee arthroplasty during follow-up. Statistical comparisons were made using Pearson for qualitative and ANOVA for quantitative variables. The significant (p>0.05) factors found in the series were: Preoperative previous knee surgery, glucocorticoids, immunosuppressants, inflammatory arthritis. prolonged surgical time, inadequate antibiotic prophylaxis, intraoperative fractures. Postoperative secretion of the wound longer than 10 days, deep palpable haematoma, need for a new surgery, and deep venous thrombosis in lower limbs. Distant infections cutaneous, generalized sepsis, urinary tract, pneumonia, abdominal. This is the first report of intraoperative fractures and deep venous thrombosis as significantly more frequent factors in infected TKAs. Other previously described risk factors for TKA PJI are also confirmed. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  20. Bipolar cloud-to-ground lightning flash observations

    NASA Astrophysics Data System (ADS)

    Saba, Marcelo M. F.; Schumann, Carina; Warner, Tom A.; Helsdon, John H.; Schulz, Wolfgang; Orville, Richard E.

    2013-10-01

    lightning is usually defined as a lightning flash where the current waveform exhibits a polarity reversal. There are very few reported cases of cloud-to-ground (CG) bipolar flashes using only one channel in the literature. Reports on this type of bipolar flashes are not common due to the fact that in order to confirm that currents of both polarities follow the same channel to the ground, one necessarily needs video records. This study presents five clear observations of single-channel bipolar CG flashes. High-speed video and electric field measurement observations are used and analyzed. Based on the video images obtained and based on previous observations of positive CG flashes with high-speed cameras, we suggest that positive leader branches which do not participate in the initial return stroke of a positive cloud-to-ground flash later generate recoil leaders whose negative ends, upon reaching the branch point, traverse the return stroke channel path to the ground resulting in a subsequent return stroke of opposite polarity.

  1. A Reevaluation of Airborne HO(x) Observations from NASA Field Campaigns

    NASA Technical Reports Server (NTRS)

    Olson, Jennifer; Crawford, James H.; Chen, Gao; Brune, William H.; Faloona, Ian C.; Tan, David; Harder, Hartwig; Martinez, Monica

    2006-01-01

    In-situ observations of tropospheric HO(x) (OH and HO2) obtained during four NASA airborne campaigns (SUCCESS, SONEX, PEM-Tropics B and TRACE-P) are reevaluated using the NASA Langley time-dependent photochemical box model. Special attention is given to previously diagnosed discrepancies between observed and predicted HO2 which increase with higher NO(x) levels and at high solar zenith angles. This analysis shows that much of the model discrepancy at high NO(x) during SUCCESS can be attributed to modeling observations at time-scales too long to capture the nonlinearity of HO(x) chemistry under highly variable conditions for NO(x). Discrepancies at high NO(x) during SONEX can be moderated to a large extent by complete use of all available precursor observations. Differences in kinetic rate coefficients and photolysis frequencies available for previous studies versus current recommendations also explain some of the disparity. Each of these causes is shown to exert greater influence with increasing NO(x) due to both the chemical nonlinearity between HO(x) and NO(x) and the increased sensitivity of HO(x) to changes in sources at high NO(x). In contrast, discrepancies at high solar zenith angles will persist until an adequate nighttime source of HO(x) can be identified. It is important to note that this analysis falls short of fully eliminating the issue of discrepancies between observed and predicted HO(x) for high NO(x) environments. These discrepancies are not resolved with the above causes in other data sets from ground-based field studies. Nevertheless, these results highlight important considerations in the application of box models to observationally based predictions of HO(x) radicals.

  2. XMM TOO Observation

    NASA Technical Reports Server (NTRS)

    Kong, Albert

    2005-01-01

    The primary research goal of this project is to perform follow-up observations of a recurrent ultraluminous supersoft X-ray source (SSS) in Ml0l. The source was first discovered by ROSAT and was confirmed as a SSS with a blackbody temperature of about l00eV by Chandra. During 2000 March, Chandra detected it at Lx=4e39 erg per second, and then in 2000 October, its luminosity dropped to around le39 erg per second. During 2004, Chandra is conducting a monitoring program for Ml0l. The SSS was near the detection limit during January, March, and May; the X-ray spectra were harder with a power-law shape, and the X-ray luminosity was about 3e37 erg/second, a factor of greater than 200 fainter than that in the previous high state. The source was found to be in outburst again during the July 5 observation, with an X-ray luminosity of about 7e39 erg/second. Data taken on July 6,7, and 8 show that the source was in a strong outburst with a peak bolometric luminosity of about 7e39 erg/second. In general, the X-ray spectra are best described with an absorbed blackbody model with temperatures of approximately 50-100eV. In addition, we found absorption edges at 0.33, 0.57, 0.66, and 0.88 keV in two of the high state spectra. These features may signal the presence of highly ionized gas in the vicinity of the accretor (e.g., warm absorber). In order to study an ultraluminous SSS in outburst in detail, we proposed a TOO XMM observation to observe the source. The observation was taken on July 23 and the source was fainter with a luminosity of 6e38 ergs, and a harder X-ray spectrum with a power-law tail seen up to 7 keV. This clearly indicates that the source was in the decline stage with spectral change. In addition to the XMM observation, we also arranged radio observation and a simultaneous CFHT observation. The X-ray results were published in ATel and ApJL. There were several more Chandra observations taken after 2004 July. The source was in a low luminosity state but it underwent

  3. Observations of Surfzone Albedo

    NASA Astrophysics Data System (ADS)

    Sinnett, G.; Feddersen, F.

    2014-12-01

    The surfzone environment (where waves break) contains several unique and previously unconsidered processes that affect the heat budget. Entering short-wave radiation is a dominant term in both shelf and surfzone heat budgets. In contrast to the shelf, however, depth limited wave breaking in the surfzone generates spray, whitewater and suspended sediments, elevating the surface albedo (ratio of reflected to incident short-wave radiation). Elevated albedo reduces the level of solar short-wave radiation entering the water, potentially resulting in less heating. Additionally, surfzone water quality is often impacted by fecal bacteria contamination. As bacteria mortality is related to short-wave solar radiation, elevated surfzone albedo could reduce pathogen mortality, impacting human health. Albedo in the open ocean has been frequently studied and parameterizations often consider solar zenith angle, wind speed and ocean chlorophyll concentration, producing albedo values typically near 0.06. However, surfzone albedo observations have been extremely sparse, yet show depth limited wave breaking may increase the albedo by nearly a factor of 10 up to 0.5. Here, we present findings from a field study at the Scripps Institution of Oceanography pier to observe the affect of waves on surfzone albedo. Concurrent measurements were taken with a four-way radiometer (to measure both downwelling and upwelling short-wave and long wave radiation) mounted above the surfzone. A co-located GoPro camera was used to relate visual aspects of the surfzone to measured reflectance, and wave height and period were observed with a bottom mounted pressure sensor in 5 m water depth just outside the surfzone. Wind speed and direction were observed on the pier 10 m above the water surface. Here, we will examine the surfzone albedo dependence on surfzone parameters, such as wave height.

  4. Investigating the effect of previous treatments on wheat biomass over multiple spatial frequencies

    NASA Astrophysics Data System (ADS)

    Milne, A. E.; Castellanos, M. T.; Cartagena, M. C.; Tarquis, A. M.; Lark, R. M.

    2010-09-01

    In this study we use the maximum overlap discrete packet transform (MODWPT) to investigate residual effects on wheat biomass of fertigation treatments applied to a previous crop. The wheat crop covered nine subplots from a previous experiment on melon response to fertigation. Each subplot had previously received a different level of applied nitrogen. Many factors affect wheat biomass, causing it to vary at different spatial frequencies. We hypothesize that these will include residual effects from fertilizer application (at relatively low spatial frequencies) and the local influence of individual plants from the previous melon crop (at high frequency). To test this hypothesis we use the MODWPT to identify the dominant spatial frequencies of wheat biomass variation, and analyse the relationship to both the previous fertilizer application and the location of individual melon plants in the previous crop. The MODWPT is particularly appropriate for this because it allows us first to identify the key spatial frequencies in the wheat biomass objectively and to analyse them, and their relationship to hypothesized driving factors without any assumptions of uniformity (stationarity) of wheat-biomass variation. The results showed that the applied nitrogen dominated the wheat biomass response, and that there was a noticeable component of wheat-biomass variation at the spatial frequency that corresponds to the melon cropping. We expected wheat biomass to be negatively correlated with the position of melons in the previous crop, due to uptake of the applied nitrogen. The MODWPT, which allows us to detect changes in correlation between variables at different frequencies, showed that such a relationship was found across part of the experiment but not uniformly.

  5. Comparative effectiveness of switching to alternative tumour necrosis factor (TNF) antagonists versus switching to rituximab in patients with rheumatoid arthritis who failed previous TNF antagonists: the MIRAR Study.

    PubMed

    Gomez-Reino, Juan J; Maneiro, Jose Ramon; Ruiz, Jorge; Roselló, Rosa; Sanmarti, Raimon; Romero, Ana Belen

    2012-11-01

    To compare the effectiveness of switching to rituximab (RTX) with switching to alternative tumour necrosis factor (TNF) antagonists in patients with rheumatoid arthritis (RA) failing on TNF antagonists. A multicentre prospective 3-year observational study was performed in patients with RA treated with RTX or an alternative TNF antagonist. The baseline 28-joint disease activity score (DAS28) and Health Assessment Questionnaire (HAQ) score were compared with 6, 9 and 12 month values, adjusting for propensity score quintiles. Propensity scores were estimated for each patient using logistic regression with treatment as the dependent variable and baseline prior number of TNFs >1, years from diagnosis >5, extra-articular manifestations, previous toxicity, use of ≥2 disease-modifying antirheumatic drugs, age and sex as independent variables. 1124 patients were treated with either RTX (n=591, 52.6%) or alternative TNF antagonists (n=533, 47.4%). RTX-treated patients had longer disease duration (p=0.0001), larger numbers of previous TNF antagonists (p<0.0001) and tender and swollen joints (p<0.0001). There was no significant difference in the reduction in DAS28 at 6, 9 and 12 months between RTX-treated patients and those treated with TNF antagonists. However, the reduction in DAS28 was significantly different between RTX-treated patients and adalimumab/infliximab-treated patients (p=0.001 and p=0.05, respectively). There was a marginally significant difference at any time period in the proportion of patients achieving an improvement in the HAQ score of >0.22 (p=0.06). Optimal treatment for patients with RA failing on treatment with TNF antagonists may include RTX. This study suggests that the improvement in DAS28 is larger in patients treated with RTX than in those treated with monoclonal anti-TNF agents.

  6. Statistical analysis of MMS observations of energetic electron escape observed at/beyond the dayside magnetopause

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

    Cohen, Ian J.; Mauk, Barry H.; Anderson, Brian J.

    Here, observations from the Energetic Particle Detector (EPD) instrument suite aboard the Magnetospheric Multiscale (MMS) spacecraft show that energetic (greater than tens of keV) magnetospheric particle escape into the magnetosheath occurs commonly across the dayside. This includes the surprisingly frequent observation of magnetospheric electrons in the duskside magnetosheath, an unexpected result given assumptions regarding magnetic drift shadowing. The 238 events identified in the 40 keV electron energy channel during the first MMS dayside season that exhibit strongly anisotropic pitch angle distributions indicating monohemispheric field-aligned streaming away from the magnetopause. A review of the extremely rich literature of energetic electron observationsmore » beyond the magnetopause is provided to place these new observations into historical context. Despite the extensive history of such research, these new observations provide a more comprehensive data set that includes unprecedented magnetic local time (MLT) coverage of the dayside equatorial magnetopause/magnetosheath. These data clearly highlight the common escape of energetic electrons along magnetic field lines concluded to have been reconnected across the magnetopause. While these streaming escape events agree with prior studies which show strong correlation with geomagnetic activity (suggesting a magnetotail source) and occur most frequently during periods of southward IMF, the high number of duskside events is unexpected and previously unobserved. Although the lowest electron energy channel was the focus of this study, the events reported here exhibit pitch angle anisotropies indicative of streaming up to 200 keV, which could represent the magnetopause loss of >1 MeV electrons from the outer radiation belt.« less

  7. Statistical analysis of MMS observations of energetic electron escape observed at/beyond the dayside magnetopause

    DOE PAGES

    Cohen, Ian J.; Mauk, Barry H.; Anderson, Brian J.; ...

    2017-08-01

    Here, observations from the Energetic Particle Detector (EPD) instrument suite aboard the Magnetospheric Multiscale (MMS) spacecraft show that energetic (greater than tens of keV) magnetospheric particle escape into the magnetosheath occurs commonly across the dayside. This includes the surprisingly frequent observation of magnetospheric electrons in the duskside magnetosheath, an unexpected result given assumptions regarding magnetic drift shadowing. The 238 events identified in the 40 keV electron energy channel during the first MMS dayside season that exhibit strongly anisotropic pitch angle distributions indicating monohemispheric field-aligned streaming away from the magnetopause. A review of the extremely rich literature of energetic electron observationsmore » beyond the magnetopause is provided to place these new observations into historical context. Despite the extensive history of such research, these new observations provide a more comprehensive data set that includes unprecedented magnetic local time (MLT) coverage of the dayside equatorial magnetopause/magnetosheath. These data clearly highlight the common escape of energetic electrons along magnetic field lines concluded to have been reconnected across the magnetopause. While these streaming escape events agree with prior studies which show strong correlation with geomagnetic activity (suggesting a magnetotail source) and occur most frequently during periods of southward IMF, the high number of duskside events is unexpected and previously unobserved. Although the lowest electron energy channel was the focus of this study, the events reported here exhibit pitch angle anisotropies indicative of streaming up to 200 keV, which could represent the magnetopause loss of >1 MeV electrons from the outer radiation belt.« less

  8. An observational study of emergency department intern activities.

    PubMed

    Zhu, Jia Ni; Weiland, Tracey J; Taylor, David M; Dent, Andrew W

    2008-05-05

    To describe how intern time is spent, and the frequency of activities performed by interns during emergency department (ED) rotations. Prospective observational study of 42 ED interns from three Melbourne city teaching hospitals during 5 months in 2006. Direct observations were made by a single researcher for 390.8 hours, sampling all days of the week and all hours of the day. Proportion of time spent on tasks and number of procedures performed or observed by interns. Direct patient-related tasks accounted for 86.6% of total intern time, including 43.9% spent on liaising and documentation, 17.5% obtaining patient histories, 9.3% on physical examinations, 5.6% on procedures, 4.8% ordering or interpreting investigations, 3.0% on handover and 4.9% on other clinical activities. Intern time spent on non-clinical activities included 4.2% on breaks, 3.7% on downtime, 1.7% on education, and 1.3% on teaching others. Adjusted for an 8-week term, the ED intern would take 253 patient histories, consult more senior ED staff on 683 occasions, perform 237 intravenous cannulations/phlebotomies, 39 arterial punctures, 12 wound repairs and apply 16 plasters. They would perform chest compressions under supervision on seven occasions, observe defibrillation twice and intubation once, but may not see a thoracostomy. The ED exposes interns to a broad range of activities. With the anticipated increase in intern numbers, dilution of the emergency medicine experience may occur, and requirements for supervision may increase. Substitution of ED rotations may deprive interns of a valuable learning experience.

  9. [Quality analysis of observational studies on pelvic organ prolapse in China].

    PubMed

    Wang, Y T; Tao, L Y; He, H J; Han, J S

    2017-06-25

    Objective: To evaluate the quality of observational studies on pelvic organ prolapse in China. Methods: The checklist of strengthening the reporting of observational studies in epidemiology (STROBE) statement was applied to evaluate the observational studies. The articles were searched in the SinoMed database using the terms: prolapse, uterine prolapse, cystocele, rectal prolapse and pelvic floor; limited to Chinese core journals in obstetrics and gynecology from January 1996 to December 2015. With two 10-year groups (1996-2005 and 2006-2015), the χ(2) test was used to evaluate inter-group differences. Results: (1) A total of 386 observational studies were selected, including 15.5%(60/386) of case-control studies, 80.6%(311/386) of cohort studies and 3.9% (15/386) of cross-sectional studies. (2) There were totally 22 items including 34 sub-items in the checklist. There were 17 sub-items (50.0%, 17/34) had a reporting ratio less than 50% in all of aticles, including: 1a (study's design) 3.9% (15/386), 6a (participants) 24.6% (95/386), 6b (matched studies) 0 (0/386), 9 (bias) 8.3% (32/386), 10 (study size) 3.9%, 11 (quantitative variables) 41.2% (159/386), 12b-12e (statistical methods in detail) 0-2.6% (10/386), 13a (numbers of individuals at each stage of study) 18.9% (73/386), 13b (reasons for non-participation at each stage) 18.9%, 13c (flow diagram) 0, 16b and 16c (results of category boundaries and relative risk) 9.6% (37/386) and 0, 19 (limitations) 31.6% (122/386), 22 (funding) 20.5% (79/386). (3) The quality of articles published in the two decades (1996-2005 and 2006-2015) were compared, and 38.2%(13/34) of sub-items had been significantly improved in the second 10-year (all P< 0.05). The improved items were as follows: 1b (integrity of abstract), 2 (background/rationale), 6a (participants), 7 (variables), 8 (data sources/measurement), 9 (bias), 11 (quantitative variables), 12a (statistical methods), 17 (other analyses), 18 (key results), 19 (limitations

  10. Spatial Distribution of Io's Neutral Oxygen Cloud Observed by Hisaki

    NASA Astrophysics Data System (ADS)

    Koga, Ryoichi; Tsuchiya, Fuminori; Kagitani, Masato; Sakanoi, Takeshi; Yoneda, Mizuki; Yoshioka, Kazuo; Yoshikawa, Ichiro; Kimura, Tomoki; Murakami, Go; Yamazaki, Atsushi; Smith, H. Todd; Bagenal, Fran

    2018-05-01

    We report on the spatial distribution of a neutral oxygen cloud surrounding Jupiter's moon Io and along Io's orbit observed by the Hisaki satellite. Atomic oxygen and sulfur in Io's atmosphere escape from the exosphere mainly through atmospheric sputtering. Some of the neutral atoms escape from Io's gravitational sphere and form neutral clouds around Jupiter. The extreme ultraviolet spectrograph called EXCEED (Extreme Ultraviolet Spectroscope for Exospheric Dynamics) installed on the Japan Aerospace Exploration Agency's Hisaki satellite observed the Io plasma torus continuously in 2014-2015, and we derived the spatial distribution of atomic oxygen emissions at 130.4 nm. The results show that Io's oxygen cloud is composed of two regions, namely, a dense region near Io and a diffuse region with a longitudinally homogeneous distribution along Io's orbit. The dense region mainly extends on the leading side of Io and inside of Io's orbit. The emissions spread out to 7.6 Jupiter radii (RJ). Based on Hisaki observations, we estimated the radial distribution of the atomic oxygen number density and oxygen ion source rate. The peak atomic oxygen number density is 80 cm-3, which is spread 1.2 RJ in the north-south direction. We found more oxygen atoms inside Io's orbit than a previous study. We estimated the total oxygen ion source rate to be 410 kg/s, which is consistent with the value derived from a previous study that used a physical chemistry model based on Hisaki observations of ultraviolet emission ions in the Io plasma torus.

  11. Globally Gridded Satellite (GridSat) Observations for Climate Studies

    NASA Technical Reports Server (NTRS)

    Knapp, Kenneth R.; Ansari, Steve; Bain, Caroline L.; Bourassa, Mark A.; Dickinson, Michael J.; Funk, Chris; Helms, Chip N.; Hennon, Christopher C.; Holmes, Christopher D.; Huffman, George J.; hide

    2012-01-01

    Geostationary satellites have provided routine, high temporal resolution Earth observations since the 1970s. Despite the long period of record, use of these data in climate studies has been limited for numerous reasons, among them: there is no central archive of geostationary data for all international satellites, full temporal and spatial resolution data are voluminous, and diverse calibration and navigation formats encumber the uniform processing needed for multi-satellite climate studies. The International Satellite Cloud Climatology Project set the stage for overcoming these issues by archiving a subset of the full resolution geostationary data at approx.10 km resolution at 3 hourly intervals since 1983. Recent efforts at NOAA s National Climatic Data Center to provide convenient access to these data include remapping the data to a standard map projection, recalibrating the data to optimize temporal homogeneity, extending the record of observations back to 1980, and reformatting the data for broad public distribution. The Gridded Satellite (GridSat) dataset includes observations from the visible, infrared window, and infrared water vapor channels. Data are stored in the netCDF format using standards that permit a wide variety of tools and libraries to quickly and easily process the data. A novel data layering approach, together with appropriate satellite and file metadata, allows users to access GridSat data at varying levels of complexity based on their needs. The result is a climate data record already in use by the meteorological community. Examples include reanalysis of tropical cyclones, studies of global precipitation, and detection and tracking of the intertropical convergence zone.

  12. Depression and anxiety in women with early breast cancer: five year observational cohort study

    PubMed Central

    Burgess, Caroline; Cornelius, Victoria; Love, Sharon; Graham, Jill; Richards, Michael; Ramirez, Amanda

    2005-01-01

    Objective To examine the prevalence of, and risk factors for, depression and anxiety in women with early breast cancer in the five years after diagnosis. Design Observational cohort study. Setting NHS breast clinic, London. Participants 222 women with early breast cancer: 170 (77%) provided complete interview data up to either five years after diagnosis or recurrence. Main outcome measures Prevalence of clinically important depression and anxiety (structured psychiatric interview with standardised diagnostic criteria) and clinical and patient risk factors, including stressful life experiences (Bedford College life events and difficulties schedule). Results Nearly 50% of the women with early breast cancer had depression, anxiety, or both in the year after diagnosis, 25% in the second, third, and fourth years, and 15% in the fifth year. Point prevalence was 33% at diagnosis, falling to 15% after one year. 45% of those with recurrence experienced depression, anxiety, or both within three months of the diagnosis. Previous psychological treatment predicted depression, anxiety, or both in the period around diagnosis (one month before diagnosis to four months after diagnosis). Longer term depression and anxiety, were associated with previous psychological treatment, lack of an intimate confiding relationship, younger age, and severely stressful non-cancer life experiences. Clinical factors were not associated with depression and anxiety, at any time. Lack of intimate confiding support also predicted more protracted episodes of depression and anxiety. Conclusion Increased levels of depression, anxiety, or both in the first year after a diagnosis of early breast cancer highlight the need for dedicated service provision during this time. Psychological interventions for women with breast cancer who remain disease free should take account of the broader social context in which the cancer occurs, with a focus on improving social support. PMID:15695497

  13. Treatment of Recurrent Dupuytren Contracture in Joints Previously Effectively Treated With Collagenase Clostridium histolyticum.

    PubMed

    Bear, Brian J; Peimer, Clayton A; Kaplan, F Thomas D; Kaufman, Gregory J; Tursi, James P; Smith, Ted

    2017-05-01

    Collagenase Clostridium histolyticum (CCH) is approved for the treatment of adults with Dupuytren contracture with a palpable cord. This open-label, phase 4 study evaluated the safety and efficacy of CCH for the retreatment of recurrent contractures in joints that were previously effectively treated with CCH. Patients participating in a long-term follow-up study who had contracture recurrence (increased ≥ 20° with a palpable cord) after successful treatment in the previous study were eligible. Recurrent joint contractures were treated with up to 3 CCH injections (∼ 1 month apart). Patients were followed for 1 year to evaluate safety. Assessments included change in joint contracture, range of motion, and the percentage of joints that achieved contracture of 5° or less at day 30 after the last injection. The efficacy analysis included 51 patients with 1 treated joint per patient (31 metacarpophalangeal, 20 proximal interphalangeal). A total of 35 joints (69%) received 1 injection, 12 (24%) received 2 injections, and 4 (8%) received 3 injections. Fifty-seven percent of joints achieved contracture of 5° or less (29 of 51). Overall, 86% (43 of 50) patients had a 20° or greater increase in range of motion. The adverse event profile was consistent with previous studies. One ligament injury was reported. At a short-term follow-up of 1 year, recurrent contracture in joints previously successfully treated with CCH may be effectively retreated with up to 3 injections of CCH. Therapeutic IV. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  14. Impact of previous cyst-enterostomy on patients’ outcome following resection of bile duct cysts

    PubMed Central

    Ouaissi, Mehdi; Kianmanesh, Reza; Ragot, Emilia; Belghiti, Jacques; Majno, Pietro; Nuzzo, Gennaro; Dubois, Remi; Revillon, Yann; Cherqui, Daniel; Azoulay, Daniel; Letoublon, Christian; Pruvot, François-René; Paye, François; Rat, Patrick; Boudjema, Karim; Roux, Adeline; Mabrut, Jean-Yves; Gigot, Jean-François

    2016-01-01

    AIM: To analyze the impact of previous cyst-enterostomy of patients underwent congenital bile duct cysts (BDC) resection. METHODS: A multicenter European retrospective study between 1974 and 2011 were conducted by the French Surgical Association. Only Todani subtypes I and IVb were included. Diagnostic imaging studies and operative and pathology reports underwent central revision. Patients with and without a previous history of cyst-enterostomy (CE) were compared. RESULTS: Among 243 patients with Todani types I and IVb BDC, 16 had undergone previous CE (6.5%). Patients with a prior history of CE experienced a greater incidence of preoperative cholangitis (75% vs 22.9%, P < 0.0001), had more complicated presentations (75% vs 40.5%, P = 0.007), and were more likely to have synchronous biliary cancer (31.3% vs 6.2%, P = 0.004) than patients without a prior CE. Overall morbidity (75% vs 33.5%; P < 0.0008), severe complications (43.8% vs 11.9%; P = 0.0026) and reoperation rates (37.5% vs 8.8%; P = 0.0032) were also significantly greater in patients with previous CE, and their Mayo Risk Score, during a median follow-up of 37.5 mo (range: 4-372 mo) indicated significantly more patients with fair and poor results (46.1% vs 15.6%; P = 0.0136). CONCLUSION: This is the large series to show that previous CE is associated with poorer short- and long-term results after Todani types I and IVb BDC resection. PMID:27358675

  15. Suicidal Imagery in a Previously Depressed Community Sample

    PubMed Central

    Crane, Catherine; Shah, Dhruvi; Barnhofer, Thorsten; Holmes, Emily A.

    2015-01-01

    This study sought to replicate previous findings of vivid suicide-related imagery in previously suicidal patients in a community sample of adults with a history of depression. Twenty-seven participants were interviewed regarding suicidal imagery. Seventeen participants reported prior suicidal ideation or behaviour in the clinical assessment, and the vast majority of these also reported experiencing suicide-related imagery when at their most depressed and despairing, in many cases in the form of flash-forwards to imagined future suicidal acts. Interestingly, five of the 10 participants who did not report suicidal ideation or behaviour in the clinical interview also described prominent imagery related to themes of death and suicide, but in several cases, these images were associated with meanings that seemed to act to reduce the likelihood of subsequent suicidal acts. Severity of prior suicidality was associated with lower levels of imagery-related distress and higher levels of imagery-related comfort. These findings support the idea that suicide-related imagery is an important component in the phenomenology of depression and despair and hint at potentially important differences in the meaning associated with such imagery between those individuals who report experiencing suicidal ideation or behaviour when depressed and those who do not. The findings are consistent with Joiner’s model of acquired capability for suicide through habituation to pain and fear of suicide and suggest that it may be useful to tackle such imagery directly in the treatment of suicidal patients. PMID:21254309

  16. Clinical Knowledge from Observational Studies: Everything You Wanted to Know but Were Afraid to Ask.

    PubMed

    Gershon, Andrea S; Jafarzadeh, S Reza; Wilson, Kevin C; Walkey, Allan J

    2018-05-07

    Well-done randomized trials provide accurate estimates of treatment effect by producing groups that are similar on all measures except for the intervention of interest. However, inferences of efficacy in tightly-controlled experimental settings may not translate into similar effectiveness in real-world settings. Observational studies generally enable inferences over a wider range of patient characteristics and evaluation of a broader range of outcomes over a longer period than randomized trials. However, clinicians are often reluctant to incorporate the findings of observational studies into clinical practice. Reason for uncertainty regarding observational studies include a lack of familiarity with observational research methods, occasional disagreements between results of observational studies and randomized trials, the perceived risk of spurious results from systematic bias, and prior teaching that randomized trials are the most reliable source of medical evidence. We propose that a better understanding of observational research will enhance clinicians' ability to distinguish reliable observational studies from those that are subjected to biases and, therefore, provide more confidence to apply observational research results into clinical practice when appropriate. Herein, we explain why observational studies may be perceived as less conclusive than randomized trials, address situations in which observational research and randomized trials produced different findings, and provide information on observational study design so that quality can be evaluated. We conclude that observational research is a valuable source of medical evidence and that clinical action is strongest when supported by both high quality observational studies and randomized trials.

  17. ASCA observations of SS Cygni during an anomalous outburst

    NASA Technical Reports Server (NTRS)

    Nousek, John A.; Baluta, Christopher J.; Corbet, Robin H. D.; Mukai, Koji; Osborne, Julian P.; Ishida, Manabu

    1994-01-01

    SS Cygni was observed by the ASCA satellite on 1993 May 27, the first cataclysmic variable studied by ASCA. The observations were conducted while the system was in an outburst of the 'anomalous' variety. The SIS spectrum cannot be explained by two-temperature Raymond-Smith coronal plasma models as invoked in previous studies with lower spectral resolution. Significantly better agreement is found for models with plasma emission at kT = 0.8, 3.5 keV and thermal bremsstrahlung at kT = 18 keV. The gas imaging spectrometer (GIS) data are consistent with the solid state imaging spectrometer (SIS) data, showing evidence for Fe line emission but showing no evidence of pulsation over times ranging from seconds to minutes. These observations seem at variance with standard theory in two regards: we simultaneously see hard X-rays and optically thin soft X-rays while the system is in outburst, and we see a nonsmooth emission measure distribution. We speculate on possible scenarios which might resolve these differences.

  18. Photometric observations of comet P/Giacobini-Zinner

    NASA Technical Reports Server (NTRS)

    Schleicher, D. G.; Millis, R. L.; Birch, P. V.

    1987-01-01

    Narrow-band filter photometry of comet P/Giacobini-Zinner was obtained on 15 nights at Lowell Observatory in the interval from June 15 to Nov. 20, 1985. The emission bands of OH, NH, CN, C3, and C2 were isolated, along with continuum points at 3650 A and 4845 A. All observed species showed pronounced asymmetry about perihelion, with preperihelion abundances being greater by more than a factor of 2 than postperihelion abundances over the heliocentric distance range of 1.0-1.5 AU. The characteristics of the asymmetry were significantly different than observed in previous apparitions, with the peak production rates occurring in late July/early August. The unusually low C2/CN abundance ratio seen in previous apparitions is confirmed by the present observations. Furthermore, the QH data demonstrate that the C2 in Giacobini-Zinner (along with C3 and NH) is depleted when compared to water (the dominant species), rather than CN being unusually over abundant.

  19. Healthcare outcomes assessed with observational study designs compared with those assessed in randomized trials.

    PubMed

    Anglemyer, Andrew; Horvath, Hacsi T; Bero, Lisa

    2014-04-29

    Researchers and organizations often use evidence from randomized controlled trials (RCTs) to determine the efficacy of a treatment or intervention under ideal conditions. Studies of observational designs are often used to measure the effectiveness of an intervention in 'real world' scenarios. Numerous study designs and modifications of existing designs, including both randomized and observational, are used for comparative effectiveness research in an attempt to give an unbiased estimate of whether one treatment is more effective or safer than another for a particular population.A systematic analysis of study design features, risk of bias, parameter interpretation, and effect size for all types of randomized and non-experimental observational studies is needed to identify specific differences in design types and potential biases. This review summarizes the results of methodological reviews that compare the outcomes of observational studies with randomized trials addressing the same question, as well as methodological reviews that compare the outcomes of different types of observational studies. To assess the impact of study design (including RCTs versus observational study designs) on the effect measures estimated.To explore methodological variables that might explain any differences identified.To identify gaps in the existing research comparing study designs. We searched seven electronic databases, from January 1990 to December 2013.Along with MeSH terms and relevant keywords, we used the sensitivity-specificity balanced version of a validated strategy to identify reviews in PubMed, augmented with one term ("review" in article titles) so that it better targeted narrative reviews. No language restrictions were applied. We examined systematic reviews that were designed as methodological reviews to compare quantitative effect size estimates measuring efficacy or effectiveness of interventions tested in trials with those tested in observational studies

  20. Observational study on the efficacy of adalimumab for the treatment of ulcerative colitis and predictors of outcome.

    PubMed

    García-Bosch, Orlando; Gisbert, Javier P; Cañas-Ventura, Alex; Merino, Olga; Cabriada, José L; García-Sánchez, Valle; Gutiérrez, Ana; Nos, Pilar; Peñalva, Mireia; Hinojosa, Joaquin; García-Planella, Esther; Muñoz, Fernando; Calvet, Xavier; Panés, Julián

    2013-10-01

    Information on efficacy and predictors of response to adalimumab in ulcerative colitis (UC) clinical practice is limited. Assessment of response to adalimumab and its predictors in an observational cohort study. Retrospective cohort study based on data obtained from ENEIDA registry. All patients diagnosed with UC treated with adalimumab were included. Response to adalimumab was evaluated at weeks 12, 28, and 54 according to the partial Mayo score, and requirement of colectomy until end of follow-up. 48 patients with UC treated with adalimumab were included; 39 (81.3%) had previously received infliximab. Response rates at weeks 12, 28 and 54 were 70.8%, 43.2% and 35% respectively. Response to prior treatment with infliximab was the only predictive factor of response to adalimumab at week 12, which was obtained in 90% of infliximab remitters, 53.8% of responders and 33.3% of primary non-responders (p=0.01). Colectomy was required in 11 patients (22.9%), after a mean time of 205 days. The only clinical independent predictor of colectomy was non-response to adalimumab at week 12: colectomy rates were 5/34 (14.7%) in responders and 6/14 (42.9%) in non-responders (p=0.035), time free of colectomy was significantly reduced in non-responders (p=0.01). Adalimumab withdrawal due to adverse events occurred in 4.2% of patients. This study shows that adalimumab is an effective treatment in patients with UC. If used as a second anti-TNF, previous achievement of remission with the first anti-TNF predicts response, and failure to achieve response at week 12 predicts colectomy. Copyright © 2012 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.