Early Elevation of Serum TNFα is Associated with Poor Outcome in Subarachnoid Hemorrhage

PubMed Central

Chou, Sherry HY.; Feske, Steven K.; Atherton, Juli; Konigsberg, Rachael G.; De Jager, Philip L.; Du, Rose; Lo, Eng H.; Ning, MingMing

2013-01-01

Objective Subarachnoid hemorrhage (SAH) is associated with inflammation which may mediate poor outcome in SAH. We hypothesize that elevated serum tumor necrosis factor-alpha (TNFα) and interleukin-6 (IL-6) are associated with vasospasm and poor outcome in SAH. Methods In 52 consecutive SAH subjects, we compared TNFα and IL-6 levels on post-SAH days 0–1, 2–3, 4–5, 6–8, and 10–14 with respect to vasospasm and to poor outcome at 3- and 6-months. Vasospasm was defined as >50% reduction in vessel caliber on angiography. Poor outcome was defined as modified Rankin score >2. Results Elevated TNFα on post-SAH days 2–3 was associated with poor 3-month outcome (p=0.0004). Global elevation of TNFα over time (post-SAH days 0–14) was independently associated with poor 3-month outcome after adjusting for Hunt-and-Hess grade and age (p=0.02). Neither cross-sectional nor IL-6 levels over time were associated with outcome. Neither TNFα nor IL-6 levels were associated with vasospasm. Conclusions Elevation in serum TNFα on post-SAH days 2–3 and global elevation of TNFα over time are associated with poor outcome but not with angiographic vasospasm in this small cohort. Future studies are needed to define the role of TNFα in SAH-related brain injury and its potential as a SAH outcome biomarker. PMID:22918199

Lidar monitoring of regions of intense backscatter with poorly defined boundaries

Treesearch

Vladimir A. Kovalev; Alexander Petkov; Cyle Wold; WeiMin Hao

2011-01-01

The upper height of a region of intense backscatter with a poorly defined boundary between this region and a region of clear air above it is found as the maximal height where aerosol heterogeneity is detectable, that is, where it can be discriminated from noise. The theoretical basis behind the retrieval technique and the corresponding lidar-data-processing procedures...

Introduction and historical perspective.

PubMed

Gunning, Peter

2008-01-01

Tropomyosin is a coiled coil dimer which forms a polymer along the major groove of the majority of actin filaments. It is therefore one of the two primary components of the actin filament. Our understanding of the biological function of tropomyosin has been driven almost entirely by its role in striated muscle. This reflects both its original discovery as part of the thin filament in skeletal muscle and its pivotal role in regulating muscle contraction. In contrast, its role in the function of the cytoskeleton of all cells has been poorly understood due, at least in part, to the technical challenge of deciphering the function of a large number of isoforms. This book has brought together many of the leading researchers who have defined the function of tropomyosin in both normal and pathological conditions. Each author brings their own perspective in a series of stand alone reviews of the areas of tropomyosin research they have played a major role in defining.

Application of response surface methodology to maximize the productivity of scalable automated human embryonic stem cell manufacture.

PubMed

Ratcliffe, Elizabeth; Hourd, Paul; Guijarro-Leach, Juan; Rayment, Erin; Williams, David J; Thomas, Robert J

2013-01-01

Commercial regenerative medicine will require large quantities of clinical-specification human cells. The cost and quality of manufacture is notoriously difficult to control due to highly complex processes with poorly defined tolerances. As a step to overcome this, we aimed to demonstrate the use of 'quality-by-design' tools to define the operating space for economic passage of a scalable human embryonic stem cell production method with minimal cell loss. Design of experiments response surface methodology was applied to generate empirical models to predict optimal operating conditions for a unit of manufacture of a previously developed automatable and scalable human embryonic stem cell production method. Two models were defined to predict cell yield and cell recovery rate postpassage, in terms of the predictor variables of media volume, cell seeding density, media exchange and length of passage. Predicted operating conditions for maximized productivity were successfully validated. Such 'quality-by-design' type approaches to process design and optimization will be essential to reduce the risk of product failure and patient harm, and to build regulatory confidence in cell therapy manufacturing processes.

A STUDY OF LONGITUDINAL PATTERNS OF FAILURE AMONG HIGH SCHOOL DROP-OUTS AND POORLY PERFORMING GRADUATES.

ERIC Educational Resources Information Center

STOLLER, DAVID S.

THE RELATIONSHIP BETWEEN PATTERNS OF POOR PERFORMANCE AND SIGNIFICANT DISTINGUISHING FACTORS WHICH MIGHT IDENTIFY DROPOUTS IS EXPLORED. DATA WERE OBTAINED ON 270 STUDENTS (FROM A PARENT POPULATION OF 2,500) WHO WERE POOR PERFORMERS (POOR PERFORMANCE BEING DEFINED AS THREE "D'S" OR "F'S" IN HIGH SCHOOL). THE VAST MAJORITY OF…

YouScript IMPACT Registry

ClinicalTrials.gov

2017-02-27

Adverse Drug Events; Adverse Drug Reactions; Drug Interaction Potentiation; Drug Metabolism, Poor, CYP2D6-RELATED; Drug Metabolism, Poor, CYP2C19-RELATED; Cytochrome P450 Enzyme Deficiency; Cytochrome P450 CYP2D6 Enzyme Deficiency; Cytochrome P450 CYP2C9 Enzyme Deficiency; Cytochrome P450 CYP2C19 Enzyme Deficiency; Cytochrome P450 CYP3A Enzyme Deficiency; Poor Metabolizer Due to Cytochrome P450 CYP2C9 Variant; Poor Metabolizer Due to Cytochrome P450 CYP2C19 Variant; Poor Metabolizer Due to Cytochrome P450 CYP2D6 Variant

Pharmacogenetic Testing Among Home Health Patients

ClinicalTrials.gov

2016-09-20

Adverse Drug Events; Adverse Drug Reactions; Drug Interaction Potentiation; Drug Metabolism, Poor, CYP2D6-RELATED; Drug Metabolism, Poor, CYP2C19-RELATED; Cytochrome P450 Enzyme Deficiency; Cytochrome P450 CYP2D6 Enzyme Deficiency; Cytochrome P450 CYP2C9 Enzyme Deficiency; Cytochrome P450 CYP2C19 Enzyme Deficiency; Cytochrome P450 CYP3A Enzyme Deficiency; Poor Metabolizer Due to Cytochrome P450 CYP2C9 Variant; Poor Metabolizer Due to Cytochrome p450 CYP2C19 Variant; Poor Metabolizer Due to Cytochrome P450 CYP2D6 Variant

Interaction of sleep quality and sleep duration on glycemic control in patients with type 2 diabetes mellitus.

PubMed

Tang, Yunzhao; Meng, Lingling; Li, Daiqing; Yang, Min; Zhu, Yanjuan; Li, Chenguang; Jiang, Zhenhuan; Yu, Ping; Li, Zhu; Song, Hongna; Ni, Changlin

2014-01-01

Copious evidence from epidemiological and laboratory studies has revealed that sleep status is associated with glucose intolerance, insulin resistance, thus increasing the risk of developing type 2 diabetes. The aim of this study was to reveal the interaction of sleep quality and sleep quantity on glycemic control in patients with type 2 diabetes mellitus. From May 2013 to May 2014, a total of 551 type 2 diabetes patients in Tianjin Metabolic Diseases Hospital were enrolled. Blood samples were taken to measure glycosylated hemoglobin (HbA1c), and all the patients completed the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) questionnaire to evaluate their sleep status. "Good sleep quality" was defined as PQSI <5, "average sleep quality" was defined as PQSI 6-8, and "poor sleep quality" was defined as PQSI >8. Poor glycemic control was defined as HbA1c ≥7%. Sleep quantity was categorized as <6, 6-8, and >8 hours/night. Short sleep time was defined as sleep duration <6 hours/night. In the poor glycemic control group, the rate of patients who had insufficient sleep was much higher than that in the other group (χ(2) = 11.16, P = 0.037). The rate of poor sleep quality in poor glycemic control group was much greater than that in the average control group (χ(2) = 9.79, P = 0.007). After adjusted by gender, age, body mass index, and disease duration, the adjusted PSQI score's OR was 1.048 (95% CI 1.007-1.092, P = 0.023) for HbA1c level. The sleep duration's OR was 0.464 (95% CI 0.236-0.912, P = 0.026) for HbA1c level. One-way analysis of variance showed that the poor sleep quality group had the highest homeostasis model assessment-insulin resistance (P < 0.01). Inadequate sleep, in both quality and quantity, should be regarded as a plausible risk factor for glycemic control in type 2 diabetes. Poor sleep might bring much more serious insulin resistance and could be the reason for bad glycemic control. A good night's sleep should be seen as a critical health component tool in the prevention and treatment of type 2 diabetes. It is important for clinicians to target the root causes of short sleep duration and/or poor sleep quality.

Global notes: counting the world's poor--how do we define poverty?

PubMed

Vidyasagar, D

2006-06-01

Health professionals are in constant interaction with parents and infants who are victims of poverty and poor socioeconomic status. But an important question remains: do we know how to define poverty? Defining poverty accurately is important as the definition is the basis of policy development. The definition of poverty has changed during the last quarter century. In addition to economic considerations, it is broadened to include other dimensions of life such as literacy, health and longevity. This article attempts to provide national and international definitions of poverty, the magnitude and effects of poverty.

Corrosion and tribocorrosion behavior of Ti-B4C composite intended for orthopaedic implants.

PubMed

Toptan, F; Rego, A; Alves, A C; Guedes, A

2016-08-01

Poor wear resistance of titanium is a major concern since relative movements due to the cyclic loads in body environment cause wear between the bone and the implant material leading to detachment of the wear debris and release of metal ions due to the simultaneous action of corrosion and wear, defined as tribocorrosion. In order to increase the tribocorrosion resistance, Grade 2 Ti matrix 24vol% B4C particle reinforced composites were processed by hot pressing. Corrosion behaviour was investigated by electrochemical impedance spectroscopy and potentiodynamic polarization in 9g/L NaCl solution at body temperature. Tribocorrosion tests were performed under open circuit potential, as well as under potentiodynamic polarization using a reciprocating ball-on-plate tribometer. Results suggested that the addition of B4C particles provided lower tendency to corrosion and lower corrosion kinetics under sliding, along with significantly reduced wear loss, mainly due to the load carrying effect given by the reinforcement particles. Copyright © 2016 Elsevier Ltd. All rights reserved.

Less strained and more efficient GaN light-emitting diodes with embedded silica hollow nanospheres

PubMed Central

Kim, Jonghak; Woo, Heeje; Joo, Kisu; Tae, Sungwon; Park, Jinsub; Moon, Daeyoung; Park, Sung Hyun; Jang, Junghwan; Cho, Yigil; Park, Jucheol; Yuh, Hwankuk; Lee, Gun-Do; Choi, In-Suk; Nanishi, Yasushi; Han, Heung Nam; Char, Kookheon; Yoon, Euijoon

2013-01-01

Light-emitting diodes (LEDs) become an attractive alternative to conventional light sources due to high efficiency and long lifetime. However, different material properties between GaN and sapphire cause several problems such as high defect density in GaN, serious wafer bowing, particularly in large-area wafers, and poor light extraction of GaN-based LEDs. Here, we suggest a new growth strategy for high efficiency LEDs by incorporating silica hollow nanospheres (S-HNS). In this strategy, S-HNSs were introduced as a monolayer on a sapphire substrate and the subsequent growth of GaN by metalorganic chemical vapor deposition results in improved crystal quality due to nano-scale lateral epitaxial overgrowth. Moreover, well-defined voids embedded at the GaN/sapphire interface help scatter lights effectively for improved light extraction, and reduce wafer bowing due to partial alleviation of compressive stress in GaN. The incorporation of S-HNS into LEDs is thus quite advantageous in achieving high efficiency LEDs for solid-state lighting. PMID:24220259

[Non adherence and topical steroids].

PubMed

Aubert, H; Barbarot, S

2012-01-01

Compliance raises very specific questions in dermatology related to the frequent use of local treatments: creams or ointments, including topical corticosteroids. The adherence in dermatology is a complex issue. It is difficult to quantify objectively because of the patient subjectivity, the constant adaptation to changes in the course of the disease, and due to the lack of adapted device. Moreover poor compliance may be related to topical corticosteroid phobia, defined as a fear vis-à-vis the topical corticosteroids, rational or not. The topical corticosteroid phobia is very common in the management of chronic inflammatory skin diseases especially in atopic dermatitis. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

[Health status, use of health services and reported morbidity: application of correspondence analysis].

PubMed

Espinàs, J A; Riba, M D; Borràs, J M; Sánchez, V

1995-01-01

The study of the relationship between self-reported morbidity, health status and health care utilization presents methodological problems due to the variety of illnesses and medical conditions that one individual may report. In this article, correspondence analysis was use to analyse these relationships. Data from the Spanish National Health Survey pertaining to the region of Catalonia was studied. Statistical analysis included multi-way correspondence analysis (MCA) followed by cluster analysis. The first factor extracted is defined by self-assessed health perception; the second, by limitation of activities, and the third is related to self-reported morbidity caused by chronic and acute health problems. Fourth and fifth factors, capture residual variability and missing values. Acute problems are more related to perception of poor health while chronic problems are related to perception of fair health. Also, it may be possible to distinguish self-reported morbidity due to relapses of chronic diseases from true acute health problems. Cluster analysis classified individuals into four groups: 1) healthy people; 2) people who assess their health as being poor and those with acute health problems; 3) people with chronic health problems, limited activity and a perception of fair health; and 4) missing values. Correspondence analysis is a useful tool when analyzing qualitative variables like those in a health survey.

In vitro gastrointestinal lipolysis of four formulations of piroxicam and cinnarizine with the self emulsifying excipients Labrasol and Gelucire 44/14.

PubMed

Fernandez, Sylvie; Chevrier, Stéphanie; Ritter, Nicolas; Mahler, Bruno; Demarne, Frédéric; Carrière, Frédéric; Jannin, Vincent

2009-08-01

Labrasol and Gelucire 44/14 are defined admixtures of acylglycerols and PEG esters which are substrates for digestive lipases. We investigated their in vitro gastrointestinal lipolysis to understand which compounds are, after digestion, responsible for keeping poorly water-soluble drugs in solution. The precipitation of piroxicam and cinnarizine formulated in these excipients during the gastrointestinal lipolysis was also studied. Monoacylglycerols and PEG monoesters are the largest compounds present at the end of gastric phase whereas PEG-monoesters are the largest compounds after the duodenal phase. The precipitation of piroxicam is mainly due to the gastric lipolysis. In the control experiments performed without digestive lipases, cinnarizine formulated in Labrasol was found to precipitate upon dilution of the gastric medium to form the solution mimicking the duodenal medium. In the presence of gastric lipase, Labrasol was hydrolyzed and the precipitation of cinnarizine was not observed in this case. When the cinnarizine was formulated with Gelucire 44/14 the precipitation was only due to the dilution of the gastric medium. Our study highlights the importance of the gastrointestinal lipolysis and the associated phenomena such as the dilution of chyme by biliary and pancreatic secretions in vivo, on the solubilisation of poorly water-soluble drugs formulated with lipid-based excipients.

Self-assembly of model graft copolymers of agarose and weak polyelectrolyte-based amphiphilic diblock copolymers: controlled drug release and degradation.

PubMed

Muppalla, Ravikumar; Jewrajka, Suresh K; Prasad, Kamalesh

2013-06-01

Polysaccharide-based copolymers are promising biomaterials due to their biocompatibility and biodegradability. For potential biomedical applications the copolymer as a whole and all the degraded species must be biocompatible and easily removable from the system. In this regards, new model pH-responsive seaweed agarose (Agr) grafted with weak polyelectrolyte-based well-defined amphiphilic block copolymers ca. poly[(methyl methacrylate)-b-(2-dimethylamino)ethyl methacrylate)] (PMMA-b-PDMA) were designed and synthesized to study the self-assembly, degradation, and in vitro hydrophobic/hydrophilic drug release behavior. The graft copolymer solutions display extremely low critical micelle concentration (CMC) and form pH responsive stable micelles. The degradation study of the graft copolymer reveals that the entire degraded components are well soluble/dispersible in water due to formation of mixed micelles. The micelles are also strongly adsorbed on the mica surface owing to electrostatic interaction. One application of the graft copolymer micelles is that it can entrap both hydrophilic and poorly water soluble hydrophobic drugs effectively and exhibit slow release kinetics. The release kinetics of both the hydrophilic and poorly water soluble hydrophobic drugs change with pH as well as with the composition of the graft copolymer. Copyright © 2012 Wiley Periodicals, Inc.

Dynamic behavior of solar wind as revealed by a correlation study of magnetic fields observed at the Venus and Earth orbits

NASA Technical Reports Server (NTRS)

Marubashi, K.

1995-01-01

Correlations between interplanetary magnetic fields (IMFs) at 0.72 AU and 1.0 AU have been examined using data sets obtained from the Pioneer Venus orbiter and Earth-orbiting spacecraft. While the two-sector structures are evident in long-term variations at these two heliocentric distances, the corresponding auto-correlation coefficients are consistently smaller at 1.0 AU than at 0.72 AU. This suggests that the IMF structures become less persistent at 1.0 AU due to the effects of changing solar wind dynamics between the Venus and Earth orbits. Short-term variations exhibit generally poor correlations between IMFs near Venus and those near Earth, though good correlations are sometimes obtained for well-defined structures when the Sun, Venus, and Earth are closely aligned. The rather poor correlations in the background streams indicate that the IMFs are still changing between the Venus and Earth orbits under the strong influence of solar wind dynamics.

Toward Conceptual Clarity in a Critical Parenting Construct: Parental Monitoring in Youth with Chronic Illness

PubMed Central

Templin, Thomas N.; Naar-King, Sylvie; Frey, Maureen A.

2008-01-01

Parental monitoring has been defined as “a set of correlated parenting behaviors involving attention to and tracking of the child's whereabouts, activities, and adaptations.” This construct is of significant interest due to its relatedness to a broad range of youth risk behaviors, including risky sexual behavior, substance abuse, and poor adherence. However, to date, measures of parental monitoring are largely absent from the chronic illness literature. The present article focuses upon two key problems in the operationalization of the monitoring construct to date: (a) poor conceptual specificity in parenting constructs such as monitoring, overprotection, and over-involvement when used to date among youth with chronic conditions and (b) the confounding of existing measures of parental monitoring with items evaluating parental knowledge of youth activities, which has resulted in a lack of data regarding the mechanisms by which parents obtain their information. Recommendations for the future development of monitoring measures are discussed. PMID:18467352

Autologous hematopoietic stem cell transplantation in peripheral T-cell lymphoma using a uniform high-dose regimen.

PubMed

Smith, S D; Bolwell, B J; Rybicki, L A; Brown, S; Dean, R; Kalaycio, M; Sobecks, R; Andresen, S; Hsi, E D; Pohlman, B; Sweetenham, J W

2007-08-01

The role of high-dose therapy and autologous stem cell transplantation (ASCT) for patients with peripheral T-cell lymphoma (PTCL) is poorly defined. Comparisons of outcomes between PTCL and B-cell non-Hodgkin's lymphoma (NHL) have yielded conflicting results, in part due to the rarity and heterogeneity of PTCL. Some retrospective studies have found comparable survival rates for patients with T- and B-cell NHL. In this study, we report our single-center experience of ASCT over one decade using a uniform chemotherapy-only high-dose regimen. Thirty-two patients with PTCL-unspecified (PTCL-u; 11 patients) and anaplastic large-cell lymphoma (21 patients) underwent autologous stem cell transplant, mostly for relapsed or refractory disease. The preparative regimen consisted of busulfan, etoposide and cyclophosphamide. Kaplan-Meier 5-year overall survival (OS) and relapse-free survival (RFS) are 34 and 18%, respectively. These results suggest a poor outcome for patients with PTCL after ASCT, and new therapies for T-cell lymphoma are needed.

Medical management of ischemic stuttering priapism: a contemporary review of the literature.

PubMed

Levey, Helen R; Kutlu, Omer; Bivalacqua, Trinity J

2012-01-01

Priapism is defined as a prolonged and persistent erection of the penis without sexual stimulation. This is a poorly understood disease process with little information on the pathophysiology of this erectile disorder. Complications from this disorder are devastating due to the irreversible erectile damage and resultant erectile dysfunction (ED). Stuttering priapism, though relatively rare, affects a high prevalence of men with sickle-cell disease (SCD) and presents a challenging problem with guidelines for treatment lacking or resulting in permanent ED. The mechanisms involved in the development of priapism in this cohort are poorly characterized; therefore, medical management of priapism represents a therapeutic challenge to urologists. Additional research is warranted, so we can effectively target treatments for these patients with prevention as the goal. This review gives an introduction to stuttering priapism and its clinical significance, specifically with regards to the patient with SCD. Additionally, the proposed mechanisms behind its pathophysiology and a summary of the current and future targets for medical management are discussed.

The ability of intensive care unit physicians to estimate long-term prognosis in survivors of critical illness.

PubMed

Soliman, Ivo W; Cremer, Olaf L; de Lange, Dylan W; Slooter, Arjen J C; van Delden, Johannes Hans J M; van Dijk, Diederik; Peelen, Linda M

2018-02-01

To assess the reliability of physicians' prognoses for intensive care unit (ICU) survivors with respect to long-term survival and health related quality of life (HRQoL). We performed an observational cohort-study in a single mixed tertiary ICU in The Netherlands. ICU survivors with a length of stay >48h were included. At ICU discharge, one-year prognosis was estimated by physicians using the four-option Sabadell score to record their expectations. The outcome of interest was poor outcome, which was defined as dying within one-year follow-up, or surviving with an EuroQoL5D-3L index <0.4. Among 1399 ICU survivors, 1068 (76%) subjects were expected to have a good outcome; 243 (18%) a poor long-term prognosis; 43 (3%) a poor short-term prognosis, and 45 (3%) to die in hospital (i.e. Sabadell score levels). Poor outcome was observed in 38%, 55%, 86%, and 100% of these groups respectively (concomitant c-index: 0.61). The expected prognosis did not match observed outcome in 365 (36%) patients. This was almost exclusively (99%) due to overoptimism. Physician experience did not affect results. Prognoses estimated by physicians incorrectly predicted long-term survival and HRQoL in one-third of ICU survivors. Moreover, inaccurate prognoses were generally the result of overoptimistic expectations of outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

Genome-scale analysis of the high-efficient protein secretion system of Aspergillus oryzae

PubMed Central

2014-01-01

Background The koji mold, Aspergillus oryzae is widely used for the production of industrial enzymes due to its particularly high protein secretion capacity and ability to perform post-translational modifications. However, systemic analysis of its secretion system is lacking, generally due to the poorly annotated proteome. Results Here we defined a functional protein secretory component list of A. oryzae using a previously reported secretory model of S. cerevisiae as scaffold. Additional secretory components were obtained by blast search with the functional components reported in other closely related fungal species such as Aspergillus nidulans and Aspergillus niger. To evaluate the defined component list, we performed transcriptome analysis on three α-amylase over-producing strains with varying levels of secretion capacities. Specifically, secretory components involved in the ER-associated processes (including components involved in the regulation of transport between ER and Golgi) were significantly up-regulated, with many of them never been identified for A. oryzae before. Furthermore, we defined a complete list of the putative A. oryzae secretome and monitored how it was affected by overproducing amylase. Conclusion In combination with the transcriptome data, the most complete secretory component list and the putative secretome, we improved the systemic understanding of the secretory machinery of A. oryzae in response to high levels of protein secretion. The roles of many newly predicted secretory components were experimentally validated and the enriched component list provides a better platform for driving more mechanistic studies of the protein secretory pathway in this industrially important fungus. PMID:24961398

Genome-scale analysis of the high-efficient protein secretion system of Aspergillus oryzae.

PubMed

Liu, Lifang; Feizi, Amir; Österlund, Tobias; Hjort, Carsten; Nielsen, Jens

2014-06-24

The koji mold, Aspergillus oryzae is widely used for the production of industrial enzymes due to its particularly high protein secretion capacity and ability to perform post-translational modifications. However, systemic analysis of its secretion system is lacking, generally due to the poorly annotated proteome. Here we defined a functional protein secretory component list of A. oryzae using a previously reported secretory model of S. cerevisiae as scaffold. Additional secretory components were obtained by blast search with the functional components reported in other closely related fungal species such as Aspergillus nidulans and Aspergillus niger. To evaluate the defined component list, we performed transcriptome analysis on three α-amylase over-producing strains with varying levels of secretion capacities. Specifically, secretory components involved in the ER-associated processes (including components involved in the regulation of transport between ER and Golgi) were significantly up-regulated, with many of them never been identified for A. oryzae before. Furthermore, we defined a complete list of the putative A. oryzae secretome and monitored how it was affected by overproducing amylase. In combination with the transcriptome data, the most complete secretory component list and the putative secretome, we improved the systemic understanding of the secretory machinery of A. oryzae in response to high levels of protein secretion. The roles of many newly predicted secretory components were experimentally validated and the enriched component list provides a better platform for driving more mechanistic studies of the protein secretory pathway in this industrially important fungus.

Once a Poor Pitch Singer, Always a Poor Pitch Singer? A Bottom up Study of Factors That May Support Singing Development

ERIC Educational Resources Information Center

Turøy, Anne Kristine Wallace

2018-01-01

Approximately 10% of students have singing difficulties appearing as poor pitch singing. During the period 2012 to 2014, I assessed 2390 recordings from 239 students. 25 students were graded below C, and thus were defined as poor pitch singers (PPS). However, these students showed varying patterns of mastery within their own portfolios of…

Pathological anxiety in animals.

PubMed

Ohl, Frauke; Arndt, Saskia S; van der Staay, F Josef

2008-01-01

Selective breeding programmes in domestic and laboratory animals generally focus on physiological and/or anatomical characteristics. However, selection may have an (unintended) impact on other characteristics and may lead to dysfunctional behaviour that can affect biological functioning and, as a consequence, compromise welfare and quality of life. In this review it is proposed that various behavioural dysfunctions in animals are due to pathological anxiety. Although several approaches have been undertaken to specify the diagnostic criteria of pathological anxiety as a behavioural disorder in animals, the causal aetiology largely remains unknown. This is mainly due to the fact that integrated concepts, combining the behavioural syndrome and (neuro-) physiological processes, are widely lacking. Moreover, even the term anxiety itself represents a poorly defined concept or category. A definition is suggested and the potential causes of pathological anxiety are explored with a plea for developing adequate diagnostic tools and therapies to fight pathological anxiety in animals based on insight from scientific research.

Working Poor Families in the Chicago Metropolitan Area. Statistical Profile and Proceedings of the Working Poor Policy Forum (Chicago, Illinois, December 8, 1993).

ERIC Educational Resources Information Center

Latino Inst., Chicago, IL.

A statistical profile of the working poor in Chicago (Illinois) and the proceedings of the Working Poor Policy Forum held to discuss the findings of the profile are presented. In America it is supposed to be impossible to work and remain chronically poor, but in fact this is not the case. There are many ways to define the income working families…

Identification and Manipulation of a Novel Signaling Mechanism to Improve Articular Cartilage Restoration After Posttraumatic Joint Injury

DTIC Science & Technology

2014-10-01

collagen II (COL II). As a result, the newly-formed fibrocartilage has poor biomechanical properties and often evidences poor integration with the... fibrocartilage generation at the site of injury defines a new potential avenue of intervention in the field of cartilage restoration. We defined the...lysophosphatidic acid (LPA)-autotaxin (ATX; encoded by the ENPP2 gene) signaling axis as an important mediator of fibrocartilage formation both in vitro and in

The clinical impact of continuing to prescribe antiretroviral therapy in patients with advanced AIDS who manifest no virologic or immunologic benefit.

PubMed

Wohl, David A; Kendall, Michelle A; Feinberg, Judith; Alston-Smith, Beverly; Owens, Susan; Chafey, Suzette; Marco, Michael; Maxwell, Sharon; Benson, Constance; Keiser, Philip; van der Horst, Charles; Jacobson, Mark A

2013-01-01

Despite the efficacy and tolerability of modern antiretroviral therapy (ART), many patients with advanced AIDS prescribed these regimens do not achieve viral suppression or immune reconstitution as a result of poor adherence, drug resistance, or both. The clinical outcomes of continued ART prescription for such patients have not been well characterized. We examined the causes and predictors of all-cause mortality, AIDS-defining conditions, and serious non-AIDS-defining events among a cohort of participants in a clinical trial of pre-emptive therapy for CMV disease. We focused on participants who, despite ART had failed to achieve virologic suppression and substantive immune reconstitution. 233 ART-receiving participants entered with a median baseline CD4+ T cell count of 30/mm(3) and plasma HIV RNA of 5 log10 copies/mL. During a median 96 weeks of follow-up, 24.0% died (a mortality rate of 10.7/100 patient-years); 27.5% reported a new AIDS-defining condition, and 22.3% a new serious non-AIDS event. Of the deaths, 42.8% were due to an AIDS-defining condition, 44.6% were due to a non-AIDS-defining condition, and 12.5% were of unknown etiology. Decreased risk of mortality was associated with baseline CD4+ T cell count ≥25/mm(3) and lower baseline HIV RNA. Among patients with advanced AIDS prescribed modern ART who achieve neither virologic suppression nor immune reconstitution, crude mortality percentages appear to be lower than reported in cohorts of patients studied a decade earlier. Also, in contrast to the era before modern ART became available, nearly half of the deaths in our modern-era study were caused by serious non-AIDS-defining events. Even among the most advanced AIDS patients who were not obtaining apparent immunologic and virologic benefit from ART, continued prescription of these medications appears to alter the natural history of AIDS--improving survival and shifting the causes of death from AIDS- to non-AIDS-defining conditions.

The age-velocity dispersion relation of the Galactic discs from LAMOST-Gaia data

NASA Astrophysics Data System (ADS)

Yu, Jincheng; Liu, Chao

2018-03-01

We present the age-velocity dispersion relation (AVR) in three dimensions in the solar neighbourhood using 3564 commonly observed sub-giant/red giant branch stars selected from The Large Sky Area Multi-Object Fiber Spectroscopic Telescope, which gives the age and radial velocity, and Gaia, which measures the distance and proper motion. The stars are separated into metal-poor ([Fe/H] < -0.2 dex and metal-rich ([Fe/H] > -0.2 dex) groups, so that the metal-rich stars are mostly α-poor, while the metal-poor group are mostly contributed by α-enhanced stars. Thus, the old and metal-poor stars likely belong to the chemically defined thick disc population, while the metal-rich sample is dominated by the thin disc. The AVR for the metal-poor sample shows an abrupt increase at ≳7 Gyr, which is contributed by the thick disc component. On the other hand, most of the thin disc stars with [Fe/H] > -0.2 dex display a power-law-like AVR with indices of about 0.3-0.4 and 0.5 for the in-plane and vertical dispersions, respectively. This is consistent with the scenario that the disc is gradually heated by the spiral arms and/or the giant molecular clouds. Moreover, the older thin disc stars (>7 Gyr) have a rounder velocity ellipsoid, i.e. σϕ/σz is close to 1.0, probably due to the more efficient heating in vertical direction. Particularly for the old metal-poor sample located with |z| > 270 pc, the vertical dispersion is even larger than its azimuthal counterpart. Finally, the vertex deviations and the tilt angles are plausibly around zero with large uncertainties.

Inequality decomposition and geographic targeting with applications to China and Vietnam.

PubMed

Wagstaff, Adam

2005-06-01

How far are income-related inequalities in the health sector due to gaps between poor and less poor areas, rather than due to differences between poor and less poor people within areas? This note sets out a method for answering this question, and illustrates it with two empirical examples. The disproportionate accrual of health subsidies to Vietnam's better-off is found to be largely due to the fact that richer provinces have larger per capita subsidies, while pro-rich inequalities in health insurance coverage in rural China are found to be largely due to the fact that better-off villages have been more successful at preventing the collapse of their insurance schemes. Copyright 2005 John Wiley & Sons, Ltd.

Classification and definition of premature ejaculation.

PubMed

Parnham, Arie; Serefoglu, Ege Can

2016-08-01

Premature ejaculation (PE) is a poorly understood condition and is considered as the most common sexual disorder in men. The ambiguity surrounding PE is in part due to the difficulty in conducting and interpreting research in the absence of a standardised definition that adequately encompasses the characteristics of these patients. An enhanced awareness of sexual dysfunctions in the recent decades has lead to an increase in scientific research that has challenged the traditional paradigm regarding PE. This has also enabled to establish a universal definition and classification of the disease. A move to a more evidence based approach has improved the clinicians' ability to define those who need medical treatment, as well as perform further research in this complex condition.

Decalogue of the Spanish Society of Arteriosclerosis to reduce therapeutic inertia.

PubMed

Blasco, Mariano; Pérez-Martínez, Pablo; Lahoz, Carlos

Therapeutic inertia (TI) is defined as the failure of the physician to initiate or intensify a treatment when the therapeutic goal has not been achieved. TI can be of 2types: inertia due to lack of prescription of drugs and inertia in the absence of control of a risk factor. The consequences of TI are poor control of risk factors, an increase in potentially preventable events and an increase in costs. There are factors of the doctor himself, the patient and the care organization that determine the presence of TI. Ten measures are proposed to reduce TI: to promote continuing education, to define clearly therapeutic objectives, to establish audits, to implement computerized medical records with alerts, to encourage research in this field, to disseminate clinical practice guidelines, to create motivational incentives, to organize care, to improve the doctor-patient relationship and to involve other health care providers. Copyright © 2017 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. All rights reserved.

Assessment of Environmental Enteropathy in the MAL-ED Cohort Study: Theoretical and Analytic Framework

PubMed Central

Kosek, Margaret; Guerrant, Richard L.; Kang, Gagandeep; Bhutta, Zulfiqar; Yori, Pablo Peñataro; Gratz, Jean; Gottlieb, Michael; Lang, Dennis; Lee, Gwenyth; Haque, Rashidul; Mason, Carl J.; Ahmed, Tahmeed; Lima, Aldo; Petri, William A.; Houpt, Eric; Olortegui, Maribel Paredes; Seidman, Jessica C.; Mduma, Estomih; Samie, Amidou; Babji, Sudhir

2014-01-01

Individuals in the developing world live in conditions of intense exposure to enteric pathogens due to suboptimal water and sanitation. These environmental conditions lead to alterations in intestinal structure, function, and local and systemic immune activation that are collectively referred to as environmental enteropathy (EE). This condition, although poorly defined, is likely to be exacerbated by undernutrition as well as being responsible for permanent growth deficits acquired in early childhood, vaccine failure, and loss of human potential. This article addresses the underlying theoretical and analytical frameworks informing the methodology proposed by the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) cohort study to define and quantify the burden of disease caused by EE within a multisite cohort. Additionally, we will discuss efforts to improve, standardize, and harmonize laboratory practices within the MAL-ED Network. These efforts will address current limitations in the understanding of EE and its burden on children in the developing world. PMID:25305293

Contrast enema findings in patients presenting with poor functional outcome after primary repair for Hirschsprung disease.

PubMed

Garrett, Kevin M; Levitt, Marc A; Peña, Alberto; Kraus, Steven J

2012-09-01

The radiologic evaluation of Hirschsprung disease is well described in the literature. However, there is a paucity of literature describing the appearance of the neo-rectum and colon after repair, specifically describing findings in patients with poor functional outcome, which would suggest the need for reoperation. We describe findings on contrast enema and correlate them with surgical findings at reoperation in children with poor functional outcome after primary repair for Hirschsprung disease who suffer from bowel dysfunction that can manifest with either soiling or obstructive symptoms such as enterocolitis. Children were identified from our colorectal surgery database. At the time of abstract submission, 35 children had contrast enemas prior to reoperation. Additional children continue to present for evaluation. The majority of children included in the study had their primary repair performed elsewhere. The initial procedures included: Duhamel (n = 11), Soave (n = 20) or Swenson (n = 3). One child had undergone a primary Soave repair and subsequently had a Swenson-type reoperation but continued to have a poor outcome. One child's initial surgical repair could not be determined. Images were reviewed by a staff pediatric radiologist and a pediatric radiology fellow. Findings encountered on contrast enema in these children include a distal narrowed segment due to stricture or aganglionic/transitional zone segment (8), dilated/hypomotile distal segment (7), thickened presacral space due to compressing Soave cuff (11), dilated Duhamel pouch (8), active enterocolitis (3) and partially obstructing twist of the pull-through segment (1). Multiple anatomical and pathological complications exist that can lead to bowel dysfunction in children after repair of Hirschsprung disease. Little recent literature exists regarding the radiographic findings in children. We had the opportunity to review a substantial series of these children, describe the contrast enema findings in these difficult cases and correlate them with operative findings. Radiologic evaluation is key to assessing such patients; it defines the potential anatomical problem with the pull-through and facilitates surgical planning.

Defining the impact of non-native species.

PubMed

Jeschke, Jonathan M; Bacher, Sven; Blackburn, Tim M; Dick, Jaimie T A; Essl, Franz; Evans, Thomas; Gaertner, Mirijam; Hulme, Philip E; Kühn, Ingolf; Mrugała, Agata; Pergl, Jan; Pyšek, Petr; Rabitsch, Wolfgang; Ricciardi, Anthony; Richardson, David M; Sendek, Agnieszka; Vilà, Montserrat; Winter, Marten; Kumschick, Sabrina

2014-10-01

Non-native species cause changes in the ecosystems to which they are introduced. These changes, or some of them, are usually termed impacts; they can be manifold and potentially damaging to ecosystems and biodiversity. However, the impacts of most non-native species are poorly understood, and a synthesis of available information is being hindered because authors often do not clearly define impact. We argue that explicitly defining the impact of non-native species will promote progress toward a better understanding of the implications of changes to biodiversity and ecosystems caused by non-native species; help disentangle which aspects of scientific debates about non-native species are due to disparate definitions and which represent true scientific discord; and improve communication between scientists from different research disciplines and between scientists, managers, and policy makers. For these reasons and based on examples from the literature, we devised seven key questions that fall into 4 categories: directionality, classification and measurement, ecological or socio-economic changes, and scale. These questions should help in formulating clear and practical definitions of impact to suit specific scientific, stakeholder, or legislative contexts. © 2014 The Authors. Conservation Biology published by Wiley Periodicals, Inc., on behalf of the Society for Conservation Biology.

Multisensory Self-Motion Compensation During Object Trajectory Judgments

PubMed Central

Dokka, Kalpana; MacNeilage, Paul R.; DeAngelis, Gregory C.; Angelaki, Dora E.

2015-01-01

Judging object trajectory during self-motion is a fundamental ability for mobile organisms interacting with their environment. This fundamental ability requires the nervous system to compensate for the visual consequences of self-motion in order to make accurate judgments, but the mechanisms of this compensation are poorly understood. We comprehensively examined both the accuracy and precision of observers' ability to judge object trajectory in the world when self-motion was defined by vestibular, visual, or combined visual–vestibular cues. Without decision feedback, subjects demonstrated no compensation for self-motion that was defined solely by vestibular cues, partial compensation (47%) for visually defined self-motion, and significantly greater compensation (58%) during combined visual–vestibular self-motion. With decision feedback, subjects learned to accurately judge object trajectory in the world, and this generalized to novel self-motion speeds. Across conditions, greater compensation for self-motion was associated with decreased precision of object trajectory judgments, indicating that self-motion compensation comes at the cost of reduced discriminability. Our findings suggest that the brain can flexibly represent object trajectory relative to either the observer or the world, but a world-centered representation comes at the cost of decreased precision due to the inclusion of noisy self-motion signals. PMID:24062317

A business planning model to identify new safety net clinic locations.

PubMed

Langabeer, James; Helton, Jeffrey; DelliFraine, Jami; Dotson, Ebbin; Watts, Carolyn; Love, Karen

2014-01-01

Community health clinics serving the poor and underserved are geographically expanding due to changes in U.S. health care policy. This paper describes the experience of a collaborative alliance of health care providers in a large metropolitan area who develop a conceptual and mathematical decision model to guide decisions on expanding its network of community health clinics. Community stakeholders participated in a collaborative process that defined constructs they deemed important in guiding decisions on the location of community health clinics. This collaboration also defined key variables within each construct. Scores for variables within each construct were then totaled and weighted into a community-specific optimal space planning equation. This analysis relied entirely on secondary data available from published sources. The model built from this collaboration revolved around the constructs of demand, sustainability, and competition. It used publicly available data defining variables within each construct to arrive at an optimal location that maximized demand and sustainability and minimized competition. This is a model that safety net clinic planners and community stakeholders can use to analyze demographic and utilization data to optimize capacity expansion to serve uninsured and Medicaid populations. Communities can use this innovative model to develop a locally relevant clinic location-planning framework.

Defining Social Class Across Time and Between Groups.

PubMed

Cohen, Dov; Shin, Faith; Liu, Xi; Ondish, Peter; Kraus, Michael W

2017-11-01

We examined changes over four decades and between ethnic groups in how people define their social class. Changes included the increasing importance of income, decreasing importance of occupational prestige, and the demise of the "Victorian bargain," in which poor people who subscribed to conservative sexual and religious norms could think of themselves as middle class. The period also saw changes (among Whites) and continuity (among Black Americans) in subjective status perceptions. For Whites (and particularly poor Whites), their perceptions of enhanced social class were greatly reduced. Poor Whites now view their social class as slightly but significantly lower than their poor Black and Latino counterparts. For Black respondents, a caste-like understanding of social class persisted, as they continued to view their class standing as relatively independent of their achieved education, income, and occupation. Such achievement indicators, however, predicted Black respondents' self-esteem more than they predicted self-esteem for any other group.

Defining Hardwood Veneer Log Quality Attributes

Treesearch

Jan Wiedenbeck; Michael Wiemann; Delton Alderman; John Baumgras; William Luppold

2004-01-01

This publication provides a broad spectrum of information on the hardwood veneer industry in North America. Veneer manufacturers and their customers impose guidelines in specifying wood quality attributes that are very discriminating but poorly defined (e.g., exceptional color, texture, and/or figure characteristics). To better understand and begin to define the most...

Does age modify the association between physical work demands and deterioration of self-rated general health?

PubMed

Burr, Hermann; Pohrt, Anne; Rugulies, Reiner; Holtermann, Andreas; Hasselhorn, Hans Martin

2017-05-01

Objective Due to the growing proportion of older employees in the work force in several countries, the importance of age in the association between work and health is becoming increasingly relevant. Few studies have investigated whether age modifies the association of physical work demands with health. We hypothesized that the association of demanding body postures with deteriorated self-rated health (SRH) is stronger among older employees than among younger employees. Method We analyzed three 5-year cohorts in the Danish Work Environment Cohort Study comprising 8318 observations from 5204 employees (follow-up participation rate 83%) with good baseline SRH. Physical work demands were assessed as demanding body postures. Age was divided into tertiles; young (18-32 years), middle-aged (33-43 years) and old (44-59 among men and 44-54 years among women). Poor SRH ("fairly good", "poor", and "very poor") was measured with a single item. Log binomial regressions were stratified by gender. Effect modification (ie, interaction) was defined as deviation from additivity and examined by calculating the relative excess risk due to interaction (RERI). The reference group was employees aged 18-32 years with low physical exposure. Results When predicting deterioration of SRH, an interaction between demanding body postures and age was found among men [RERI: 0.75, 95% confidence interval (95% CI) 0.16-1.34, regarding the age group 44-59 years] and among women (RERI: 0.84, 95% CI 0.19-1.34, for the age group 33-43 years; and 1.17, 95% CI 0.42-1.93, for the age group 44-54 years). Conclusion The study findings suggest that demanding body postures have a stronger impact on health among older compared to younger employees.

"Crowdsourcing" ten years in: A review.

PubMed

Wazny, Kerri

2017-12-01

First coined by Howe in 2006, the field of crowdsourcing has grown exponentially. Despite its growth and its transcendence across many fields, the definition of crowdsourcing has still not been agreed upon, and examples are poorly indexed in peer-reviewed literature. Many examples of crowdsourcing have not been scaled-up past the pilot phase. In spite of this, crowdsourcing has great potential, especially in global health where resources are lacking. This narrative review seeks to review both indexed and grey crowdsourcing literature broadly in order to explore the current state of the field. This is a review of reviews of crowdsourcing. Semantic searches were conducted using Google Scholar rather than indexed databases due to poor indexing of the topic. 996 articles were retrieved, of which 69 were initially identified as being reviews or theoretically-based. 21 of these were found to be irrelevant and 48 articles were reviewed. This narrative review focuses on defining crowdsourcing, taxonomies of crowdsourcing, who constitutes the crowd, research that is amenable to crowdsourcing, regulatory and ethical aspects of crowdsourcing and some notable examples of crowdsourcing. Crowdsourcing has the potential to be hugely promising, especially in global health, due to its ability to collect information rapidly, inexpensively and accurately. Rigorous ethical and regulatory controls are needed to ensure data are collected and analysed appropriately and crowdsourcing should be considered complementary to traditional research methods.

Penetrating head injuries in children due to BB and pellet guns: a poorly recognized public health risk.

PubMed

Kumar, Ravi; Kumar, Ramesh; Mallory, Grant W; Jacob, Jeffrey T; Daniels, David J; Wetjen, Nicholas M; Foy, Andrew B; O'Neill, Brent R; Clarke, Michelle J

2015-10-23

OBJECT Nonpowder guns, defined as spring- or gas-powered BB or pellet guns, can be dangerous weapons that are often marketed to children. In recent decades, advances in compressed-gas technology have led to a significant increase in the power and muzzle velocity of these weapons. The risk of intracranial injury in children due to nonpowder weapons is poorly documented. METHODS A retrospective review was conducted at 3 institutions studying children 16 years or younger who had intracranial injuries secondary to nonpowder guns. RESULTS The authors reviewed 14 cases of intracranial injury in children from 3 institutions. Eleven (79%) of the 14 children were injured by BB guns, while 3 (21%) were injured by pellet guns. In 10 (71%) children, the injury was accidental. There was 1 recognized assault, but there were no suicide attempts; in the remaining 3 patients, the intention was indeterminate. There were no mortalities among the patients in this series. Ten (71%) of the children required operative intervention, and 6 (43%) were left with permanent neurological injuries, including epilepsy, cognitive deficits, hydrocephalus, diplopia, visual field cut, and blindness. CONCLUSIONS Nonpowder guns are weapons with the ability to penetrate a child's skull and brain. Awareness should be raised among parents, children, and policy makers as to the risk posed by these weapons.

“Crowdsourcing” ten years in: A review

PubMed Central

Wazny, Kerri

2017-01-01

Background First coined by Howe in 2006, the field of crowdsourcing has grown exponentially. Despite its growth and its transcendence across many fields, the definition of crowdsourcing has still not been agreed upon, and examples are poorly indexed in peer–reviewed literature. Many examples of crowdsourcing have not been scaled–up past the pilot phase. In spite of this, crowdsourcing has great potential, especially in global health where resources are lacking. This narrative review seeks to review both indexed and grey crowdsourcing literature broadly in order to explore the current state of the field. Methods This is a review of reviews of crowdsourcing. Semantic searches were conducted using Google Scholar rather than indexed databases due to poor indexing of the topic. 996 articles were retrieved, of which 69 were initially identified as being reviews or theoretically–based. 21 of these were found to be irrelevant and 48 articles were reviewed. Results This narrative review focuses on defining crowdsourcing, taxonomies of crowdsourcing, who constitutes the crowd, research that is amenable to crowdsourcing, regulatory and ethical aspects of crowdsourcing and some notable examples of crowdsourcing. Conclusions Crowdsourcing has the potential to be hugely promising, especially in global health, due to its ability to collect information rapidly, inexpensively and accurately. Rigorous ethical and regulatory controls are needed to ensure data are collected and analysed appropriately and crowdsourcing should be considered complementary to traditional research methods. PMID:29302322

Concurrent hyperthyroidism and papillary thyroid cancer: a fortuitous and ambiguous case report from a resource-poor setting.

PubMed

Kadia, Benjamin Momo; Dimala, Christian Akem; Bechem, Ndemazie Nkafu; Aroke, Desmond

2016-07-26

Concurrent thyroid cancer (TC) and hyperthyroidism (HT) is rare though increasingly being reported. HT due to TC is much rarer and more challenging especially in Africa where TC and HT have significant case fatality rates. We present a 37-year-old Cameroonian female who had been on irregular regimens of propranolol and digoxin as treatment for worsening palpitations for 12 months. She came to our district hospital for her propranolol medication refill. We fortuitously identified features of HT and found a left uninodular goiter with no cervical lymphadenopathy. She was referred for thyroid assessment which suggested primary HT and an enlarged heterogeneous left lobe with a well-defined homogenous solid mass. We restarted her on propranolol and referred her for a course of methimazole. At the referral hospital, she also underwent a left thyroid lobectomy. The resected lobe was sent for histopathology which revealed a neoplastic nodule with features suggestive of a papillary thyroid cancer (PTC) causing HT. The patient's clinical progress postoperatively was good and there was regression of hyperthyroid symptoms. The historical, clinical, and laboratory findings were suggestive of HT due to PTC. A high index of suspicion, prompt referral and counter-referral lead to a positive outcome of such a rare case in a resource poor setting. We advocate for systematic and careful evaluation of all thyroid nodules.

IVF outcomes in average- and poor-prognosis infertile women according to the number of embryos transferred.

PubMed

Vega, Mario G; Gleicher, Norbert; Darmon, Sarah K; Weghofer, Andrea; Wu, Yan-Guang; Wang, Qi; Zhang, Lin; Albertini, David F; Barad, David H; Kushnir, Vitaly A

2016-09-01

Outcome measures of IVF success, which account for effectiveness of IVF and perinatal outcome risks, have recently been described. The association between number of embryos transferred in average and poor-prognosis IVF patients, and the chances of having good or poor IVF and perinatal outcomes, was investigated. Good IVF and perinatal outcome was defined as the birth of a live, term, normal-weight infant (≥2500 g). Poor IVF and perinatal outcome was defined as no live birth or birth of a very low weight neonate (<1500 g) or severe prematurity (birth at <32 weeks gestation). Each neonate was analysed as a separate outcome. A total of 713 IVF cycles in 504 average and poor-prognosis patients from January 2010 to December 2013 were identified. The odds of having good IVF and perinatal outcomes increased by 28% for each additional embryo transferred. The odds of poor IVF and perinatal outcome decreased by 32% with an additional embryo transferred. The likelihood of live birth with good perinatal outcome in average- and poor-prognosis patients after IVF increases with additional embryos being transferred. These data add to recently reported evidence in favour of multiple embryo transfer in older women and those with average or poor IVF prognosis. Copyright © 2016 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Highly specific reasons for nonadherence to antiretroviral therapy: results from the German adherence study.

PubMed

Boretzki, Johanna; Wolf, Eva; Wiese, Carmen; Noe, Sebastian; Balogh, Annamaria; Meurer, Anja; Krznaric, Ivanka; Zink, Alexander; Lersch, Christian; Spinner, Christoph D

2017-01-01

Reasons for and frequency of nonadherence to antiretroviral therapy (ART) may have changed due to pharmacological improvements. In addition, the importance of known non-pharmacologic reasons for nonadherence is unclear. We performed a cross-sectional, noninterventional, multicenter study to identify current reasons for nonadherence. Patients were categorized by physicians into the following adherence groups: good, unstable, or poor adherence. Co-variables of interest included age, sex, time since HIV diagnosis, ART duration, current ART regimen, HIV transmission route, comorbidity, HIV-1 RNA viral load (VL), and CD4 cell count. Patients self-reported the number of missed doses and provided their specific reasons for nonadherent behavior. Statistical analyses were performed using Fisher's extended exact test, Kruskal-Wallis test, and logistic regression models. Our study assessed 215 participants with good (n=162), unstable (n=36), and poor adherence (n=17). Compared to patients with good adherence, patients with unstable and poor adherence reported more often to have missed at least one dose during the last week (good 11% vs unstable 47% vs poor 63%, p <0.001). Physicians' adherence assessment was concordant with patients' self-reports of missed doses during the last week (no vs one or more) in 81% cases. Similarly, we found a strong association of physicians' assessment with viral suppression. Logistic regression analysis showed that "reduced adherence" - defined as unstable or poor - was significantly associated with patients <30 years old, intravenous drug use, history of acquired immune deficiency syndrome (AIDS), and psychiatric disorders ( p <0.05). Univariate analyses showed that specific reasons, such as questioning the efficacy/dosing of ART, HIV stigma, interactive toxicity beliefs regarding alcohol and/or party drugs, and dissatisfaction with regimen complexity, correlated with unstable or poor adherence ( p <0.05). Identification of factors associated with poor adherence helps in identifying patients with a higher risk for nonadherence. Reasons for nonadherence should be directly addressed in every patient, because they are common and constitute possible adherence intervention points.

Victimization of Obese Adolescents

ERIC Educational Resources Information Center

Robinson, Sabrina

2006-01-01

Peer victimization of obese adolescents has been associated with low self-esteem, body dissatisfaction, social isolation, marginalization, poor psychosocial adjustment, depression, eating disorders, and suicidal ideation and attempts, not to mention poor academic performance. Weight-based peer victimization is defined as unsolicited bullying and…

New insights into environmental enteric dysfunction

USDA-ARS?s Scientific Manuscript database

Environmental enteric dysfunction (EED) has been recognised as an important contributing factor to physical and cognitive stunting, poor response to oral vaccines, limited resilience to acute infections and ultimately global childhood mortality. The aetiology of EED remains poorly defined but the ep...

Cardiovascular Risk Factors in Patients with Poorly Controlled Diabetes Mellitus.

PubMed

Dizdarevic-Bostandzic, Amela; Begovic, Ermin; Burekovic, Azra; Velija-Asimi, Zelija; Godinjak, Amina; Karlovic, Vanja

2018-02-01

Diabetes mellitus(DM) is considered an independent cardiovascular risk factor. Having in mind concomitant occurence of diabetes and other cardiovascular risk factors, it is expected that patients with poor glucoregulation will have more cardiovascular risk factors and higher cardiovascular risk than patients with good glucoregulation. To compare cardiovascular risk and cardiovascular risk factors between patients with poorly controlled and patients with well-controlled Diabetes mellitus. Hundered ten patients aged 40-70 years suffering from Diabetes mellitus type 2 were included. Research is designed as a retrospective, descriptive study. Patients with glycosylated hemoglobin (HbA1c) > 7% were considered to have poorly controlled diabetes. The following data and parameters were monitored: age,sex, family history, data on smoking and alcohol consumption, BMI (body mass index), blood pressure, blood glucose, total cholesterol, triglycerides, LDL, HDL, fibrinogen, uric acid. For the assessment of cardiovascular risk, the WHO / ISH (World Health Organization/International Society of hypertension) tables of the 10-year risk were used, and due to the assessment of the risk factors prevalence, the optimal values of individual numerical variables were defined. Differences in the mean values of systolic, diastolic blood pressure, fasting glucose, total cholesterol, LDL cholesterol are statistically significant higher in patients with poorly controlled diabetes. Hypertension more frequently occurre in patients with poorly controlled DM. The majority of patients with well-controlled DM belong to the group of low and medium cardiovascular risk, while the majority of patients with poorly controlled DM belong to the group of high and very high cardiovascular risk. In our research, there was a significant difference in cardiovascular risk in relation to the degree of DM regulation, and HbA1c proved to be an important indicator for the emergence of the CVD. There are significant differences in certain risk factors between patients with poorly controlled and well controlled DM. Patients with poorly controlled diabetes mellitus have a higher cardiovascular risk than patients with well controlled diabetes. The value of HbA1c should be considered when assessing cardiovascular risk.

Self-defining memories during exposure to music in Alzheimer's disease.

PubMed

El Haj, Mohamad; Antoine, Pascal; Nandrino, Jean Louis; Gély-Nargeot, Marie-Christine; Raffard, Stéphane

2015-10-01

Research suggests that exposure to music may enhance autobiographical recall in Alzheimer's Disease (AD) patients. This study investigated whether exposure to music could enhance the production of self-defining memories, that is, memories that contribute to self-discovery, self-understanding, and identity in AD patients. Twenty-two mild-stage AD patients and 24 healthy controls were asked to produce autobiographical memories in silence, while listening to researcher-chosen music, and to their own-chosen music. AD patients showed better autobiographical recall when listening to their own-chosen music than to researcher-chosen music or than in silence. More precisely, they produced more self-defining memories during exposure to their own-chosen music than to researcher-chosen music or during silence. Additionally, AD patients produced more self-defining memories than autobiographical episodes or personal-semantics during exposure to their own-chosen music. This pattern contrasted with the poor production of self-defining memories during silence or during exposure to researcher-chosen music. Healthy controls did not seem to enjoy the same autobiographical benefits nor the same self-defining memory enhancement in the self-chosen music condition. Poor production of self-defining memories, as observed in AD, may somehow be alleviated by exposure to self-chosen music.

A Study of Poor Black Children Who Are Successful Readers. Reading Education Report No. 33.

ERIC Educational Resources Information Center

Durkin, Dolores

A study was conducted to acquire information about poor black children who were successful readers in order to determine what can be done to increase the number of such children. For purposes of the study, "successful" was defined as scoring at or above grade level on a standardized reading test at the end of fifth grade, while "poor" was defined…

Poor outcome prediction by burst suppression ratio in adults with post-anoxic coma without hypothermia.

PubMed

Yang, Qinglin; Su, Yingying; Hussain, Mohammed; Chen, Weibi; Ye, Hong; Gao, Daiquan; Tian, Fei

2014-05-01

Burst suppression ratio (BSR) is a quantitative electroencephalography (qEEG) parameter. The purpose of our study was to compare the accuracy of BSR when compared to other EEG parameters in predicting poor outcomes in adults who sustained post-anoxic coma while not being subjected to therapeutic hypothermia. EEG was registered and recorded at least once within 7 days of post-anoxic coma onset. Electrodes were placed according to the international 10-20 system, using a 16-channel layout. Each EEG expert scored raw EEG using a grading scale adapted from Young and scored amplitude-integrated electroencephalography tracings, in addition to obtaining qEEG parameters defined as BSR with a defined threshold. Glasgow outcome scales of 1 and 2 at 3 months, determined by two blinded neurologists, were defined as poor outcome. Sixty patients with Glasgow coma scale score of 8 or less after anoxic accident were included. The sensitivity (97.1%), specificity (73.3%), positive predictive value (82.5%), and negative prediction value (95.0%) of BSR in predicting poor outcome were higher than other EEG variables. BSR1 and BSR2 were reliable in predicting death (area under the curve > 0.8, P < 0.05), with the respective cutoff points being 39.8% and 61.6%. BSR1 was reliable in predicting poor outcome (area under the curve  =  0.820, P < 0.05) with a cutoff point of 23.9%. BSR1 was also an independent predictor of increased risk of death (odds ratio  =  1.042, 95% confidence intervals: 1.012-1.073, P  =  0.006). BSR may be a better predictor in prognosticating poor outcomes in patients with post-anoxic coma who do not undergo therapeutic hypothermia when compared to other qEEG parameters.

Drug & Gene Interaction Risk Analysis With & Without Genetic Testing Among Patients Undergoing MTM

ClinicalTrials.gov

2017-02-22

Cytochrome P450 CYP2D6 Enzyme Deficiency; Poor Metabolizer Due to Cytochrome P450 CYP2D6 Variant; Ultrarapid Metabolizer Due to Cytochrome P450 CYP2D6 Variant; Extensive Metabolizer Due to Cytochrome P450 CYP2D6 Variant; Cytochrome P450 CYP2C9 Enzyme Deficiency; Cytochrome P450 CYP2C19 Enzyme Deficiency; Drug Metabolism, Poor, CYP2D6-RELATED; Drug Metabolism, Poor, CYP2C19-RELATED; CYP2D6 Polymorphism

Radiographic patterns in the diagnostic approach to organizing pneumonia.

PubMed

Utrilla Contreras, C; Fernández-Velilla Peña, M; García Río, F; Torres Sánchez, M I

2014-01-01

A 56-year-old woman, non-smoker, who complained of dry cough and dyspnea during the last month came to the emergency department due to increased dyspnea. The chest X-ray showed areas of poorly defined, bilateral alveolar opacities, leading to the diagnosis of bronchopneumonia with partial respiratory failure. During admission, she experienced an exacerbation of the dyspnea. A high-resolution computed tomography scan was performed, showing areas of ground glass opacities with interlobular septal thickening ("crazy-paving" pattern), predominantly in lower lobes. She required mechanical ventilation and she was admitted to the intensive care unit. Subsequently, an open lung biopsy was performed. The following questions should be proposed: Copyright © 2013 Elsevier España, S.L. All rights reserved.

Image-guided intervention in the coagulopathic patient.

PubMed

Kohli, Marc; Mayo-Smith, William; Zagoria, Ronald; Sandrasegaran, Kumar

2016-04-01

Determining practice parameters for interventional procedures is challenging due to many factors including unreliable laboratory tests to measure bleeding risk, variable usage of standardized terminology for adverse events, poorly defined standards for administration of blood products, and the growing numbers of anticoagulant and antiplatelet medications. We aim to address these and other issues faced by radiologists performing invasive procedures through a review of available literature, and experiential guidance from three academic medical centers. We discuss the significant limitations with respect to using prothrombin-time and international normalized ratio to measure bleeding risk, especially in patients with synthetic defects due to liver function. Factors affecting platelet function including the impact of uremia; recent advances in laboratory testing, including platelet function testing; and thromboelastography are also discussed. A review of the existing literature of fresh-frozen plasma replacement therapy is included. The literature regarding comorbidities affecting coagulation including malignancy, liver failure, and uremia are also reviewed. Finally, the authors present a set of recommendations for laboratory thresholds, corrective transfusions, as well as withholding and restarting medications.

New Insights into Understanding Irreversible and Reversible Lithium Storage within SiOC and SiCN Ceramics

PubMed Central

Graczyk-Zajac, Magdalena; Reinold, Lukas Mirko; Kaspar, Jan; Sasikumar, Pradeep Vallachira Warriam; Soraru, Gian-Domenico; Riedel, Ralf

2015-01-01

Within this work we define structural properties of the silicon carbonitride (SiCN) and silicon oxycarbide (SiOC) ceramics which determine the reversible and irreversible lithium storage capacities, long cycling stability and define the major differences in the lithium storage in SiCN and SiOC. For both ceramics, we correlate the first cycle lithiation or delithiation capacity and cycling stability with the amount of SiCN/SiOC matrix or free carbon phase, respectively. The first cycle lithiation and delithiation capacities of SiOC materials do not depend on the amount of free carbon, while for SiCN the capacity increases with the amount of carbon to reach a threshold value at ~50% of carbon phase. Replacing oxygen with nitrogen renders the mixed bond Si-tetrahedra unable to sequester lithium. Lithium is more attracted by oxygen in the SiOC network due to the more ionic character of Si-O bonds. This brings about very high initial lithiation capacities, even at low carbon content. If oxygen is replaced by nitrogen, the ceramic network becomes less attractive for lithium ions due to the more covalent character of Si-N bonds and lower electron density on the nitrogen atom. This explains the significant difference in electrochemical behavior which is observed for carbon-poor SiCN and SiOC materials. PMID:28347008

Hospital volume and mortality due to preterm patent ductus arteriosus.

PubMed

Michihata, Nobuaki; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo

2016-11-01

Preterm patent ductus arteriosus (PDA) requires neonatal intensive care. The relationship between hospital volume and mortality of PDA remains poorly understood. This was a retrospective observational study, using a national inpatient database in Japan. We identified patients who were diagnosed with PDA; exclusion criteria were as follows: (i) other cardiac complications; (ii) mild PDA treated without oral/i.v. indomethacin, surgery, or catheter intervention; (iii) age >1 year at admission; (iv) gestational age ≥32 weeks; (v) death within 3 days of admission; and (vi) transferal to other hospitals. Information was collected using the Japanese Diagnosis Procedure Combination database from July 2010 to March 2013. Hospital volume was defined as the average annual number of neonates with gestational age <32 weeks at each hospital. The outcome measure was in-hospital mortality. A total of 2437 eligible patients treated at 199 hospitals were included. Low, medium, and high volume were defined as average annual number of preterm infants <34, 34-65, and >65, respectively. There were no significant differences in in-hospital mortality according to hospital volume. In-hospital mortality was identical in patients who received indomethacin alone, surgical or catheter intervention, or both after adjustment for patient background. There was no significant relationship between hospital volume and in-hospital mortality due to preterm PDA. Centralization of patients with this condition may not be necessary. © 2016 Japan Pediatric Society.

Spectrum and Predictors of Refractory Status Epilepticus in a Developing Country.

PubMed

Dubey, Deepanshu; Bhoi, Sanjeev K; Kalita, Jayantee; Misra, Usha K

2017-09-01

Refractory status epilepticus (RSE) can influence the outcome of status epilepticus (SE). In the present study, we report the aetiology and predictors of outcomes of RSE in a developing country. This is a prospective hospital-based study of SE patients (continuous seizures for five minutes or more). Those who had SE persisting after two antiepileptic drugs were defined as having RSE. We present the demographic information, duration, and type of SE, and we note its severity using the status epilepticus severity score (STESS), its aetiology, comorbidities and imaging findings. The outcome of RSE was defined as cessation of seizures and the condition upon discharge, as assessed by the modified Rankin Scale. A total of 35 (42.5%) of our 81 patients had RSE. The median duration of SE before starting treatment was 2 hours (range=0.008-160 h). The most common causes of RSE were stroke in 5 (14.3%), central nervous system (CNS) infections in 12 (34.3%) and metabolic encephalopathies in 13 (37.1%) patients. Some 21 (60%) patients had comorbidities, and the STESS was favourable in 7 (20%) patients. A total of 14 (20%) patients died, but death was directly related to SE in only one of these. Some 10 patients had super-refractory status epilepticus, which was due to CNS infection in 5 (50%) and metabolic encephalopathy in 3 (30%). On multivariate analysis, an unfavourable STESS (p=0.05) and duration of SE before treatment (p=0.01) predicted RSE. Metabolic aetiology (p=0.05), mechanical ventilation (p60 years (p=0.003) were predictors of poor outcomes. RSE was common (42.5%) among patients with SE in a tertiary care center in India. It was associated with high mortality and poor outcomes. Age above 60 years and metabolic aetiology were found to be predictors of poor outcomes.

Sex differences in athletic performance emerge coinciding with the onset of male puberty.

PubMed

Handelsman, David J

2017-07-01

Male performance in athletic events begins to exceed that of age-matched females during early adolescence, but the timing of this divergence relative to the onset of male puberty and the rise in circulating testosterone remains poorly defined. This study is a secondary quantitative analysis of four published sources which aimed to define the timing of the gender divergence in athletic performance and relating it to the rise in circulating testosterone due to male puberty. Four data sources reflecting elite swimming and running and jumping track and field events as well as hand-grip strength in nonathletes were analysed to define the age-specific gender differences through adolescence and their relationship to the rising circulating testosterone during male puberty. The onset and tempo of gender divergence were very similar for swimming, running and jumping events as well as the hand-grip strength in nonathletes, and all closely paralleled the rise in circulating testosterone in adolescent boys. The gender divergence in athletic performance begins at the age of 12-13 years and reaches adult plateau in the late teenage years with the timing and tempo closely parallel to the rise in circulating testosterone in boys during puberty. © 2017 John Wiley & Sons Ltd.

A parsimonious land data assimilation system for the SMAP/GPM satellite era

USDA-ARS?s Scientific Manuscript database

Land data assimilation systems typically require complex parameterizations in order to: define required observation operators, quantify observing/forecasting errors and calibrate a land surface assimilation model. These parameters are commonly defined in an arbitrary manner and, if poorly specified,...

Plasma Vitamin D Deficiency Is Associated with Poor Sleep Quality and Night-Time Eating at Mid-Pregnancy in Singapore

PubMed Central

Cheng, Tuck Seng; Loy, See Ling; Cheung, Yin Bun; Cai, Shirong; Colega, Marjorelee T.; Godfrey, Keith M.; Chong, Yap-Seng; Tan, Kok Hian; Shek, Lynette Pei-Chi; Lee, Yung Seng; Lek, Ngee; Chan, Jerry Kok Yen; Chong, Mary Foong-Fong; Yap, Fabian

2017-01-01

Plasma 25-hydroxyvitamin D (25OHD) deficiency, poor sleep quality, and night-time eating, have been independently associated with adverse pregnancy outcomes, but their inter-relationships are yet to be evaluated. We aimed to investigate the associations between maternal plasma 25OHD status and sleep quality and circadian eating patterns during pregnancy. Data on pregnant women (n = 890) from a prospective cohort (Growing Up in Singapore Towards healthy Outcomes) were analyzed. Plasma 25OHD concentration was measured, while the Pittsburgh sleep quality index (PSQI) and 24-h dietary recall were administered to women at 26–28 weeks’ gestation. Plasma 25OHD status was defined as sufficient (>75 nmol/L), insufficient (50–75 nmol/L), or deficient (<50 nmol/L). Poor sleep quality was defined by a total global PSQI score >5. Predominantly day-time (pDT) and predominantly night-time (pNT) were defined according to consumption of greater proportion of calories (i.e., >50%) from 07:00–18:59 and from 19:00–06:59, respectively. After adjustment for confounders, women with plasma 25OHD deficiency had higher odds of poor sleep quality (odds ratio (OR) 3.49; 95% confidence interval (CI) 1.84–6.63) and pNT eating (OR: 1.85; 95% CI 1.00–3.41) than those who were 25OHD sufficient. Our findings show the association of maternal plasma 25OHD deficiency with poor sleep quality and pNT eating at mid-pregnancy. PMID:28353643

Self-assembly of diphenylalanine with preclick components as capping groups.

PubMed

Gemma, Andrea; Mayans, Enric; Ballano, Gema; Torras, Juan; Díaz, Angélica; Jiménez, Ana I; Puiggalí, Jordi; Cativiela, Carlos; Alemán, Carlos

2017-10-11

Alkyne and azide, which are commonly used in the cycloaddition reaction recognized as "click chemistry", have been used as capping groups of two engineered diphenylalanine (FF) derivatives due to their ability to form weak intermolecular interactions (i.e. dipole-π and π-π stacking). In Poc-FF-N 3 , alkyne and azide act as N- and C-terminal capping groups, respectively, while such positions are exchanged in N 3 -FF-OPrp. The self-assembly of such two synthesized peptides has been extensively studied in their "pre-click" state, considering the influence of three different factors: the peptide concentration, the polarity of the medium, and the nature of the substrate. Poc-FF-N 3 assembles into microfibers that, depending on the medium and the substrate, can aggregate hierarchically in supramolecular structures with different morphologies. The most distinctive one corresponds to very stable birefringent dendritic-like microstructures, which are derived from the ordered agglomeration of microfibers. These branched supramolecular structures, which are observed under a variety of conditions, are relatively uncommon in short FF sequences. At the molecular level, Poc-FF-N 3 organizes in antiparallel β-sheets stabilized by N-HO intermolecular hydrogen bonds and re-enforced by weak interactions between the azide and alkyne groups of neighbouring molecules. In contrast, N 3 -FF-OPrp exhibits a very poor tendency to organize into structures with a well-defined morphology. Theoretical calculations on model complexes indicate that the tendency of the latter peptide to organize into small amorphous agglomerates is due to its poor ability to form specific intermolecular interactions in comparison with Poc-FF-N 3 . The implications of the weak interactions induced by the alkyne and azide groups, which strengthen peptidepeptide hydrogen bonds and π-ladders due to the stacked aromatic phenyl side groups, are discussed.

Influence of hip and knee osteoarthritis on dynamic postural control parameters among older fallers.

PubMed

Mat, Sumaiyah; Ng, Chin Teck; Tan, Maw Pin

2017-03-06

To compare the relationship between postural control and knee and hip osteoarthritis in older adults with and without a history of falls. Fallers were those with ≥ 2 falls or 1 injurious fall over 12 months. Non-fallers were volunteers with no falls in the past year. Radiological evidence of osteoarthritis with no reported symptoms was considered "asymptomatic osteoarthritis", while "symptomatic osteoarthritis" was defined as radiographic osteoarthritis with pain or stiffness. Dynamic postural control was quantified with the limits of stability test measured on a balance platform (Neurocom® Balancemaster, California, USA). Parameters assessed were end-point excursion, maximal excursion, and directional control. A total of 102 older individuals, mean age 73 years (standard deviation 5.7) years were included. The association between falls and poor performance in maximal excursion and directional control was confounded by age and comorbidities. In the same linear equation model with falls, symptomatic osteoarthritis remained independently associated with poor end-point excursion (β-coefficient (95% confidence interval) -6.80 (-12.14 to -1.42)). Poor performance in dynamic postural control (maximal excursion and directional control) among fallers was not accounted for by hip/knee osteoarthritis, but was confounded by old age and comorbidities. Loss of postural control due to hip/knee osteoarthritis is not a risk factor for falls among community-dwelling older adults.

A Search for Nitrogen-enhanced Metal-poor Stars

NASA Astrophysics Data System (ADS)

Johnson, Jennifer A.; Herwig, Falk; Beers, Timothy C.; Christlieb, Norbert

2007-04-01

Theoretical models of very metal-poor intermediate-mass asymptotic giant branch (AGB) stars predict a large overabundance of primary nitrogen. The very metal-poor, carbon-enhanced, s-process-rich stars, which are thought to be the polluted companions of now extinct AGB stars, provide direct tests of the predictions of these models. Recent studies of the carbon and nitrogen abundances in metal-poor stars have focused on the most carbon-rich stars, leading to a potential selection bias against stars that have been polluted by AGB stars that produced large amounts of nitrogen and hence have small [C/N] ratios. We call these stars nitrogen-enhanced metal-poor (NEMP) stars and define them as having [N/Fe]>+0.5 and [C/N]<-0.5. In this paper we report on the [C/N] abundances of a sample of 21 carbon-enhanced stars, all but three of which have [C/Fe]<+2.0. If NEMP stars were made as easily as carbon-enhanced metal-poor (CEMP) stars, then we expected to find between two and seven NEMP stars. Instead, we found no NEMP stars in our sample. Therefore, this observational bias is not an important contributor to the apparent dearth of N-rich stars. Our [C/N] values are in the same range as values reported previously in the literature (-0.5 to +2.0), and all stars are in disagreement with the predicted [C/N] ratios for both low- and high-mass AGB stars. We suggest that the decrease in [C/N] from the low-mass AGB models is due to enhanced extramixing, while the lack of NEMP stars may be caused by unfavorable mass ratios in binaries or the difficulty of mass transfer in binary systems with large mass ratios. Based on observations obtained at Cerro Tololo Inter-American Observatory and Kitt Peak National Observatory, a division of the National Optical Astronomy Observatory, which is operated by the Association of Universities for Research in Astronomy, Inc., under cooperative agreement with the National Science Foundation.

Public Schools and the Common Good.

ERIC Educational Resources Information Center

Reese, William J.

1988-01-01

Improving public school education, especially for the poor, requires defining and articulating some vision of the common good. This article reviews key positions taken by liberals and conservatives regarding educational reform during the 19th and 20th centuries and critiques these positions with regard to their disservice to the poor. (IAH)

Rare cancers: a sea of opportunity.

PubMed

Boyd, Niki; Dancey, Janet E; Gilks, C Blake; Huntsman, David G

2016-02-01

Rare cancers, as a collective, account for around a quarter of all cancer diagnoses and deaths. Historically, they have been divided into two groups: cancers defined by their unusual histogenesis (cell of origin or differentiation state)--including chordomas or adult granulosa cell tumours--and histologically defined subtypes of common cancers. Most tumour types in the first group are still clinically and biologically relevant, and have been disproportionately important as sources of insight into cancer biology. By contrast, most of those in the second group have been shown to have neither defining molecular features nor clinical utility. Omics-based analyses have splintered common cancers into a myriad of molecularly, rather than histologically, defined subsets of common cancers, many of which have immediate clinical relevance. Now, almost all rare cancers are either histomolecular entities, which often have pathognomonic mutations, or molecularly defined subsets of more common cancers. The presence of specific genetic variants provides rationale for the testing of targeted drugs in rare cancers. However, in addition to molecular alterations, it is crucial to consider the contributions of both mutation and cell context in the development, biology, and behaviour of these cancers. Patients with rare cancers are disadvantaged because of the challenge of leading clinical trials in this setting due to poor accrual. However, the number of patients with rare cancers will only increase as more molecular subsets of common cancers are identified, necessitating a shift in the focus of clinical trials and research into these cancer types, which, by epidemiological definitions, will become rare tumours. Copyright © 2016 Elsevier Ltd. All rights reserved.

A proposal for the classification of biological weapons sensu lato.

PubMed

Rozsa, Lajos

2014-12-01

Due to historical and legislation reasons, the category of bioweapons is rather poorly defined. Authors often disagree on involving or excluding agents like hormones, psychochemicals, certain plants and animals (such as weeds or pests) or synthetic organisms. Applying a wide definition apparently threatens by eroding the regime of international legislation, while narrow definitions abandon several important issues. Therefore, I propose a category of 'biological weapons sensu lato' (BWsl) that is defined here as any tool of human aggression whose acting principle is based on disciplines of biology including particularly microbiology, epidemiology, medical biology, physiology, psychology, pharmacology and ecology, but excluding those based on inorganic agents. Synthetically produced equivalents (not necessarily exact copies) and mock weapons are also included. This definition does not involve any claim to subject all these weapons to international legislation but serves a purely scholarly purpose. BWsl may be properly categorized on the base of the magnitude of the human population potentially targeted (4 levels: individuals, towns, countries, global) and the biological nature of the weapons' intended effects (4 levels: agricultural-ecological agents, and non-pathogenic, pathogenic, or lethal agents against humans).

Multidrug and extensively drug-resistant tuberculosis.

PubMed

Maitre, T; Aubry, A; Jarlier, V; Robert, J; Veziris, N

2017-02-01

The emergence of drug-resistant tuberculosis (TB) compromises global tuberculosis control. The incidence of multidrug-resistant strains (MDR) defined as resistant to the two main antituberculosis drugs, rifampicin and isoniazid, was raised in the 1990s. Ten percent of these strains have developed additional resistance to the main second-line antituberculosis drugs: fluoroquinolones and aminoglycosides. These strains are defined as extensively drug-resistant (XDR). The prognosis of MDR-TB and XDR-TB is poor due to limited therapeutic resources. However, many new innovations may lead to a radical change in this field. Genotypic testing is now able to detect drug resistance within a few hours. Genotypic diagnosis of rifampicin resistance is now recommended in France for each new case of TB. The currently recommended treatment for MDR-TB is long (18-24 months) and toxic. It is, however, on the verge of being replaced by a 9-month treatment. New antituberculosis drugs such as bedaquiline and delamanid should also improve the prognosis of MDR-TB and XDR-TB. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Species delimitation in the Grayling genus Pseudochazara (Lepidoptera, Nymphalidae, Satyrinae) supported by DNA barcodes

PubMed Central

Verovnik, Rudi; Wiemers, Martin

2016-01-01

Abstract The Palaearctic Grayling genus Pseudochazara encompasses a number of petrophilous butterfly species, most of which are local endemics especially in their centre of radiation in SW Asia and the Balkans. Due to a lack of consistent morphological characters, coupled with habitat induced variability, their taxonomy is poorly understood and species delimitation is hampered. We employed a DNA barcoding approach to address the question of separate species status for several European taxa and provide first insight into the phylogeny of the genus. Unexpectedly we found conflicting patterns with deep divergences between presumably conspecific taxa and lack of divergence among well-defined species. We propose separate species status for Pseudochazara tisiphone, Pseudochazara amalthea, Pseudochazara amymone, and Pseudochazara kermana all of which have separate well supported clades, with the majority of them becoming local endemics. Lack of resolution in the ‘Mamurra’ species group with well-defined species (in terms of wing pattern and coloration) such as Pseudochazara geyeri, Pseudochazara daghestana and Pseudochazara alpina should be further explored using nuclear molecular markers with higher genetic resolution. PMID:27408604

Optimization of Pre-transplantation Conditions to Enhance the Efficacy of Mesenchymal Stem Cells

PubMed Central

Haque, Nazmul; Kasim, Noor Hayaty Abu; Rahman, Mohammad Tariqur

2015-01-01

Mesenchymal stem cells (MSCs) are considered a potential tool for cell based regenerative therapy due to their immunomodulatory property, differentiation potentials, trophic activity as well as large donor pool. Poor engraftment and short term survival of transplanted MSCs are recognized as major limitations which were linked to early cellular ageing, loss of chemokine markers during ex vivo expansion, and hyper-immunogenicity to xeno-contaminated MSCs. These problems can be minimized by ex vivo expansion of MSCs in hypoxic culture condition using well defined or xeno-free media i.e., media supplemented with growth factors, human serum or platelet lysate. In addition to ex vivo expansion in hypoxic culture condition using well defined media, this review article describes the potentials of transient adaptation of expanded MSCs in autologous serum supplemented medium prior to transplantation for long term regenerative benefits. Such transient adaptation in autologous serum supplemented medium may help to increase chemokine receptor expression and tissue specific differentiation of ex vivo expanded MSCs, thus would provide long term regenerative benefits. PMID:25678851

The magnitude and origin of groundwater discharge to eastern U.S. and Gulf of Mexico coastal waters

USGS Publications Warehouse

Befus, Kevin; Kroeger, Kevin D.; Smith, Christopher G.; Swarzenski, Peter W.

2017-01-01

Fresh groundwater discharge to coastal environments contributes to the physical and chemical conditions of coastal waters, but the role of coastal groundwater at regional to continental scales remains poorly defined due to diverse hydrologic conditions and the difficulty of tracking coastal groundwater flow paths through heterogeneous subsurface materials. We use three-dimensional groundwater flow models for the first time to calculate the magnitude and source areas of groundwater discharge from unconfined aquifers to coastal waterbodies along the entire eastern U.S. We find that 27.1 km3/yr (22.8–30.5 km3/yr) of groundwater directly enters eastern U.S. and Gulf of Mexico coastal waters. The contributing recharge areas comprised ~175,000 km2 of U.S. land area, extending several kilometers inland. This result provides new information on the land area that can supply natural and anthropogenic constituents to coastal waters via groundwater discharge, thereby defining the subterranean domain potentially affecting coastal chemical budgets and ecosystem processes.

Sensitivity analysis as an aid in modelling and control of (poorly-defined) ecological systems. [closed ecological systems

NASA Technical Reports Server (NTRS)

Hornberger, G. M.; Rastetter, E. B.

1982-01-01

A literature review of the use of sensitivity analyses in modelling nonlinear, ill-defined systems, such as ecological interactions is presented. Discussions of previous work, and a proposed scheme for generalized sensitivity analysis applicable to ill-defined systems are included. This scheme considers classes of mathematical models, problem-defining behavior, analysis procedures (especially the use of Monte-Carlo methods), sensitivity ranking of parameters, and extension to control system design.

Treatment of Cutaneous Leishmaniasis Caused by Leishmania aethiopica: A Systematic Review

PubMed Central

van Griensven, Johan; Gadisa, Endalamaw; Aseffa, Abraham; Hailu, Asrat; Beshah, Abate Mulugeta; Diro, Ermias

2016-01-01

Leishmania aethiopica is the etiological agent of cutaneous leishmaniasis (CL) in Ethiopia and can cause severe and complicated cases such as diffuse CL (DCL), mucocutaneous leishmaniasis or extensive CL, requiring systemic treatment. Despite the substantial burden, evidence-based treatment guidelines are lacking. We conducted a systematic review of clinical studies reporting on treatment outcomes of CL due to L aethiopica in order to help identify potentially efficacious medications on CL that can be taken forward for clinical trials. We identified a total of 24 records reporting on 506 treatment episodes of CL presumably due to L aethiopica. The most commonly used drugs were antimonials (n = 201), pentamidine (n = 150) and cryotherapy (n = 103). There were 20 case reports/series, with an overall poor study quality. We only identified two small and/or poor quality randomized controlled trials conducted a long time ago. There were two prospective non-randomized studies reporting on cryotherapy, antimonials and pentamidine. With cryotherapy, cure rates were 60–80%, and 69–85% with antimonials. Pentamidine appeared effective against complicated CL, also in cases non-responsive to antimonials. However, all studies suffered from methodological limitations. Data on miltefosine, paromomycin and liposomal amphotericin B are extremely scarce. Only a few studies are available on DCL. The only potentially effective treatment options for DCL seem to be antimonials with paromomycin in combination or pentamidine, but none have been properly evaluated. In conclusion, the evidence-base for treatment of complicated CL due to L aethiopica is extremely limited. While antimonials remain the most available CL treatment in Ethiopia, their efficacy and safety in CL should be better defined. Most importantly, alternative first line treatments (such as miltefosine or paromomycin) should be explored. High quality trials on CL due to L aethiopica are urgently needed, exploring group sequential methods to evaluate several options in parallel. PMID:26938448

More than science: family learning in a Mexican science museum

NASA Astrophysics Data System (ADS)

Briseño-Garzón, Adriana

2013-06-01

Latin American audiences living in their countries of origin are poorly understood as museum learners due to the scarcity of research in this field. Through a case study approach, I investigate and report on the ways of learning of 20 Mexican family groups. In particular, I examine the influence of the Mexican sociocultural context on the participant family members' learning outcomes from a Mexican science museum. Conducted in Universum Museo de las Ciencias, a science museum located in Mexico City, this research study is based on the premise that understanding the role of the sociocultural elements of learning is essential to understanding the nature of learning in museums. The cognitive and social outcomes of the participants are discussed in the light of the sociocultural elements that define Mexicans as museum learners.

Redesigning journal club in residency.

PubMed

Al Achkar, Morhaf

2016-01-01

The gap between production and implementation of knowledge is the main reason for the suboptimal quality of health care. To eliminate this gap and improve the quality of patient care, journal club (JC) in graduate medical education provides an opportunity for learning the skills of evidence-based medicine. JC, however, continues to face many challenges mainly due to poorly defined goals, inadequate preparation, and lack of interest. This article presents an innovative model to prepare and present JC based on three pillars: dialogical learning through group discussion, mentored residents as peer teachers, and including JC as part of a structured curriculum to learn evidence-based medicine. This engaging model has the potential to transform JC from a moribund session that is daunting for residents into a lively discussion to redefine clinical practice using the most current evidence.

Listeria membrane protrusion collapse: Requirement of Cyclophilin A for Listeria cell-to-cell spreading.

PubMed

Dhanda, Aaron S; Lulic, Katarina T; Vogl, A Wayne; Mc Gee, Margaret M; Chiu, Robert H; Guttman, Julian A

2018-05-04

Listeria generate actin-rich tubular protrusions at the plasma membrane that propel the bacteria into neighbouring cells. The precise molecular mechanisms governing the formation of these protrusions remain poorly defined. Here we demonstrate that the PPIase Cyclophilin A (CypA) is hijacked by Listeria at membrane protrusions used for cell-to-cell spreading. CypA localizes within the F-actin of these structures and is crucial for their proper formation, as in cells depleted of CypA, these extended actin-rich structures are mis-shaped and collapsed due to changes within the F-actin network. The lack of structural integrity within the Listeria membrane protrusions hampers the microbes from spreading from CypA null cells. Our results demonstrate a crucial role for CypA during Listeria infections.

Medicaid eligibility policy in the 1980s: medical utilitarianism and the "deserving" poor.

PubMed

Tanenbaum, S J

1995-01-01

Between 1981 and the early 1990s, the Medicaid program grew substantially, in part because, for the first time in the program's history, eligibility for medical assistance was severed from eligibility for income-maintenance payments. Program participation had always been reserved for the "deserving poor," and these were originally defined as persons excluded from market relationships through no fault of their own. The Medicaid expansion of the 1980s, however, created a new constituency of poor, and not-so-poor, persons whose actual or predictable medical problems promised a calculable return on program funds.

How to Classify and Measure Ecosystem Services to Connect to Human Well Being -- Is there an Answer?

EPA Science Inventory

Abstract 2.0: Ecosystem services remain poorly defined despite an extensive and growing literature. While approaches are many and varied, none appear to adequately define a systematic, complete, and non-duplicative solution to the crucial problem of connecting ecosystems to hum...

77 FR 9876 - Proposed Modification of VOR Federal Airways V-10, V-12, and V-508 in the Vicinity of Olathe, KS

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-21

... (OJC) VOR/DME navigation aid located on the Johnson County Executive Airport, Olathe, KS, due to poor performance of the navigation aid. The OJC VOR/DME performs poorly due to suburban encroachment into the...

DEVELOPING A METHOD TO IDENTIFY HORIZONTAL CURVE SEGMENTS WITH HIGH CRASH OCCURRENCES USING THE HAF ALGORITHM

DOT National Transportation Integrated Search

2018-04-01

Crashes occur every day on Utahs highways. Curves can be particularly dangerous as they require driver focus due to potentially unseen hazards. Often, crashes occur on curves due to poor curve geometry, a lack of warning signs, or poor surface con...

The Caribbean conundrum of Holocene sea level.

NASA Astrophysics Data System (ADS)

Jackson, Luke; Mound, Jon

2014-05-01

In the tropics, pre-historic sea-level curve reconstruction is often problematic because it relies upon sea-level indicators whose vertical relationship to the sea surface is poorly constrained. In the Caribbean, fossil corals, mangrove peats and shell material dominate the pre-historic indicator record. The common approach to reconstruction involves the use of modern analogues to these indicators to establish a fixed vertical habitable range. The aim of these reconstructions is to find spatial variability in the Holocene sea level in an area gradually subsiding (< 1.2 mm yr-1) due the water loading following the deglaciation of the Laurentide ice sheet. We construct two catalogues: one of published Holocene sea-level indicators and the other of published, modern growth rates, abundance and coverage of mangrove and coral species for different depths. We use the first catalogue to calibrate 14C ages to give a probabilistic age range for each indicator. We use the second catalogue to define a depth probability distribution function (pdf) for mangroves and each coral species. The Holocene indicators are grouped into 12 sub-regions around the Caribbean. For each sub-region we apply our sea-level reconstruction, which involves stepping a fixed-length time window through time and calculating the position (and rate) of sea-level (change) using a thousand realisations of the time/depth pdfs to define an envelope of probable solutions. We find that the sub-regional relative sea-level curves display spatio-temporal variability including a south-east to north-west 1500 year lag in the arrival of Holocene sea level to that of the present day. We demonstrate that these variations are primarily due to glacial-isostatic-adjustment induced sea-level change and that sub-regional variations (where sufficient data exists) are due to local uplift variability.

Transglutaminase 2 expression in acute myeloid leukemia: Association with adhesion molecule expression and leukemic blast motility

PubMed Central

Meyer, Stefan; Ravandi-Kashani, Farhad; Borthakur, Gautam; Coombes, Kevin R.; Zhang, Nianxiang; Kornblau, Steven

2016-01-01

Acute myeloid leukemia (AML) is a heterogenous disease with differential oncogene association, outcome and treatment regimens. Treatment strategies for AML have improved outcome but despite increased molecular biological information AML is still associated with poor prognosis. Proteomic analysis on the effects of a range of leukemogenic oncogenes showed that the protein transglutaminase 2 (TG2) is expressed at greater levels as a consequence of oncogenic transformation. Further analysis of this observation was performed with 511 AML samples using reverse phase proteomic arrays, demonstrating that TG2 expression was higher at relapse than diagnosis in many cases. In addition elevated TG2 expression correlated with increased expression of numerous adhesion proteins and many apoptosis regulating proteins, two processes related to leukemogenesis. TG2 has previously been linked to drug resistance in cancer and given the negative correlation between TG2 levels and peripheral blasts observed increased TG2 levels may lead to the protection of the leukemic stem cell due to increased adhesion/reduced motility. TG2 may therefore form part of a network of proteins that define poor outcome in AML patients and potentially offer a target to sensitize AML stem cells to drug treatment. PMID:23576428

Comparative Study With New Accuracy Metrics for Target Volume Contouring in PET Image Guided Radiation Therapy

PubMed Central

Shepherd, T; Teras, M; Beichel, RR; Boellaard, R; Bruynooghe, M; Dicken, V; Gooding, MJ; Julyan, PJ; Lee, JA; Lefèvre, S; Mix, M; Naranjo, V; Wu, X; Zaidi, H; Zeng, Z; Minn, H

2017-01-01

The impact of positron emission tomography (PET) on radiation therapy is held back by poor methods of defining functional volumes of interest. Many new software tools are being proposed for contouring target volumes but the different approaches are not adequately compared and their accuracy is poorly evaluated due to the ill-definition of ground truth. This paper compares the largest cohort to date of established, emerging and proposed PET contouring methods, in terms of accuracy and variability. We emphasize spatial accuracy and present a new metric that addresses the lack of unique ground truth. Thirty methods are used at 13 different institutions to contour functional volumes of interest in clinical PET/CT and a custom-built PET phantom representing typical problems in image guided radiotherapy. Contouring methods are grouped according to algorithmic type, level of interactivity and how they exploit structural information in hybrid images. Experiments reveal benefits of high levels of user interaction, as well as simultaneous visualization of CT images and PET gradients to guide interactive procedures. Method-wise evaluation identifies the danger of over-automation and the value of prior knowledge built into an algorithm. PMID:22692898

Vaginal microbial flora and outcome of pregnancy.

PubMed

Donati, Laura; Di Vico, Augusto; Nucci, Marta; Quagliozzi, Lorena; Spagnuolo, Terryann; Labianca, Antonietta; Bracaglia, Marina; Ianniello, Francesca; Caruso, Alessandro; Paradisi, Giancarlo

2010-04-01

The vaginal microflora of a healthy asymptomatic woman consists of a wide variety of anaerobic and aerobic bacterial genera and species dominated by the facultative, microaerophilic, anaerobic genus Lactobacillus. The activity of Lactobacillus is essential to protect women from genital infections and to maintain the natural healthy balance of the vaginal flora. Increasing evidence associates abnormalities in vaginal flora during pregnancy with preterm labor and delivery with potential neonatal sequelae due to prematurity and poor perinatal outcome. Although this phenomenon is relatively common, even in populations of women at low risk for adverse events, the pathogenetic mechanism that leads to complications in pregnancy is still poorly understood. This review summarizes the current knowledge and uncertainties in defining alterations of vaginal flora in non-pregnant adult women and during pregnancy, and, in particular, investigates the issue of bacterial vaginosis and aerobic vaginitis. This could help specialists to identify women amenable to treatment during pregnancy leading to the possibility to reduce the preterm birth rate, preterm premature rupture of membranes, chorioamnionitis, neonatal, puerperal and maternal-fetal infectious diseases. Vaginal ecosystem study with the detection of pathogens is a key instrument in the prevention of preterm delivery, pPROM, chorioamnionitis, neonatal, puerperal and maternal-fetal infections.

Probabilities of good, marginal, and poor flying conditions for space shuttle ferry flights

NASA Technical Reports Server (NTRS)

Whiting, D. M.; Guttman, N. B.

1977-01-01

Empirical probabilities are provided for good, marginal, and poor flying weather for ferrying the Space Shuttle Orbiter from Edwards AFB, California, to Kennedy Space Center, Florida, and from Edwards AFB to Marshall Space Flight Center, Alabama. Results are given by month for each overall route plus segments of each route. The criteria for defining a day as good, marginal, or poor and the method of computing the relative frequencies and conditional probabilities for monthly reference periods are described.

Efficacy of caesarean scar defect repair in improving postmenstrual bleeding and factors associated with poor effect.

PubMed

Xu, He-Yang; Yang, Meng-Yi; Zhang, Xuyin; Wang, Qing; Yi, Xiao-Fang; Ding, Jing-Xin; Hua, Ke-Qin

2017-11-01

Caesarean scar defect (CSD) can cause postmenstrual bleeding. Defect repair is an effective technique to improve this symptom, but there are still a few patients getting little improvement. This retrospective study evaluates the efficacy of scar repair and explores the factors associated with poor effect. In total, 123 patients were involved in the final analysis. All of them complained about menstruation period >7 days due to postmenstrual bleeding. Before surgery, 87.8% of patients had a menstruation period more than 10 days and 20.3% had a period more than 15 days. After surgery, a normal menstruation period (< =7 days) was achieved in 46.3% (95%CI 37.3%-55.6%) of patients and a menstruation period lasting no more than 10 days was achieved in 74.8% (95%CI 66.2%-82.2%). Through multivariate logistic analysis, four factors were found dependently associated with poor effect (defined as menstruation period >10 days after surgery): repeated caesarean section (OR 9.75, 95%CI 2.30-41.36, 0.002) was a risk factor, while defect volume >600 mm 3 (OR 0.14, 95%CI 0.03-0.56, 0.006), interval from caesarean section to symptom emerging >3 months (OR 0.25, 95%CI 0.07-0.94, 0.041) and straight or retroflexed uterus (OR 0.19, 95%CI 0.05-0.79, 0.022) were protective factors. Impact statement What is already known on this subject? Caesarean scar defect can cause postmenstrual bleeding. Defect repair can improve this symptom, but there are still a few patients getting little improvement after surgery. What do the results of this study add? Defect volume >600 mm 3 , interval from caesarean section to symptom emerging >3 months and straight or retroflexed uterus are protective factors of poor effect (defined as menstruation period >10 days after surgery), and repeated caesarean section is a risk factor. What are the implications of these findings for clinical practice and/or further research? These findings may help in counselling the patients and in medical decision. Further researches are needed to explore other factors associated with surgical effect and build prediction models.

Health of the Disadvantaged. Chart Book-II.

ERIC Educational Resources Information Center

Health Resources Administration (DHHS/PHS), Hyattsville, MD.

The tables and charts in this book act as resources for information on the health status of racial and ethnic minorities and the poor. The four minority groups referred to are blacks, Hispanic Americans, Native Americans, and Asian Americans. The poor are defined as those whose income falls below the poverty line specified by the Census Bureau.…

CERT Resiliency Engineering Framework

DTIC Science & Technology

2007-03-01

Heightened threat level and increasing uncertainty Shorter-lived skills 5 Operational risk management problems Poor planning and execution No asset...increasingly effective & efficient Today’s operational environment No operational boundaries Pervasive & rapidly changing technology Dynamic & expanding risks ...management function Seen as a technical function or responsibility Searching for magic bullet: CobiT , ITIL, ISO17799, NFP1600 Poorly defined and measured

Promoting Upward Mobility for the Working Poor.

ERIC Educational Resources Information Center

Rupured, Michael

2000-01-01

The working poor are typically defined by researchers as individuals who work at least part of the year and earn less than a given percentage of the federal poverty level. This definition tends to understate the problem. In 1997, 15.8 million employed parents had incomes below 200 percent of the federal poverty level. The federal Earned Income Tax…

Blood urea nitrogen to serum creatinine ratio is an accurate predictor of outcome in diarrhea-associated hemolytic uremic syndrome, a preliminary study.

PubMed

Keenswijk, Werner; Vanmassenhove, Jill; Raes, Ann; Dhont, Evelyn; Vande Walle, Johan

2017-03-01

Diarrhea-associated hemolytic uremic syndrome (D+HUS) is a common thrombotic microangiopathy during childhood and early identification of parameters predicting poor outcome could enable timely intervention. This study aims to establish the accuracy of BUN-to-serum creatinine ratio at admission, in addition to other parameters in predicting the clinical course and outcome. Records were searched for children between 1 January 2008 and 1 January 2015 admitted with D+HUS. A complicated course was defined as developing one or more of the following: neurological dysfunction, pancreatitis, cardiac or pulmonary involvement, hemodynamic instability, and hematologic complications while poor outcome was defined by death or development of chronic kidney disease. Thirty-four children were included from which 11 with a complicated disease course/poor outcome. Risk of a complicated course/poor outcome was strongly associated with oliguria (p = 0.000006) and hypertension (p = 0.00003) at presentation. In addition, higher serum creatinine (p = 0.000006) and sLDH (p = 0.02) with lower BUN-to-serum creatinine ratio (p = 0.000007) were significantly associated with development of complications. A BUN-to-sCreatinine ratio ≤40 at admission was a sensitive and highly specific predictor of a complicated disease course/poor outcome. A BUN-to-serum Creatinine ratio can accurately identify children with D+HUS at risk for a complicated course and poor outcome. What is Known: • Oliguria is a predictor of poor long-term outcome in D+HUS What is New: • BUN-to-serum Creatinine ratio at admission is an entirely novel and accurate predictor of poor outcome and complicated clinical outcome in D+HUS • Early detection of the high risk group in D+HUS enabling early treatment and adequate monitoring.

Associations between health-related quality of life and financial barriers to care among women veterans and women non-veterans.

PubMed

Shen, Chan; Sambamoorthi, Usha

2012-01-01

The authors of this study examined the association between health-related quality of life and financial barriers to care, defined as not getting the needed care due to cost considerations. To better understand health-related quality of life among women veterans, the authors compared women veterans to women non-veterans. The authors conducted cross-sectional analyses using data from the 2009 Behavioral Risk Factor Surveillance System survey. The authors assessed four health-related quality of life measures: (1) general health; (2) physical health; (3) mental health; and (4) functional status. The authors performed multinomial logistic regressions to examine the relationship between financial barriers to receiving healthcare and health-related quality of life measures after controlling for other independent variables. The authors included women veterans not in active military duty (N = 3,747) and a matched sample of women non-veterans (N = 3,747), selected using a propensity score method so that they would have distributions of demographic and socioeconomic characteristics similar to those of the veterans. Overall, 14% of women reported financial barriers. Women who reported financial barriers to receiving healthcare were more likely to have poor health-related quality of life in all four dimensions than those who did not report such barriers. Compared to women non-veterans, women veterans did not differ in reported financial barriers but were more likely to report poor health-related quality of life. Reporting financial barriers to receiving needed healthcare was significantly associated with poor health-related quality of life among women. Veteran status was also significantly associated with poor health-related quality of life. These findings suggest the need for healthcare policy makers and practitioners to align emerging new models of healthcare delivery to improve health-related quality of life for women veterans.

A coupled hydrological-hydraulic flood inundation model calibrated using post-event measurements and integrated uncertainty analysis in a poorly gauged Mediterranean basin

NASA Astrophysics Data System (ADS)

Hdeib, Rouya; Abdallah, Chadi; Moussa, Roger; Colin, Francois

2017-04-01

Developing flood inundation maps of defined exceedance probabilities is required to provide information on the flood hazard and the associated risk. A methodology has been developed to model flood inundation in poorly gauged basins, where reliable information on the hydrological characteristics of floods are uncertain and partially captured by the traditional rain-gauge networks. Flood inundation is performed through coupling a hydrological rainfall-runoff (RR) model (HEC-HMS) with a hydraulic model (HEC-RAS). The RR model is calibrated against the January 2013 flood event in the Awali River basin, Lebanon (300 km2), whose flood peak discharge was estimated by post-event measurements. The resulting flows of the RR model are defined as boundary conditions of the hydraulic model, which is run to generate the corresponding water surface profiles and calibrated against 20 post-event surveyed cross sections after the January-2013 flood event. An uncertainty analysis is performed to assess the results of the models. Consequently, the coupled flood inundation model is simulated with design storms and flood inundation maps are generated of defined exceedance probabilities. The peak discharges estimated by the simulated RR model were in close agreement with the results from different empirical and statistical methods. This methodology can be extended to other poorly gauged basins facing common stage-gauge failure or characterized by floods with a stage exceeding the gauge measurement level, or higher than that defined by the rating curve.

Individual Differences in Anatomy Predict Reading and Oral Language Impairments in Children

ERIC Educational Resources Information Center

Leonard, Christiana; Eckert, Mark; Given, Barbara; Virginia, Berninger; Eden, Guinevere

2006-01-01

Developmental dyslexia (DD) and specific language impairment (SLI) are disorders of language that differ in diagnostic criteria and outcome. DD is defined by isolated reading deficits. SLI is defined by poor receptive and expressive oral language skills. Reading deficits, although prevalent, are not necessary for the diagnosis of SLI. An enduring…

Sampling Methods and the Accredited Population in Athletic Training Education Research

ERIC Educational Resources Information Center

Carr, W. David; Volberding, Jennifer

2009-01-01

Context: We describe methods of sampling the widely-studied, yet poorly defined, population of accredited athletic training education programs (ATEPs). Objective: There are two purposes to this study; first to describe the incidence and types of sampling methods used in athletic training education research, and second to clearly define the…

Prediction and Stability of Reading Problems in Middle Childhood

ERIC Educational Resources Information Center

Ritchey, Kristen D.; Silverman, Rebecca D.; Schatschneider, Christopher; Speece, Deborah L.

2015-01-01

The longitudinal prediction of reading problems from fourth grade to sixth grade was investigated with a sample of 173 students. Reading problems at the end of sixth grade were defined by significantly below average performance (= 15th percentile) on reading factors defining word reading, fluency, and reading comprehension. Sixth grade poor reader…

Wounding induces changes in cytokinin and auxin content in potato tuber, but does not induce formation of gibberellins

USDA-ARS?s Scientific Manuscript database

Cytokinin, auxin and gibberellin content in resting and wound-responding potato tuber are not clearly defined. Consequently, the coordination and possible networking of these classical hormones in the regulation of wound-healing processes are poorly understood. Using a well-defined tuber wound-hea...

Discordance between Psychometric Testing and Questionnaire-Based Definitions of Executive Function Deficits in Individuals with ADHD

ERIC Educational Resources Information Center

Biederman, Joseph; Petty, Carter R.; Fried, Ronna; Black, Sarah; Faneuil, Alicia; Doyle, Alysa E.; Seidman, Larry J.; Faraone, Stephen V.

2008-01-01

Objective: One suspected source of negative outcomes associated with ADHD has been deficits in executive functions. Although both psychometrically defined and self-reported executive function deficits (EFDs) have been shown to be associated with poor academic and occupational outcomes, whether these two approaches define the same individuals…

Features of Patients With Severe Hepatitis Due to Mushroom Poisoning and Factors Associated With Outcome.

PubMed

Bonacini, Maurizio; Shetler, Katerina; Yu, Ira; Osorio, Robert C; Osorio, Robert W

2017-05-01

Acute liver failure after ingestion of toxic mushrooms is a significant medical problem. Most exposures to toxic mushrooms produce no symptoms or only mild gastroenteritis, but some lead to severe hepatic necrosis and fulminant hepatic failure requiring liver transplantation. We aimed to assess mortality from mushroom poisoning and identify variables associated with survival and liver transplantation. We collected information from 27 patients (13 male; median age, 47 years) admitted to the emergency department within 24 hours of ingesting wild mushrooms. They developed severe liver injury (serum levels of transaminases greater than 400 IU/L) and were treated with activated charcoal and N-acetylcysteine at a tertiary medical center in San Francisco, California from January 1997 through December 2014. Viral hepatitis, autoimmune liver disease, acetaminophen, salicylate toxicity, and chronic liver diseases were ruled out for all patients. We analyzed patient demographics, time since ingestion, presenting symptoms, laboratory values, and therapies administered. A good outcome was defined as survival without need for liver transplant. A poor outcome was defined as death or liver transplant. Positive predictive values were calculated, and the χ 2 test was used to analyze dichotomous variables. Liver injury was attributed to ingestion of Amanita phalloides in 24 patients and Amanita ocreata in 3 patients. Twenty-four of the patients ingested mushrooms with meals and 3 patients for hallucinogenic purpose. At 24-48 hours after ingestion, all patients had serum levels of alanine aminotransferase ranging from 554 to 4546 IU/L (median, 2185 IU/L). Acute renal impairment developed in 5 patients. Twenty-three patients survived without liver transplantation, and 4 patients had poor outcomes (1 woman underwent liver transplantation on day 20 after mushroom ingestion, and 3 women died of hepatic failure). Of the 23 patients with peak levels of total bilirubin of 2 mg/dL or more during hospitalization, only 4 had a poor outcome. Peak serum level of aspartate aminotransferase less than 4000 IU/L, peak international normalized ratio less than 2, and a value of serum factor V greater than 30% identified patients with good outcomes with 100% positive predictive value; if these peak values were used as a cutoff, 10 of 27 patients (37%), 7 of 27 patients (26%), and 6 of 12 patients (50%), respectively, could have avoided transfer to a transplant center. In an analysis of 27 patients with hepatocellular damage due to mushroom (Amanita) poisoning and peak levels of total bilirubin greater than 2 mg/dL, the probability of liver transplantation or death is 17%, fulfilling Hy's law. Patients with peak levels of aspartate aminotransferase less than 4000 IU/L can be monitored in a local hospital, whereas patients with higher levels should be transferred to liver transplant centers. Women and older patients were more likely to have a poor outcome than men and younger patients. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

CD56‐positive haematological neoplasms of the skin: a multicentre study of the Cutaneous Lymphoma Project Group of the European Organisation for Research and Treatment of Cancer

PubMed Central

Assaf, Chalid; Gellrich, Sylke; Whittaker, Sean; Robson, Alistair; Cerroni, Lorenzo; Massone, Cesare; Kerl, Helmut; Rose, Christian; Chott, Andreas; Chimenti, Sergio; Hallermann, Christian; Petrella, Tony; Wechsler, Janine; Bagot, Martine; Hummel, Michael; Bullani‐Kerl, Katrin; Bekkenk, Marcel W; Kempf, Werner; Meijer, Chris J L M; Willemze, Rein; Sterry, Wolfram

2007-01-01

Background Cutaneous lymphomas expressing CD56, a neural cell adhesion molecule, are characterised in most cases by a highly aggressive clinical course and a poor prognosis. However, prognostic subsets within the CD56+ group have been difficult to identify due to the lack of uniform clinicopathological and immunophenotypical criteria. Methods A multicentre study was conducted by the Cutaneous Lymphoma Task Force of the European Organisation for Research and Treatment of Cancer to define prognostic parameters and establish diagnostic and therapeutic guidelines for CD56+ haematological neoplasms presenting primarily in the skin. Results Four different subtypes of lymphoproliferations with CD56 expression were identified: (1) haematodermic neoplasm; (2) skin infiltration as the first manifestation of CD56+ acute myeloid leukaemia; (3) nasal‐type extranodal natural killer/T‐cell lymphoma; and (4) “classical” cases of cutaneous T‐cell lymphoma (CTCL) with co‐expression of the CD56 molecule. Patients in the first three groups had a poor outcome (93% died) with a median survival rate of 11 months (95% CI 2–72 months), whereas all patients with CD56+ CTCL were alive at the last follow‐up. Conclusion Results show that CD56+ cutaneous lymphoproliferative disorders, with the exception of CD56+ CTCL have a very poor prognosis. It is therefore clinically important to separate CD56+ CTCL from the remaining CD56+ haematological disorders. PMID:17018683

Imaging of acute ischemic stroke.

PubMed

El-Koussy, Marwan; Schroth, Gerhard; Brekenfeld, Caspar; Arnold, Marcel

2014-01-01

Over 80% of strokes result from ischemic damage to the brain due to an acute reduction in the blood supply. Around 25-35% of strokes present with large vessel occlusion, and the patients in this category often present with severe neurological deficits. Without early treatment, the prognosis is poor. Stroke imaging is critical for assessing the extent of tissue damage and for guiding treatment. This review focuses on the imaging techniques used in the diagnosis and treatment of acute ischemic stroke, with an emphasis on those involving the anterior circulation. Key Message: Effective and standardized imaging protocols are necessary for clinical decision making and for the proper design of prospective studies on acute stroke. Each minute without treatment spells the loss of an estimated 1.8 million neurons ('time is brain'). Therefore, stroke imaging must be performed in a fast and efficient manner. First, intracranial hemorrhage and stroke mimics should be excluded by the use of computed tomography (CT) or magnetic resonance imaging (MRI). The next key step is to define the extent and location of the infarct core (values of >70 ml, >1/3 of the middle cerebral artery (MCA) territory or an ASPECTS score ≤ 7 indicate poor clinical outcome). Penumbral imaging is currently based on the mismatch concept. It should be noted that the penumbra is a dynamic zone and can be sustained in the presence of good collateral circulation. A thrombus length of >8 mm predicts poor recanalization after intravenous thrombolysis. © 2014 S. Karger AG, Basel.

Epidemiology, determinants, and management of AIDS cholangiopathy: A review

PubMed Central

Naseer, Maliha; Dailey, Francis E; Juboori, Alhareth Al; Samiullah, Sami; Tahan, Veysel

2018-01-01

Diseases of the liver and biliary tree have been described with significant frequency among patients with human immunodeficiency virus (HIV), and its advanced state, acquired immunodeficiency syndrome (AIDS). Through a variety of mechanisms, HIV/AIDS has been shown to affect the hepatic parenchyma and biliary tree, leading to liver inflammation and biliary strictures. One of the potential hepatobiliary complications of this viral infection is AIDS cholangiopathy, a syndrome of biliary obstruction and liver damage due to infection-related strictures of the biliary tract. AIDS cholangiopathy is highly associated with opportunistic infections and advanced immunosuppression in AIDS patients, and due to the increased availability of highly active antiretroviral therapy, is now primarily seen in instances of poor access to anti-retroviral therapy and medication non-compliance. While current published literature describes well the clinical, biochemical, and endoscopic management of AIDS-related cholangiopathy, information on its epidemiology, natural history, and pathology are not as well defined. The objective of this review is to summarize the available literature on AIDS cholangiopathy, emphasizing its epidemiology, course of disease, and determinants, while also revealing an updated approach for its evaluation and management. PMID:29467548

Epidemiology, determinants, and management of AIDS cholangiopathy: A review.

PubMed

Naseer, Maliha; Dailey, Francis E; Juboori, Alhareth Al; Samiullah, Sami; Tahan, Veysel

2018-02-21

Diseases of the liver and biliary tree have been described with significant frequency among patients with human immunodeficiency virus (HIV), and its advanced state, acquired immunodeficiency syndrome (AIDS). Through a variety of mechanisms, HIV/AIDS has been shown to affect the hepatic parenchyma and biliary tree, leading to liver inflammation and biliary strictures. One of the potential hepatobiliary complications of this viral infection is AIDS cholangiopathy, a syndrome of biliary obstruction and liver damage due to infection-related strictures of the biliary tract. AIDS cholangiopathy is highly associated with opportunistic infections and advanced immunosuppression in AIDS patients, and due to the increased availability of highly active antiretroviral therapy, is now primarily seen in instances of poor access to anti-retroviral therapy and medication non-compliance. While current published literature describes well the clinical, biochemical, and endoscopic management of AIDS-related cholangiopathy, information on its epidemiology, natural history, and pathology are not as well defined. The objective of this review is to summarize the available literature on AIDS cholangiopathy, emphasizing its epidemiology, course of disease, and determinants, while also revealing an updated approach for its evaluation and management.

Sleep-Wake Disturbances in Sedentary Community-Dwelling Elders With Functional Limitations

PubMed Central

Vaz Fragoso, Carlos A.; Miller, Michael E.; Fielding, Roger A.; King, Abby C.; Kritchevsky, Stephen B.; McDermott, Mary M.; Myers, Valerie; Newman, Anne B.; Pahor, Marco; Gill, Thomas M.

2014-01-01

OBJECTIVES To evaluate sleep-wake disturbances in sedentary community-dwelling elders with functional limitations. DESIGN Cross-sectional. SETTING Lifestyle Interventions and Independence in Elder (LIFE) Study. PARTICIPANTS 1635 community-dwelling persons, mean age 78.9, who spent <20 minutes/week in the past month of regular physical activity and <125 minutes/week of moderate physical activity, and had a Short Physical Performance Battery (SPPB) score <10. MEASUREMENTS Mobility was evaluated by the 400-meter walk time (slow gait speed defined as <0.8 m/s) and SPPB score (≤7 defined moderate-to-severe mobility impairment). Physical inactivity was defined by sedentary time, as percent of accelerometry wear time with activity <100 counts/min); top quartile established high sedentary time. Sleep-wake disturbances were evaluated by the Insomnia Severity Index (ISI) (range 0–28; ≥8 defined insomnia), Epworth Sleepiness Scale (ESS) (range 0–24; ≥10 defined daytime drowsiness), Pittsburgh Sleep Quality Index (PSQI) (range 0–21; >5 defined poor sleep quality), and Berlin Questionnaire (high risk of sleep apnea). RESULTS Prevalence rates were 43.5% for slow gait speed and 44.7% for moderate-to-severe mobility impairment, with 77.0% of accelerometry wear time spent as sedentary time. Prevalence rates were 33.0% for insomnia, 18.1% for daytime drowsiness, 47.8% for poor sleep quality, and 32.9% for high risk of sleep apnea. Participants with insomnia, daytime drowsiness, and poor sleep quality had mean values of 12.1 for ISI, 12.5 for ESS, and 9.2 for PSQI, respectively. In adjusted models, measures of mobility and physical inactivity were generally not associated with sleep-wake disturbances, using continuous or categorical variables. CONCLUSION In a large sample of sedentary community-dwelling elders with functional limitations, sleep-wake disturbances were prevalent but only mildly severe, and were generally not associated with mobility impairment or physical inactivity. PMID:24889836

Influence of trabecular bone quality and implantation direction on press-fit mechanics.

PubMed

Damm, Niklas B; Morlock, Michael M; Bishop, Nicholas E

2017-02-01

Achieving primary stability of uncemented press-fit prostheses in patients with poor quality bone can involve axial implantation forces large enough to cause bone fracture. Radial implantation eliminates intraoperative impaction forces and could prevent this damage. Platens of two commercial implant surfaces ("Beaded" and "Flaked") were implanted onto trabecular bone specimens of varying quality in a press-fit simulator. Samples were implanted with varying interference, either axially (shear) or radially (normal). Push-in and pull-out forces were measured to assess stability. Microstructural changes in the bone were determined from μCT analysis. For force-defined implantation analysis, push-in and pull-out forces both increased proportionally with increasing radial force, independent of implantation direction, bone quality or implant surface. For position-defined implantation analysis, pull-out forces were generally found to increase with interference and to be greater for radial than axial implantation direction, and to be lower for poor quality bone. Bone density increased locally at the tested interface due to implantation, in particular for the Beaded surface under axial implantation. If a safe radial stress can be determined for cortical bone in a particular patient, the associated implantation force, and pull-out force which represents primary stability, can be directly derived, regardless of implantation direction, bone quality or implant surface. Radial implantation delivers primary stability that is no worse than that for axial implantation and may eliminate potentially damaging impaction forces. Development of implant designs based on this principal might improve implant fixation. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:224-233, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Clinical markers of vitiligo activity.

PubMed

Benzekri, Laila; Gauthier, Yvon

2017-05-01

Current modalities of understanding disease state (active/stable) are limited when considering treatment of vitiligo. We sought to develop a rapid, accurate, and noninvasive assessment of vitiligo state. In daylight and Wood's light examinations, 2 common clinical types of vitiligo were identified as amelanotic with sharply demarcated borders and hypomelanotic with poorly defined borders. Photographs were taken at the time of examination and a skin biopsy at the edge of a vitiligo lesion was performed. One year after the initial visit, the vitiligo was classified as stable if no new lesions had appeared, and as active if the number, size, or both of existing vitiligo lesions were increased. Skin biopsy specimens from 71 patients were stained and immunostained for melanocytes, CD8 + T lymphocytes, and E-cadherin. The active lesions were associated with hypomelanotic appearance with poorly defined borders (P < .001), and histologically with an infiltration of CD8 + T lymphocytes in the epidermis and dermis (P = .017), with a strong expression of E-cadherin (P = .044). The fact that this was a single-center study and that activity was sometimes site-dependent are limitations. The hypomelanotic with poorly defined borders type could be a good indicator of the actual activity of a vitiligo lesion. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

The intention to disclose medical errors among doctors in a referral hospital in North Malaysia.

PubMed

Hs, Arvinder-Singh; Rashid, Abdul

2017-01-23

In this study, medical errors are defined as unintentional patient harm caused by a doctor's mistake. This topic, due to limited research, is poorly understood in Malaysia. The objective of this study was to determine the proportion of doctors intending to disclose medical errors, and their attitudes/perception pertaining to medical errors. This cross-sectional study was conducted at a tertiary public hospital from July- December 2015 among 276 randomly selected doctors. Data was collected using a standardized and validated self-administered questionnaire intending to measure disclosure and attitudes/perceptions. The scale had four vignettes in total two medical and two surgical. Each vignette consisted of five questions and each question measured the disclosure. Disclosure was categorised as "No Disclosure", "Partial Disclosure" or "Full Disclosure". Data was keyed in and analysed using STATA v 13.0. Only 10.1% (n = 28) intended to disclose medical errors. Most respondents felt that they possessed an attitude/perception of adequately disclosing errors to patients. There was a statistically significant difference (p < 0.001) when comparing the intention of disclosure with perceived disclosures. Most respondents were in common agreement that disclosing an error would make them less likely to get sued, that minor errors should be reported and that they experienced relief from disclosing errors. Most doctors in this study would not disclose medical errors although they perceived that the errors were serious and felt responsible for it. Poor disclosure could be due the fear of litigations and improper mechanisms/procedures available for disclosure.

Factors determining poor prognostic outcomes following diabetic hand infections

PubMed Central

Ince, Bilsev; Dadaci, Mehmet; Arslan, Abdullah; Altuntas, Zeynep; Evrenos, Mustafa Kursat; Fatih Karsli, Mehmet

2015-01-01

Background and Objective: Hand ulcers are seen in a small percentage of patients with diabetes. The predisposing factors of diabetic hand varies between different countries. However, the effects of predisposing factors on prognosis are not clear in diabetic hand infections. In this study, our aim was to determine the effects of predisposing factors on poor prognostic outcomes in patients with diabetes mellitus. Methods: Thirty-four patients with diabetes mellitus who were treated and followed up for a hand infection in between 2008 and 2014 were investigated retrospectively. Patients were evaluated according to predisposing factors defined in the literature that included disease period, age, gender, admission time, presence of neuropathy, smoking habits, HbA1c levels at admission time, peripheral vascular disease, end-stage renal disease (ESRD), and trauma. Death and minor/major amputation cases during treatment were defined as poor prognosis. Results: Patients who had ESRD, peripheral neuropathy, or an HbA1c level greater than 10% had significantly higher amputation rates. Conclusions: Peripheral neuropathy, ESRD, and HbA1c levels greater than 10% at the time of admission were determined as poor prognosis criteria for diabetic hand treatment. PMID:26150838

Cerebral toxoplasmosis combined with disseminated tuberculosis.

PubMed

Hwang, Eui Ho; Ahn, Poong Gi; Lee, Dong Min; Kim, Hyeok Su

2012-05-01

A 24-year-old man presented with mental change, fever, abdominal pain, tenderness and palpable mass on the lower abdomen. He was a non-Korean engineer and did not accompany a legal guardian, so medical history taking was difficult due to his mental status. Brain magnetic resonance imaging showed multiple rim-enhanced lesions of the brain, and abdominal computed tomography showed huge paraspinal abscess. Chest X-ray and computed tomography showed poorly defined nodular opacities. We initially thought that this patient was infected with toxoplasmosis with typical cerebral image finding and immunoglobulin laboratory finding of cerebrospinal fluid and serum study. The abdominal abscess was confirmed as tuberculosis through the pathologic finding of caseous necrosis. We used anti-tuberculosis medication and anti-toxoplasmosis medication for almost 4 months, and then his clinical state and radiological findings were considerably improved.

Climate forcings in the industrial era.

PubMed

Hansen, J E; Sato, M; Lacis, A; Ruedy, R; Tegen, I; Matthews, E

1998-10-27

The forcings that drive long-term climate change are not known with an accuracy sufficient to define future climate change. Anthropogenic greenhouse gases (GHGs), which are well measured, cause a strong positive (warming) forcing. But other, poorly measured, anthropogenic forcings, especially changes of atmospheric aerosols, clouds, and land-use patterns, cause a negative forcing that tends to offset greenhouse warming. One consequence of this partial balance is that the natural forcing due to solar irradiance changes may play a larger role in long-term climate change than inferred from comparison with GHGs alone. Current trends in GHG climate forcings are smaller than in popular "business as usual" or 1% per year CO2 growth scenarios. The summary implication is a paradigm change for long-term climate projections: uncertainties in climate forcings have supplanted global climate sensitivity as the predominant issue.

Healthy mental ageing.

PubMed

Flicker, Leon; Lautenschlager, Nicola T; Almeida, Osvaldo P

2006-09-01

Healthy mental ageing may be defined as the absence of the common disabling mental health problems of older people, especially cognitive decline and depression, accompanied by the perception of a positive quality of life. Older people are particularly prone to negative effects on mental health due to poor physical health. Modifiable aspects of lifestyle have been shown to be associated with healthy mental ageing. These include increased physical activity, intellectual stimulation (including education), avoidance of smoking and various aspects of diet. There is reasonably strong evidence that the treatment of hypertension will decrease the risk of cognitive impairment, and moderate alcohol intake may also have some benefits on cognition. These modifiable lifestyle factors may benefit from deliberate individual and population health promotion strategies to maximize mental health in old age, although to date intervention trials have not been performed to support the evidence obtained from observational studies.

Climate Forcings in the Industrial Era

NASA Technical Reports Server (NTRS)

Hansen, James E.; Sato, Makiko; Lacis, Andrew; Ruedy, Reto; Tegen, Ina; Matthews, Elaine

1998-01-01

The forcings that drive long-term climate change are not known with an accuracy sufficient to define future climate change. Anthropogenic greenhouse gases (GHGs), which are well measured, cause a strong positive (warming) forcing. But other, poorly measured, anthropogenic forcings, especially changes of atmospheric aerosols, clouds, and land-use patterns, cause a negative forcing that tends to offset greenhouse warming. One consequence of this partial balance is-that the natural forcing due to solar irradiance changes may play a larger role in long-term climate change than inferred from comparison with GHGs alone. Current trends in GHG climate forcings are smaller than in popular "business as usual" or 1% per year CO2 growth scenarios. The summary implication is a paradigm change for long-term climate projections: uncertainties in climate forcings have supplanted global climate sensitivity as the predominant issue.

Climate forcings in the Industrial era

PubMed Central

Hansen, James E.; Sato, Makiko; Lacis, Andrew; Ruedy, Reto; Tegen, Ina; Matthews, Elaine

1998-01-01

The forcings that drive long-term climate change are not known with an accuracy sufficient to define future climate change. Anthropogenic greenhouse gases (GHGs), which are well measured, cause a strong positive (warming) forcing. But other, poorly measured, anthropogenic forcings, especially changes of atmospheric aerosols, clouds, and land-use patterns, cause a negative forcing that tends to offset greenhouse warming. One consequence of this partial balance is that the natural forcing due to solar irradiance changes may play a larger role in long-term climate change than inferred from comparison with GHGs alone. Current trends in GHG climate forcings are smaller than in popular “business as usual” or 1% per year CO2 growth scenarios. The summary implication is a paradigm change for long-term climate projections: uncertainties in climate forcings have supplanted global climate sensitivity as the predominant issue. PMID:9788985

Climate Simulations of Past, Present and Future

NASA Technical Reports Server (NTRS)

Hansen, James E.

1999-01-01

The forcings that drive long-term climate change are not known with an accuracy sufficient to define future climate change. Anthropogenic greenhouse gases (GHGs), which are well measured, cause a strong positive (warming) forcing. But other, poorly measured, anthropogenic forcings, especially changes of atmospheric aerosols, clouds, and land-use patterns, cause a negative forcing that tends to offset greenhouse warming. One consequence of this partial balance is that the natural forcing due to solar irradiance changes may play a larger role in long-term climate change than inferred from comparison with GHGs alone. Current trends in GHG climate forcings are smaller than in popular "business as usual" or 1% per year CO2 growth scenarios. The summary implication is a paradigm change for long-term climate projections: uncertainties in climate forcings have supplanted global climate sensitivity as the predominant issue.

Climate Forcing in the Industrial Era

NASA Technical Reports Server (NTRS)

Hansen, James E.

1998-01-01

The forcings that drive long-term climate change are not known with an accuracy sufficient to define future climate change. Anthropogenic greenhouse gases (GHGs), which are well measured, cause a strong positive (warming) forcing. But other, poorly measured, anthropogenic forcings, especially changes of atmospheric aerosols, clouds, and land-use patterns, cause a negative forcing that tends to offset greenhouse warming. One consequence of this partial balance is that the natural forcing due to solar irradiance changes may play a larger role in long-term climate change than inferred from comparison with GHGs alone. Current trends in GHG climate forcings are smaller than in popular "business as usual" or 1% per year CO2 growth scenarios. The summary implication is a paradigm change for long-term climate projections: uncertainties in climate forcings have supplanted global climate sensitivity as the predominant issue.

Perspective: Climate Forcings in the Industrial Era

NASA Technical Reports Server (NTRS)

Hansen, James E.; Sato, Makiko; Lacis, Andrew; Ruedy, Reto; Tegen, Ina; Matthews, Elaine

1998-01-01

The forcings that drive long-term climate change are not known with an accuracy sufficient to define future climate change. Anthropogenic greenhouse gases (GHGs), which are well measured, cause a strong positive (warming) forcing. But other, poorly measured, anthropogenic forcings, especially changes of atmospheric aerosols, clouds, and land-use patterns, cause a negative forcing that tends to offset greenhouse warming. One consequence of this partial balance is that the natural forcing due to solar irradiance changes may play a larger role in long-term climate change than inferred from comparison with GHGs alone. Current trends in GHG climate forcings are smaller than in popular "business as usual" or 1% per year CO growth scenarios. The summary implication is a paradigm change for long-term climate projections: uncertainties in climate forcings have supplanted global climate sensitivity as the predominant issue.

Prevalence of Poor Bone Quality in Women Undergoing Spinal Fusion Using Biomechanical-CT Analysis.

PubMed

Burch, Shane; Feldstein, Michael; Hoffmann, Paul F; Keaveny, Tony M

2016-02-01

Retrospective, cross-sectional analysis of vertebral bone quality in spine-fusion patients at a single medical center. To characterize the prevalence of osteoporosis and fragile bone strength in a spine-fusion population of women with an age range of 50 years to 70 years. Fragile bone strength is defined as the level of vertebral strength below which a patient is at as high a risk of future vertebral fracture as a patient having bone density-defined osteoporosis. Poor bone quality--defined here as the presence of either osteoporosis or fragile bone strength--is a risk factor for spine-fusion patients that often goes undetected but can now be assessed preoperatively by additional postprocessing of computed tomography (CT) scans originally ordered for perioperative clinical assessment. Utilizing such perioperative CT scans for a cohort of 98 women (age range: 51-70 yr) about to undergo spine fusion, we retrospectively used a phantomless calibration technique and biomechanical-CT postprocessing analysis to measure vertebral trabecular bone mineral density (BMD) (in mg/cm³) and by nonlinear finite element analysis, vertebral compressive strength (in Newtons, N) in the L1 or L2 vertebra. Preestablished validated threshold values were used to define the presence of osteoporosis (trabecular BMD of 80 mg/cm³ or lower) and fragile bone strength (vertebral strength of 4500 N or lower). Fourteen percent of the women tested positive for osteoporosis, 27% tested positive for fragile bone strength, and 29% were classified as having poor bone quality (either osteoporosis or fragile bone strength). Over this narrow age range, neither BMD nor vertebral strength were significantly correlated with age, weight, height, or body mass index (P values 0.14-0.97 for BMD; 0.13-0.51 for strength). Poor bone quality appears to be common in women between ages 50 years and 70 years undergoing spinal fusion surgery. 3.

Assessment of environmental enteropathy in the MAL-ED cohort study: theoretical and analytic framework.

PubMed

Kosek, Margaret; Guerrant, Richard L; Kang, Gagandeep; Bhutta, Zulfiqar; Yori, Pablo Peñataro; Gratz, Jean; Gottlieb, Michael; Lang, Dennis; Lee, Gwenyth; Haque, Rashidul; Mason, Carl J; Ahmed, Tahmeed; Lima, Aldo; Petri, William A; Houpt, Eric; Olortegui, Maribel Paredes; Seidman, Jessica C; Mduma, Estomih; Samie, Amidou; Babji, Sudhir

2014-11-01

Individuals in the developing world live in conditions of intense exposure to enteric pathogens due to suboptimal water and sanitation. These environmental conditions lead to alterations in intestinal structure, function, and local and systemic immune activation that are collectively referred to as environmental enteropathy (EE). This condition, although poorly defined, is likely to be exacerbated by undernutrition as well as being responsible for permanent growth deficits acquired in early childhood, vaccine failure, and loss of human potential. This article addresses the underlying theoretical and analytical frameworks informing the methodology proposed by the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) cohort study to define and quantify the burden of disease caused by EE within a multisite cohort. Additionally, we will discuss efforts to improve, standardize, and harmonize laboratory practices within the MAL-ED Network. These efforts will address current limitations in the understanding of EE and its burden on children in the developing world. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Determinants of childhood immunisation coverage in urban poor settlements of Delhi, India: a cross-sectional study

PubMed Central

Devasenapathy, Niveditha; Ghosh Jerath, Suparna; Sharma, Saket; Allen, Elizabeth; Shankar, Anuraj H; Zodpey, Sanjay

2016-01-01

Objectives Aggregate data on childhood immunisation from urban settings may not reflect the coverage among the urban poor. This study provides information on complete childhood immunisation coverage among the urban poor, and explores its household and neighbourhood-level determinants. Setting Urban poor community in the Southeast district of Delhi, India. Participants We randomly sampled 1849 children aged 1–3.5 years from 13 451 households in 39 clusters (cluster defined as area covered by a community health worker) in 2 large urban poor settlements. Of these, 1343 completed the survey. We collected information regarding childhood immunisation (BCG, oral polio vaccine, diphtheria–pertussis–tetanus vaccine, hepatitis B and measles) from vaccination cards or mothers’ recall. We used random intercept logistic regression to explore the sociodemographic determinants of complete immunisation. Results Complete immunisation coverage was 46.7% and 7.5% were not immunised. The odds of complete vaccination (OR, 95% CI) were lower in female children (0.70 (0.55 to 0.89)) and Muslim households (0.65 (0.45 to 0.94)). The odds of complete vaccination were higher if the mother was literate (1.6 (1.15 to 2.16)), if the child was born within the city (2.7 (1.97 to 3.65)), in a health facility ( 1.5 (1.19 to 2.02)), belonged to the highest wealth quintile (compared with the poorest; 2.46 (1.5 to 4.02)) or possessed a birth certificate (1.40 (1.03 to 1.91)). Cluster effect due to unmeasured neighbourhood factors expressed as median OR was 1.32. Conclusions Immunisation coverage in this urban poor area was much lower than that of regional surveys reporting overall urban data. Socioeconomic status of the household, female illiteracy, health awareness and gender inequality were important determinants of coverage in this population. Hence, in addition to enhancing the infrastructure for providing mother and child services, efforts are also needed to address these issues in order to improve immunisation coverage in deprived urban communities. Trial registration number CTRI/2011/091/000095. PMID:27566644

Psychological distress and academic self-perception among international medical students: the role of peer social support.

PubMed

Yamada, Yukari; Klugar, Miloslav; Ivanova, Katerina; Oborna, Ivana

2014-11-28

Psychological distress among medical students is commonly observed during medical education and is generally related to poor academic self-perception. We evaluated the role of peer social support at medical schools in the association between psychological distress and academic self-perception. An online survey was conducted in a medical degree program for 138 international students educated in English in the Czech Republic. The Medical Student Well-Being Index was used to define the students' psychological distress. Perceived peer social support was investigated with the Multidimensional Scale of Perceived Social Support. Poor academic self-perception was defined as the lowest 30% of a subscale score of the Dundee Ready Education Environment Measure. Analyses evaluated the presence of additive interactions between psychological distress and peer social support on poor academic self-perception, adjusted for possible confounders. Both psychological distress and low peer social support were negatively associated with poor academic self-perception, adjusted for local language proficiency and social support from family. Students with psychological distress and low peer social support had an odds ratio of 11.0 (95% confidence interval (CI): 2.1-56.6) for poor academic self-perception as compared with those without distress who had high peer social support. The presence of an additive interaction was confirmed in that the joint association was four times as large as what would have been expected to be on summing the individual risks of psychological distress and low peer social support (synergy index = 4.5, 95% CI: 1.3-14.9). Psychological distress and low peer social support may synergistically increase the probability of poor academic self-perception among international medical students. Promoting peer social relationships at medical school may interrupt the vicious cycle of psychological distress and poor academic performance.

Poor sleep health and its association with mental health, substance use, and condomless anal intercourse among gay, bisexual, and other men who have sex with men

PubMed Central

Duncan, Dustin T.; Goedel, William C.; Mayer, Kenneth H.; Safren, Steven A.; Palamar, Joseph J.; Hagen, Daniel; Jean-Louis, Girardin

2017-01-01

Objectives The purpose of this study was to evaluate the prevalence of poor sleep health (ie, poor sleep quality and short sleep duration) in a sample of men who have sex with men (MSM). In addition, this study examined whether poor sleep health was associated with depressive symptoms, substance use, and sexual risk behaviors in this sample. Design Cross-sectional survey. Participants Broadcast advertisements were placed on a popular smartphone application for MSM in January 2016 to recruit users in the London metropolitan area (n = 202) to complete a Web-based survey, which included validated measures of sleep quality and duration. Measurements Poor sleep quality was defined based on self-report as very or fairly bad. Short sleep duration was defined as less than 7 hours each night. Regression models were used to assess associations between sleep variables and self-reported depressive symptoms, substance use, and sexual risk behaviors. Results About one-third (34.6%) of the respondents reported poor sleep quality and almost half (43.6%) reported sleeping less than 7 hours every night. Several poor sleep health variables were independently associated with depressive symptoms, substance use (eg, use of alcohol or marijuana), and condomless anal intercourse. For example, typical nightly sleep duration of less than 7 hours was associated with condomless receptive anal intercourse with a higher number of sexual partners (incidence rate ratio, 2.65; 95% confidence interval: 1.63–4.30; P < .001). Conclusion Sleep health promotion interventions should be developed for MSM, which may promote positive mental health as well as reduce substance use and sexual risk behaviors in this population. PMID:29073390

Poor sleep health and its association with mental health, substance use, and condomless anal intercourse among gay, bisexual, and other men who have sex with men.

PubMed

Duncan, Dustin T; Goedel, William C; Mayer, Kenneth H; Safren, Steven A; Palamar, Joseph J; Hagen, Daniel; Jean-Louis, Girardin

2016-12-01

The purpose of this study was to evaluate the prevalence of poor sleep health (ie, poor sleep quality and short sleep duration) in a sample of men who have sex with men (MSM). In addition, this study examined whether poor sleep health was associated with depressive symptoms, substance use, and sexual risk behaviors in this sample. Cross-sectional survey. Broadcast advertisements were placed on a popular smartphone application for MSM in January 2016 to recruit users in the London metropolitan area (n=202) to complete a Web-based survey, which included validated measures of sleep quality and duration. Poor sleep quality was defined based on self-report as very or fairly bad. Short sleep duration was defined as less than 7 hours each night. Regression models were used to assess associations between sleep variables and self-reported depressive symptoms, substance use, and sexual risk behaviors. About one-third (34.6%) of the respondents reported poor sleep quality and almost half (43.6%) reported sleeping less than 7 hours every night. Several poor sleep health variables were independently associated with depressive symptoms, substance use (eg, use of alcohol or marijuana), and condomless anal intercourse. For example, typical nightly sleep duration of less than 7 hours was associated with condomless receptive anal intercourse with a higher number of sexual partners (incidence rate ratio, 2.65; 95% confidence interval: 1.63-4.30; P<.001). Sleep health promotion interventions should be developed for MSM, which may promote positive mental health as well as reduce substance use and sexual risk behaviors in this population. Copyright \\© 2016 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Impact and sustainability of low-head drip irrigation kits, in the semi-arid Gwanda and Beitbridge Districts, Mzingwane Catchment, Limpopo Basin, Zimbabwe

NASA Astrophysics Data System (ADS)

Moyo, Richard; Love, David; Mul, Marloes; Mupangwa, Walter; Twomlow, Steve

Resource-poor smallholder farmers in the semi-arid Gwanda and Beitbridge districts face food insecurity on an annual basis due to a combination of poor and erratic rainfall (average 500 mm/a and 345 mm/a, respectively, for the period 1970-2003) and technologies inappropriate to their resource status. This impacts on both household livelihoods and food security. In an attempt to improve food security in the catchment a number of drip kit distribution programmes have been initiated since 2003 as part of an on-going global initiative aimed at 2 million poor households per year. A number of recent studies have assessed the technical performance of the drip kits in-lab and in-field. In early 2005 a study was undertaken to assess the impacts and sustainability of the drip kit programme. Representatives of the NGOs, local government, traditional leadership and agricultural extension officers were interviewed. Focus group discussions with beneficiaries and other villagers were held at village level. A survey of 114 households was then conducted in two districts, using a questionnaire developed from the output of the interviews and focus group discussions. The results from the study showed that the NGOs did not specifically target the distribution of the drip kits to poor members of the community (defined for the purpose of the study as those not owning cattle). Poor households made up 54% of the beneficiaries. This poor targeting of vulnerable households could have been a result of conditions set by some implementing NGOs that beneficiaries must have an assured water source. On the other hand, only 2% of the beneficiaries had used the kit to produce the expected 5 harvests over the 2 years, owing to problems related to water shortage, access to water and also pests and diseases. About 51% of the respondents had produced at least 3 harvests and 86% produced at least 2 harvests. Due to water shortages during the dry season 61% of production with the drip kit occurred during the wet season. This suggests that most households use the drip kits as supplementary irrigation. Conflicts between beneficiaries and water point committees or other water users developed in some areas especially during the dry season. The main finding from this study was that low cost drip kit programs can only be a sustainable intervention if implemented as an integral part of a long-term development program, not short-term relief programs and the programme should involve a broad range of stakeholders. A first step in any such program, especially in water scarce areas such as Gwanda and Beitbridge, is a detailed analysis of the existing water resources to assess availability and potential conflicts, prior to distribution of drip kits.

Factors associated with poor satisfaction with treatment and trial discontinuation in chronic schizophrenia.

PubMed

Schoemaker, Joep H; Vingerhoets, Ad J J M; Emsley, Robin A

2018-06-05

IntroductionDespite consistently high discontinuation rates due to withdrawal of consent (WOC) and insufficient therapeutic effect (ITE) in schizophrenia trials, insight into the underlying factors contributing to poor satisfaction with treatment and dropout is limited. A better understanding of these factors could help to improve trial design and completion rates. Using data from 1,136 trial participants with schizophrenia or schizoaffective disorder, we explored associations between predictor variables with (1) dropout due to WOC and ITE and (2) satisfaction with treatment among patients and investigators by means of hierarchic multiple regression analyses. ITE was associated with poor clinical improvement, poor investigator satisfaction with treatment, and poor patient insight into their own disease, whereas WOC only showed a meaningful association with poor patient satisfaction with treatment. Investigator satisfaction with treatment appeared most strongly associated with Positive and Negative Syndrome Scale (PANSS) positive factor endpoint scores, whereas patient satisfaction with treatment was best predicted by the endpoint score on the PANSS emotional distress factor. The occurrence of severe side effects showed no meaningful association to satisfaction with treatment among investigators and patients, and neither did a patient's experienced psychopathology, nor their self-rating of functional impairment. Whereas trial discontinuation due to ITE is associated with poor treatment effectiveness, a patient's decision to withdraw from an antipsychotic trial remains unpredictable and may occur even when the investigator observes a global clinical improvement and is satisfied with the treatment.

Work disability prevention in rural healthcare workers.

PubMed

Franche, Renée L; Murray, Eleanor J; Ostry, Aleck; Ratner, Pamela A; Wagner, Shannon L; Harder, Henry G

2010-01-01

Approximately 20% of healthcare workers in high-income countries such as Australia, Canada and the USA work in rural areas. Healthcare workers are known to be vulnerable to occupational injury and poor work disability outcomes; given their rural-urban distribution, it is possible to compare work disability prevention in rural and urban areas. However, little attention has been paid to work disability prevention issues specific to rural workers, including rural healthcare workers. A comprehensive review of the literature was conducted to identify rural-urban differences in work disability outcomes (defined as the incidence of occupational injury and the duration of associated work absence), as well as risk factors for poor work disability outcomes in rural healthcare workers. The databases MEDLINE, CINAHL, and EMBASE were searched, as were relevant research centers and government agencies, to identify all quantitative and qualitative English-language studies published between 1 January 2000 and 6 October 2009 that discussed occupational injury, work absence duration, work disability management, or risk factors for poor work disability outcomes, for rural workers specifically, or in comparison with urban workers. To ensure inclusion of studies of healthcare workers as a distinct group among other sector-specific groups, a broad search for literature related to all industrial sectors was conducted. Of 860 references identified, 5 discussed work disability outcomes and 25 discussed known risk factors. Known risk factors were defined as factors firmly established to be associated with poor work disability outcomes in the general worker population based on systematic reviews, well-established conceptual models of work disability prevention, and public health literature. Although somewhat conflicting, the evidence suggests that rural healthcare workers experience higher rates of occupational injury compared with urban healthcare workers, within occupational categories. Rural workers also appear to be more vulnerable to prolonged work absence although the data are limited. No studies directly compared risk factors for work disability prevention outcomes between rural and urban healthcare workers. However, potential risk factors were identified at the level of the environment, worker, job, organization, worker compensation system and healthcare access. Important methodological limitations were noted, including unclear definitions of rurality, inadequate methods of urban-rural comparisons such as comparing samples from different countries, and a paucity of studies applying longitudinal or multivariate designs. There is a notable lack of evidence about work disability prevention issues for healthcare workers in rural areas. Available evidence supports the hypothesis that rural healthcare workers are vulnerable to occupational injury, and suggests they are vulnerable to prolonged work absence. They may be particularly vulnerable to poor work disability prevention outcomes due to complex patient needs in the context of risk factors such as heavy workloads, long hours, heavy on-call demands, high stress levels, limited support and workplace violence. Additional vulnerability may occur because their work conditions are managed in distant urban administrative centers, and due to barriers in their own healthcare access. Although rural healthcare workers seem generally at greater risk of injury, one study suggests that urban emergency medical service workers experience a high vulnerability to injury that may outweigh the effects of rurality. Additional research is needed to document rural-urban disparities in work disability outcomes and to identify associated sources and risk factors. Other issues to address are access to and quality of healthcare for rural healthcare workers, streamlining the compensation system, the unique needs of Aboriginal healthcare workers, and the management of prolonged work absence. Finally, occupational injury and work absence duration programs should be tailored to meet the needs of rural workers.

Soil Water Retention as Indicator for Soil Physical Quality - Examples from Two SoilTrEC European Critical Zone Observatories

NASA Astrophysics Data System (ADS)

Rousseva, Svetla; Kercheva, Milena; Shishkov, Toma; Dimitrov, Emil; Nenov, Martin; Lair, Georg J.; Moraetis, Daniel

2014-05-01

Soil water retention is of primary importance for majority of soil functions. The characteristics derived from Soil Water Retention Curve (SWRC) are directly related to soil structure and soil water regime and can be used as indicators for soil physical quality. The aim of this study is to present some parameters and relationships based on the SWRC data from the soil profiles characterising the European SoilTrEC Critical Zone Observatories Fuchsenbigl and Koiliaris. The studied soils are representative for highly productive soils managed as arable land in the frame of soil formation chronosequence at "Marchfeld" (Fuchsenbigl CZO), Austria and heavily impacted soils during centuries through intensive grazing and farming, under severe risk of desertification in context of climatic and lithological gradient at Koiliaris, Crete, Greece. Soil water retention at pF ≤ 2.52 was determined using the undisturbed soil cores (100 cm3 and 50 cm3) by a suction plate method. Water retention at pF = 4.2 was determined by a membrane press method and at pF ≥ 5.6 - by adsorption of water vapour at controlled relative humidity, both using ground soil samples. The soil physical quality parameter (S-parameter) was defined as the slope of the water retention curve at its inflection point (Dexter, 2006), determined with the obtained parameters of van Genuhten (1980) water retention equation. The S-parameter values were categorised to assess soil physical quality as follows: S < 0.020 very poor, 0.020 ≤ S < 0.035 poor, 0.035 ≤ S < 0.050 good, S ≥ 0.050 very good (Dexter, 2004). The results showed that most of the studied topsoil horizons have good physical quality according to both the S-parameter and the Plant-Available Water content (PAW), with the exception of the soils from croplands at CZO Fuxenbigl (F4, F5) which are with poor soil structure. The link between the S-parameter and the indicator of soil structure stability (water stable soil aggregates with size 1-3 mm) is not well defined. The scattering is due to high values of S in subsoil, which does not always coincide with favourable physical properties, as it can be seen from the relationship with the PAW content. It was found that values of S ≥ 0.05 correspond to PAW > 20 % vol. in the topsoil horizons. The high values of S in subsoil horizons are due to the low PAW and restrict the application of the S categories in these cases. Well defined links are found between the PAW content and the S-parameter when the data from the topsoil horizons are grouped in 2 groups according to the ratio between air-filled pores (at pF 2.52) and plant available water: <2 and ≥ 2. The authors acknowledge gratefully the European Commission Research Directorate-General for funding the SoilTrEC project (Contract No 244118) under its 7th Framework Programme.

Standard & Poor's "Return on Resources" Measure of School Performance. Issue Brief. Volume 1, Issue 1

ERIC Educational Resources Information Center

Reeder, Brian

2004-01-01

Standard & Poors (S&P) uses a measure they call a Performance Cost Index (PCI) as their measure of a school or district?s ?Return on Resources?. The Performance Cost Index is defined as the average cost per measured ?unit? of student performance. In its simplest form, the Performance Cost Index is calculated as per student expenditures divided by…

Lab Astro and the Origins of the Chemical Elements

NASA Astrophysics Data System (ADS)

Lawler, James E.

2010-03-01

Interpretation of the spectra of metal-poor Galactic halo stars is dependent on AMO laboratory data [1,2]. Metal-poor Galactic halo stars were born when the Milky Way was young and they provide a record of the chemical evolution of the Galaxy. Elements heavier than iron are produced via r(apid)-process and s(low)-process n(eutron)-capture mechanisms. The s-process mechanism, which occurs in certain AGB stars, is relatively well understood. The explosive r-process is not well understood. The r-process n-capture mechanism was dominant early in the Galaxy's history [3]. New large aperture telescopes make it possible to record high-resolution spectra with high signal-to-noise ratios on a growing number of metal-poor stars. In addition to mapping the chemical evolution of the Galaxy, these studies are yielding an increasingly well-defined r-process elemental abundance pattern which constrains models of r-process nucleosynthesis [1]. The next phase of this ongoing research will address challenges in modeling stellar photospheres. Peculiar trends in abundances of specific Fe-group elements as a function of stellar age or metallicity may be due to limitations in traditional one dimensional (1d) local thermodynamic equilibrium (LTE) models of stellar photospheres or may be due to poorly understood nucleosynthesis [4]. Efforts are now underway to test the Saha or ionization equilibrium in a variety of stellar atmospheres for several Fe-group elements using the best available spectroscopic data for selected transitions. More comprehensive spectroscopic data of improved accuracy and accurate collisional data, especially for inelastic collisions of H atoms with metal atoms and ions, will be needed to fully develop 3d/non-LTE models of photospheres [e.g. 5]. [4pt] [1] C. Sneden, J. E. Lawler, J. J. Cowan, I. I. Ivans, and E. A. Den Hartog, Astrophys. J. Suppl. Ser. 182, 80-96 (2009). [0pt] [2] J. E. Lawler, C. Sneden, J. J. Cowan, I. I. Ivans, and E. A. Den Hartog, Astrophys. J. Suppl. Ser. 182, 51-79 (2009). [0pt] [3] J. Simmerer, C. Sneden, J. J. Cowan, J. Collier, V. M. Woolf, and J. E. Lawler, Astrophys. J. 617, 1091-1114 (2004). [0pt] [4] A. McWilliam, Ann. Rev. Astron. & Astrophys. 35, 503 (1997). [0pt] [5] M. Asplund, Ann. Rev. Astron. & Astrophys. 43, 481 (2005).

Injuries associated with police use of force.

PubMed

Bozeman, William P; Stopyra, Jason P; Klinger, David A; Martin, Brian P; Graham, Derrel D; Johnson, James C; Mahoney-Tesoriero, Katherine; Vail, Sydney J

2018-03-01

Use of force [UOF] by police can result in serious injuries and fatalities. The risk of significant injuries associated with different force modalities is poorly defined. We sought to determine the incidence of police UOF and compare the likelihood of significant injury with different force modalities. A prospective multicenter observational study of all UOF incidents was conducted via mandatory UOF investigations at three mid-sized police agencies over a two year period. Expert physicians reviewed police and medical records to determine injury severity using a priori injury severity stratification criteria. There were 893 UOF incidents, representing a UOF rate of 0.086% of 1,041,737 calls for service (1 in 1167) and 0.78% of 114,064 criminal arrests(1 in 128). Suspects were primarily young (mean age, 31 years; range, 12-86 years) males (89%). The 1,399 force utilizations included unarmed physical force (n = 710, 51%), CEWs (504, 30%), chemical (88, 6.3%), canines (47, 3.4%), impact weapons (9, 0.6%), kinetic impact munitions (8, 0.6%), firearms (6, 0.4%), and other (27, 1.9%). Among 914 suspects, 898 (98%) sustained no or mild injury after police UOF. Significant (moderate or severe) injuries occurred in 16 (1.8%) subjects. Logistic regression analysis shows these are most associated with firearm and canine use. There was one fatality (0.1%) due to gunshots. No significant injuries occurred among 504 CEW uses (0%; 95% confidence interval, 0.0-0.9%). Of the 355 suspects transported to a medical facility, 78 (22%) were hospitalized. The majority of hospitalizations were unrelated to UOF (n = 59, 76%), whereas a minority (n = 19, 24%) were due to injuries related to police UOF. Police UOF is rare. When force is used officers most commonly rely on unarmed physical force and CEWs. Significant injuries are rare. Transport for medical evaluation is a poor surrogate for significant injury due to UOF. Epidemiological, level II.

40 CFR Appendix D to Part 132 - Great Lakes Water Quality Initiative Methodology for the Development of Wildlife Criteria

Code of Federal Regulations, 2014 CFR

2014-07-01

...-conducted study of 90 days or greater designed to observe subchronic or chronic effects as defined in this document. 2. The avian data must come from at least one well-conducted study of 70 days or greater designed... poorly defined comparative toxicokinetic and toxicodynamic parameters between mammals and birds. However...

40 CFR Appendix D to Part 132 - Great Lakes Water Quality Initiative Methodology for the Development of Wildlife Criteria

Code of Federal Regulations, 2011 CFR

2011-07-01

...-conducted study of 90 days or greater designed to observe subchronic or chronic effects as defined in this document. 2. The avian data must come from at least one well-conducted study of 70 days or greater designed... poorly defined comparative toxicokinetic and toxicodynamic parameters between mammals and birds. However...

40 CFR Appendix D to Part 132 - Great Lakes Water Quality Initiative Methodology for the Development of Wildlife Criteria

Code of Federal Regulations, 2012 CFR

2012-07-01

...-conducted study of 90 days or greater designed to observe subchronic or chronic effects as defined in this document. 2. The avian data must come from at least one well-conducted study of 70 days or greater designed... poorly defined comparative toxicokinetic and toxicodynamic parameters between mammals and birds. However...

40 CFR Appendix D to Part 132 - Great Lakes Water Quality Initiative Methodology for the Development of Wildlife Criteria

Code of Federal Regulations, 2013 CFR

2013-07-01

...-conducted study of 90 days or greater designed to observe subchronic or chronic effects as defined in this document. 2. The avian data must come from at least one well-conducted study of 70 days or greater designed... poorly defined comparative toxicokinetic and toxicodynamic parameters between mammals and birds. However...

40 CFR Appendix D to Part 132 - Great Lakes Water Quality Initiative Methodology for the Development of Wildlife Criteria

Code of Federal Regulations, 2010 CFR

2010-07-01

...-conducted study of 90 days or greater designed to observe subchronic or chronic effects as defined in this document. 2. The avian data must come from at least one well-conducted study of 70 days or greater designed... poorly defined comparative toxicokinetic and toxicodynamic parameters between mammals and birds. However...

Geologic framework of the Alaska Peninsula, southwest Alaska, and the Alaska Peninsula terrane

USGS Publications Warehouse

Wilson, Frederic H.; Detterman, Robert L.; DuBois, Gregory D.

2015-01-01

The boundaries separating the Alaska Peninsula terrane from other terranes are commonly indistinct or poorly defined. A few boundaries have been defined at major faults, although the extensions of these faults are speculative through some areas. The west side of the Alaska Peninsula terrane is overlapped by Tertiary sedimentary and volcanic rocks and Quaternary deposits.

Biochars impact on soil moisture storage in an Ultisol and two Aridisols

USDA-ARS?s Scientific Manuscript database

Droughts associated with low or erratic rainfall distribution can cause detrimental crop moisture stress. This problem is exacerbated in the USA’s arid western and southeastern Coastal Plain due to poor rainfall distribution, poor soil water storage, or poorly-aggregated, subsurface hard layers that...

Retrospective evaluation of thoracic computed tomography findings in dogs naturally infected by Angiostrongylus vasorum.

PubMed

Coia, Mark E; Hammond, Gawain; Chan, Daniel; Drees, Randi; Walker, David; Murtagh, Kevin; Stone, Janine; Bexfield, Nicholas; Reeve, Lizzie; Helm, Jenny

2017-09-01

Angiostrongylus vasorum (A. vasorum) is an important emerging disease of canidae. Cardiorespiratory signs are common in affected dogs, therefore thoracic imaging is critical for diagnosing and monitoring disease. Descriptions of thoracic computed tomography (CT) findings in dogs naturally infected with A. vasorum are currently lacking. Aims of this multicenter, retrospective study were to describe thoracic CT findings in a group of dogs with confirmed disease, determine whether any changes were consistent among dogs, and propose standardized terms for describing thoracic CT findings. Nine UK-based referral centers' clinical and imaging databases were searched for dogs that had a confirmed diagnosis of A. vasorum, and had undergone thoracic CT examination. Eighteen dogs, from seven of the centers, fulfilled the inclusion criteria. The lung lobes were divided into the following three zones and the CT changes described in each: pleural (zone 1), subpleural (zone 2), and peribronchovascular (zone 3). The predominent abnormality was increased lung attenuation due to poorly defined ground-glass opacity or consolidation. There were regions of mosaic attenuation due to peripheral bronchiectasis. Nine/18 (50%) dogs showed hyperattenuating nodules of varying sizes with ill-defined margins. The distribution always affected zones 1 and 2 with varied involvement of zone 3; this resulted in clear delineation between zones 2 and 3. Tracheobronchial lymphadenomegaly was frequently noted. Findings were nonspecific and there was considerable overlap with other pulmonary conditions. However, authors recommend that A. vasorum be considered a likely differential diagnosis for dogs with a predominantly peripheral distribution of lung changes. © 2017 American College of Veterinary Radiology.

Medication self-management skills and cognitive impairment in older adults hospitalized for heart failure: A cross-sectional study.

PubMed

Howell, Erik H; Senapati, Alpana; Hsich, Eileen; Gorodeski, Eiran Z

2017-01-01

Cognitive impairment is highly prevalent among older adults (aged ≥65 years) hospitalized for heart failure and has been associated with poor outcomes. Poor medication self-management skills have been associated with poor outcomes in this population as well. The presence and extent of an association between cognitive impairment and poor medication self-management skills in this population has not been clearly defined. We assessed the cognition of consecutive older adults hospitalized for heart failure, in relation to their medication self-management skills. We conducted a cross-sectional study of older adults (aged ≥65 years) who were hospitalized for heart failure and were being discharged home. Prior to discharge, we assessed cognition using the Mini-Cog. We also tested patients' ability to read a pill bottle label, open a pill bottle safety cap, and allocate mock pills to a pill box. Pill allocation performance was assessed quantitatively (counts of errors of omission and commission) and qualitatively (patterns suggestive of knowledge-based mistakes, rule-based mistakes, or skill-based slips). Of 55 participants, 22% were found to have cognitive impairment. Patients with cognitive impairment tended to be older as compared to those without cognitive impairment (mean age = 81 vs 76 years, p = NS). Patients with cognitive impairment had a higher prevalence of inability to read pill bottle label (prevalence ratio = 5.8, 95% confidence interval = 3.2-10.5, p = 0.001) and inability to open pill bottle safety cap (prevalence ratio = 3.3, 95% confidence interval = 1.3-8.4, p = 0.03). While most patients (65%) had pill-allocation errors regardless of cognition, those patients with cognitive impairment tended to have more errors of omission (mean number of errors = 48 vs 23, p = 0.006), as well as more knowledge-based mistakes (75% vs 40%, p = 0.03). There is an association between cognitive impairment and poor medication self-management skills. Medication taking failures due to poor medication self-management skills may be part of the pathway linking cognitive impairment to poor post-discharge outcomes among patients with heart failure transitioning from hospital to home.

Poor oral hygiene and gingivitis are associated with obesity and overweight status in paediatric subjects.

PubMed

Franchini, Roberto; Petri, Antonella; Migliario, Mario; Rimondini, Lia

2011-11-01

The association between obesity and periodontitis has been extensively investigated in adults but not in young people. Our aim is to evaluate whether overweight/obese paediatric patients have a greater chance of being affected by gingivitis than those of normal weight. Ninety-eight subjects ranging between 10 and 17 years of age were classified as obese/overweight or normal weight on the basis of body mass index. Auxological data, blood pressure, insulin resistance, psychological profile, oral hygiene habits, plaque and gingival indices were collected. Anthropometric measurements and blood pressure were significantly higher in overweight/obese subjects than in the normal-weight subjects (p<0001). The overweight/obese subjects showed a worse attitude towards oral hygiene. Two-way anova revealed a significant effect of obesity status (p<0001) on the gingival index. Logistic and linear regression analyses identified gingivitis as dependent on insulin resistance and bad oral hygiene rather than on the overweight/obese status simply defined. Negative psychological features related to physical and academic self-concept were also risk factors for gingivitis probably because they were related to a generic poor self-awareness. The gingivitis observed in overweight and obese young subjects is probably due to a combination of metabolic and inflammatory profiles and neglected attitude towards oral hygiene. © 2011 John Wiley & Sons A/S.

The early history of glaucoma: the glaucous eye (800 BC to 1050 AD)

PubMed Central

Leffler, Christopher T; Schwartz, Stephen G; Hadi, Tamer M; Salman, Ali; Vasuki, Vivek

2015-01-01

To the ancient Greeks, glaukos occasionally described diseased eyes, but more typically described healthy irides, which were glaucous (light blue, gray, or green). During the Hippocratic period, a pathologic glaukos pupil indicated a media opacity that was not dark. Although not emphasized by present-day ophthalmologists, the pupil in acute angle closure may appear somewhat green, as the mid-dilated pupil exposes the cataractous lens. The ancient Greeks would probably have described a (normal) green iris or (diseased) green pupil as glaukos. During the early Common Era, eye pain, a glaucous hue, pupil irregularities, and absence of light perception indicated a poor prognosis with couching. Galen associated the glaucous hue with a large, anterior, or hard crystalline lens. Medieval Arabic authors translated glaukos as zarqaa, which also commonly described light irides. Ibn Sina (otherwise known as Avicenna) wrote that the zarqaa hue could occur due to anterior prominence of the lens and could occur in an acquired manner. The disease defined by the glaucous pupil in antiquity is ultimately indeterminate, as the complete syndrome of acute angle closure was not described. Nonetheless, it is intriguing that the glaucous pupil connoted a poor prognosis, and came to be associated with a large, anterior, or hard crystalline lens. PMID:25673972

Motor testing at 1 year improves the prediction of motor and mental outcome at 2 years after perinatal hypoxic-ischaemic encephalopathy.

PubMed

van Schie, Petra E M; Becher, Jules G; Dallmeijer, Annet J; Barkhof, Frederik; Van Weissenbruch, Mirjam M; Vermeulen, R Jeroen

2010-01-01

To investigate the predictive value of motor testing at 1 year for motor and mental outcome at 2 years after perinatal hypoxic-ischaemic encephalopathy (HIE) in term neonates. Motor and mental outcome at 2 years was assessed with the Bayley Scales of Infant Development, 2nd edition (BSID-II) in 32 surviving children (20 males, 12 females; mean gestational age 40.2 wk, SD 1.4; mean birthweight 3217g, SD 435) participating in a prospective cohort study of HIE. The predictive value of three motor tests (Alberta Infant Motor Scale [AIMS], BSID-II, and the Neurological Optimality Score [NOS]) at 1 year was analysed, in addition to predictions based on neonatal Sarnat staging and magnetic resonance imaging (MRI). Poor motor test results were defined as an AIMS z-score of <-2, a psychomotor developmental index of the BSID-II of <70, or a NOS of <26. Poor motor and poor mental outcome at 2 years was defined as a psychomotor developmental index or mental developmental index of the BSID-II of <70. Twelve children, all with Sarnat grade II, had a poor motor outcome and 12 children, of whom one had Sarnat grade I, had a poor mental outcome at 2 years. Nine children had cerebral palsy, of whom five had quadriplegia, three had dyskinesia, and one had hemiplegia. Poor motor tests at 1 year increased the probability of a poor motor outcome from 71% (range 92 to 100%), and a poor mental outcome from 59% (range 77 to 100%) in children with Sarnat grade II and abnormal MRI, assessed with the AIMS and BSID-II or NOS respectively. Additional motor testing at 1 year improves the prediction of motor and mental outcome at 2 years in children with Sarnat grade II and abnormal MRI.

When Care is a "Systematic Route of Torture": Conceptualizing the Violence of Medical Negligence in Resource-Poor Settings.

PubMed

Heckert, Carina

2016-12-01

Descriptions of patient mistreatment fill ethnographic accounts of healthcare in resource-poor settings. Often, anthropologists point to structural factors and the ways that the global political economy produces substandard care. This approach makes it difficult to hold parties accountable when there is blatant disregard for human life on the part of individuals providing care. In this article, I draw on the illness narrative of Magaly Chacón, the first HIV positive individual in Bolivia to file charges of medical negligence after failing to receive care to prevent mother-to-child transmission. Magaly's narrative demonstrates how structural conditions are often used to explain away poor patient outcomes, shifting attention away from and normalizing the symbolic violence that also perpetuates substandard care of marginalized patients. I use Magaly's accusations to interrogate how defining acts of mistreatment as medical negligence can be a productive exercise, even when it is difficult to disentangle structural constraints from blatant acts of negligence. Defining who is negligent in resource-poor settings is not easy, as Magaly's case demonstrates. However, Magaly's case also demonstrates that accusations of negligence themselves can demand accountability and force changes within the local structures that contribute to the systematic mistreatment of marginalized patients.

The Difference Between the Healing and the Nonhealing Diabetic Foot Ulcer: A Review of the Role of the Microcirculation.

PubMed

Lowry, Danielle; Saeed, Mujahid; Narendran, Parth; Tiwari, Alok

2017-09-01

Diabetic foot disease carries a high morbidity and is a leading cause of lower limb amputation. This may in part be due to the effect diabetes mellitus (DM) has on the microcirculation including in the skin. We conducted a review of studies that have examined the relationship between microcirculatory function and wound healing in patients with DM. A search of the Medline, Embase, and Web of Science databases was performed coupled with a review of references for the period 1946 to March 2015. Nineteen studies of diverse methodology and cohort selection were identified. Poor function of the microcirculation was related to poor outcome. Transcutaneous oxygen pressure (TcPO 2 ) was the most commonly used method to measure the microcirculation and thresholds for poor outcome proposed ranged from 10 mmHg to <34 mmHg. Two studies reexamined microcirculatory function following revascularization. Both found an increase in TcPO 2 , however only 1 reached statistical significance. No significant difference in the results of microcirculation tests was found between diabetic and nondiabetic patients. While it is not possible to draw firm conclusions from the evidence currently available there are clear areas that warrant research. Good microcirculation unsurprisingly appears to associate with better wound healing. The influence of DM is not clear, and neither is the degree of improvement required to achieve healing. Studies that examine a clearly defined cohort both with and without DM are urgently required. Accurate quantitative assessment of microcirculation will aid prediction of wound healing identifying those at greatest risk of amputation.

Defining the Interaction of HIV-1 with the Mucosal Barriers of the Female Reproductive Tract

PubMed Central

Carias, Ann M.; McCoombe, Scott; McRaven, Michael; Anderson, Meegan; Galloway, Nicole; Vandergrift, Nathan; Fought, Angela J.; Lurain, John; Duplantis, Maurice; Veazey, Ronald S.

2013-01-01

Worldwide, HIV-1 infects millions of people annually, the majority of whom are women. To establish infection in the female reproductive tract (FRT), HIV-1 in male ejaculate must overcome numerous innate and adaptive immune factors, traverse the genital epithelium, and establish infection in underlying CD4+ target cells. How the virus achieves this remains poorly defined. By utilizing a new technique, we define how HIV-1 interacts with different tissues of the FRT using human cervical explants and in vivo exposure in the rhesus macaque vaginal transmission model. Despite previous claims of the squamous epithelium being an efficient barrier to virus entry, we reveal that HIV-1 can penetrate both intact columnar and squamous epithelial barriers to depths where the virus can encounter potential target cells. In the squamous epithelium, we identify virus entry occurring through diffusive percolation, penetrating areas where cell junctions are absent. In the columnar epithelium, we illustrate that virus does not transverse barriers as well as previously thought due to mucus impediment. We also show a statistically significant correlation between the viral load of inocula and the ability of HIV-1 to pervade the squamous barrier. Overall, our results suggest a diffusive percolation mechanism for the initial events of HIV-1 entry. With these data, we also mathematically extrapolate the number of HIV-1 particles that penetrate the mucosa per coital act, providing a biological description of the mechanism for HIV-1 transmission during the acute and chronic stages of infection. PMID:23966398

Breast mass segmentation in mammograms combining fuzzy c-means and active contours

NASA Astrophysics Data System (ADS)

Hmida, Marwa; Hamrouni, Kamel; Solaiman, Basel; Boussetta, Sana

2018-04-01

Segmentation of breast masses in mammograms is a challenging issue due to the nature of mammography and the characteristics of masses. In fact, mammographic images are poor in contrast and breast masses have various shapes and densities with fuzzy and ill-defined borders. In this paper, we propose a method based on a modified Chan-Vese active contour model for mass segmentation in mammograms. We conduct the experiment on mass Regions of Interest (ROI) extracted from the MIAS database. The proposed method consists of mainly three stages: Firstly, the ROI is preprocessed to enhance the contrast. Next, two fuzzy membership maps are generated from the preprocessed ROI based on fuzzy C-Means algorithm. These fuzzy membership maps are finally used to modify the energy of the Chan-Vese model and to perform the final segmentation. Experimental results indicate that the proposed method yields good mass segmentation results.

MITOCHONDRIAL DISEASES PART II: MOUSE MODELS OF OXPHOS DEFICIENCIES CAUSED BY DEFECTS IN REGULATORY FACTORS AND OTHER COMPONENTS REQUIRED FOR MITOCHONDRIAL FUNCTION

PubMed Central

Iommarini, Luisa; Peralta, Susana; Torraco, Alessandra; Diaz, Francisca

2015-01-01

Mitochondrial disorders are defined as defects that affect the oxidative phosphorylation system (OXPHOS). They are characterized by a heterogeneous array of clinical presentations due in part to a wide variety of factors required for proper function of the components of the OXPHOS system. There is no cure for these disorders owing our poor knowledge of the pathogenic mechanisms of disease. To understand the mechanisms of human disease numerous mouse models have been developed in recent years. Here we summarize the features of several mouse models of mitochondrial diseases directly related to those factors affecting mtDNA maintenance, replication, transcription, translation as well to other proteins that are involved in mitochondrial dynamics and quality control which affect mitochondrial OXPHOS function without been intrinsic components of the system. We discuss how these models have contributed to our understanding of mitochondrial diseases and their pathogenic mechanisms. PMID:25640959

Laminated beams: deflection and stress as a function of epoxy shear modulus

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

Bialek, J.

1976-01-01

The large toroidal field coil deflections observed during the PLT power test are due to the poor shear behavior of the insulation material used between layers of copper. Standard techniques for analyzing such laminated structures do not account for this effect. This paper presents an analysis of laminated beams that corrects this deficiency. The analysis explicitly models the mechanical behavior of each layer in a laminated beam and hence avoids the pitfalls involved in any averaging technique. In particular, the shear modulus of the epoxy in a laminated beam (consisting of alternate layers of metal and epoxy) may span themore » entire range of values from zero to classical. Solution of the governing differential equations defines the stress, strain, and deflection for any point within a laminated beam. The paper summarizes these governing equations and also includes a parametric study of a simple laminated beam.« less

Properties of Roman bricks and mortars used in Serapis temple in the city of Pergamon

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

Ozkaya, Ozlem Aslan; Boeke, Hasan, E-mail: hasanboke@iyte.edu.tr

Serapis temple, which was constructed in the Roman period in the city of Pergamon (Bergama/Turkey), is one of the most important monuments of the world heritage. In this study, the characteristics of bricks and mortars used in the temple have been determined in order to define the necessary characteristics of the intervention materials, which will be used in the conservation works of the temple. Several analyses were carried out to determine their basic physical properties, raw material compositions, mineralogical and microstructural properties using X-ray diffraction, Scanning Electron Microscope and a Thermo Gravimetric Analyzer. Analysis results indicated that the mortars aremore » stiff, compact and hydraulic due to the use of natural pozzolanic aggregates. The Roman bricks are of low density, high porosity and were produced from raw materials containing calcium poor clays fired at low temperatures.« less

Polarization loss correction derived from hydrogen local-resistance measurement in low Pt-loaded polymer-electrolyte fuel cells

DOE PAGES

Freiberg, Anna T. S.; Tucker, Michael C.; Weber, Adam Z.

2017-04-12

The reduction of platinum-loading on the cathode side of polymer-electrolyte fuel cells leads to a poorly understood increase in mass-transport resistance (MTR) at high current densities. This local resistance was measured using a facile hydrogen-pump technique with dilute active gases for membrane-electrode assemblies with catalyst layers of varying platinum-loading (0.03-0.40 mgPt/cm²). Furthermore, polarization curves in H 2/air were measured and corrected for the overpotential caused by the increased MTR for low loadings on the air side due to the reduced concentration of reactant gas at the catalyst surface. The difference in performance after correction for all resistances including the MTRmore » is minor, suggesting its origin to be diffusive in nature, and proving the meaningfulness of the facile hydrogen-pump technique for the characterization of the cathode catalyst layer under defined operation conditions.« less

Current Treatment Strategies for Tricuspid Regurgitation.

PubMed

Al-Hijji, Mohammed; Fender, Erin A; El Sabbagh, Abdallah; Holmes, David R

2017-09-14

Tricuspid regurgitation is common; however, recognition and diagnosis, clinical outcomes, and management strategies are poorly defined. Here, we will describe the etiology and natural history of tricuspid regurgitation (TR), evaluate existing surgical outcomes data, and review the evolving field of percutaneous interventions to treat TR. Previously, the only definitive corrective therapy for TR was surgical valve repair or replacement which is associated with significant operative mortality. Advances in percutaneous valve repair techniques are now being translated to the tricuspid valve. These novel interventions may offer a lower-risk alternative treatment in patients at increased surgical risk. Significant TR adversely impacts survival. Surgery remains the only proven therapy for treatment of TR and may be underutilized due to mixed outcomes data. Early experience with percutaneous interventions is promising, but large clinical experience is lacking. Further study will be required before these therapies are introduced into broader clinical practice.

Guidelines for the medical treatment of idiopathic pulmonary fibrosis.

PubMed

Xaubet, Antoni; Molina-Molina, María; Acosta, Orlando; Bollo, Elena; Castillo, Diego; Fernández-Fabrellas, Estrella; Rodríguez-Portal, José Antonio; Valenzuela, Claudia; Ancochea, Julio

2017-05-01

Idiopathic pulmonary fibrosis is defined as chronic fibrosing interstitial pneumonia limited to the lung, with poor prognosis. The incidence has been rising in recent years probably due to improved diagnostic methods and increased life expectancy. In 2013, the SEPAR guidelines for the diagnosis and treatment for idiopathic pulmonary fibrosis were published. Since then, clinical trials and meta-analyses have shown strong scientific evidence for the use of pirfenidone and nintedanib in the treatment of idiopathic pulmonary fibrosis. In 2015, the international consensus of 2011 was updated and new therapeutic recommendations were established, prompting us to update our recommendation for the medical treatment of idiopathic pulmonary fibrosis accordingly. Diagnostic aspects and non-pharmacological treatment will not be discussed as no relevant developments have emerged since the 2013 guidelines. Copyright © 2017 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

Daphnia swarms: from single agent dynamics to collective vortex formation

NASA Astrophysics Data System (ADS)

Ordemann, Anke; Balazsi, Gabor; Caspari, Elizabeth; Moss, Frank

2003-05-01

Swarm theories have become fashionable in theoretical physics over the last decade. They span the range of interactions from individual agents moving in a mean field to coherent collective motions of large agent populations, such as vortex-swarming. But controlled laboratory tests of these theories using real biological agents have been problematic due primarily to poorly known agent-agent interactions (in the case of e.g. bacteria and slime molds) or the large swarm size (e.g. for flocks of birds and schools of fish). Moreover, the entire range of behaviors from single agent interactions to collective vortex motions of the swarm have here-to-fore not been observed with a single animal. We present the results of well defined experiments with the zooplankton Daphnia in light fields showing this range of behaviors. We interpret our results with a theory of the motions of self-propelled agents in a field.

Challenges of pediatric residency training in Taiwan.

PubMed

Tsai, Tsuen-Chiuan; Harasym, Peter H

2006-01-01

A crisis in pediatric residency training today has raised serious concerns about the healthcare quality for children in Taiwan. The purpose of this study was to document the problems and to propose possible solutions for improvement. The problems include: 1) manpower shortage due to the difficulty of recruiting pediatric residents; 2) heavy workload that hinders learning; 3) lack of assessment and poor program planning; and 4) inadequate institutional and financial support. As a result, physicians' competencies are not guaranteed at the end of residency training, even with the pediatric board certification. Possible solutions may include: 1) conducting research on physician manpower statistics, work hours and environment; 2) establishing a Residency Program Review Committee and provision of standards for accreditation; 3) defining the competencies mandated as a general pediatrician and developing a set of measurable qualitative standards; 4) encouraging new programs with flexibility (e.g., primary care); and 5) pursuing adequate institutional and financial supports.

Improvements of the offshore earthquake locations in the Earthquake Early Warning System

NASA Astrophysics Data System (ADS)

Chen, Ta-Yi; Hsu, Hsin-Chih

2017-04-01

Since 2014 the Earthworm Based Earthquake Alarm Reporting (eBEAR) system has been operated and been used to issue warnings to schools. In 2015 the system started to provide warnings to the public in Taiwan via television and the cell phone. Online performance of the eBEAR system indicated that the average reporting times afforded by the system are approximately 15 and 28 s for inland and offshore earthquakes, respectively. The eBEAR system in average can provide more warning time than the current EEW system (3.2 s and 5.5 s for inland and offshore earthquakes, respectively). However, offshore earthquakes were usually located poorly because only P-wave arrivals were used in the eBEAR system. Additionally, in the early stage of the earthquake early warning system, only fewer stations are available. The poor station coverage may be a reason to answer why offshore earthquakes are difficult to locate accurately. In the Geiger's inversion procedure of earthquake location, we need to put an initial hypocenter and origin time into the location program. For the initial hypocenter, we defined some test locations on the offshore area instead of using the average of locations from triggered stations. We performed 20 programs concurrently running the Geiger's method with different pre-defined initial position to locate earthquakes. We assume that if the program with the pre-defined initial position is close to the true earthquake location, during the iteration procedure of the Geiger's method the processing time of this program should be less than others. The results show that using pre-defined locations for trial-hypocenter in the inversion procedure is able to improve the accurate of offshore earthquakes. Especially for EEW system, in the initial stage of the EEW system, only use 3 or 5 stations to locate earthquakes may lead to bad results because of poor station coverage. In this study, the pre-defined trial-locations provide a feasible way to improve the estimations of earthquake locations in EEW system.

Problems with Interagency Integration in Contemporary Operations

DTIC Science & Technology

2014-12-04

IBM Center for the Business of Government, 2013. Adobe PDF eBook . Journals Armstrong, Nicholas J., and Corri Zoli. "Post 9/11 Stability... issues are due to poor use of existing doctrine to facilitate integrated planning. Past and current doctrine offers guidelines and principles to direct...sharing, and undefined roles created conflict in civil- military relationships. These issues are due to poor use of existing doctrine to facilitate

Trauma and posttraumatic stress disorder in women with chronic pelvic pain.

PubMed

Meltzer-Brody, Samantha; Leserman, Jane; Zolnoun, Denniz; Steege, John; Green, Emily; Teich, Alice

2007-04-01

To examine the effect of abuse history, other major trauma, and posttraumatic stress disorder (PTSD) on medical symptoms and health-related daily functioning in women with chronic pelvic pain. We administered a questionnaire to 713 consecutive women seen in a referral-based pelvic pain clinic. We found that 46.8% reported having either a sexual or physical abuse history. A total of 31.3% had a positive screen for PTSD. Using regression and path analysis, controlling for demographic variables, we found that a trauma history was associated with worse daily physical functioning due to poor health (P<.001), more medical symptoms (P<.001), more lifetime surgeries (P<.001), more days spent in bed (P<.001), and more dysfunction due to pain (P<.001). Furthermore, a positive screen for PTSD was highly related to most measures of poor health status (P<.001) and somewhat explained the trauma-related poor health status. The association of trauma with poor health may be due in part to the development of PTSD resulting from trauma. These findings demonstrate the importance of screening for trauma and PTSD in women with chronic pelvic pain. II.

Analysis of Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome Defined on the Basis of Bronchodilator Response and Degree of Emphysema.

PubMed

Cosentino, James; Zhao, Huaqing; Hardin, Megan; Hersh, Craig P; Crapo, James; Kim, Victor; Criner, Gerard J

2016-09-01

Despite the increasing recognition of asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS) as a clinical entity, it remains poorly characterized due to a lack of agreement on its definition and diagnostic criteria. The aim of this study was to use spirometry and computed tomography (CT) to help better define ACOS as well as to classify subjects with ACOS based on Global Initiative for Chronic Obstructive Lung Disease (GOLD) letter grade. We analyzed 10,192 subjects enrolled in the COPDGene Study. Subjects were non-Hispanic white or African American current or former smokers aged 45-80 years with at least a 10-pack-year smoking history. Subjects were categorized as having either ACOS with a bronchodilator response or chronic obstructive pulmonary disease with emphysema on the basis of spirometry, high-resolution CT, and a history of asthma or hay fever. Subjects with ACOS were younger (60.6 vs. 65.9 years old; P < 0.0001), more likely to be African American (26.8% vs. 14.4%; P < 0.0001), had a higher body mass index (29.6 vs. 25.1 kg/m(2); P < 0.0001), and were more likely to be current smokers (50.9% vs. 20.7%; P < 0.0001). The majority of subjects with ACOS were categorized as GOLD grade B. Despite less severe spirometry and CT findings in subjects with ACOS, there was no significant difference in severe or frequent exacerbations. Bronchodilator responsiveness and degree of emphysema can help define ACOS. When defined on the basis of bronchodilator responsiveness and degree of emphysema, patients with ACOS represent a unique and high-risk group with distinct clinical features.

Indicators of Youth Social Capital: The Case for Not Using Adult Indicators in the Measurement of Youth Social Capital

ERIC Educational Resources Information Center

Billett, Paulina

2012-01-01

Social capital is a difficult concept to define, and the task of defining the social capital of youth is even more complicated. The concept has not only been poorly researched but is also imperfectly understood. This article examines the problems faced in the use of adult indicators in youth social capital research and explores current…

Applying Q-methodology to select and define attributes for non-market valuation: A case study from Northwest Wyoming, United States

Treesearch

Christopher A. Armatas; Tyron J. Venn; Alan E. Watson

2014-01-01

The underlying validity of stated preference non-market valuation methods relies on the analyst's ability to identify, select, define, and articulate the goods being valued in a way that is relevant and understandable to the respondent, which requires detailed understanding of the respondents' experiences and points of view. Poor articulation of the good...

Prostatic Artery Embolization as an Alternative to Indwelling Bladder Catheterization to Manage Benign Prostatic Hyperplasia in Poor Surgical Candidates

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

Rampoldi, Antonio; Barbosa, Fabiane, E-mail: fabiane001@hotmail.com; Secco, Silvia

PurposeTo prospectively assess discontinuation of indwelling bladder catheterization (IBC) and relief of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) following prostate artery embolization (PAE) in poor surgical candidates.MethodsPatients ineligible for surgical intervention were offered PAE after at least 1 month of IBC for management of urinary retention secondary to BPH; exclusion criteria for PAE included eligibility for surgery, active bladder cancer or known prostate cancer. Embolization technical and clinical success were defined as bilateral prostate embolization and removal of IBC, respectively. Patients were followed for at least 6 months and evaluated for International Prostate Symptom Score, quality ofmore » life, prostate size and uroflowmetric parameters.ResultsA total of 43 patients were enrolled; bilateral embolization was performed in 33 (76.7%), unilateral embolization was performed in 8 (18.6%), and two patients could not be embolized due to tortuous and atherosclerotic pelvic vasculature (4.7%). Among the patients who were embolized, mean prostate size decreased from 75.6 ± 33.2 to 63.0 ± 23.2 g (sign rank p = 0.0001, mean reduction of 19.6 ± 17.3%), and IBC removal was achieved in 33 patients (80.5%). Clavien II complications were reported in nine patients (21.9%) and included urinary tract infection (three patients, 7.3%) and recurrent acute urinary retention (six patients, 14.6%). Nine patients (22.0%) experienced post-embolization syndrome.ConclusionsPAE is a safe and feasible for the relief of LUTS and IBC in highly comorbid patients without surgical treatment options.« less

The Low FODMAP Diet: Many Question Marks for a Catchy Acronym.

PubMed

Catassi, Giulia; Lionetti, Elena; Gatti, Simona; Catassi, Carlo

2017-03-16

FODMAP, "Fermentable Oligo-, Di- and Mono-saccharides And Polyols", is a heterogeneous group of highly fermentable but poorly absorbed short-chain carbohydrates and polyols. Dietary FODMAPs might exacerbate intestinal symptoms by increasing small intestinal water volume, colonic gas production, and intestinal motility. In recent years the low-FODMAP diet for treatment of irritable bowel syndrome (IBS) has gained increasing popularity. In the present review we aim to summarize the physiological, clinical, and nutritional issues, suggesting caution in the prolonged use of this dietary treatment on the basis of the existing literature. The criteria for inclusion in the FODMAPs list are not fully defined. Although the low-FODMAP diet can have a positive impact on the symptoms of IBS, particularly bloating and diarrhea, the quality of the evidence is lower than optimal, due to frequent methodological flaws, particularly lack of a proper control group and/or lack of blinding. In particular, it remains to be proven whether this regimen is superior to conventional IBS diets. The drastic reduction of FODMAP intake has physiological consequences, e.g., on the intestinal microbiome and colonocyte metabolism, which are still poorly understood. A low-FODMAP diet imposes an important restriction of dietary choices due to the elimination of some staple foods, such as wheat derivatives, lactose-containing dairy products, many vegetables and pulses, and several types of fruits. For this reason, patients may be at risk of reduced intake of fiber, calcium, iron, zinc, folate, B and D vitamins, and natural antioxidants. The nutritional risk of the low-FODMAP diet may be higher in persons with limited access to the expensive, alternative dietary items included in the low-FODMAP diet.

Glioma IL13Rα2 Is Associated with Mesenchymal Signature Gene Expression and Poor Patient Prognosis

PubMed Central

Starr, Renate; Deng, Xutao; Badie, Behnam; Yuan, Yate-Ching; Forman, Stephen J.; Barish, Michael E.

2013-01-01

A major challenge for successful immunotherapy against glioma is the identification and characterization of validated targets. We have taken a bioinformatics approach towards understanding the biological context of IL-13 receptor α2 (IL13Rα2) expression in brain tumors, and its functional significance for patient survival. Querying multiple gene expression databases, we show that IL13Rα2 expression increases with glioma malignancy grade, and expression for high-grade tumors is bimodal, with approximately 58% of WHO grade IV gliomas over-expressing this receptor. By several measures, IL13Rα2 expression in patient samples and low-passage primary glioma lines most consistently correlates with the expression of signature genes defining mesenchymal subclass tumors and negatively correlates with proneural signature genes as defined by two studies. Positive associations were also noted with proliferative signature genes, whereas no consistent associations were found with either classical or neural signature genes. Probing the potential functional consequences of this mesenchymal association through IPA analysis suggests that IL13Rα2 expression is associated with activation of proinflammatory and immune pathways characteristic of mesenchymal subclass tumors. In addition, survival analyses indicate that IL13Rα2 over-expression is associated with poor patient prognosis, a single gene correlation ranking IL13Rα2 in the top ~1% of total gene expression probes with regard to survival association with WHO IV gliomas. This study better defines the functional consequences of IL13Rα2 expression by demonstrating association with mesenchymal signature gene expression and poor patient prognosis. It thus highlights the utility of IL13Rα2 as a therapeutic target, and helps define patient populations most likely to respond to immunotherapy in present and future clinical trials. PMID:24204956

Glioma IL13Rα2 is associated with mesenchymal signature gene expression and poor patient prognosis.

PubMed

Brown, Christine E; Warden, Charles D; Starr, Renate; Deng, Xutao; Badie, Behnam; Yuan, Yate-Ching; Forman, Stephen J; Barish, Michael E

2013-01-01

A major challenge for successful immunotherapy against glioma is the identification and characterization of validated targets. We have taken a bioinformatics approach towards understanding the biological context of IL-13 receptor α2 (IL13Rα2) expression in brain tumors, and its functional significance for patient survival. Querying multiple gene expression databases, we show that IL13Rα2 expression increases with glioma malignancy grade, and expression for high-grade tumors is bimodal, with approximately 58% of WHO grade IV gliomas over-expressing this receptor. By several measures, IL13Rα2 expression in patient samples and low-passage primary glioma lines most consistently correlates with the expression of signature genes defining mesenchymal subclass tumors and negatively correlates with proneural signature genes as defined by two studies. Positive associations were also noted with proliferative signature genes, whereas no consistent associations were found with either classical or neural signature genes. Probing the potential functional consequences of this mesenchymal association through IPA analysis suggests that IL13Rα2 expression is associated with activation of proinflammatory and immune pathways characteristic of mesenchymal subclass tumors. In addition, survival analyses indicate that IL13Rα2 over-expression is associated with poor patient prognosis, a single gene correlation ranking IL13Rα2 in the top ~1% of total gene expression probes with regard to survival association with WHO IV gliomas. This study better defines the functional consequences of IL13Rα2 expression by demonstrating association with mesenchymal signature gene expression and poor patient prognosis. It thus highlights the utility of IL13Rα2 as a therapeutic target, and helps define patient populations most likely to respond to immunotherapy in present and future clinical trials.

Defining response to anti-VEGF therapies in neovascular AMD.

PubMed

Amoaku, W M; Chakravarthy, U; Gale, R; Gavin, M; Ghanchi, F; Gibson, J; Harding, S; Johnston, R L; Kelly, S P; Kelly, S; Lotery, A; Mahmood, S; Menon, G; Sivaprasad, S; Talks, J; Tufail, A; Yang, Y

2015-06-01

The introduction of anti-vascular endothelial growth factor (anti-VEGF) has made significant impact on the reduction of the visual loss due to neovascular age-related macular degeneration (n-AMD). There are significant inter-individual differences in response to an anti-VEGF agent, made more complex by the availability of multiple anti-VEGF agents with different molecular configurations. The response to anti-VEGF therapy have been found to be dependent on a variety of factors including patient's age, lesion characteristics, lesion duration, baseline visual acuity (VA) and the presence of particular genotype risk alleles. Furthermore, a proportion of eyes with n-AMD show a decline in acuity or morphology, despite therapy or require very frequent re-treatment. There is currently no consensus as to how to classify optimal response, or lack of it, with these therapies. There is, in particular, confusion over terms such as 'responder status' after treatment for n-AMD, 'tachyphylaxis' and 'recalcitrant' n-AMD. This document aims to provide a consensus on definition/categorisation of the response of n-AMD to anti-VEGF therapies and on the time points at which response to treatment should be determined. Primary response is best determined at 1 month following the last initiation dose, while maintained treatment (secondary) response is determined any time after the 4th visit. In a particular eye, secondary responses do not mirror and cannot be predicted from that in the primary phase. Morphological and functional responses to anti-VEGF treatments, do not necessarily correlate, and may be dissociated in an individual eye. Furthermore, there is a ceiling effect that can negate the currently used functional metrics such as >5 letters improvement when the baseline VA is good (ETDRS>70 letters). It is therefore important to use a combination of both the parameters in determining the response.The following are proposed definitions: optimal (good) response is defined as when there is resolution of fluid (intraretinal fluid; IRF, subretinal fluid; SRF and retinal thickening), and/or improvement of >5 letters, subject to the ceiling effect of good starting VA. Poor response is defined as <25% reduction from the baseline in the central retinal thickness (CRT), with persistent or new IRF, SRF or minimal or change in VA (that is, change in VA of 0+4 letters). Non-response is defined as an increase in fluid (IRF, SRF and CRT), or increasing haemorrhage compared with the baseline and/or loss of >5 letters compared with the baseline or best corrected vision subsequently. Poor or non-response to anti-VEGF may be due to clinical factors including suboptimal dosing than that required by a particular patient, increased dosing intervals, treatment initiation when disease is already at an advanced or chronic stage), cellular mechanisms, lesion type, genetic variation and potential tachyphylaxis); non-clinical factors including poor access to clinics or delayed appointments may also result in poor treatment outcomes. In eyes classified as good responders, treatment should be continued with the same agent when disease activity is present or reactivation occurs following temporary dose holding. In eyes that show partial response, treatment may be continued, although re-evaluation with further imaging may be required to exclude confounding factors. Where there is persistent, unchanging accumulated fluid following three consecutive injections at monthly intervals, treatment may be withheld temporarily, but recommenced with the same or alternative anti-VEGF if the fluid subsequently increases (lesion considered active). Poor or non-response to anti-VEGF treatments requires re-evaluation of diagnosis and if necessary switch to alternative therapies including other anti-VEGF agents and/or with photodynamic therapy (PDT). Idiopathic polypoidal choroidopathy may require treatment with PDT monotherapy or combination with anti-VEGF. A committee comprised of retinal specialists with experience of managing patients with n-AMD similar to that which developed the Royal College of Ophthalmologists Guidelines to Ranibizumab was assembled. Individual aspects of the guidelines were proposed by the committee lead (WMA) based on relevant reference to published evidence base following a search of Medline and circulated to all committee members for discussion before approval or modification. Each draft was modified according to feedback from committee members until unanimous approval was obtained in the final draft. A system for categorising the range of responsiveness of n-AMD lesions to anti-VEGF therapy is proposed. The proposal is based primarily on morphological criteria but functional criteria have been included. Recommendations have been made on when to consider discontinuation of therapy either because of success or futility. These guidelines should help clinical decision-making and may prevent over and/or undertreatment with anti-VEGF therapy.

Non-convulsive seizures and electroencephalography findings as predictors of clinical outcomes at a tertiary intensive care unit in Saudi Arabia.

PubMed

Al-Said, Youssef A; Baeesa, Saleh S; Shivji, Zaitoon; Kayyali, Husam; Alqadi, Khalid; Kadi, Ghada; Cupler, Edward J; Abuzinadah, Ahmad R

2018-06-05

Electroencephalography (EEG) in the intensive care unit (ICU) is often done to detect non-convulsive seizures (NCS). The outcome of ICU patients with NCS strongly depends on the underlying etiology. The implication of NCS and other EEG findings on clinical outcome independent from their etiology is not well understood and our aim to investigate it. We retrospectively identified all adult patients in the ICU who underwent EEG monitoring between January 2008 and December 2011. The main goals were to define the rate of NCS or non-convulsive status epilepticus (NCSE) occurrence in our center among patients who underwent EEG monitoring and to examine if NCS/NCSE are associated with poor outcome [defined as death or dependence] with and without adjustment for underlying etiology. The rate of poor outcome among different EEG categories were also investigated. During the study period, 177 patients underwent EEG monitoring in our ICU. The overall outcome was poor in 62.7% of those undergoing EEG. The rate of occurrence of NCS/NCSE was 8.5% and was associated with poor outcome in 86.7% with an odds ratio (OR) of 5.1 (95% confidence interval [CI] 1.09-23.8). This association was maintained after adjusting for underlying etiologies with OR 5.6 (95% CI 1.05-29.6). The rate of poor outcome was high in the presence of periodic discharges and sharp and slow waves of 75% and 61.5%, respectively. Our cohort of ICU patients undergoing EEGs had a poor outcome. Those who developed NCS/NCSE experienced an even worse outcome regardless of the underlying etiology. Copyright © 2018 Elsevier B.V. All rights reserved.

Reverse shoulder arthroplasty for massive rotator cuff tear: risk factors for poor functional improvement.

PubMed

Hartzler, Robert U; Steen, Brandon M; Hussey, Michael M; Cusick, Michael C; Cottrell, Benjamin J; Clark, Rachel E; Frankle, Mark A

2015-11-01

Some patients unexpectedly have poor functional improvement after reverse shoulder arthroplasty (RSA) for massive rotator cuff tear without glenohumeral arthritis. Our aim was to identify risk factors for this outcome. We also assessed the value of RSA for cases with poor functional improvement vs. The study was a retrospective case-control analysis for primary RSA performed for massive rotator cuff tear without glenohumeral arthritis with minimum 2-year follow-up. Cases were defined as Simple Shoulder Test (SST) score improvement of ≤1, whereas controls improved SST score ≥2. Risk factors were chosen on the basis of previous association with poor outcomes after shoulder arthroplasty. Latissimus dorsi tendon transfer results were analyzed as a subgroup. Value was defined as improvement in American Shoulder and Elbow Surgeons (ASES) score per $10,000 hospital cost. In a multivariate binomial logistic regression analysis, neurologic dysfunction (P = .006), age <60 years (P = .02), and high preoperative SST score (P = .03) were independently associated with poor functional improvement. Latissimus dorsi tendon transfer patients significantly improved in active external rotation (-0.3° to 38.7°; P < .01). The value of RSA (ΔASES/$10,000 cost) for cases was 0.8 compared with 17.5 for controls (P < .0001). Young age, high preoperative function, and neurologic dysfunction were associated with poor functional improvement. Surgeons should consider these associations in counseling and selection of patients. Concurrent latissimus dorsi transfer was successful in restoring active external rotation in a subgroup of patients. The critical economic importance of improved patient selection is emphasized by the very low value of the procedure in the case group. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Geology of the Gladys McCall geopressured-geothermal prospect, Cameron Parish, Louisiana

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

John, C.J.

The Gladys McCall prospect lies at the western edge of the Rockefeller Wildlife Refuge about 88 km (55 mi) southeast of Lake Charles in Cameron Parish, Louisiana. The test well is 4825 m (15,831 ft) deep and was drilled in 1981 under the U.S. Department of Energy geopressured-geothermal research program. The well was shut in at the end of October 1987 after it had produced over 27 million barrels of brine and 676 MMscf gas, without any significant pressure decline. The stratigraphic section seen in this test well consists of alternating sandstones and shales with about 350 m (1150 ft)more » of net sand between 4393 m (14,412 ft) and 4974 m (16,320 ft). The producing reservoir is bounded on the north and south by faults. The east-west dimension is poorly defined due to lack of deep well control. Eleven prospective production zones have been identified. The pressure maintenance and the continuous high brine yield from the reservoir may be due to laterally overlapping and connected sandstones, communication between overlying and/or underlying reservoirs, growth faults acting as passageways for brine, shale dewatering, or possible communication of zones behind the casing.« less

Drug vaping applied to cannabis: Is “Cannavaping” a therapeutic alternative to marijuana?

PubMed Central

Varlet, Vincent; Concha-Lozano, Nicolas; Berthet, Aurélie; Plateel, Grégory; Favrat, Bernard; De Cesare, Mariangela; Lauer, Estelle; Augsburger, Marc; Thomas, Aurélien; Giroud, Christian

2016-01-01

Therapeutic cannabis administration is increasingly used in Western countries due to its positive role in several pathologies. Dronabinol or tetrahydrocannabinol (THC) pills, ethanolic cannabis tinctures, oromucosal sprays or table vaporizing devices are available but other cannabinoids forms can be used. Inspired by the illegal practice of dabbing of butane hashish oil (BHO), cannabinoids from cannabis were extracted with butane gas, and the resulting concentrate (BHO) was atomized with specific vaporizing devices. The efficiency of “cannavaping,” defined as the “vaping” of liquid refills for e-cigarettes enriched with cannabinoids, including BHO, was studied as an alternative route of administration for therapeutic cannabinoids. The results showed that illegal cannavaping would be subjected to marginal development due to the poor solubility of BHO in commercial liquid refills (especially those with high glycerin content). This prevents the manufacture of liquid refills with high BHO concentrations adopted by most recreational users of cannabis to feel the psychoactive effects more rapidly and extensively. Conversely, “therapeutic cannavaping” could be an efficient route for cannabinoids administration because less concentrated cannabinoids-enriched liquid refills are required. However, the electronic device marketed for therapeutic cannavaping should be carefully designed to minimize potential overheating and contaminant generation. PMID:27228348

Probability density function characterization for aggregated large-scale wind power based on Weibull mixtures

DOE PAGES

Gomez-Lazaro, Emilio; Bueso, Maria C.; Kessler, Mathieu; ...

2016-02-02

Here, the Weibull probability distribution has been widely applied to characterize wind speeds for wind energy resources. Wind power generation modeling is different, however, due in particular to power curve limitations, wind turbine control methods, and transmission system operation requirements. These differences are even greater for aggregated wind power generation in power systems with high wind penetration. Consequently, models based on one-Weibull component can provide poor characterizations for aggregated wind power generation. With this aim, the present paper focuses on discussing Weibull mixtures to characterize the probability density function (PDF) for aggregated wind power generation. PDFs of wind power datamore » are firstly classified attending to hourly and seasonal patterns. The selection of the number of components in the mixture is analyzed through two well-known different criteria: the Akaike information criterion (AIC) and the Bayesian information criterion (BIC). Finally, the optimal number of Weibull components for maximum likelihood is explored for the defined patterns, including the estimated weight, scale, and shape parameters. Results show that multi-Weibull models are more suitable to characterize aggregated wind power data due to the impact of distributed generation, variety of wind speed values and wind power curtailment.« less

Drug vaping applied to cannabis: Is "Cannavaping" a therapeutic alternative to marijuana?

PubMed

Varlet, Vincent; Concha-Lozano, Nicolas; Berthet, Aurélie; Plateel, Grégory; Favrat, Bernard; De Cesare, Mariangela; Lauer, Estelle; Augsburger, Marc; Thomas, Aurélien; Giroud, Christian

2016-05-26

Therapeutic cannabis administration is increasingly used in Western countries due to its positive role in several pathologies. Dronabinol or tetrahydrocannabinol (THC) pills, ethanolic cannabis tinctures, oromucosal sprays or table vaporizing devices are available but other cannabinoids forms can be used. Inspired by the illegal practice of dabbing of butane hashish oil (BHO), cannabinoids from cannabis were extracted with butane gas, and the resulting concentrate (BHO) was atomized with specific vaporizing devices. The efficiency of "cannavaping," defined as the "vaping" of liquid refills for e-cigarettes enriched with cannabinoids, including BHO, was studied as an alternative route of administration for therapeutic cannabinoids. The results showed that illegal cannavaping would be subjected to marginal development due to the poor solubility of BHO in commercial liquid refills (especially those with high glycerin content). This prevents the manufacture of liquid refills with high BHO concentrations adopted by most recreational users of cannabis to feel the psychoactive effects more rapidly and extensively. Conversely, "therapeutic cannavaping" could be an efficient route for cannabinoids administration because less concentrated cannabinoids-enriched liquid refills are required. However, the electronic device marketed for therapeutic cannavaping should be carefully designed to minimize potential overheating and contaminant generation.

NATO Phase Zero Contracting - A Proposed Strategic and Operational Planning Construct Within the NATO Framework for Defense Planning and Standardization

DTIC Science & Technology

2015-02-12

become better stewards of scarce resources, to eliminate potential waste, and to reduce abuse of taxpayer money due to poor management, operational...stewards of scarce resources, to eliminate potential waste, and to reduce abuse of taxpayer money due to poor management, operational redundancy and...Conference—Best Practices and Lessons Learned and Training and Educating for Acquisition, Procurement and Contracting in Defense Institutions

An Investigation of the Complexities of Successful and Unsuccessful Guide Dog Matching and Partnerships

PubMed Central

Lloyd, Janice; Budge, Claire; La Grow, Steve; Stafford, Kevin

2016-01-01

Matching a person who is blind or visually impaired with a guide dog is a process of finding the most suitable guide dog available for that individual. Not all guide dog partnerships are successful, and the consequences of an unsuccessful partnership may result in reduced mobility and quality of life for the handler (owner), and are costly in time and resources for guide dog training establishments. This study examined 50 peoples’ partnerships with one or more dogs (118 pairings) to ascertain the outcome of the relationship. Forty-three of the 118 dogs were returned to the guide dog training establishment before reaching retirement age, with the majority (n = 40) being categorized as having dog-related issues. Most (n = 26) of these dogs’ issues were classified as being behavioral in character, including work-related and non-work-related behavior, and 14 were due to physical causes (mainly poor health). Three dogs were returned due to matters relating to the handlers’ behavior. More second dogs were returned than the handlers’ first or third dogs, and dogs that had been previously used as a guide could be rematched successfully. Defining matching success is not clear-cut. Not all dogs that were returned were considered by their handlers to have been mismatched, and not all dogs retained until retirement were thought to have been good matches, suggesting that some handlers were retaining what they considered to be a poorly matched dog. Almost all the handlers who regarded a dog as being mismatched conceded that some aspects of the match were good. For example, a dog deemed mismatched for poor working behavior may have shown good home and/or other social behaviors. The same principle was true for successful matches, where few handlers claimed to have had a perfect dog. It is hoped that these results may help the guide dog industry identify important aspects of the matching process, and/or be used to identify areas where a matching problem exists. PMID:28018910

Modeling of lung cancer risk due to radon exhalation of granite stone in dwelling houses.

PubMed

Abbasi, Akbar

2017-01-01

Due to increasing occurrences of lung cancer, radon exhalation rates, radon concentrations, and lung cancer risks in several types of commonly used granite stone, samples used for flooring in buildings, have been investigated. We measured the radon exhalation rates due to granite stones by means of an AlphaGUARD Model PQ2000 in a cube container with changeable floor by various granite stones. The lung cancer risk and percentage of lung cancer deaths (LCRn) due to those conditions were calculated using Darby's model. The radon exhalation rates ranged from 1.59 ± 0.41 to 9.43 ± 0.74 Bq/m 2/h. The radon concentrations in the standard room with poor and normal ventilation were calculated 20.10-71.09 Bq/m 3 and 16.12-47.01 Bq/m 3, respectively. The estimated numbers of lung cancer deaths attributable to indoor radon due to granite stones in 2013 were 145 (3.33%) and 103 (2.37%) for poor and normal ventilation systems, respectively. According to our estimations, the values of 3.33% and 2.37% of lung cancer deaths in 2013 are attributed to radon exhalation of granite stones with poor and normal ventilation systems, respectively.

A mesh partitioning algorithm for preserving spatial locality in arbitrary geometries

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

Nivarti, Girish V., E-mail: g.nivarti@alumni.ubc.ca; Salehi, M. Mahdi; Bushe, W. Kendal

2015-01-15

Highlights: •An algorithm for partitioning computational meshes is proposed. •The Morton order space-filling curve is modified to achieve improved locality. •A spatial locality metric is defined to compare results with existing approaches. •Results indicate improved performance of the algorithm in complex geometries. -- Abstract: A space-filling curve (SFC) is a proximity preserving linear mapping of any multi-dimensional space and is widely used as a clustering tool. Equi-sized partitioning of an SFC ignores the loss in clustering quality that occurs due to inaccuracies in the mapping. Often, this results in poor locality within partitions, especially for the conceptually simple, Morton ordermore » curves. We present a heuristic that improves partition locality in arbitrary geometries by slicing a Morton order curve at points where spatial locality is sacrificed. In addition, we develop algorithms that evenly distribute points to the extent possible while maintaining spatial locality. A metric is defined to estimate relative inter-partition contact as an indicator of communication in parallel computing architectures. Domain partitioning tests have been conducted on geometries relevant to turbulent reactive flow simulations. The results obtained highlight the performance of our method as an unsupervised and computationally inexpensive domain partitioning tool.« less

The onset of fabric development in deep marine sediments

NASA Astrophysics Data System (ADS)

Maffione, Marco; Morris, Antony

2017-09-01

Post-depositional compaction is a key stage in the formation of sedimentary rocks that results in porosity reduction, grain realignment and the production of sedimentary fabrics. The progressive time-depth evolution of the onset of fabric development in deep marine sediments is poorly constrained due to the limited quantity and resolution of existing data. Here we present high-resolution anisotropy of magnetic susceptibility (AMS) results from clay-rich deep marine sediments recovered at International Ocean Discovery Program Site U1438 (Philippine Sea). AMS is a petrofabric tool sensitive to the preferred orientation of grains in rocks. Down-section variations of AMS parameters, density, porosity and the inclination of magnetic remanences demonstrate that fabrics develop in response to compaction and dewatering but also that they do not develop progressively with depth below the mudline. Instead, a horizontal foliation first forms at 83 mbsf once the sediment load reaches an effective stress threshold for the onset of compaction and is then continuously enhanced down to 113 mbsf, defining a 30 m-thick 'initial compaction window'. The magnetostratigraphic age model for IODP Site U1438 indicates a delay of 5.7 Ma in initial fabric formation following sediment deposition, with strongly defined fabrics then taking an additional 6.5 Ma to develop.

The localization of facial motor impairment in sporadic Möbius syndrome.

PubMed

Cattaneo, L; Chierici, E; Bianchi, B; Sesenna, E; Pavesi, G

2006-06-27

To investigate the neurophysiologic aspects of facial motor control in patients with sporadic Möbius syndrome defined as nonprogressive congenital facial and abducens palsy. The authors assessed 24 patients with sporadic Möbius syndrome by performing a complete clinical examination and neurophysiologic tests including facial nerve conduction studies, needle electromyography examination of facial muscles, and recording of the blink reflex and of the trigeminofacial inhibitory reflex. Two distinct groups of patients were identified according to neurophysiologic testing. The first group was characterized by increased facial distal motor latencies (DMLs) and poor recruitment of small and polyphasic motor unit action potentials (MUAPs). The second group was characterized by normal facial DMLs and neuropathic MUAPs. It is hypothesized that in the first group, the disorder is due to a rhombencephalic maldevelopment with selective sparing of small-size MUs, and in the second group, the disorder is related to an acquired nervous injury during intrauterine life, with subsequent neurogenic remodeling of MUs. The trigeminofacial reflexes showed that in most subjects of both groups, the functional impairment of facial movements was caused by a nuclear or peripheral site of lesion, with little evidence of brainstem interneuronal involvement. Two different neurophysiologically defined phenotypes can be distinguished in sporadic Möbius syndrome, with different pathogenetic implications.

Sonographic findings of hepatobiliary fascioliasis accompanied by extrahepatic expansion and ectopic lesions.

PubMed

Teke, Memik; Önder, Hakan; Çiçek, Mutalip; Hamidi, Cihad; Göya, Cemil; Çetinçakmak, Mehmet Güli; Hattapoğlu, Salih; Ülger, Burak Veli

2014-12-01

The aim of the study was to describe the sonographic findings of hepatobiliary fascioliasis with extrahepatic expansion and ectopic lesions. The study included 45 patients with fascioliasis. All diagnoses were confirmed via serologic enzyme-linked immunosorbent assays. Sonographic findings in the hepatobiliary system, extrahepatic expansion, and ectopic lesions were defined. The most common hepatic lesions were subcapsular localized, small, confluent, multiple hypoechoic nodules with poorly defined borders. We also detected ectopic lesion in 5 patients (11.1%) and live parasites in the gallbladder and bile duct in 11 (24.4%). The large spectrum of entities in the differential diagnosis of hepatobiliary fascioliasis may lead to misdiagnosis and incorrect treatment. However, the diagnosis can be made when the characteristic sonographic features are seen, such as heterogeneity of the liver with multiple poorly defined hypoechoic-isoechoic lesions and multiple echogenic nonshadowing particles in the gallbladder or common bile ducts. Nonetheless, the differential diagnosis of fascioliasis versus other hepatic lesions may still be difficult. In these situations, pathologic confirmation should be performed to exclude the possibility of malignancy. © 2013 by the American Institute of Ultrasound in Medicine.

European Measures of Poverty and "Social Exclusion": Material Deprivation, Consumption, and Life Satisfaction

ERIC Educational Resources Information Center

Gilbert, Neil

2009-01-01

The conventional view of poverty in the European Union countries is based on a relative measure, which defines all those with incomes below 60 percent of the median as poor. In the U.S., poverty is defined according to an absolute measure--the federal poverty line computed by the Census Bureau--which was $21,200 for a family of four in 2008…

Asthma exacerbations: risk factors for hospital readmissions.

PubMed

Gonzalez-Barcala, F-J; Calvo-Alvarez, U; Garcia-Sanz, M-T; Garcia-Couceiro, N; Martin-Lancharro, P; Pose, A; Carreira, J-M; Moure-Gonzalez, J-D; Valdes-Cuadrado, L; Muñoz, X

2018-02-01

The aim of our study is to analyse hospital readmissions due to asthma, as well as the factors associated with their increase. We carried out a retrospective study including all admissions of patients over 18 years old due to exacerbation of asthma occurring in our hospital between the years 2000 and 2010. The data were gathered by two members of the research team, by reviewing the clinical records. The first hospital admission of each patient was included for this study. An early readmission (ER) was defined as that which occurred in the following 15 days after hospital discharge and late readmission (LR) to that occurring from 16 days after discharge. This study included 2166 hospital admissions and 1316 patients, with a mean age of 62.6 years. Of the 1316 patients analysed, 36 (2.7%) had one ER and 313 (23.8%) one LR. The only factor independently associated with a higher probability of an ER was poor lung function. A higher probability of LR was associated with a greater severity of the asthma (OR: 17.8, for severe asthma versus intermittent asthma), to have had any hospital admission in the previous year (OR: 3.5) and the use of a combination of ICS-LABA as maintenance treatment. About 25% of the patients in our area admitted to hospital due to asthma exacerbation had repeat episodes of hospitalisation.

Targeting the Poor: Evidence from a Field Experiment in Indonesia

PubMed Central

Alatas, Vivi; Banerjee, Abhijit; Hanna, Rema; Olken, Benjamin A.; Tobias, Julia

2014-01-01

This paper reports an experiment in 640 Indonesian villages on three approaches to target the poor: proxy-means tests (PMT), where assets are used to predict consumption; community targeting, where villagers rank everyone from richest to poorest; and a hybrid. Defining poverty based on PPP$2 per-capita consumption, community targeting and the hybrid perform somewhat worse in identifying the poor than PMT, though not by enough to significantly affect poverty outcomes for a typical program. Elite capture does not explain these results. Instead, communities appear to apply a different concept of poverty. Consistent with this finding, community targeting results in higher satisfaction. PMID:25197099

Prescribing patterns of hydrocortisone in septic shock: a single-center experience of how surviving sepsis guidelines are interpreted and translated into bedside practice.

PubMed

Contrael, Katlynd M; Killian, Alley J; Gregg, Sara R; Buchman, Timothy G; Coopersmith, Craig M

2013-10-01

The Surviving Sepsis Campaign suggests giving hydrocortisone to septic patients only if their "blood pressure is poorly responsive to fluid resuscitation and vasopressor therapy." Because the definition of "poorly responsive" is not provided, the purpose of this study was to identify prescribing triggers for hydrocortisone in septic shock. Retrospective chart review of patients with septic shock over 17 months, who received hydrocortisone, followed by a survey of all intensivists who attended in the study ICUs to determine whether provider attitudes matched clinical practice. Eight ICUs in an academic hospital and a hybrid academic/community hospital. A total of 155 patients with septic shock in whom vasopressors were initiated and hydrocortisone was prescribed. Ninety-nine patients (64%) were already receiving two vasopressors before hydrocortisone was prescribed. An additional 22 patients were on a single high-dose vasopressor prior to corticosteroid initiation. Of patients who survived to have their hydrocortisone dose changed, 57% had their corticosteroids tapered, whereas 43% were abruptly discontinued. Seventy-six percent of patients were no longer on vasopressors when the first dosing change was made. Twenty-seven out of 36 intensivists (75%) completed the survey. The majority (72%) defined "poorly responsive to vasopressors" as the presence of two vasopressors, and 70% stated that they required patients to be off vasopressors prior to altering the corticosteroid dose. Significant variability exists when corticosteroids are prescribed for septic shock, with the most common interpretation in our institution of "poorly responsive to fluid resuscitation and vasopressor therapy" being the presence of two vasopressors. The method and timing of corticosteroid discontinuation also differed among providers. Self-described prescribing patterns from intensivists closely matched their actual behavior, suggesting variability is due to differing interpretations of the guidelines themselves, rather than a deficit in knowledge translation.

Geochemical control of microbial Fe(III) reduction potential in wetlands: Comparison of the rhizosphere to non-rhizosphere soil

USGS Publications Warehouse

Weiss, J.V.; Emerson, D.; Megonigal, J.P.

2004-01-01

We compared the reactivity and microbial reduction potential of Fe(III) minerals in the rhizosphere and non-rhizosphere soil to test the hypothesis that rapid Fe(III) reduction rates in wetland soils are explained by rhizosphere processes. The rhizosphere was defined as the area immediately adjacent to a root encrusted with Fe(III)-oxides or Fe plaque, and non-rhizosphere soil was 0.5 cm from the root surface. The rhizosphere had a significantly higher percentage of poorly crystalline Fe (66??7%) than non-rhizosphere soil (23??7%); conversely, non-rhizosphere soil had a significantly higher proportion of crystalline Fe (50??7%) than the rhizosphere (18??7%, P<0.05 in all cases). The percentage of poorly crystalline Fe(III) was significantly correlated with the percentage of FeRB (r=0.76), reflecting the fact that poorly crystalline Fe(III) minerals are labile with respect to microbial reduction. Abiotic reductive dissolution consumed about 75% of the rhizosphere Fe(III)-oxide pool in 4 h compared to 23% of the soil Fe(III)-oxide pool. Similarly, microbial reduction consumed 75-80% of the rhizosphere pool in 10 days compared to 30-40% of the non-rhizosphere soil pool. Differences between the two pools persisted when samples were amended with an electron-shuttling compound (AQDS), an Fe(III)-reducing bacterium (Geobacter metallireducens), and organic carbon. Thus, Fe(III)-oxide mineralogy contributed strongly to differences in the Fe(III) reduction potential of the two pools. Higher amounts of poorly crystalline Fe(III) and possibly humic substances, and a higher Fe(III) reduction potential in the rhizosphere compared to the non-rhizosphere soil, suggested the rhizosphere is a site of unusually active microbial Fe cycling. The results were consistent with previous speculation that rapid Fe cycling in wetlands is due to the activity of wetland plant roots. ?? 2004 Federation of European Microbiological Societies. Published by Elsevier B.V. All rights reserved.

Naïve CD8 T cell activation by liver bone marrow-derived cells leads to a "neglected" IL-2low Bimhigh phenotype, poor CTL function and cell death.

PubMed

Holz, Lauren E; Benseler, Volker; Vo, Michelle; McGuffog, Claire; Van Rooijen, Nico; McCaughan, Geoffrey W; Bowen, David G; Bertolino, Patrick

2012-10-01

The occurrence of primary CD8 T cell activation within the liver, unique among the non-lymphoid organs, is now well accepted. However, the outcome of intrahepatic T cell activation remains controversial. We have previously reported that activation initiated by hepatocytes results in a tolerogenic phenotype characterized by low expression of CD25 and IL-2, poor cytotoxic T lymphocyte (CTL) function, and excessive expression of the pro-apoptotic protein Bim. To investigate whether this phenotype was due to activation in the absence of co-stimulation, we generated bone marrow (bm) radiation chimeras in which adoptively transferred naïve transgenic CD8 T cells were activated in the presence of co-stimulation by liver bm-derived cells. Despite expressing pro-inflammatory cytokines, high levels of CD25 and CD54, donor T cells activated by liver bm-derived cells did not produce detectable IL-2 and displayed poor CTL function, suggesting incomplete acquisition of effector function. Simultaneously, these cells expressed high levels of Bim and died by neglect. Transfer of Bim-deficient T cells resulted in increased T cell numbers. These results imply that expression of CD25 and CD54 is co-stimulation dependent and distinguishes T cell activated by hepatocytes and liver bm-derived cells. In contrast, low expression of IL-2, poor CTL function and excess Bim production represent a more universal phenotype defining T cells undergoing primary activation by both types of hepatic antigen presenting cells (APC). These results have important implications for transplantation, in which all liver antigen presenting cells contribute to activation of T cells specific for the allograft. Copyright © 2012 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Extending the time window for endovascular procedures according to collateral pial circulation.

PubMed

Ribo, Marc; Flores, Alan; Rubiera, Marta; Pagola, Jorge; Sargento-Freitas, Joao; Rodriguez-Luna, David; Coscojuela, Pilar; Maisterra, Olga; Piñeiro, Socorro; Romero, Francisco J; Alvarez-Sabin, Jose; Molina, Carlos A

2011-12-01

Good collateral pial circulation (CPC) predicts a favorable outcome in patients undergoing intra-arterial procedures. We aimed to determine if CPC status may be used to decide about pursuing recanalization efforts. Pial collateral score (0-5) was determined on initial angiogram. We considered good CPC when pial collateral score<3, defined total time of ischemia (TTI) as onset-to-recanalization time, and clinical improvement>4-point decline in admission-discharge National Institutes of Health Stroke Scale. We studied CPC in 61 patients (31 middle cerebral artery, 30 internal carotid artery). Good CPC patients (n=21 [34%]) had lower discharge National Institutes of Health Stroke Scale score (7 versus 21; P=0.02) and smaller infarcts (56 mL versus 238 mL; P<0.001). In poor CPC patients, a receiver operating characteristic curve defined a TTI cutoff point<300 minutes (sensitivity 67%, specificity 75%) that better predicted clinical improvement (TTI<300: 66.7% versus TTI>300: 25%; P=0.05). For good CPC patients, no temporal cutoff point could be defined. Although clinical improvement was similar for patients recanalizing within 300 minutes (poor CPC: 60% versus good CPC: 85.7%; P=0.35), the likelihood of clinical improvement was 3-fold higher after 300 minutes only in good CPC patients (23.1% versus 90.1%; P=0.01). Similarly, infarct volume was reduced 7-fold in good as compared with poor CPC patients only when TTI>300 minutes (TTI<300: poor CPC: 145 mL versus good CPC: 93 mL; P=0.56 and TTI>300: poor CPC: 217 mL versus good CPC: 33 mL; P<0.01). After adjusting for age and baseline National Institutes of Health Stroke Scale score, TTI<300 emerged as an independent predictor of clinical improvement in poor CPC patients (OR, 6.6; 95% CI, 1.01-44.3; P=0.05) but not in good CPC patients. In a logistic regression, good CPC independently predicted clinical improvement after adjusting for TTI, admission National Institutes of Health Stroke Scale score, and age (OR, 12.5; 95% CI, 1.6-74.8; P=0.016). Good CPC predicts better clinical response to intra-arterial treatment beyond 5 hours from onset. In patients with stroke receiving endovascular treatment, identification of good CPC may help physicians when considering pursuing recanalization efforts in late time windows.

Comparison of the survival between coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with poor left ventricular function (ejection fraction <30%): a propensity-matched analysis.

PubMed

Shah, Shaneel; Benedetto, Umberto; Caputo, Massimo; Angelini, Gianni D; Vohra, Hunaid A

2018-06-22

Existing evidence comparing the outcomes of coronary artery bypass graft (CABG) surgery versus percutaneous coronary intervention (PCI) in patients with poor left ventricular function (LVF) is sparse and flawed. This is largely due to patients with poor LVF being underrepresented in major research trials and the outdated nature of some studies that do not consider drug-eluting stent PCI. Following strict inclusion criteria, 717 patients who underwent revascularization by CABG or PCI between 2002 and 2015 were enrolled. All patients had poor LVF (defined by ejection fraction <30%). By employing a propensity score analysis, 134 suitable matches (67 CABG and 67 PCI) were identified. Several outcomes were evaluated, in the matched population, using data extracted from national registry databases. CABG patients required a longer length of hospital stay post-revascularization compared to PCI in the propensity-matched population, 7 days (lower-upper quartile; 6-12) and 2 days (lower-upper quartile; 1-6), respectively (Mood's median test, P = 0.001). Stratified Cox-regression proportional-hazards analysis of the propensity-matched population found that PCI patients experienced a higher adjusted 8-year mortality rate (hazard ratio 3.291, 95% confidence interval 1.776-6.101; P < 0.001). This trend was consistent amongst urgent cases of revascularization: patients with 3 or more vessels with coronary artery disease and patients where complete revascularization was achieved. Although sub-analyses found no difference between survival distributions of on-pump versus off-pump CABG (log-rank P = 0.726), both modes of CABG were superior to PCI (stratified log-rank P = 0.002). Despite a longer length of hospital stay, patients with impaired LVF requiring intervention for coronary artery disease experienced a greater post-procedural survival benefit if they received CABG compared to PCI. We have demonstrated this at 30 days, 90 days, 1 year, 3 years, 5 years and 8 years following revascularization. At present, CABG remains a superior revascularization modality to PCI in patients with poor LVF.

Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist.

PubMed

Terwee, Caroline B; Mokkink, Lidwine B; Knol, Dirk L; Ostelo, Raymond W J G; Bouter, Lex M; de Vet, Henrica C W

2012-05-01

The COSMIN checklist is a standardized tool for assessing the methodological quality of studies on measurement properties. It contains 9 boxes, each dealing with one measurement property, with 5-18 items per box about design aspects and statistical methods. Our aim was to develop a scoring system for the COSMIN checklist to calculate quality scores per measurement property when using the checklist in systematic reviews of measurement properties. The scoring system was developed based on discussions among experts and testing of the scoring system on 46 articles from a systematic review. Four response options were defined for each COSMIN item (excellent, good, fair, and poor). A quality score per measurement property is obtained by taking the lowest rating of any item in a box ("worst score counts"). Specific criteria for excellent, good, fair, and poor quality for each COSMIN item are described. In defining the criteria, the "worst score counts" algorithm was taken into consideration. This means that only fatal flaws were defined as poor quality. The scores of the 46 articles show how the scoring system can be used to provide an overview of the methodological quality of studies included in a systematic review of measurement properties. Based on experience in testing this scoring system on 46 articles, the COSMIN checklist with the proposed scoring system seems to be a useful tool for assessing the methodological quality of studies included in systematic reviews of measurement properties.

Seizure outcome after AED failure in pediatric focal epilepsy: impact of underlying etiology.

PubMed

Wirrell, Elaine C; Wong-Kisiel, Lily C; Nickels, Katherine C

2014-05-01

This study aimed to identify long-term seizure outcome in pediatric nonsyndromic focal epilepsy after failure of serial antiepileptic drugs (AEDs) due to lack of efficacy. Children (1 month-17 years) with new-onset focal epilepsy not meeting the criteria for a defined electroclinical syndrome diagnosed between 1980 and 2009 while residing in Olmsted County, MN, were retrospectively identified. Medical records of those followed for ≥2 years were reviewed to assess etiology, the number of AEDs that failed due to lack of efficacy, and seizure outcome at final follow-up. Etiology was classified into structural/metabolic, genetic, or unknown. Favorable outcome was defined as seizure freedom ≥1 year, on or off AEDs, without prior epilepsy surgery. Poor outcome was defined as ongoing seizures in the preceding year or having undergone prior epilepsy surgery. Nonsyndromic focal epilepsy accounted for 275/468 (59%) of all patients with newly diagnosed epilepsy--of these, 256 (93%) were followed for a minimum of two years and were included in the study. Median duration of follow-up was 10.0 years. At least one AED had failed due to lack of efficacy in 100 (39.1%) children. Favorable outcomes occurred in 149/156 (95.5%) children with no AED failure, 16/30 (53.3%) with one AED failure, 8/25 (32%) with two AED failures, and only 2/45 (4.4%) with three AED failures. After two AED failures, the seizures of nearly one-quarter of children who had epilepsy with an unknown cause responded favorably to the third AED compared with only 7.8% of the cohort that had epilepsy with a structural/metabolic cause. Children with a remote brain insult had a significantly higher likelihood of favorable outcome with serial AEDs than those with other structural abnormalities. Etiology is an important determinant of pharmacoresistance in nonsyndromic focal epilepsy. Surgical evaluation should be considered after failure of 1-2 AEDs in those who have epilepsy with structural causes, excluding remote brain insults. Conversely, as surgical success is lower with normal MRI or more diffuse brain insults, it appears reasonable to hold off surgical evaluation until 2-3 AEDs have failed in such children. Copyright © 2014 Elsevier Inc. All rights reserved.

Healthy work environment--a challenge?

PubMed

Jansson von Vultée, Pia Hannele

2015-01-01

In Sweden, leave due to sickness was high during the 1990s. The Swedish Social Insurance Agency was able to decrease sick days in the period between 2000 and 2010 but sick days are rising again in Sweden, mostly due to psychological problems among women and partly due to their work environment. It is important to find methods to identify poor work settings to prevent absenteeism due to sickness. The paper aims to discuss these issues. The authors created a web questionnaire focusing on the organizational setting and its impact on employee wellbeing--reported as mental energy, work-related exhaustion and work satisfaction. The questionnaire measures good and poor work environment factors to help managers improve organizational settings. The questionnaire was validated qualitatively and quantitatively. It is possible to measure individual wellbeing in an organizational context at an early stage. The authors followed a company undergoing organizational change and identified groups at risk of developing illness. Managers uncertain about employee mental status can measure employee wellbeing easily and cost effectively to prevent illness. The authors created a method, statistically evaluated, to proactively identify good and poor work environments to promote healthy co-workers.

Using the ovarian sensitivity index to define poor, normal, and high response after controlled ovarian hyperstimulation in the long gonadotropin-releasing hormone-agonist protocol: suggestions for a new principle to solve an old problem.

PubMed

Huber, Malin; Hadziosmanovic, Nermin; Berglund, Lars; Holte, Jan

2013-11-01

To explore the utility of using the ratio between oocyte yield and total dose of FSH, i.e., the ovarian sensitivity index (OSI), to define ovarian response patterns. Retrospective cross-sectional study. University-affiliated private center. The entire unselected cohort of 7,520 IVF/intracytoplasmic sperm injection treatments (oocyte pick-ups [OPUs]) during an 8-year period (long GnRH agonist-recombinant FSH protocol). None. The distribution of the OSI (oocytes recovered × 1,000/total dose of FSH), the cutoff levels for poor and high response, set at ±1 SD, and the relationship between OSI and treatment outcome. OSI showed a log-normal distribution with cutoff levels for poor and high response at 1.697/IU and 10.07/IU, respectively. A nomogram is presented. Live-birth rates per OPU were 10.5 ± 0.1%, 26.9 ± 0.6%, and 36.0 ± 1.4% for poor, normal, and high response treatments, respectively. The predictive power (C-statistic) for OSI to predict live birth was superior to that of oocyte yield. The OSI improves the definition of ovarian response patterns because it takes into account the degree of stimulation. The nomogram presents evidence-based cutoff levels for poor, normal, and high response and could be used for unifying study designs involving ovarian response patterns. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Factors associated with persistent poorly controlled diabetes mellitus: clues to improving management in patients with resistant poor control.

PubMed

Crowley, Matthew J; Holleman, Rob; Klamerus, Mandi L; Bosworth, Hayden B; Edelman, David; Heisler, Michele

2014-12-01

Patients with persistent poorly controlled diabetes mellitus (PPDM), defined as an uninterrupted hemoglobin A1c >8.0% for ≥1 year despite standard care, are at high risk for complications. Additional research to define patient factors associated with PPDM could suggest barriers to improvement in this group and inform the development of targeted strategies to address these patients' resistant diabetes. We analyzed patients with type 2 diabetes from a multi-site randomized trial. We characterized patients with PPDM relative to other patients using detailed survey data and multivariable modeling. Of 963 patients, 118 (12%) had PPDM, 265 (28%) were intermittently poorly controlled, and 580 (60%) were well-controlled. Patients with PPDM had younger age, earlier diabetes diagnosis, insulin use, higher antihypertensive burden, higher low-density lipoprotein cholesterol, and lower statin use relative to well-controlled patients. Among patients with objective adherence data (Veterans Affairs patients), a larger oral diabetes medication refill gap was associated with PPDM. Strategies are needed to target-specific barriers to improvement among patients whose diabetes is resistant to standard diabetes care. Our data suggest that strategies for targeting PPDM should accommodate younger patients' lifestyles, include medication management for insulin titration and comorbid disease conditions, and address barriers to self-management adherence. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Intrathoracic leak after an Ivor Lewis procedure for an esophageal neoplasm treated with a stent.

PubMed

Afonso Luis, Natalia; Acosta Mérida, María Asunción; Marchena Gómez, Joaquín

2018-04-01

A 75-year-old male who underwent an Ivor Lewis esophagectomy due to a distal adenocarcinoma had a leak at the gastroplasty on the 5th day after surgery, which required two surgeries and a primary suture. He was transferred to our hospital due to a poor outcome and endoscopy revealed a 2.5cm gap perianastomotically on the gastroplasty wall, for which a stent was placed. Due to hemodynamic impairment, a thoracotomy procedure was performed, which revealed stent protrusion into the cavity. The patient underwent an esophagogastric anastomosis resection, cervical esophagostomy and gastrostomy. Sepsis was resolved postoperatively and the patient had a protracted stay in the PACU due to poor respiratory dynamics following a prolonged intubation.

Determinants of childhood immunisation coverage in urban poor settlements of Delhi, India: a cross-sectional study.

PubMed

Devasenapathy, Niveditha; Ghosh Jerath, Suparna; Sharma, Saket; Allen, Elizabeth; Shankar, Anuraj H; Zodpey, Sanjay

2016-08-26

Aggregate data on childhood immunisation from urban settings may not reflect the coverage among the urban poor. This study provides information on complete childhood immunisation coverage among the urban poor, and explores its household and neighbourhood-level determinants. Urban poor community in the Southeast district of Delhi, India. We randomly sampled 1849 children aged 1-3.5 years from 13 451 households in 39 clusters (cluster defined as area covered by a community health worker) in 2 large urban poor settlements. Of these, 1343 completed the survey. We collected information regarding childhood immunisation (BCG, oral polio vaccine, diphtheria-pertussis-tetanus vaccine, hepatitis B and measles) from vaccination cards or mothers' recall. We used random intercept logistic regression to explore the sociodemographic determinants of complete immunisation. Complete immunisation coverage was 46.7% and 7.5% were not immunised. The odds of complete vaccination (OR, 95% CI) were lower in female children (0.70 (0.55 to 0.89)) and Muslim households (0.65 (0.45 to 0.94)). The odds of complete vaccination were higher if the mother was literate (1.6 (1.15 to 2.16)), if the child was born within the city (2.7 (1.97 to 3.65)), in a health facility ( 1.5 (1.19 to 2.02)), belonged to the highest wealth quintile (compared with the poorest; 2.46 (1.5 to 4.02)) or possessed a birth certificate (1.40 (1.03 to 1.91)). Cluster effect due to unmeasured neighbourhood factors expressed as median OR was 1.32. Immunisation coverage in this urban poor area was much lower than that of regional surveys reporting overall urban data. Socioeconomic status of the household, female illiteracy, health awareness and gender inequality were important determinants of coverage in this population. Hence, in addition to enhancing the infrastructure for providing mother and child services, efforts are also needed to address these issues in order to improve immunisation coverage in deprived urban communities. CTRI/2011/091/000095. 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/

A systematic review of discontinued trials suggested that most reasons for recruitment failure were preventable.

PubMed

Briel, Matthias; Olu, Kelechi Kalu; von Elm, Erik; Kasenda, Benjamin; Alturki, Reem; Agarwal, Arnav; Bhatnagar, Neera; Schandelmaier, Stefan

2016-12-01

To collect and classify reported reasons for recruitment failure in discontinued randomized controlled trials (RCTs) and to assess reporting quality. We systematically searched MEDLINE and EMBASE (2010-2014) and a previous cohort of RCTs for published RCTs reporting trial discontinuation due to poor recruitment. Teams of two investigators selected eligible RCTs working independently and extracted information using standardized forms. We used an iterative approach to classify reasons for poor recruitment. We included 172 RCTs discontinued due to poor recruitment (including 26 conference abstracts and 63 industry-funded RCTs). Of those, 131 (76%) reported one or more reasons for discontinuation due to poor recruitment. We identified 28 different reasons for recruitment failure; most frequently mentioned were overestimation of prevalence of eligible participants and prejudiced views of recruiters and participants on trial interventions. Few RCTs reported relevant details about the recruitment process such as how eligible participants were identified, the number of patients assessed for eligibility, and who actually recruited participants. Our classification could serve as a checklist to assist investigators in the planning of RCTs. Most reasons for recruitment failure seem preventable with a pilot study that applies the planned informed consent procedure. Copyright © 2016 Elsevier Inc. All rights reserved.

An assessment of the possible extent of confounding in epidemiological studies of lung cancer risk among roofers

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

Mundt, D.J.; van Wijngaarden, E.; Mundt, K.A.

2007-07-01

We evaluated the likelihood and extent to which the observed increased risk of lung cancer may be due to confounding (a mixing of effects of multiple exposures) by co-exposure to other potential carcinogens present in roofing or to lifestyle variables. We conducted a review of the epidemiological and industrial hygiene literature of asphalt-exposed workers. Peer-reviewed epidemiological studies of asphalt fumes, related occupational exposures, and confounding factors were identified from MEDLINE (1966 early 2004). Industrial hygiene studies of asphalt workers were identified through MEDLINE, publicly available government documents, and asphalt industry documents. Using well established statistical methods, we quantified the extentmore » to which lung cancer relative risk estimates among roofers reflect confounding from other exposures, using different prevalence and risk scenarios. The relative risk of lung cancer varied from 1.2 to 5.0 in 13 epidemiological studies of roofers; most studies reported a relative risk between 1.2 and 1.4. Smoking, asbestos and coal tar were the most likely confounders, but the prevalence of these factors varied over time. The results of the study indicate that much of the observed risk reported in epidemiological studies of cancer among roofers is well within the range of what may have resulted from confounding by reasonable and expected levels of smoking, asbestos or coal tar. This may be particularly true for those studies that did not adjust for these confounders and where the exposure was defined as employment in the roofing industry. In addition to poorly defined asphalt exposure, uncontrolled confounding cannot reliably be ruled out in studies of lung cancer among asphalt-exposed roofers. Therefore, it is not possible to conclude whether roofers are at increased risk of lung cancer due to asphalt exposure.« less

Well-Defined Nanostructured, Single-Crystalline TiO2 Electron Transport Layer for Efficient Planar Perovskite Solar Cells.

PubMed

Choi, Jongmin; Song, Seulki; Hörantner, Maximilian T; Snaith, Henry J; Park, Taiho

2016-06-28

An electron transporting layer (ETL) plays an important role in extracting electrons from a perovskite layer and blocking recombination between electrons in the fluorine-doped tin oxide (FTO) and holes in the perovskite layers, especially in planar perovskite solar cells. Dense TiO2 ETLs prepared by a solution-processed spin-coating method (S-TiO2) are mainly used in devices due to their ease of fabrication. Herein, we found that fatal morphological defects at the S-TiO2 interface due to a rough FTO surface, including an irregular film thickness, discontinuous areas, and poor physical contact between the S-TiO2 and the FTO layers, were inevitable and lowered the charge transport properties through the planar perovskite solar cells. The effects of the morphological defects were mitigated in this work using a TiO2 ETL produced from sputtering and anodization. This method produced a well-defined nanostructured TiO2 ETL with an excellent transmittance, single-crystalline properties, a uniform film thickness, a large effective area, and defect-free physical contact with a rough substrate that provided outstanding electron extraction and hole blocking in a planar perovskite solar cell. In planar perovskite devices, anodized TiO2 ETL (A-TiO2) increased the power conversion efficiency by 22% (from 12.5 to 15.2%), and the stabilized maximum power output efficiency increased by 44% (from 8.9 to 12.8%) compared with S-TiO2. This work highlights the importance of the ETL geometry for maximizing device performance and provides insights into achieving ideal ETL morphologies that remedy the drawbacks observed in conventional spin-coated ETLs.

An Improved Ivermectin-activated Chloride Channel Receptor for Inhibiting Electrical Activity in Defined Neuronal Populations*

PubMed Central

Lynagh, Timothy; Lynch, Joseph W.

2010-01-01

The ability to silence the electrical activity of defined neuronal populations in vivo is dramatically advancing our understanding of brain function. This technology may eventually be useful clinically for treating a variety of neuropathological disorders caused by excessive neuronal activity. Several neuronal silencing methods have been developed, with the bacterial light-activated halorhodopsin and the invertebrate allatostatin-activated G protein-coupled receptor proving the most successful to date. However, both techniques may be difficult to implement clinically due to their requirement for surgically implanted stimulus delivery methods and their use of nonhuman receptors. A third silencing method, an invertebrate glutamate-gated chloride channel receptor (GluClR) activated by ivermectin, solves the stimulus delivery problem as ivermectin is a safe, well tolerated drug that reaches the brain following systemic administration. However, the limitations of this method include poor functional expression, possibly due to the requirement to coexpress two different subunits in individual neurons, and the nonhuman origin of GluClR. Here, we describe the development of a modified human α1 glycine receptor as an improved ivermectin-gated silencing receptor. The crucial development was the identification of a mutation, A288G, which increased ivermectin sensitivity almost 100-fold, rendering it similar to that of GluClR. Glycine sensitivity was eliminated via the F207A mutation. Its large unitary conductance, homomeric expression, and human origin may render the F207A/A288G α1 glycine receptor an improved silencing receptor for neuroscientific and clinical purposes. As all known highly ivermectin-sensitive GluClRs contain an endogenous glycine residue at the corresponding location, this residue appears essential for exquisite ivermectin sensitivity. PMID:20308070

Influence of Prostatic Edema on {sup 131}CS Permanent Prostate Seed Implants: A Dosimetric and Radiobiological Study

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

Kehwar, Than S., E-mail: kehwarts@upmc.ed; Jones, Heather A.; Huq, M. Saiful

2011-06-01

Purpose: To study the influence of prostatic edema on postimplant physical and radiobiological parameters using {sup 131}Cs permanent prostate seed implants. Methods and Materials: Thirty-one patients with early prostate cancer who underwent {sup 131}Cs permanent seed implantation were evaluated. Dose-volume histograms were generated for each set of prostate volumes obtained at preimplantation and postimplantion days 0, 14, and 28 to compute quality indices (QIs) and fractional doses at level x (FD{sub x}). A set of equations for QI, FD{sub x}, and biologically effective doses at dose level D{sub x} (BED{sub x}) were defined to account for edema changes with timemore » after implant. Results: There were statistically significant differences found between QIs of pre- and postimplant plans at day 0, except for the overdose index (ODI). QIs correlated with postimplant time, and FD{sub x} was found to increase with increasing postimplant time. With the effect of edema, BED at different dose levels showed less improvement due to the short half-life of {sup 131}Cs, which delivers about 85% of the prescribed dose before the prostate reaches its original volume due to dissipation of edema. Conclusions: Results of the study show that QIs, FD{sub x}, and BEDs at the level of D{sub x} changed from preneedle plans to postimplant plans and have statistically significant differences (p < 0.05), except for the ODI (p = 0.106), which suggests that at the time of {sup 131}C seed implantation, the effect of edema must be accounted for when defining the seed positions, to avoid the possibility of poor dosimetric and radiobiologic results for {sup 131}Cs seed implants.« less

Anakinra as a diagnostic challenge and treatment option for systemic autoinflammatory disorders of undefined etiology

PubMed Central

Harrison, Stephanie R.; McGonagle, Dennis; Nizam, Sharmin; Jarrett, Stephen; van der Hilst, Jeroen; McDermott, Michael F.

2016-01-01

BACKGROUND. Some adult patients presenting with unexplained pyrexia, serositis, skin rashes, arthralgia, myalgia, and other symptoms commonly found in autoinflammatory disorders may not fit a specific diagnosis, either because their clinical phenotype is nondiagnostic or genetic tests are negative. We used the term undifferentiated systemic autoinflammatory disorder (uSAID) to describe such cases. Given that well-defined autoinflammatory diseases show responses to IL-1 blockade, we evaluated whether anakinra was useful for both diagnosing and treating uSAID patients. METHODS. We performed a retrospective analysis of consecutive patients presenting with uSAID between 2012–2015 who were treated with the recombinant IL-1 receptor antagonist anakinra. uSAID was diagnosed after excluding malignancy, infection, and pathogenic mutations in known hereditary fever syndromes (HFS) genes and where clinical criteria for adult onset Still’s disease (AOSD) were not met. RESULTS. A total of 11 patients presented with uSAID (5 males and 6 females), with a mean time to diagnosis of 3.5 years (1–8 years). Patients were unresponsive or only partially controlled on disease-modifying antirheumatic drug (DMARD)/steroid treatment. Anakinra controlled symptoms within 4–6 weeks of starting treatment in 9 of 11 cases. Two patients discontinued therapy — one due to incomplete response and another due to severe injection-site reactions. CONCLUSION. This retrospective case series demonstrates that the spectrum of poorly defined autoinflammatory disorders that show responsiveness to anakinra is considerable. Anakinra seems a viable treatment option for these patients, who are unresponsive to standard steroid/DMARD treatments. Moreover, given the mechanisms of action, response to anakinra implicates underlying IL-1 dysregulation in the disease pathogenesis of responding uSAIDs patients. PMID:27699261

Determinants in the β and δ subunit cytoplasmic loop regulate Golgi trafficking and surface expression of the muscle acetylcholine receptor.

PubMed

Rudell, Jolene Chang; Borges, Lucia S; Rudell, John B; Beck, Kenneth A; Ferns, Michael J

2014-01-03

The molecular determinants that govern nicotinic acetylcholine receptor (AChR) assembly and trafficking are poorly defined, and those identified operate largely during initial receptor biogenesis in the endoplasmic reticulum. To identify determinants that regulate later trafficking steps, we performed an unbiased screen using chimeric proteins consisting of CD4 fused to the muscle AChR subunit cytoplasmic loops. In C2 mouse muscle cells, we found that CD4-β and δ subunit loops were expressed at very low levels on the cell surface, whereas the other subunit loops were robustly expressed on the plasma membrane. The low surface expression of CD4-β and δ loops was due to their pronounced retention in the Golgi apparatus and also to their rapid internalization from the plasma membrane. Both retention and recovery were mediated by the proximal 25-28 amino acids in each loop and were dependent on an ordered sequence of charged and hydrophobic residues. Indeed, βK353L and δK351L mutations increased surface trafficking of the CD4-subunit loops by >6-fold and also decreased their internalization from the plasma membrane. Similarly, combined βK353L and δK351L mutations increased the surface levels of assembled AChR expressed in HEK cells to 138% of wild-type levels. This was due to increased trafficking to the plasma membrane and not decreased AChR turnover. These findings identify novel Golgi retention signals in the β and δ subunit loops that regulate surface trafficking of assembled AChR and may help prevent surface expression of unassembled subunits. Together, these results define molecular determinants that govern a Golgi-based regulatory step in nicotinic AChR trafficking.

Simulation of Urban Heat Island Mitigation Strategies in Atlanta, GA Using High-Resolution Land Use/Land Cover Data Set to Enhance Meteorological Modeling

NASA Technical Reports Server (NTRS)

Crosson, William L.; Dembek, Scott; Estes, Maurice G., Jr.; Limaye, Ashutosh S.; Lapenta, William; Quattrochi, Dale A.; Johnson, Hoyt; Khan, Maudood

2006-01-01

The specification of land use/land cover (LULC) and associated land surface parameters in meteorological models at all scales has a major influence on modeled surface energy fluxes and boundary layer states. In urban areas, accurate representation of the land surface may be even more important than in undeveloped regions due to the large heterogeneity within the urban area. Deficiencies in the characterization of the land surface related to the spatial or temporal resolution of the data, the number of LULC classes defined, the accuracy with which they are defined, or the degree of heterogeneity of the land surface properties within each class may degrade the performance of the models. In this study, an experiment was conducted to test a new high-resolution LULC data set for meteorological simulations for the Atlanta, Georgia metropolitan area using a mesoscale meteorological model and to evaluate the effects of urban heat island (UHI) mitigation strategies on modeled meteorology for 2030. Simulation results showed that use of the new LULC data set reduced a major deficiency of the land use data used previously, specifically the poor representation of urban and suburban land use. Performance of the meteorological model improved substantially, with the overall daytime cold bias reduced by over 30%. UHI mitigation strategies were projected to offset much of a predicted urban warming between 2000 and 2030. In fact, for the urban core, the cooling due to UHI mitigation strategies was slightly greater than the warming associated with urbanization over this period. For the larger metropolitan area, cooling only partially offset the projected warming trend.

Changes in the proportion of facility-based deliveries and related maternal health services among the poor in rural Jhang, Pakistan: results from a demand-side financing intervention.

PubMed

Agha, Sohail

2011-11-30

Demand-side financing projects are now being implemented in many developing countries, yet evidence showing that they reach the poor is scanty. A maternal health voucher scheme provided voucher-paid services in Jhang, a predominantly rural district of Pakistan, during 2010. A pre-test/post-test quasi-experimental design was used to assess the changes in the proportion of facility-based deliveries and related maternal health services among the poor. Household interviews were conducted with randomly selected women in the intervention and control union councils, before and after the intervention.A strong outreach model was used. Voucher promoters were given basic training in identification of poor women using the Poverty Scorecard for Pakistan, in the types of problems women could face during delivery, and in the promotion of antenatal care (ANC), institutional delivery and postnatal care (PNC). Voucher booklets valued at Rs. 4,000 ($48), including three ANC visits, a PNC visit, an institutional delivery, and a postnatal family planning visit, were sold for Rs. 100 ($1.2) to low-income women targeted by project outreach workers. Women suffering from complications were referred to emergency obstetric care services.Analysis was conducted at the bivariate and the multivariate levels. At the multivariate level, logistic regression analysis was conducted to determine whether the increase in institutional delivery was greater among poor women (defined for this study as women in the fourth or fifth quintiles) relative to non-poor women (defined for this study as women in the first quintile) in the intervention union councils compared to the control union councils. Bivariate analysis showed significant increases in the institutional delivery rate among women in the fourth or fifth wealth quintiles in the intervention union councils but no significant changes in this indicator among women in the same wealth quintiles in the control union councils. Multivariate analysis showed that the increase in institutional delivery among poor women relative to non-poor women was significantly greater in the intervention compared to the control union councils. Demand-side financing projects using vouchers can be an effective way of reducing inequities in institutional delivery.

Knowledge of diabetes mellitus among pregnant women in three districts of Nepal.

PubMed

Shrestha, S; Thapa, P; Saleh, F; Thapa, N; Stray, B Pedersen; Khanom, K

2013-09-01

Diabetes mellitus is an emerging health problem in developing world with the consumption of energy dense diet and inactive lifestyle. The problem of diabetes is further expanded due to ignorance and lack of knowledge. The aim of the study was to assess the knowledge of diabetes among pregnant women in three districts of Nepal. A community based cross-sectional study was conducted in three districts in mountain, hilly and plain areas of Nepal. A total of 590 pregnant women were interviewed during the period of July 2009 to June 2010. A knowledge score system was applied. Poor score was <40%, average (40-60%) and good (>60%) of the total score. Statistical software SPSS 11.5 was used for data entry, data management and analysis. Out of 590 pregnant women, only 41% had heard about diabetes mellitus. Majority of the participants (75%) from age group >30 years had not heard about diabetes. Among the 241 with some knowledge, the knowledge score median percent(range) on the meaning, symptoms, risk factors, treatment, prevention, complications and overall knowledge were 50%(0-100), 25% (0-75), 20% (0-60), 20% (0-100), 25% (0-100), 20% (0-60) and 26% (0- 58) respectively. According to defined category, majority of those who ever heard about diabetes had poor knowledge (95%). Knowledge among literate women (p=.001), women residing in Kailali district (plain region) (p=.003) and those with positive family history of diabetes (p=.003) was found to be significant. As large proportions of Nepalese pregnant women do not have any knowledge or have poor knowledge regarding diabetes, extensive health education and health promotion programs are urgently recommended to prevent diabetes in Nepal.

Hardship financing of healthcare among rural poor in Orissa, India

PubMed Central

2012-01-01

Background This study examines health-related "hardship financing" in order to get better insights on how poor households finance their out-of-pocket healthcare costs. We define hardship financing as having to borrow money with interest or to sell assets to pay out-of-pocket healthcare costs. Methods Using survey data of 5,383 low-income households in Orissa, one of the poorest states of India, we investigate factors influencing the risk of hardship financing with the use of a logistic regression. Results Overall, about 25% of the households (that had any healthcare cost) reported hardship financing during the year preceding the survey. Among households that experienced a hospitalization, this percentage was nearly 40%, but even among households with outpatient or maternity-related care around 25% experienced hardship financing. Hardship financing is explained not merely by the wealth of the household (measured by assets) or how much is spent out-of-pocket on healthcare costs, but also by when the payment occurs, its frequency and its duration (e.g. more severe in cases of chronic illnesses). The location where a household resides remains a major predictor of the likelihood to have hardship financing despite all other household features included in the model. Conclusions Rural poor households are subjected to considerable and protracted financial hardship due to the indirect and longer-term deleterious effects of how they cope with out-of-pocket healthcare costs. The social network that households can access influences exposure to hardship financing. Our findings point to the need to develop a policy solution that would limit that exposure both in quantum and in time. We therefore conclude that policy interventions aiming to ensure health-related financial protection would have to demonstrate that they have reduced the frequency and the volume of hardship financing. PMID:22284934

Social relationships and cognitive decline: a systematic review and meta-analysis of longitudinal cohort studies.

PubMed

Kuiper, Jisca S; Zuidersma, Marij; Zuidema, Sytse U; Burgerhof, Johannes Gm; Stolk, Ronald P; Oude Voshaar, Richard C; Smidt, Nynke

2016-08-01

Although poor social relationships are assumed to contribute to cognitive decline, meta-analytic approaches have not been applied. Individual study results are mixed and difficult to interpret due to heterogeneity in measures of social relationships. We conducted a systematic review and meta-analysis to investigate the relation between poor social relationships and cognitive decline. MEDLINE, Embase and PsycINFO were searched for longitudinal cohort studies examining various aspects of social relationships and cognitive decline in the general population. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using random effects meta-analysis. Sources of heterogeneity were explored and likelihood of publication bias was assessed. We stratified analyses according to three aspects of social relationships: structural, functional and a combination of these. We identified 43 articles. Poor social relationships predicted cognitive decline; for structural (19 studies): pooled OR: 1.08 (95% CI: 1.05-1.11); functional (8 studies): pooled OR: 1.15 (95% CI: 1.00-1.32); and combined measures (7 studies): pooled OR: 1.12 (95% CI: 1.01-1.24). Meta-regression and subgroup analyses showed that the heterogeneity could be explained by the type of social relationship measurement and methodological quality of included studies. Despite heterogeneity in study design and measures, our meta-analyses show that multiple aspects of social relationships are associated with cognitive decline. As evidence for publication bias was found, the association might be overestimated and should therefore be interpreted with caution. Future studies are needed to better define the mechanisms underlying these associations. Potential causality of this prognostic association should be examined in future randomized controlled studies. © The Author 2016; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Germline BRCA mutations are associated with higher risk of nodal involvement, distant metastasis, and poor survival outcomes in prostate cancer.

PubMed

Castro, Elena; Goh, Chee; Olmos, David; Saunders, Ed; Leongamornlert, Daniel; Tymrakiewicz, Malgorzata; Mahmud, Nadiya; Dadaev, Tokhir; Govindasami, Koveela; Guy, Michelle; Sawyer, Emma; Wilkinson, Rosemary; Ardern-Jones, Audrey; Ellis, Steve; Frost, Debra; Peock, Susan; Evans, D Gareth; Tischkowitz, Marc; Cole, Trevor; Davidson, Rosemarie; Eccles, Diana; Brewer, Carole; Douglas, Fiona; Porteous, Mary E; Donaldson, Alan; Dorkins, Huw; Izatt, Louise; Cook, Jackie; Hodgson, Shirley; Kennedy, M John; Side, Lucy E; Eason, Jacqueline; Murray, Alex; Antoniou, Antonis C; Easton, Douglas F; Kote-Jarai, Zsofia; Eeles, Rosalind

2013-05-10

To analyze the baseline clinicopathologic characteristics of prostate tumors with germline BRCA1 and BRCA2 (BRCA1/2) mutations and the prognostic value of those mutations on prostate cancer (PCa) outcomes. This study analyzed the tumor features and outcomes of 2,019 patients with PCa (18 BRCA1 carriers, 61 BRCA2 carriers, and 1,940 noncarriers). The Kaplan-Meier method and Cox regression analysis were used to evaluate the associations between BRCA1/2 status and other PCa prognostic factors with overall survival (OS), cause-specific OS (CSS), CSS in localized PCa (CSS_M0), metastasis-free survival (MFS), and CSS from metastasis (CSS_M1). PCa with germline BRCA1/2 mutations were more frequently associated with Gleason ≥ 8 (P = .00003), T3/T4 stage (P = .003), nodal involvement (P = .00005), and metastases at diagnosis (P = .005) than PCa in noncarriers. CSS was significantly longer in noncarriers than in carriers (15.7 v 8.6 years, multivariable analyses [MVA] P = .015; hazard ratio [HR] = 1.8). For localized PCa, 5-year CSS and MFS were significantly higher in noncarriers (96% v 82%; MVA P = .01; HR = 2.6%; and 93% v 77%; MVA P = .009; HR = 2.7, respectively). Subgroup analyses confirmed the poor outcomes in BRCA2 patients, whereas the role of BRCA1 was not well defined due to the limited size and follow-up in this subgroup. Our results confirm that BRCA1/2 mutations confer a more aggressive PCa phenotype with a higher probability of nodal involvement and distant metastasis. BRCA mutations are associated with poor survival outcomes and this should be considered for tailoring clinical management of these patients.

Churg-Strauss syndrome.

PubMed

Greco, Antonio; Rizzo, Maria Ida; De Virgilio, Armando; Gallo, Andrea; Fusconi, Massimo; Ruoppolo, Giovanni; Altissimi, Giancarlo; De Vincentiis, Marco

2015-04-01

Churg-Strauss syndrome (CSS), alternatively known as eosinophilic granulomatosis with polyangiitis (EGPA), was first described in 1951 by Churg and Strauss as a rare disease characterized by disseminated necrotizing vasculitis with extravascular granulomas occurring exclusively among patients with asthma and tissue eosinophilia. EGPA is classified as a small-vessel vasculitis associated with antineutrophil cytoplasmic antibodies (ANCAs) and the hypereosinophilic syndromes (HESs) in which vessel inflammation and eosinophilic proliferation are thought to contribute to organ damage. Although still considered an idiopathic condition, EGPA is classically considered a Th2-mediated disease. Emerging clinical observations provide compelling evidence that ANCAs are primarily and directly involved in the pathogenesis of AASVs, although recent evidence implicates B cells and the humoral response as further contributors to EGPA pathogenesis. EGPA has traditionally been described as evolving through a prodromic phase characterized by asthma and rhino-sinusitis, an eosinophilic phase marked by peripheral eosinophilia and organ involvement, and a vasculitic phase with clinical manifestations due to small-vessel vasculitis. The American College of Rheumatology defined the classification criteria to distinguish the different types of vasculitides and identified six criteria for EGPA. When four or more of these criteria are met, vasculitis can be classified as EGPA. The French Vasculitis Study Group has identified five prognostic factors that make up the so-called five-factor score (FFS). Patients without poor prognosis factors (FFS=0) have better survival rates than patients with poor prognosis factors (FFS≥1). The treatment of patients with CSS must be tailored to individual patients according to the presence of poor prognostic factors. A combination of high-dose corticosteroids and cyclophosphamide is still the gold standard for the treatment of severe cases, but the use of biological agents such as rituximab or mepolizumab seems to be a promising therapeutic alternative. Copyright © 2015 Elsevier B.V. All rights reserved.

Hardship financing of healthcare among rural poor in Orissa, India.

PubMed

Binnendijk, Erika; Koren, Ruth; Dror, David M

2012-01-27

This study examines health-related "hardship financing" in order to get better insights on how poor households finance their out-of-pocket healthcare costs. We define hardship financing as having to borrow money with interest or to sell assets to pay out-of-pocket healthcare costs. Using survey data of 5,383 low-income households in Orissa, one of the poorest states of India, we investigate factors influencing the risk of hardship financing with the use of a logistic regression. Overall, about 25% of the households (that had any healthcare cost) reported hardship financing during the year preceding the survey. Among households that experienced a hospitalization, this percentage was nearly 40%, but even among households with outpatient or maternity-related care around 25% experienced hardship financing.Hardship financing is explained not merely by the wealth of the household (measured by assets) or how much is spent out-of-pocket on healthcare costs, but also by when the payment occurs, its frequency and its duration (e.g. more severe in cases of chronic illnesses). The location where a household resides remains a major predictor of the likelihood to have hardship financing despite all other household features included in the model. Rural poor households are subjected to considerable and protracted financial hardship due to the indirect and longer-term deleterious effects of how they cope with out-of-pocket healthcare costs. The social network that households can access influences exposure to hardship financing. Our findings point to the need to develop a policy solution that would limit that exposure both in quantum and in time. We therefore conclude that policy interventions aiming to ensure health-related financial protection would have to demonstrate that they have reduced the frequency and the volume of hardship financing.

Germline BRCA Mutations Are Associated With Higher Risk of Nodal Involvement, Distant Metastasis, and Poor Survival Outcomes in Prostate Cancer

PubMed Central

Castro, Elena; Goh, Chee; Olmos, David; Saunders, Ed; Leongamornlert, Daniel; Tymrakiewicz, Malgorzata; Mahmud, Nadiya; Dadaev, Tokhir; Govindasami, Koveela; Guy, Michelle; Sawyer, Emma; Wilkinson, Rosemary; Ardern-Jones, Audrey; Ellis, Steve; Frost, Debra; Peock, Susan; Evans, D. Gareth; Tischkowitz, Marc; Cole, Trevor; Davidson, Rosemarie; Eccles, Diana; Brewer, Carole; Douglas, Fiona; Porteous, Mary E.; Donaldson, Alan; Dorkins, Huw; Izatt, Louise; Cook, Jackie; Hodgson, Shirley; Kennedy, M. John; Side, Lucy E.; Eason, Jacqueline; Murray, Alex; Antoniou, Antonis C.; Easton, Douglas F.; Kote-Jarai, Zsofia; Eeles, Rosalind

2013-01-01

Purpose To analyze the baseline clinicopathologic characteristics of prostate tumors with germline BRCA1 and BRCA2 (BRCA1/2) mutations and the prognostic value of those mutations on prostate cancer (PCa) outcomes. Patients and Methods This study analyzed the tumor features and outcomes of 2,019 patients with PCa (18 BRCA1 carriers, 61 BRCA2 carriers, and 1,940 noncarriers). The Kaplan-Meier method and Cox regression analysis were used to evaluate the associations between BRCA1/2 status and other PCa prognostic factors with overall survival (OS), cause-specific OS (CSS), CSS in localized PCa (CSS_M0), metastasis-free survival (MFS), and CSS from metastasis (CSS_M1). Results PCa with germline BRCA1/2 mutations were more frequently associated with Gleason ≥ 8 (P = .00003), T3/T4 stage (P = .003), nodal involvement (P = .00005), and metastases at diagnosis (P = .005) than PCa in noncarriers. CSS was significantly longer in noncarriers than in carriers (15.7 v 8.6 years, multivariable analyses [MVA] P = .015; hazard ratio [HR] = 1.8). For localized PCa, 5-year CSS and MFS were significantly higher in noncarriers (96% v 82%; MVA P = .01; HR = 2.6%; and 93% v 77%; MVA P = .009; HR = 2.7, respectively). Subgroup analyses confirmed the poor outcomes in BRCA2 patients, whereas the role of BRCA1 was not well defined due to the limited size and follow-up in this subgroup. Conclusion Our results confirm that BRCA1/2 mutations confer a more aggressive PCa phenotype with a higher probability of nodal involvement and distant metastasis. BRCA mutations are associated with poor survival outcomes and this should be considered for tailoring clinical management of these patients. PMID:23569316

Preclinical dose number and its application in understanding drug absorption risk and formulation design for preclinical species.

PubMed

Wuelfing, W Peter; Daublain, Pierre; Kesisoglou, Filippos; Templeton, Allen; McGregor, Caroline

2015-04-06

In the drug discovery setting, the ability to rapidly identify drug absorption risk in preclinical species at high doses from easily measured physical properties is desired. This is due to the large number of molecules being evaluated and their high attrition rate, which make resource-intensive in vitro and in silico evaluation unattractive. High-dose in vivo data from rat, dog, and monkey are analyzed here, using a preclinical dose number (PDo) concept based on the dose number described by Amidon and other authors (Pharm. Res., 1993, 10, 264-270). PDo, as described in this article, is simply calculated as dose (mg/kg) divided by compound solubility in FaSSIF (mg/mL) and approximates the volume of biorelevant media per kilogram of animal that would be needed to fully dissolve the dose. High PDo values were found to be predictive of difficulty in achieving drug exposure (AUC)-dose proportionality in in vivo studies, as could be expected; however, this work analyzes a large data set (>900 data points) and provides quantitative guidance to identify drug absorption risk in preclinical species based on a single solubility measurement commonly carried out in drug discovery. Above the PDo values defined, >50% of all in vivo studies exhibited poor AUC-dose proportionality in rat, dog, and monkey, and these values can be utilized as general guidelines in discovery and early development to rapidly assess risk of solubility-limited absorption for a given compound. A preclinical dose number generated by biorelevant dilutions of formulated compounds (formulated PDo) was also evaluated and defines solubility targets predictive of suitable AUC-dose proportionality in formulation development efforts. Application of these guidelines can serve to efficiently identify compounds in discovery that are likely to present extreme challenges with respect to solubility-limited absorption in preclinical species as well as reduce the testing of poor formulations in vivo, which is a key ethical and resource matter.

Risk predictors for adverse outcome in pediatric febrile neutropenia: Single center experience from a low and middle-income country.

PubMed

Prasad, M; Chinnaswamy, G; Arora, B; Vora, T; Hawaldar, R; Banavali, S

2014-01-01

Risk stratification of patients with febrile neutropenia (FN) into those at "High Risk" and "Low Risk" of developing complications helps in making decisions regarding optimal treatment, such as whether to treat with oral or intravenous antibiotics, whether to treat as inpatient or outpatient and how long to treat. Risk predictors obtained from Western studies on pediatric FN are unlikely to be relevant to low middle-income country (LMICs). Our study aimed to identify clinical and laboratory parameters predictive of poor outcomes in children with chemotherapy-induced FN in a LMIC. Two hundred and fifty consecutive episodes of chemotherapy-induced FN in pediatric (<15 years) patients were analyzed prospectively. Adverse outcomes were defined as per SPOG 2003 FN study as serious medical complications (SMC) due to infection, microbiologically defined infection, and radiologically defined pneumonia (RDP). Variables found to be significant for adverse outcome (P < 0.05) on univariate analysis were selected for multivariate analysis. Five factors that were found to independently predict adverse outcome were (a) previously documented infection in the past 6 months, (b) presence of significant focus of infection, (c) absolute phagocyte count <100/mm3, (d) peak temperature more than 39°C in this episode of FN, and (e) fever lasting more than 5 days during this episode of FN. Identifying the risk factors for adverse outcome in pediatric FN, which are objective and applicable across LMICs would contribute in developing guidelines for the management of FN in a resource-limited setting.

Acute pure motor quadriplegia: is it dengue myositis?

PubMed

Kalita, J; Misra, U K; Mahadevan, A; Shankar, S K

2005-01-01

In view of paucity of comprehensive evaluation about dengue infection producing quadriplegia, we report the clinical, laboratory and neurophysiological studies in these patients. Seven out of 16 patients with dengue infection presented with quadriplegia and they were subjected to a detailed clinical history and examination. Diagnosis of dengue was based on characteristic clinical and positive serum IgM ELISA. Blood counts, serum chemistry, CSF analysis and nerve conduction and electromyographic (EMG) studies were performed in all. Outcome was defined at the end of 1 month into complete, partial and poor on the basis of activities of daily living The age of the patients ranged between 9 and 42 years and 2 were females. Fever was present in all and myalgia in 5 patients. Weakness developed within 3-5 days of illness, which was severe in 4 and moderate in 3 patients. Hypotonia and hyporeflexia were present in 5 patients. Nerve conduction and EMG studies were normal in all except one whose EMG was myopathic. Serum CPK and SGPT were raised in all and serum bilirubin in 3 patients. All the patients had coagulopathy and 6 had thrombocytopenia. Muscle biopsy in 1 patient was suggestive of myositis. Six patients improved completely and one had poor recovery who needed ventilatory support. Dengue virus infection may result in acute pure motor quadriplegia due to myositis. In an endemic area it should be considered in the differential diagnosis of acute flaccid paralysis.

New insights into the pathogenesis of IgA nephropathy.

PubMed

Yeo, See Cheng; Cheung, Chee Kay; Barratt, Jonathan

2018-05-01

IgA nephropathy is the most common form of glomerulonephritis in many parts of the world and remains an important cause of end-stage renal disease. Current evidence suggests that IgA nephropathy is not due to a single pathogenic insult, but rather the result of multiple sequential pathogenic "hits". An abnormally increased level of circulating poorly O-galactosylated IgA1 and the production of O-glycan-specific antibodies leads to the formation of IgA1-containing immune complexes, and their subsequent mesangial deposition results in inflammation and glomerular injury. While this general framework has formed the foundation of our current understanding of the pathogenesis of IgA nephropathy, much work is ongoing to try to precisely define the genetic, epigenetic, immunological, and molecular basis of IgA nephropathy. In particular, the precise origin of poorly O-galactosylated IgA1 and the inciting factors for the production of O-glycan-specific antibodies continue to be intensely evaluated. The mechanisms responsible for mesangial IgA1 deposition and subsequent renal injury also remain incompletely understood. In this review, we summarize the current understanding of the key steps involved in the pathogenesis of IgA nephropathy. It is hoped that further advances in our understanding of this common glomerulonephritis will lead to novel diagnostic and prognostic biomarkers, and targeted therapies to ameliorate disease progression.

Can a virtual reality assessment of fine motor skill predict successful central line insertion?

PubMed

Mohamadipanah, Hossein; Parthiban, Chembian; Nathwani, Jay; Rutherford, Drew; DiMarco, Shannon; Pugh, Carla

2016-10-01

Due to the increased use of peripherally inserted central catheter lines, central lines are not performed as frequently. The aim of this study is to evaluate whether a virtual reality (VR)-based assessment of fine motor skills can be used as a valid and objective assessment of central line skills. Surgical residents (N = 43) from 7 general surgery programs performed a subclavian central line in a simulated setting. Then, they participated in a force discrimination task in a VR environment. Hand movements from the subclavian central line simulation were tracked by electromagnetic sensors. Gross movements as monitored by the electromagnetic sensors were compared with the fine motor metrics calculated from the force discrimination tasks in the VR environment. Long periods of inactivity (idle time) during needle insertion and lack of smooth movements, as detected by the electromagnetic sensors, showed a significant correlation with poor force discrimination in the VR environment. Also, long periods of needle insertion time correlated to the poor performance in force discrimination in the VR environment. This study shows that force discrimination in a defined VR environment correlates to needle insertion time, idle time, and hand smoothness when performing subclavian central line placement. Fine motor force discrimination may serve as a valid and objective assessment of the skills required for successful needle insertion when placing central lines. Copyright © 2016 Elsevier Inc. All rights reserved.

[Thyroid carcinoma--differentiated, poorly differentiated and anaplastic carcinoma].

PubMed

Kakudo, Kennichi; Bai, Yanhua; Li, Yaqiong; Wakasa, Tomoko; Mori, Ichiro

2007-11-01

The poorly differentiated carcinoma was first added as a new member in the lists of classification of thyroid carcinomas in the WHO 2004 edition. However its histological criteria include necrosis and increased mitoses in addition to the original definition by Sakamoto's proposal, solid, trabecular and schirrhous growth. This modification creates a significant change in the incidence and prognosis of this carcinoma. This carcinoma, defined by the new WHO classification, is about 1-5% of all thyroid malignancy and has more aggressive outcome than the previous definition.

A Validation of the Proposed Royal Australian Navy Standard Work Week and Naval Management Diary Using a Simulated Crew of an Armidale Class Patrol Boat

DTIC Science & Technology

2015-12-01

Reduced mental capacity, poor decision making, emotional outbursts or withdrawals, and reduced alertness are among the side effects that have been...Guide.” The guide defined fatigue as “the product of intense and prolonged emotional strain, poor and inadequate diet, strenuous physical exertion...scheduling bodily functions and periods of sleepiness and wakefulness. Circadian rhythms control numerous factors in the human body including body

Multiple scene attitude estimator performance for LANDSAT-1

NASA Technical Reports Server (NTRS)

Rifman, S. S.; Monuki, A. T.; Shortwell, C. P.

1979-01-01

Initial results are presented to demonstrate the performance of a linear sequential estimator (Kalman Filter) used to estimate a LANDSAT 1 spacecraft attitude time series defined for four scenes. With the revised estimator a GCP poor scene - a scene with no usable geodetic control points (GCPs) - can be rectified to higher accuracies than otherwise based on the use of GCPs in adjacent scenes. Attitude estimation errors was determined by the use of GCPs located in the GCP-poor test scene, but which are not used to update the Kalman filter. Initial results achieved indicate that errors of 500m (rms) can be attained for the GCP-poor scenes. Operational factors are related to various scenarios.

ADEQUACY OF DISINFECTION FOR CONTROL OF NEWLY RECOGNIZED WATERBORNE PATHOGENS

EPA Science Inventory

Agents recently recognized as causes or potential causes of waterborne outbreaks include pathogenic bacteria (Campylobacter jejuni, Yersinia enterocoliticia), viruses (rotavirus, Norwalk virus and other poorly defined viral agents) and Giardia lamblia, a protozoan agent. Although...

SOCIODEMOGRAPHIC DOMAINS OF DEPRIVATION AND PRETERM BIRTH

EPA Science Inventory

Area-level deprivation is consistently associated with poor health outcomes. Using US census data (2000) and principal components analysis, a priori defined socio-demographic indices of poverty, housing, residential stability, occupation, employment and education were created fo...

Transcriptional markers of sub-optimal nutrition in developing Apis mellifera nurse workers

PubMed Central

2014-01-01

Background Honey bees (Apis mellifera) contribute substantially to the worldwide economy and ecosystem health as pollinators. Pollen is essential to the bee’s diet, providing protein, lipids, and micronutrients. The dramatic shifts in physiology, anatomy, and behavior that accompany normal worker development are highly plastic and recent work demonstrates that development, particularly the transition from nurse to foraging roles, is greatly impacted by diet. However, the role that diet plays in the developmental transition of newly eclosed bees to nurse workers is poorly understood. To further understand honey bee nutrition and the role of diet in nurse development, we used a high-throughput screen of the transcriptome of 3 day and 8 day old worker bees fed either honey and stored pollen (rich diet) or honey alone (poor diet) within the hive. We employed a three factor (age, diet, age x diet) analysis of the transcriptome to determine whether diet affected nurse worker physiology and whether poor diet altered the developmental processes normally associated with aging. Results Substantial changes in gene expression occurred due to starvation. Diet-induced changes in gene transcription occurring in younger bees were largely a subset of those occurring in older bees, but certain signatures of starvation were only evident 8 day old workers. Of the 18,542 annotated transcripts in the A. mellifera genome, 150 transcripts exhibited differential expression due to poor diet at 3d of age compared with 17,226 transcripts that differed due to poor diet at 8d of age, and poor diet caused more frequent down-regulation of gene expression in younger bees compared to older bees. In addition, the age-related physiological changes that accompanied early adult development differed due to the diet these young adult bees were fed. More frequent down-regulation of gene expression was observed in developing bees fed a poor diet compared to those fed an adequate diet. Functional analyses also suggest that the physiological and developmental processes occurring in well-fed bees are vastly different than those occurring in pollen deprived bees. Our data support the hypothesis that poor diet causes normal age-related development to go awry. Conclusion Poor nutrition has major consequences for the expression of genes underlying the physiology and age-related development of nurse worker bees. More work is certainly needed to fully understand the consequences of starvation and the complex biology of nutrition and development in this system, but the genes identified in the present study provide a starting point for understanding the consequences of poor diet and for mitigating the economic costs of colony starvation. PMID:24529032

EFFECT OF STRUCTURED PHYSICAL ACTIVITY ON SLEEP-WAKE BEHAVIORS IN SEDENTARY ELDERS WITH MOBILITY LIMITATIONS

PubMed Central

Vaz Fragoso, Carlos A.; Miller, Michael E.; King, Abby C.; Kritchevsky, Stephen B.; Liu, Christine K.; Myers, Valerie H.; Nadkarni, Neelesh K.; Pahor, Marco; Spring, Bonnie J.; Gill, Thomas M.

2016-01-01

OBJECTIVE To evaluate the effect of structured physical activity on sleep-wake behaviors in sedentary community-dwelling elders with mobility limitations. DESIGN Multicenter, randomized trial of moderate-intensity physical activity versus health education, with sleep-wake behaviors pre-specified as a tertiary outcome over a planned intervention period ranging between 24 and 30 months. SETTING Lifestyle Interventions and Independence in Elder (LIFE) Study. PARTICIPANTS 1635 community-dwelling persons, aged 70–89 years, who were initially sedentary with a Short Physical Performance Battery score <10. MEASUREMENTS Sleep-wake behaviors were evaluated by the Insomnia Severity Index (ISI) (≥8 defined insomnia), Epworth Sleepiness Scale (ESS) (≥10 defined daytime drowsiness), and Pittsburgh Sleep Quality Index (PSQI) (> 5 defined poor sleep quality) — administered at baseline and subsequently at 6, 18, and 30 months. RESULTS The randomized groups were similar on baseline demographic variables, including mean age (79 years) and sex (67% female). Relative to health education, structured physical activity significantly reduced the likelihood of having poor sleep quality (adjusted odds ratios [adjOR] for PSQI >5 of 0.80 [0.68, 0.94]), including a reduction in new cases (adjOR for PSQI >5 of 0.70 [0.54, 0.89]) but not in resolution of prevalent cases (adjOR for PSQI ≤5 of 1.13 [0.90, 1.43]). No significant intervention effects were observed for ISI or ESS. CONCLUSION Structured physical activity reduced the likelihood of developing poor sleep quality (PSQI >5) over the intervention period, when compared with health education, but had no effect on prevalent cases of poor sleep quality, or on sleep-wake behaviors evaluated by the ISI or ESS. These results suggest that the benefit of physical activity in this sample was preventive and limited to sleep-wake behaviors evaluated by the PSQI. PMID:26115386

Effect of Structured Physical Activity on Sleep-Wake Behaviors in Sedentary Elderly Adults with Mobility Limitations.

PubMed

Vaz Fragoso, Carlos A; Miller, Michael E; King, Abby C; Kritchevsky, Stephen B; Liu, Christine K; Myers, Valerie H; Nadkarni, Neelesh K; Pahor, Marco; Spring, Bonnie J; Gill, Thomas M

2015-07-01

To evaluate the effect of structured physical activity on sleep-wake behaviors in sedentary community-dwelling elderly adults with mobility limitations. Multicenter, randomized trial of moderate-intensity physical activity versus health education, with sleep-wake behaviors prespecified as a tertiary outcome over a planned intervention period ranging from 24 to 30 months. Lifestyle Interventions and Independence for Elders Study. Community-dwelling persons aged 70 to 89 who were initially sedentary and had a Short Physical Performance Battery score less than 10 (N = 1,635). Sleep-wake behaviors were evaluated using the Insomnia Severity Index (ISI) (≥8 defined insomnia), Epworth Sleepiness Scale (ESS) (≥10 defined daytime drowsiness), and Pittsburgh Sleep Quality Index (PSQI) (>5 defined poor sleep quality) administered at baseline and 6, 18, and 30 months. The randomized groups were similar in terms of baseline demographic variables, including mean age (79) and sex (67% female). Structured physical activity resulted in a significantly lower likelihood of having poor sleep quality (adjusted odds ratios (aOR) for PSQI >5 = 0.80, 95% confidence interval (CI) = 0.68-0.94), including fewer new cases (aOR for PSQI >5 = 0.70, 95% CI = 0.54-0.89), than health education but not in resolution of prevalent cases (aOR for PSQI ≤5 = 1.13, 95% CI = 0.90-1.43). No significant intervention effects were observed for the ISI or ESS. Structured physical activity resulted in a lower likelihood of developing poor sleep quality (PSQI >5) over the intervention period than health education but had no effect on prevalent cases of poor sleep quality or on sleep-wake behaviors evaluated using the ISI or ESS. These results suggest that the benefit of physical activity in this sample was preventive and limited to sleep-wake behaviors evaluated using the PSQI. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

A relationship between eye movement patterns and performance in a precognitive tracking task

NASA Technical Reports Server (NTRS)

Repperger, D. W.; Hartzell, E. J.

1977-01-01

Eye movements made by various subjects in the performance of a precognitive tracking task are studied. The tracking task persented by an antiaircraft artillery (AAA) simulator has an input forcing function represented by a deterministic aircraft fly-by. The performance of subjects is ranked by two metrics. Good, mediocre, and poor trackers are selected for analysis based on performance during the difficult segment of the tracking task and over replications. Using phase planes to characterize both the eye movement patterns and the displayed error signal, a simple metric is developed to study these patterns. Two characterizations of eye movement strategies are defined and quantified. Using these two types of eye strategies, two conclusions are obtained about good, mediocre, and poor trackers. First, the eye tracker who used a fixed strategy will consistently perform better. Secondly, the best fixed strategy is defined as a Crosshair Fixator.

Cytochrome P450-2D6 Screening Among Elderly Using Antidepressants (CYSCE)

ClinicalTrials.gov

2017-08-15

Depression; Depressive Disorder; Poor Metabolizer Due to Cytochrome P450 CYP2D6 Variant; Intermediate Metabolizer Due to Cytochrome P450 CYP2D6 Variant; Ultrarapid Metabolizer Due to Cytochrome P450 CYP2D6 Variant

Kinematics and dynamics of the MKW/AWM poor clusters

NASA Technical Reports Server (NTRS)

Beers, Timothy C.; Kriessler, Jeffrey R.; Bird, Christina M.; Huchra, John P.

1995-01-01

We report 472 new redshifts for 416 galaxies in the regions of the 23 poor clusters of galaxies originally identified by Morgan, Kayser, and White (MKW), and Albert, White, and Morgan (AWM). Eighteen of the poor clusters now have 10 or more available redshifts within 1.5/h Mpc of the central galaxy; 11 clusters have at least 20 available redshifts. Based on the 21 clusters for which we have sufficient velocity information, the median velocity scale is 336 km/s, a factor of 2 smaller than found for rich clusters. Several of the poor clusters exhibit complex velocity distributions due to the presence of nearby clumps of galaxies. We check on the velocity of the dominant galaxy in each poor cluster relative to the remaining cluster members. Significantly high relative velocities of the dominant galaxy are found in only 4 of 21 poor clusters, 3 of which we suspect are due to contamination of the parent velocity distribution. Several statistical tests indicate that the D/cD galaxies are at the kinematic centers of the parent poor cluster velocity distributions. Mass-to-light ratios for 13 of the 15 poor clusters for which we have the required data are in the range 50 less than or = M/L(sub B(0)) less than or = 200 solar mass/solar luminosity. The complex nature of the regions surrounding many of the poor clusters suggests that these groupings may represent an early epoch of cluster formation. For example, the poor clusters MKW7 and MKWS are shown to be gravitationally bound and likely to merge to form a richer cluster within the next several Gyrs. Eight of the nine other poor clusters for which simple two-body dynamical models can be carried out are consistent with being bound to other clumps in their vicinity. Additional complex systems with more than two gravitationally bound clumps are observed among the poor clusters.

The Gradual Shift of Overweight, Obesity, and Abdominal Obesity Towards the Poor in a Multi-ethnic Developing Country: Findings From the Malaysian National Health and Morbidity Surveys

PubMed Central

Mariapun, Jeevitha; Ng, Chiu-Wan; Hairi, Noran N.

2018-01-01

Background Economic development is known to shift the distribution of obesity from the socioeconomically more advantaged to the less advantaged. We assessed the socioeconomic trends in overweight, obesity, and abdominal obesity across a period of significant economic growth. Methods We used the Malaysian National Health and Morbidity Survey data sets for the years 1996, 2006, and 2011 to analyze the trends among adults aged 30 years and above. The World Health Organization’s Asian body mass index cut-off points of ≥23.0 kg/m2 and ≥27.5 kg/m2 were used to define overweight and obesity, respectively. Abdominal obesity was defined as having a waist circumference of ≥90 cm for men and ≥80 cm for women. Household per-capita income was used as a measure of socioeconomic position. As a summary measure of inequality, we computed the concentration index. Results Women in Peninsular Malaysia demonstrated patterns that were similar to that of developed countries in which the distributions for overweight, obesity, and abdominal obesity became concentrated among the poor. For women in East Malaysia, distributions became neither concentrated among the rich nor poor, while distributions for men were still concentrated among the rich. Chinese women, particularly from the richest quintile, had the lowest rates and lowest increase in overweight and obesity. All distributions of Chinese women were concentrated among the poor. The distributions of Malay men were still concentrated among the rich, while distributions for Chinese and Indian men and Malay and Indian women were neither concentrated among the rich nor poor. Conclusion As the country continues to progress, increasing risks of overweight and obesity among the socioeconomically less advantaged is expected. PMID:29657257

The Gradual Shift of Overweight, Obesity, and Abdominal Obesity Towards the Poor in a Multi-ethnic Developing Country: Findings From the Malaysian National Health and Morbidity Surveys.

PubMed

Mariapun, Jeevitha; Ng, Chiu-Wan; Hairi, Noran N

2018-06-05

Economic development is known to shift the distribution of obesity from the socioeconomically more advantaged to the less advantaged. We assessed the socioeconomic trends in overweight, obesity, and abdominal obesity across a period of significant economic growth. We used the Malaysian National Health and Morbidity Survey data sets for the years 1996, 2006, and 2011 to analyze the trends among adults aged 30 years and above. The World Health Organization's Asian body mass index cut-off points of ≥23.0 kg/m 2 and ≥27.5 kg/m 2 were used to define overweight and obesity, respectively. Abdominal obesity was defined as having a waist circumference of ≥90 cm for men and ≥80 cm for women. Household per-capita income was used as a measure of socioeconomic position. As a summary measure of inequality, we computed the concentration index. Women in Peninsular Malaysia demonstrated patterns that were similar to that of developed countries in which the distributions for overweight, obesity, and abdominal obesity became concentrated among the poor. For women in East Malaysia, distributions became neither concentrated among the rich nor poor, while distributions for men were still concentrated among the rich. Chinese women, particularly from the richest quintile, had the lowest rates and lowest increase in overweight and obesity. All distributions of Chinese women were concentrated among the poor. The distributions of Malay men were still concentrated among the rich, while distributions for Chinese and Indian men and Malay and Indian women were neither concentrated among the rich nor poor. As the country continues to progress, increasing risks of overweight and obesity among the socioeconomically less advantaged is expected.

High urinary albumin/creatinine ratio at admission predicts poor functional outcome in patients with acute ischaemic stroke.

PubMed

Watanabe, Yoko; Suda, Satoshi; Kanamaru, Takuya; Katsumata, Toshiya; Okubo, Seiji; Kaneko, Tomohiro; Mii, Akiko; Sakai, Yukinao; Katayama, Yasuo; Kimura, Kazumi; Tsuruoka, Shuichi

2017-03-01

Albuminuria and a low estimated glomerular filtration rate (eGFR) are widely recognized indices of kidney dysfunction and have been linked to cardiovascular events, including stroke. We evaluated albuminuria, measured using the urinary albumin/creatinine ratio (UACR), and the eGFR in the acute phase of ischaemic stroke, and investigated the clinical characteristics of ischaemic stroke patients with and those without kidney dysfunction. The study included 422 consecutive patients admitted between June 2010 and May 2012. General blood and urine examinations were performed at admission. Kidney dysfunction was defined as a low eGFR (<60 mL/min per 1.73 m 2 ), high albuminuria (≥30 mg/g creatinine), or both. Neurological severity was evaluated using the National Institutes of Health Stroke Scale (NIHSS) at admission and the modified Rankin scale (mRS) at discharge. A poor outcome was defined as a mRS score of 3-5 or death. The impacts of the eGFR and UACR on outcomes at discharge were evaluated using multiple logistic regression analysis. Kidney dysfunction was diagnosed in 278 of the 422 patients (65.9%). The eGFR was significantly lower and UACR was significantly higher in patients with a poor outcome than in those with a good outcome. In multivariate analyses performed after adjusting for confounding factors, UACR >31.2 mg/g creatinine (OR, 2.58; 95% CI, 1.52-4.43; P = 0.0005) was independently associated with a poor outcome, while a low eGFR was not associated. A high UACR at admission may predict a poor outcome at discharge in patients with acute ischaemic stroke. © 2016 Asian Pacific Society of Nephrology.

Sleep and Depression in Postpartum Women: A Population-Based Study

PubMed Central

Dørheim, Signe Karen; Bondevik, Gunnar Tschudi; Eberhard-Gran, Malin; Bjorvatn, Bjørn

2009-01-01

Study Objectives: (1) To describe the prevalence of and risk factors for postpartum maternal sleep problems and depressive symptoms simultaneously, (2) identify factors independently associated with either condition, and (3) explore associations between specific postpartum sleep components and depression. Design: Cross-sectional. Setting: Population-based. Participants: All women (n = 4191) who had delivered at Stavanger University Hospital from October 2005 to September 2006 were mailed a questionnaire seven weeks postpartum. The response rate was 68% (n = 2830). Interventions: None. Measurements and results: Sleep was measured using the Pittsburgh Sleep Quality Index (PSQI), and depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS). The prevalence of sleep problems, defined as PSQI > 5, was 57.7%, and the prevalence of depression, defined as EPDS ≥ 10, was 16.5%. The mean self-reported nightly sleep duration was 6.5 hours and sleep efficiency 73%. Depression, previous sleep problems, being primiparous, not exclusively breastfeeding, or having a younger or male infant were factors associated with poor postpartum sleep quality. Poor sleep was also associated with depression when adjusted for other significant risk factors for depression, such as poor partner relationship, previous depression, depression during pregnancy and stressful life events. Sleep disturbances and subjective sleep quality were the aspects of sleep most strongly associated with depression. Conclusions: Poor sleep was associated with depression independently of other risk factors. Poor sleep may increase the risk of depression in some women, but as previously known risk factors were also associated, mothers diagnosed with postpartum depression are not merely reporting symptoms of chronic sleep deprivation. Citation: Dørheim SK; Bondevik GT; Eberhard-Gran M; Bjorvatn B. Sleep and depression in postpartum women: a population-based study. SLEEP 2009;32(7):847-855. PMID:19639747

Language Impairment From 4 to 12 Years: Prediction and Etiology

PubMed Central

Hayiou-Thomas, Marianna E.; Dale, Philip S.; Plomin, Robert

2014-01-01

Purpose The authors of this article examined the etiology of developmental language impairment (LI) at 4 and 12 years of age, as well as the relationship between the 2. Method Phenotypic and quantitative genetic analyses using longitudinal data from the Twins Early Development Study (Oliver & Plomin, 2007) were conducted. A total of 2,923 pairs of twins (1,075 monozygotic [MZ]; 975 dizygotic same sex [DZss]; and 873 dizygotic opposite sex [DZos]) provided data at 4 and 12 years. At 4 years, (a) psychometric LI was defined on the basis of a low parent-reported expressive vocabulary score (−1.25 SDs; 226 MZ and 115 DZss probands for genetic analysis); and (b) parent referral was defined as having seen a medical professional or speech-language pathologist following parental concern (112 MZ and 104 DZss probands). The 12-year language measure was a composite of 4 web-administered receptive language tests. Results (a) Psychometric LI at 4 years is more predictive than parent referral of poor language performance at age 12 years, and (b) parent referral is substantially and significantly more heritable than psychometric LI. Conclusions Parents’ concern about their child’s language development seems to be the marker of a more heritable disorder than poor expressive language skills alone. However, the language difficulties that arouse parental concern in preschool children, although more heritable, are not predictive of language difficulties in early adolescence. Rather, poor expressive language skills at age 4 years, psychometrically defined, are a better predictor than parent referral of continuing language difficulties at age 12 years. PMID:24167234

Associations between Poor Health and School-Related Behavior Problems at the Child and Family Levels: A Cross-Sectional Study of Migrant Children and Adolescents in Southwest Urban China

ERIC Educational Resources Information Center

Zhang, Jing-Jing; Li, Ning-Xiu; Liu, Chao-Jie

2010-01-01

Background: Due to urbanization in China, the numbers of migrant children and adolescents in urban environments have increased. Previous studies have indicated that children and adolescents are more likely to suffer from health problems and poor school achievement. The present study identified associations between poor health and school-related…

The association between hardship and self-rated health: does the choice of indicator matter?

PubMed

Marshall, Gillian L; Tucker-Seeley, Reginald

2018-07-01

The purpose of this study was to investigate the association between four specific forms of hardship (difficulty paying bills, ongoing financial stress, medication reduction due to cost, and food insecurity) and self-rated health among older men and women. Cross-sectional logistic regression analysis was conducted using the 2010 wave of the Health and Retirement Study Leave-Behind Questionnaire (N = 7619) to determine the association between four hardship indicators and self-rated health. Hardship indicators (difficulty paying bills, ongoing financial stress, medication reduction due to cost, and food insecurity) were dichotomized (0 = no hardship, 1 = yes hardship) for this analysis. After adjusting for sociodemographic factors, participants reporting difficulty paying bills had an 1.8 higher odds of reporting poor self-rated health (95% confidence intervals [CI]: 1.57, 2.15) and those reporting taking less medication due to cost had a 2.5 times higher odds of poor self-rated health (95% CI: 1.97, 3.09) compared to those not reporting these hardships. When stratified by gender, and adjusting for sociodemographic factors, men who took less medication due to cost had a 1.93 higher odds of low self-rated health (95% CI: 1.39, 2.67) and women who took less medications due to cost had a 2.9 higher odds of reporting poor self-rated health (95% CI: 2.23, 2.70) compared to women not reporting these hardships. Research in this area can provide greater conceptual and measurement clarity on the hardship experience and further elucidate the pathway between specific hardships and poor health outcomes to inform intervention development. Copyright © 2018 Elsevier Inc. All rights reserved.

Evidence for Broadening Criteria for Atypical Depression Which May Define a Reactive Depressive Disorder.

PubMed

Silverstein, Brett; Angst, Jules

2015-01-01

Objective. Arguing that additional symptoms should be added to the criteria for atypical depression. Method. Published research articles on atypical depression are reviewed. Results. (1) The original studies upon which the criteria for atypical depression were based cited fatigue, insomnia, pain, and loss of weight as characteristic symptoms. (2) Several studies of DSM depressive criteria found patients with atypical depression to exhibit high levels of insomnia, fatigue, and loss of appetite/weight. (3) Several studies have found atypical depression to be comorbid with headaches, bulimia, and body image issues. (4) Most probands who report atypical depression meet criteria for "somatic depression," defined as depression associated with several of disordered eating, poor body image, headaches, fatigue, and insomnia. The gender difference in prevalence of atypical depression results from its overlap with somatic depression. Somatic depression is associated with psychosocial measures related to gender, linking it with the descriptions of atypical depression as "reactive" appearing in the studies upon which the original criteria for atypical depression were based. Conclusion. Insomnia, disordered eating, poor body image, and aches/pains should be added as criteria for atypical depression matching criteria for somatic depression defining a reactive depressive disorder possibly distinct from endogenous melancholic depression.

Unilateral congenital corneal keloid with anterior segment mesenchymal dysgenesis and subluxated lens: case report and review of literature.

PubMed

Vanathi, M; Sen, Seema; Panda, Anita; Dada, Tanuj; Behera, Geeta; Khokhar, Sudharshan

2007-01-01

To report the unusual association of unilateral congenital corneal keloid with anterior-segment mesenchymal dysgenesis and bilateral subluxated lens. A 20-year old man presented with a mass lesion involving the left cornea. The corneal lesion had been present since birth. On biomicroscopic examination, a well-defined vascularized, grayish-white mass occupying the whole of the left cornea was seen. The right eye showed multiple peripheral corneal opacities with iridocorneal adhesions, a poorly defined supranasal limbus, and a subluxated lens. Excision biopsy of the mass was done for histopathologic examination. Histopathologic examination of the excised corneal mass showed features consistent with that of a corneal keloid: thickened keratinized epithelium, absent Bowman membrane layer, and fibrovascular hyperplasia composed of hyalinized collagen fibers with irregular orientation of the collagen lamellae. During penetrating keratoplasty of the left eye, an anomalous iris pattern with poorly defined angle and a supranasal subluxated lens was also observed. Extraction of the subluxated lens was also done. The graft failed subsequent to a nonhealing persistent epithelial defect. Our case report highlights the rare association of a unilateral congenital corneal keloid with anterior-segment mesenchymal dysgenesis and bilateral subluxated lens.

Planning the Breast Boost: Comparison of Three Techniques and Evolution of Tumor Bed During Treatment

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

Hepel, Jaroslaw T.; Department of Radiation Oncology, Brown University, Rhode Island Hospital, Providence, RI; Evans, Suzanne B.

2009-06-01

Purpose: To evaluate the accuracy of two clinical techniques for electron boost planning compared with computed tomography (CT)-based planning. Additionally, we evaluated the tumor bed characteristics at whole breast planning and boost planning. Methods and Materials: A total of 30 women underwent tumor bed boost planning within 2 weeks of completing whole breast radiotherapy using three planning techniques: scar-based planning, palpation/clinical-based planning, and CT-based planning. The plans were analyzed for dosimetric coverage of the CT-delineated tumor bed. The cavity visualization score was used to define the CT-delineated tumor bed as well or poorly defined. Results: Scar-based planning resulted in inferiormore » tumor bed coverage compared with CT-based planning, with the minimal dose received by 90% of the target volume >90% in 53% and a geographic miss in 53%. The results of palpation/clinical-based planning were significantly better: 87% and 10% for the minimal dose received by 90% of the target volume >90% and geographic miss, respectively. Of the 30 tumor beds, 16 were poorly defined by the cavity visualization score. Of these 16, 8 were well demarcated by the surgical clips. The evaluation of the 22 well-defined tumor beds revealed similar results. A comparison of the tumor bed volume from the initial planning CT scan to the boost planning CT scan revealed a decrease in size in 77% of cases. The mean decrease in volume was 52%. Conclusion: The results of our study have shown that CT-based planning allows for optimal tumor bed coverage compared with clinical and scar-based approaches. However, in the setting of a poorly visualized cavity on CT without surgical clips, palpation/clinical-based planning can help delineate the appropriate target volumes and is superior to scar-based planning. CT simulation at boost planning could allow for a reduction in the boost volumes.« less

A tissue-engineered subcutaneous pancreatic cancer model for antitumor drug evaluation.

PubMed

He, Qingyi; Wang, Xiaohui; Zhang, Xing; Han, Huifang; Han, Baosan; Xu, Jianzhong; Tang, Kanglai; Fu, Zhiren; Yin, Hao

2013-01-01

The traditional xenograft subcutaneous pancreatic cancer model is notorious for its low incidence of tumor formation, inconsistent results for the chemotherapeutic effects of drug molecules of interest, and a poor predictive capability for the clinical efficacy of novel drugs. These drawbacks are attributed to a variety of factors, including inoculation of heterogeneous tumor cells from patients with different pathological histories, and use of poorly defined Matrigel(®). In this study, we aimed to tissue-engineer a pancreatic cancer model that could readily cultivate a pancreatic tumor derived from highly homogenous CD24(+)CD44(+) pancreatic cancer stem cells delivered by a well defined electrospun scaffold of poly(glycolide-co-trimethylene carbonate) and gelatin. The scaffold supported in vitro tumorigenesis from CD24(+)CD44(+) cancer stem cells for up to 7 days without inducing apoptosis. Moreover, CD24(+)CD44(+) cancer stem cells delivered by the scaffold grew into a native-like mature pancreatic tumor within 8 weeks in vivo and exhibited accelerated tumorigenesis as well as a higher incidence of tumor formation than the traditional model. In the scaffold model, we discovered that oxaliplatin-gemcitabine (OXA-GEM), a chemotherapeutic regimen, induced tumor regression whereas gemcitabine alone only capped tumor growth. The mechanistic study attributed the superior antitumorigenic performance of OXA-GEM to its ability to induce apoptosis of CD24(+)CD44(+) cancer stem cells. Compared with the traditional model, the scaffold model demonstrated a higher incidence of tumor formation and accelerated tumor growth. Use of a tiny population of highly homogenous CD24(+)CD44(+) cancer stem cells delivered by a well defined scaffold greatly reduces the variability associated with the traditional model, which uses a heterogeneous tumor cell population and poorly defined Matrigel. The scaffold model is a robust platform for investigating the antitumorigenesis mechanism of novel chemotherapeutic drugs with a special focus on cancer stem cells.

THE MULTIDISCIPLINARY INFLUENCE OF COMMON SUSTAINABILITY INDICES

EPA Science Inventory

Sustainability is often poorly defined and difficult to measure. We describe several concepts based in ecology, economics, and physics that have contributed to sustainability indices, and discuss their positive and negative aspects. Indices range from mostly ecological (such as e...

The relationship between serum asymmetric dimethylarginine levels and subjective sleep quality in normotensive patients with type 2 diabetes mellitus.

PubMed

Aribas, Alpay; Kayrak, Mehmet; Tekinalp, Mehmet; Akilli, Hakan; Alibasic, Hayrudin; Yildirim, Serkan; Gunduz, Mehmet; Taner, Alpaslan; Unlu, Ali

2015-05-01

Poor sleep quality (SQ) is associated with increased cardiovascular mortality and morbidity. Additionally, asymmetric dimethylarginine (ADMA) is an independent predictor of cardiovascular mortality and morbidity. However, no sufficient data regarding the relationship between ADMA levels and SQ have been reported. The goal of the current study was to evaluate the association between SQ and ADMA levels in normotensive patients with type 2 diabetes mellitus. The study participants consisted of 78 normotensive type 2 diabetics. The SQ of all participants was assessed using the Pittsburgh Sleep Quality Index (PSQI). Patients with a global PSQI score > 5 were defined as "poor sleepers." Factors associated with poor SQ were analyzed using a multiple regression model. Serum ADMA levels were measured using high performance liquid chromatography. The median ADMA levels of the poor sleepers were increased compared with patients defined as good sleepers (5.5 [4.2 to 6.6] vs. 4.4 [2.9 to 5.4], p < 0.01, respectively). However, the L-arginine/ADMA ratio was decreased in poor sleepers (p < 0.01). Global PSQI scores were positively correlated with ADMA levels (p < 0.01) and negatively correlated with the L-arginine/ADMA ratio (p = 0.02). ADMA levels were correlated with sleep latency (p < 0.01) and sleep efficiency (p = 0.01). Logistic regression analysis showed that ADMA levels (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.16 to 2.44; p = 0.01) and body mass index (OR, 1.15; 95% CI, 1.01 to 1.31; p = 0.04) were associated with poor SQ independently of glomerular filtration rate, sex, age, duration of diabetes, hemoglobin A1c, total cholesterol, and systolic blood pressure. Self-reported SQ was independently associated with ADMA levels in normotensive patients with diabetes mellitus.

Hospitalizations due to diseases associated with poor sanitation in the public health care network of the metropolitan region of Porto Alegre, Rio Grande do Sul State, Brazil, 2010-2014.

PubMed

Siqueira, Mariana Santiago; Rosa, Roger Dos Santos; Bordin, Ronaldo; Nugem, Rita de Cássia

2017-01-01

to describe the occurrence, characteristics and expenditures of hospitalizations due to diseases associated with poor sanitation funded by the Brazilian National Health System (SUS) among residents of the metropolitan region of Porto Alegre-RS, Brazil, from 2010 to 2014. descriptive study with data from SUS Hospital Information System (SIH/SUS). out of 13,929 hospitalizations for diseases associated with poor sanitation, 93.7% were related to fecal-oral transmission diseases and 20.4% were children from 1 to 4 years of age (28.1 hospitalizations/10,000 inhabitants/year); hospital fatality rate was of 2.2%, fecal-oral transmission diseases were the main causes of death; intensive care unit (ICU) was used in 2.0% of hospitalizations; total expenditures on hospitalizations was around BRL6.1 million. diseases associated with poor sanitation are still an important issue in the metropolitan region of Porto Alegre-RS, although this region presents good development indicators.

Viscoelastic properties of PLA/PCL blends compatibilized with different methods

NASA Astrophysics Data System (ADS)

Shin, Boo Young; Han, Do Hung

2017-11-01

The aim of this study was to observe changes in the viscoelastic properties of PLA/PCL (80/20) blends produced using different compatibilization methods. Reactive extrusion and high-energy radiation methods were used for blend compatibilization. Storage and loss moduli, complex viscosity, transient stress relaxation modulus, and tan δ of blends were analyzed and blend morphologies were examined. All compatibilized PLA/PCL blends had smaller dispersed particle sizes than the non-compatibilized blend, and well compatibilized blends had finer morphologies than poorly compatibilized blends. Viscoelastic properties differentiated well compatibilized and poorly compatibilized blends. Well compatibilized blends had higher storage and loss moduli and complex viscosities than those calculated by the log-additive mixing rule due to strong interfacial adhesion, whereas poorly compatibilized blends showed negative deviations due to weak interfacial adhesion. Moreover, well compatibilized blends had much slower stress relaxation than poorly compatibilized blends and didn't show tan δ plateau region caused by slippage at the interface between continuous and dispersed phases.

Microbial keratitis secondary to unintended poor compliance with scleral gas-permeable contact lenses.

PubMed

Zimmerman, Aaron B; Marks, Amanda

2014-01-01

To report a case of neurotrophic keratitis in which scleral contact lenses improved vision from 20/100 to 20/20, however, due to poor lens care, an incident of microbial keratitis developed. A 64-year-old man with an ocular history of neurotrophic keratitis secondary to herpes simplex in each eye was successfully fit with scleral lenses. He subsequently developed microbial keratitis due to a number of risk factors. The lesion was culture negative, yet was very responsive to treatment with moxifloxacin. The lesion fully healed, and the patient did not suffer additional vision loss. This case demonstrates the ability of scleral lenses to correct visual impairments secondary to poor epithelial integrity and illustrates the importance of the practitioner providing detailed lens care instruction.

Guidelines for the diagnosis and treatment of idiopathic pulmonary fibrosis. Sociedad Española de Neumología y Cirugía Torácica (SEPAR) Research Group on Diffuse Pulmonary Diseases.

PubMed

Xaubet, Antoni; Ancochea, Julio; Bollo, Elena; Fernández-Fabrellas, Estrella; Franquet, Tomás; Molina-Molina, Maria; Montero, Maria Angeles; Serrano-Mollar, Anna

2013-08-01

Idiopathic pulmonary fibrosis is defined as a chronic fibrosing interstitial pneumonia limited to the lung, of unknown cause, with poor prognosis and few treatment options. In recent years there has been an increase in their prevalence, probably due to the optimization of diagnostic methods and increased life expectancy. The ATS/ERS Consensus (2000) established the diagnostic criteria and recommendations for the assessment of the disease course and treatment. Later studies have helped to redefine diagnostic criteria and treatment options. In 2011, an international consensus was published, establishing diagnostic criteria and new treatment strategies. These guidelines have been updated with the newest aspects of diagnosis and treatment of idiopathic pulmonary fibrosis. A level of evidence has been identified for the most relevant questions, particularly with regard to treatment options. Copyright © 2012 SEPAR. Published by Elsevier Espana. All rights reserved.

Quantitative Analysis of Adventitious Root Growth Phenotypes in Carnation Stem Cuttings

PubMed Central

Birlanga, Virginia; Villanova, Joan; Cano, Antonio; Cano, Emilio A.; Acosta, Manuel; Pérez-Pérez, José Manuel

2015-01-01

Carnation is one of the most important species on the worldwide market of cut flowers. Commercial carnation cultivars are vegetatively propagated from terminal stem cuttings that undergo a rooting and acclimation process. For some of the new cultivars that are being developed by ornamental breeders, poor adventitious root (AR) formation limits its commercial scaling-up, due to a significant increase in the production costs. We have initiated a genetical-genomics approach to determine the molecular basis of the differences found between carnation cultivars during adventitious rooting. The detailed characterization of AR formation in several carnation cultivars differing in their rooting losses has been performed (i) during commercial production at a breeders’ rooting station and (ii) on a defined media in a controlled environment. Our study reveals the phenotypic signatures that distinguishes the bad-rooting cultivars and provides the appropriate set-up for the molecular identification of the genes involved in AR development in this species. PMID:26230608

ptk7 mutant zebrafish models of congenital and idiopathic scoliosis implicate dysregulated Wnt signalling in disease

PubMed Central

Hayes, Madeline; Gao, Xiaochong; Yu, Lisa X; Paria, Nandina; Henkelman, R. Mark; Wise, Carol A.; Ciruna, Brian

2014-01-01

Scoliosis is a complex genetic disorder of the musculoskeletal system, characterized by three-dimensional rotation of the spine. Curvatures caused by malformed vertebrae (congenital scoliosis (CS)) are apparent at birth. Spinal curvatures with no underlying vertebral abnormality (idiopathic scoliosis (IS)) most commonly manifest during adolescence. The genetic and biological mechanisms responsible for IS remain poorly understood due largely to limited experimental models. Here we describe zygotic ptk7 (Zptk7) mutant zebrafish, deficient in a critical regulator of Wnt signalling, as the first genetically defined developmental model of IS. We identify a novel sequence variant within a single IS patient that disrupts PTK7 function, consistent with a role for dysregulated Wnt activity in disease pathogenesis. Furthermore, we demonstrate that embryonic loss-of-gene function in maternal-zygotic ptk7 mutants (MZptk7) leads to vertebral anomalies associated with CS. Our data suggest novel molecular origins of, and genetic links between, congenital and idiopathic forms of disease. PMID:25182715

From kissing to belly stridulation: comparative analysis reveals surprising diversity, rapid evolution, and much homoplasy in the mating behaviour of 27 species of sepsid flies (Diptera: Sepsidae).

PubMed

Puniamoorthy, N; Ismail, M R B; Tan, D S H; Meier, R

2009-11-01

Our understanding of how fast mating behaviour evolves in insects is rather poor due to a lack of comparative studies among insect groups for which phylogenetic relationships are known. Here, we present a detailed study of the mating behaviour of 27 species of Sepsidae (Diptera) for which a well-resolved and supported phylogeny is available. We demonstrate that mating behaviour is extremely diverse in sepsids with each species having its own mating profile. We define 32 behavioural characters and document them with video clips. Based on sister species comparisons, we provide several examples where mating behaviour evolves faster than all sexually dimorphic morphological traits. Mapping the behaviours onto the molecular tree reveals much homoplasy, comparable to that observed for third positions of mitochondrial protein-encoding genes. A partitioned Bremer support (PBS) analysis reveals conflict between the molecular and behavioural data, but behavioural characters have higher PBS values per parsimony-informative character than DNA sequence characters.

Impact of autologous and allogeneic stem cell transplantation in peripheral T-cell lymphomas.

PubMed

Reimer, Peter

2010-01-01

Peripheral T/NK-cell lymphomas (PTCLs) are rare malignancies characterized by poor prognosis. So far, no standard therapy has been established, due to the lack of randomised studies. High-dose therapy and autologous stem cell transplantation (HDT-autoSCT) have shown good feasibility with low toxicity in retrospective studies. In relapsing and refractory PTCL several comparison analyses suggest similar efficacy for PTCL when compared with aggressive B-cell lymphoma. In the upfront setting, prospective data show promising results with a long-lasting overall survival in a relevant subset of patients. Achieving a complete remission at transplantation seems to be the most important prognostic factor. Allogeneic stem cell transplantation (alloSCT) has been investigated only as salvage treatment. Especially when using reduced intensity conditioning regimen, eligible patients seem to benefit from this approach. To define the role for upfront stem cell transplantation a randomised trial by the German High-Grade Non-Hodgkin Lymphoma Study Group comparing HDT-autoSCT and alloSCT will be initiated this year.

Thermal expansion anomaly regulated by entropy.

PubMed

Liu, Zi-Kui; Wang, Yi; Shang, ShunLi

2014-11-13

Thermal expansion, defined as the temperature dependence of volume under constant pressure, is a common phenomenon in nature and originates from anharmonic lattice dynamics. However, it has been poorly understood how thermal expansion can show anomalies such as colossal positive, zero, or negative thermal expansion (CPTE, ZTE, or NTE), especially in quantitative terms. Here we show that changes in configurational entropy due to metastable micro(scopic)states can lead to quantitative prediction of these anomalies. We integrate the Maxwell relation, statistic mechanics, and first-principles calculations to demonstrate that when the entropy is increased by pressure, NTE occurs such as in Invar alloy (Fe3Pt, for example), silicon, ice, and water, and when the entropy is decreased dramatically by pressure, CPTE is expected such as in anti-Invar cerium, ice and water. Our findings provide a theoretic framework to understand and predict a broad range of anomalies in nature in addition to thermal expansion, which may include gigantic electrocaloric and electromechanical responses, anomalously reduced thermal conductivity, and spin distributions.

Fidaxomicin jams Mycobacterium tuberculosis RNA polymerase motions needed for initiation via RbpA contacts

PubMed Central

Lilic, Mirjana; Palka, Margaret; Mooney, Rachel Anne; Landick, Robert

2018-01-01

Fidaxomicin (Fdx) is an antimicrobial RNA polymerase (RNAP) inhibitor highly effective against Mycobacterium tuberculosis RNAP in vitro, but clinical use of Fdx is limited to treating Clostridium difficile intestinal infections due to poor absorption. To identify the structural determinants of Fdx binding to RNAP, we determined the 3.4 Å cryo-electron microscopy structure of a complete M. tuberculosis RNAP holoenzyme in complex with Fdx. We find that the actinobacteria general transcription factor RbpA contacts fidaxomycin, explaining its strong effect on M. tuberculosis. Additional structures define conformational states of M. tuberculosis RNAP between the free apo-holoenzyme and the promoter-engaged open complex ready for transcription. The results establish that Fdx acts like a doorstop to jam the enzyme in an open state, preventing the motions necessary to secure promoter DNA in the active site. Our results provide a structural platform to guide development of anti-tuberculosis antimicrobials based on the Fdx binding pocket. PMID:29480804

Curcumin and dietary polyphenol research: beyond drug discovery.

PubMed

Jin, Tian-Ru

2018-05-01

Numerous natural products available over the counter are commonly consumed by healthy, sub-healthy or ill people for the treatment and prevention of various chronic diseases. Among them, a few dietary polyphenols, including the curry compound curcumin, have been attracting the most attention from biomedical researchers and drug developers. Unlike many so-called "good drug candidates", curcumin and several other dietary polyphenols do not have a single known therapeutic target or defined receptor. In addition, the bioavailability of these polyphenols is usually very low due to their poor absorption in the gut. These recently debated features have created enormous difficulties for drug developers. In this review, I do not discuss how to develop curcumin, other dietary polyphenols or their derivatives into pharmaceutical agents. Instead, I comment on how curcumin and dietary polyphenol research has enriched our knowledge of insulin signaling, including the presentation of my perspectives on how these studies will add to our understanding of the famous hepatic insulin function paradox.

["When the ad is good, the product is sold." The MonitorACAO Project and drug advertising in Brazil].

PubMed

Soares, Jussara Calmon Reis de Souza

2008-04-01

This paper presents an analysis on drug advertising in Brazil, based on the final report of the MonitorACAO Project, by the group from the Universidade Federal Fluminense, Niterói, Rio de Janeiro. Due to a partnership between the university and the National Agency for Health Surveillance (ANVISA), drug advertisements were monitored and analyzed for one year, according to the methodology defined by the Agency. The samples were collected in medical practices and hospitals, drugstores, pharmacies and in scientific magazines. TV and radio programs were monitored, in the case of OTC drugs. 159 advertisements referring to pharmaceuticals were sent to ANVISA,from a total of 263 irregular ads analyzed between October 2004 and August 2005. The main problems found were the poor quality of drug information to health professionals, as well as misleading drug use to lay population. Based on the results of this project and on other studies, the banning of drug advertising in Brazil is proposed.

Mechanical Excitation of IHC Stereocilia: An Attempt to Fit Together Diverse Evidence

NASA Astrophysics Data System (ADS)

Guinan, John J.

2011-11-01

The output of the cochlea is controlled by the bending of inner-hair-cell (IHC) stereocilia, but the mechanisms that produce this bending are poorly understood. Relevant evidence comes from several sources: measurements of cochlear motion from in-vitro and live preparations, as well as inferences about cochlear motions from responses of auditory-nerve fibers. The common conception that IHC excitation is due to shearing between the reticular lamina (RL) and the tectorial membrane (TM) does not explain the data. A hypothesis is presented that fits many of the observations into a coherent picture of how IHCs are excited. The key new concept is that stretching of outer-hair-cell (OHC) stereocilia (defined broadly) changes the RL-TM gap and produces fluid flow within the gap that bends the IHC stereocilia. Changes in the RL-TM gap and the resulting bending of IHC stereocilia provide a mechanism by which OHC active processes can enhance cochlear output without a corresponding enhancement of basilar-membrane motion.

Cost considerations in implementing a screening and surveillance strategy for Barrett's oesophagus.

PubMed

Inadomi, John M

2015-02-01

There is increasing concern over the rising costs of healthcare leading to debate regarding the use of resources to implement preventive strategies. Oesophageal adenocarcinoma and its precursor, Barrett's oesophagus provides an excellent opportunity to highlight this issue since cancer is uncommon even among individuals with documented Barrett's oesophagus. This review provides a brief introduction to economic analysis in healthcare and summarizes published studies of the cost-effectiveness of strategies to reduce mortality from cancer. Current best estimates highlight the cost-effectiveness of endoscopic ablation among patients with Barrett's oesophagus and high-grade dysplasia and the low cost-effectiveness of ablation among patients without dysplasia. The cost-effectiveness of ablation among patients with Barrett's and low-grade dysplasia is poorly defined due to the ambiguity of diagnosing dysplasia, the unknown risk of cancer among patients with low-grade dysplasia, and the uncertain durability of ablation to maintain remission from metaplasia and dysplasia and prevent cancer. Copyright © 2015 Elsevier Ltd. All rights reserved.

Stem cells and fluid flow drive cyst formation in an invertebrate excretory organ

PubMed Central

Thi-Kim Vu, Hanh; Rink, Jochen C; McKinney, Sean A; McClain, Melainia; Lakshmanaperumal, Naharajan; Alexander, Richard; Sánchez Alvarado, Alejandro

2015-01-01

Cystic kidney diseases (CKDs) affect millions of people worldwide. The defining pathological features are fluid-filled cysts developing from nephric tubules due to defective flow sensing, cell proliferation and differentiation. The underlying molecular mechanisms, however, remain poorly understood, and the derived excretory systems of established invertebrate models (Caenorhabditis elegans and Drosophila melanogaster) are unsuitable to model CKDs. Systematic structure/function comparisons revealed that the combination of ultrafiltration and flow-associated filtrate modification that is central to CKD etiology is remarkably conserved between the planarian excretory system and the vertebrate nephron. Consistently, both RNA-mediated genetic interference (RNAi) of planarian orthologues of human CKD genes and inhibition of tubule flow led to tubular cystogenesis that share many features with vertebrate CKDs, suggesting deep mechanistic conservation. Our results demonstrate a common evolutionary origin of animal excretory systems and establish planarians as a novel and experimentally accessible invertebrate model for the study of human kidney pathologies. DOI: http://dx.doi.org/10.7554/eLife.07405.001 PMID:26057828

[Abdominal ultrasound course an introduction to the ultrasound technique. Physical basis. Ultrasound language].

PubMed

Segura-Grau, A; Sáez-Fernández, A; Rodríguez-Lorenzo, A; Díaz-Rodríguez, N

2014-01-01

Ultrasound is a non-invasive, accessible, and versatile diagnostic technique that uses high frequency ultrasound waves to define outline the organs of the human body, with no ionising radiation, in real time and with the capacity to visual several planes. The high diagnostic yield of the technique, together with its ease of uses plus the previously mentioned characteristics, has currently made it a routine method in daily medical practice. It is for this reason that the multidisciplinary character of this technique is being strengthened every day. To be able to perform the technique correctly requires knowledge of the physical basis of ultrasound, the method and the equipment, as well as of the human anatomy, in order to have the maximum information possible to avoid diagnostic errors due to poor interpretation or lack of information. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

Thermal Expansion Anomaly Regulated by Entropy

NASA Astrophysics Data System (ADS)

Liu, Zi-Kui; Wang, Yi; Shang, Shunli

2014-11-01

Thermal expansion, defined as the temperature dependence of volume under constant pressure, is a common phenomenon in nature and originates from anharmonic lattice dynamics. However, it has been poorly understood how thermal expansion can show anomalies such as colossal positive, zero, or negative thermal expansion (CPTE, ZTE, or NTE), especially in quantitative terms. Here we show that changes in configurational entropy due to metastable micro(scopic)states can lead to quantitative prediction of these anomalies. We integrate the Maxwell relation, statistic mechanics, and first-principles calculations to demonstrate that when the entropy is increased by pressure, NTE occurs such as in Invar alloy (Fe3Pt, for example), silicon, ice, and water, and when the entropy is decreased dramatically by pressure, CPTE is expected such as in anti-Invar cerium, ice and water. Our findings provide a theoretic framework to understand and predict a broad range of anomalies in nature in addition to thermal expansion, which may include gigantic electrocaloric and electromechanical responses, anomalously reduced thermal conductivity, and spin distributions.

Iron status in Norwegian blood donors: comparison of iron status in new blood donors registered in 1993-1997 and in 2005-2006.

PubMed

Røsvik, A S; Hervig, T; Wentzel-Larsen, T; Ulvik, R J

2009-01-01

The impact of a poor iron status on the difficulties to keep recruitment of new donors at pace with the ongoing increased demand for blood transfusions was studied by comparing the iron status of new donors recruited in 1993-1997 and in 2005-2006. Iron status was defined by haemoglobin and serum ferritin. Inclusion criteria for approving new donors were haemoglobin >/= 12.5 g/dl for women and >/= 13.5 g/dl for men, and serum ferritin > 15 microg/l for both genders. Data were gathered retrospectively from 943 subjects (55% women) in the 1990 ties and prospectively from 1013 subjects (63% women) 10 years later. In women, there was a significant fall in haemoglobin and serum ferritin mean values from 13.2 to 13.1 g/dl and from 30.9 to 26.9 microg/l, respectively. Rejection due to low haemoglobin was significantly increased from 14% to 24%. In men, there were minor changes that did not affect rejection rates. Iron status of women who want to serve as blood donors has deteriorated in the last 10 years, leading to an increased rejection due to haemoglobin below the inclusion criterion for blood donors.

Prostate cancer molecular profiling: the Achilles heel for the implementation of precision medicine.

PubMed

Oliveira-Barros, Eliane Gouvêa; Nicolau-Neto, Pedro; Da Costa, Nathalia Meireles; Pinto, Luís Felipe Ribeiro; Palumbo, Antonio; Nasciutti, Luiz Eurico

2017-11-01

Cancer has been mainly treated by traditional therapeutic approaches which do not consider the human genetic diversity and present limitations, probably as a consequence of a poor knowledge of both patient's genetic background and tumor biology. Due to genome project conclusion and large-scale gene analyses emergence, the therapeutic management of several prevalent and aggressive tumors has dramatically improved and represents the closest examples of a precision medicine intervention in this field. Nonetheless, prostate cancer (PCa) remains as a challenge to personalized medicine implementation, probably due to its notorious heterogeneous molecular profile. Cancer treatment personalized approaches rely on the premise that a well-defined panorama of tumor molecular alterations can help selecting new and specific therapeutic targets for its treatment and potentially discriminate tumors which behave differentially. Lately, molecular and genetic studies have been investigating PCa basis, revealing multiple recurrent genomic alterations that include mutations, DNA copy-number variations, rearrangements, and gene fusions, among others. In addition to the increment on PCa molecular biology knowledge, mapping the molecular alterations pattern of this neoplasia, especially the differences existent between tumors displaying distinct behaviors, could represent a great improvement concerning the identification of new targets, personalized medicine, and patients' management and prognosis. © 2017 International Federation for Cell Biology.

Lanfrediella amphicirrus gen. nov. sp. nov. Nematotaeniidae (Cestoda: Cyclophyllidea), a tapeworm parasite of Rhinella marina (Linnaeus, 1758) (Amphibia: Bufonidae).

PubMed

Melo, Francisco Tiago de Vasconcelos; Giese, Elane Guerreiro; Furtado, Adriano Penha; Soares, Maurílio José; Gonçalves, Evonnildo Costa; Vallinoto, Antonio Carlos Rosário; Santos, Jeannie Nascimento dos

2011-09-01

The family Nematotaeniidae, tapeworms commonly found in the small intestines of amphibians and reptiles, includes 27 recognised species distributed among four genera: Bitegmen Jones, Cylindrotaenia Jewell, Distoichometra Dickey and Nematotaenia Lühe. The taxonomy of these cestodes is poorly defined, due in part to the difficulties of observing many anatomical traits. This study presents and describes a new genus and species of nematotaeniid parasite found in cane toads (Rhinella marina) from eastern Brazilian Amazonia. The cestodes were collected during the necropsy of 20 hosts captured in the urban area of Belém, Pará. The specimens were fixed and processed for light microscopy, scanning electron microscopy (SEM) and three-dimensional (3D) reconstruction. Samples were also collected for molecular analyses. The specimens presented a cylindrical body, two testes and paruterine organs. However, they could not be allocated to any of the four existing nematotaeniid genera due to the presence of two each of dorsal compact medullary testes, cirri, cirrus pouches, genital pores, ovaries and vitelline glands per mature segment. Lanfrediella amphicirrus gen. nov. sp. nov. is the first nematotaeniid studied using Historesin analysis, SEM and 3D reconstruction, and it is the second taxon for which molecular data have been deposited in GenBank.

Phagocytosis depends on TRPV2-mediated calcium influx and requires TRPV2 in lipids rafts: alteration in macrophages from patients with cystic fibrosis.

PubMed

Lévêque, Manuella; Penna, Aubin; Le Trionnaire, Sophie; Belleguic, Chantal; Desrues, Benoît; Brinchault, Graziella; Jouneau, Stéphane; Lagadic-Gossmann, Dominique; Martin-Chouly, Corinne

2018-03-09

Whereas many phagocytosis steps involve ionic fluxes, the underlying ion channels remain poorly defined. As reported in mice, the calcium conducting TRPV2 channel impacts the phagocytic process. Macrophage phagocytosis is critical for defense against pathogens. In cystic fibrosis (CF), macrophages have lost their capacity to act as suppressor cells and thus play a significant role in the initiating stages leading to chronic inflammation/infection. In a previous study, we demonstrated that impaired function of CF macrophages is due to a deficient phagocytosis. The aim of the present study was to investigate TRPV2 role in the phagocytosis capacity of healthy primary human macrophage by studying its activity, its membrane localization and its recruitment in lipid rafts. In primary human macrophages, we showed that P. aeruginosa recruits TRPV2 channels at the cell surface and induced a calcium influx required for bacterial phagocytosis. We presently demonstrate that to be functional and play a role in phagocytosis, TRPV2 might require a preferential localization in lipid rafts. Furthermore, CF macrophage displays a perturbed calcium homeostasis due to a defect in TRPV2. In this context, deregulated TRPV2-signaling in CF macrophages could explain their defective phagocytosis capacity that contribute to the maintenance of chronic infection.

Determination of the low molecular weight fraction of food-grade carrageenans.

PubMed

Spichtig, Véronique; Austin, Sean

2008-01-01

Recently there has been some debate regarding the presence and associated health risk of low molecular weight carrageenan in foodstuffs. Unfortunately measurement of the low molecular weight tail (LMT) of food-grade carrageenans (defined here as the carrageenan having relative molecular mass (Mr) below 50,000) is not trivial, largely due to its low abundance. So far methods employing light scattering have been unsuccessful in producing reproducible results, probably due to the poor detector response at low masses. In this work a method based on high performance size exclusion chromatography coupled to a refractive index detector (HPSEC-RI) has been used for the measurement of the LMT in food-grade carrageenan ingredients and in a carrageenan-containing finished product (a jelly). Over the course of half a year, 19 measurements were made on a reference carrageenan; the results demonstrated that the method had excellent reproducibility. Applied to a number of different carrageenan ingredients, it was found that, in general, the LMT represents less than 8% of the total carrageenan in ingredients, and under the correct conditions increases little during food processing. The data also indicated that pH appears to be a critical factor during food processing and pH levels below 4.0 should be avoided.

Poor safety climate, long work hours, and musculoskeletal discomfort among Latino horse farm workers.

PubMed

Swanberg, Jennifer; Clouser, Jessica Miller; Gan, Wenqi; Flunker, John C; Westneat, Susan; Browning, Steven R

2017-09-03

This study investigated the prevalence of self-reported musculoskeletal discomfort (MSD) and work-related factors associated with elevated MSD among Latino thoroughbred farm workers. Participants (N = 225) were recruited using a community-based purposive sampling approach to participate in in-person interviews. Of these workers, 85% experienced MSD. MSD was divided into tertiles; the upper tertile was defined as elevated. Multivariable Poisson regression revealed associations between any elevated MSD and longer tenure on horse farms, longer work hours, and poor safety climate. Elevated neck/back MSD was associated with longer tenure, longer work hours, and poor safety climate. Elevated upper extremity MSD was associated with age and poor safety climate. Elevated lower extremity MSD was associated with longer tenure, longer work hours, and being female. Musculoskeletal discomfort is common among these workers. Improving safety climate and minimizing long work hours is recommended.

[Analysis of population survey for determining the factors associated with the control diabetes mellitus in Mexico].

PubMed

Hernández-Romieu, Alfonso Claudio; Elnecavé-Olaiz, Alejandro; Huerta-Uribe, Nidia; Reynoso-Noverón, Nancy

2011-01-01

Determine the influence of nutritional counseling, exercise, access to social healthcare and drugs, and the quality of medical care on the control of diabetics. The information and blood samples were obtained in 2005. Glycemic control was defined as good if HbA1c was ≤7.0%, poor from 7.01%-9.50% and very poor if HbA1c >9.5%. Binary logistic regression models were used to determine the association of these factors with HbA1c>9.5%. Thirty percent of the patients with a medical diagnosis of diabetes had adequate metabolic control. Nutritional guidance was associated with an increase in the degree of control. A majority of diabetics have poor or very poor glycemic control. Strengthening the quality of and access to medical care for these patients is urgently needed.

48 CFR 1509.170-4 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... each performance category. Ratings are defined as follows: 0 = unsatisfactory, 1 = poor, 2 = fair, 3... PLANNING CONTRACTOR QUALIFICATIONS Contractor Performance Evaluations 1509.170-4 Definitions. (a) Contractor Performance Report is an evaluation of a contractor's performance for a specified period of time...

Gastrointestinal metabolic surgery for the treatment of type 2 diabetes mellitus

PubMed Central

Pok, Eng-Hong; Lee, Wei-Jei

2014-01-01

Medical therapy for type 2 diabetes mellitus is ineffective in the long term due to the progressive nature of the disease, which requires increasing medication doses and polypharmacy. Conversely, bariatric surgery has emerged as a cost-effective strategy for obese diabetic individuals; it has low complication rates and results in durable weight loss, glycemic control and improvements in the quality of life, obesity-related co-morbidity and overall survival. The finding that glucose homeostasis can be achieved with a weight loss-independent mechanism immediately after bariatric surgery, especially gastric bypass, has led to the paradigm of metabolic surgery. However, the primary focus of metabolic surgery is the alteration of the physio-anatomy of the gastrointestinal tract to achieve glycemic control, metabolic control and cardio-metabolic risk reduction. To date, metabolic surgery is still not well defined, as it is used most frequently for less obese patients with poorly controlled diabetes. The mechanism of glycemic control is still incompletely understood. Published research findings on metabolic surgery are promising, but many aspects still need to be defined. This paper examines the proposed mechanism of diabetes remission, the efficacy of different types of metabolic procedures, the durability of glucose control, and the risks and complications associated with this procedure. We propose a tailored approach for the selection of the ideal metabolic procedure for different groups of patients, considering the indications and prognostic factors for diabetes remission. PMID:25339819

Intracerebral haemorrhage in Down syndrome: protected or predisposed?

PubMed Central

Buss, Lewis; Fisher, Elizabeth; Hardy, John; Nizetic, Dean; Groet, Jurgen; Pulford, Laura; Strydom, André

2016-01-01

Down syndrome (DS), which arises from trisomy of chromosome 21, is associated with deposition of large amounts of amyloid within the central nervous system. Amyloid accumulates in two compartments: as plaques within the brain parenchyma and in vessel walls of the cerebral microvasculature. The parenchymal plaque amyloid is thought to result in an early onset Alzheimer’s disease (AD) dementia, a phenomenon so common amongst people with DS that it could be considered a defining feature of the condition. The amyloid precursor protein ( APP) gene lies on chromosome 21 and its presence in three copies in DS is thought to largely drive the early onset AD. In contrast, intracerebral haemorrhage (ICH), the main clinical consequence of vascular amyloidosis, is a more poorly defined feature of DS. We review recent epidemiological data on stroke (including haemorrhagic stroke) in order to make comparisons with a rare form of familial AD due to duplication (i.e. having three copies) of the APP region on chromosome 21, here called ‘dup-APP’, which is associated with more frequent and severe ICH. We conclude that although people with DS are at increased risk of ICH, this is less common than in dup-APP, suggesting the presence of mechanisms that act protectively. We review these mechanisms and consider comparative research into DS and dup-APP that may yield further pathophysiological insight. PMID:27239286

Selective PEGylation of Parylene-C/SiO2 Substrates for Improved Astrocyte Cell Patterning.

PubMed

Raos, B J; Doyle, C S; Simpson, M C; Graham, E S; Unsworth, C P

2018-02-09

Controlling the spatial distribution of glia and neurons in in vitro culture offers the opportunity to study how cellular interactions contribute to large scale network behaviour. A recently developed approach to cell-patterning uses differential adsorption of animal-serum protein on parylene-C and SiO 2 surfaces to enable patterning of neurons and glia. Serum, however, is typically poorly defined and generates reproducibility challenges. Alternative activation methods are highly desirable to enable patterning without relying on animal serum. We take advantage of the innate contrasting surface chemistries of parylene-C and SiO 2 to enable selective bonding of polyethylene glycol SiO 2 surfaces, i.e. PEGylation, rendering them almost completely repulsive to cell adhesion. As the reagents used in the PEGylation protocol are chemically defined, the reproducibility and batch-to-batch variability complications associated with the used of animal serum are avoided. We report that PEGylated parylene-C/SiO 2 substrates achieve a contrast in astrocyte density of 65:1 whereas the standard serum-immersion protocol results in a contrast of 5.6:1. Furthermore, single-cell isolation was significantly improved on PEGylated substrates when astrocytes were grown on close-proximity parylene-C nodes, whereas isolation was limited on serum-activated substrates due tolerance for cell adhesion on serum-adsorbed SiO 2 surfaces.

Associations between perceived crisis mode work climate and poor information exchange within hospitals.

PubMed

Patterson, Mark E; Bogart, Miller S; Starr, Kathleen R

2015-03-01

Because hospital units operating in crisis mode could create unsafe transitions of care due to miscommunication, our objective was to estimate associations between perceived crisis mode work climate and patient information exchange problems within hospitals. Self-reported data from 247,140 hospital staff members across 884 hospitals were obtained from the 2010 Hospital Survey on Patient Safety Culture. Presence of a crisis mode work climate was defined as respondents agreeing that the hospital unit in which they work tries to do too much too quickly. Presence of patient information exchange problems was defined as respondents agreeing that problems often occur in exchanging patient information across hospital units. Multivariable ordinal regressions estimated the likelihood of perceived problems in exchanging patient information across hospital units, controlling for perceived levels of crisis mode work climate, skill levels, work climate, and hospital infrastructure. Compared to those disagreeing, hospital staff members agreeing that the hospital unit in which they work tries to do too much too quickly were 1.6 times more likely to perceive problems in exchanging patient information across hospital units (odds ratio: 1.6, 95% confidence interval: 1.58-1.65). Hospital staff members perceiving crisis mode work climates within their hospital unit are more likely to perceive problems in exchanging patient information across units, underscoring the need to improve communication during transitions of care. © 2014 Society of Hospital Medicine.

Adduct-specific monoclonal antibodies for the measurement of cisplatin-induced DNA lesions in individual cell nuclei

PubMed Central

Liedert, Bernd; Pluim, Dick; Schellens, Jan; Thomale, Jürgen

2006-01-01

The anticancer drug cisplatin executes its cytotoxic activity via formation of intra- and interstrand crosslinks in DNA. The relative contribution of structurally defined cisplatin adducts to induce apoptosis and the cellular processing of these lesions is still poorly understood mostly due to the lack of sensitive analytical tools for in vivo studies. Here we describe a new method to establish and characterize monoclonal antibodies (Mab) for structurally defined DNA adducts. The two major reaction products of cisplatin, the guanine–guanine (Pt-[GG]) and adenine–guanine (Pt-[AG]) intrastrand crosslinks are recognized by Mab R-C18 and R-B3, respectively. Both antibodies were employed in an immuno-cytological assay allowing the quantification of drug-induced lesions in individual cell nuclei at clinically relevant doses. Analyzing various tissues of cisplatin-treated C57Bl/6 mice the accumulation of Pt-(GG) was highest in kidney tubular cells compared with 30, 50 and 90% lower levels in kidney stroma, liver and peripheral blood cells, respectively. Adduct kinetics revealed that wild type mouse cells remove up to 80% of the crosslinks in contrast to their complete persistence in nucleotide excision repair-deficient (XPC−/−) mice. The aptitude of the immunoassay for human molecular dosimetry studies was demonstrated by measuring adduct levels in tumor biopsies from patients treated with cisplatin. PMID:16571898

Next generation sequencing of the genomes of 11 international RWA biotypes

USDA-ARS?s Scientific Manuscript database

Scientists researching poorly characterized species struggle to gain understanding of the species they study on a sub-cellular level due to the time and investment required to build up an informative knowledge base. This becomes problematic when a poorly characterized species is a pest of a major e...

Evaluation of organic matter addition and incorporation on steep cut slopes : phase I, literature review and potential applicable equipment evaluation.

DOT National Transportation Integrated Search

2003-08-01

Erosion of steep highway cut slopes in Montana is the consequence of poor vegetation development in : nutrient-poor growth media resulting from highway construction where topsoil cannot physically be : replaced due to slope steepness. A literature re...

Evaluation of organic matter compost addition and incorporation on steep cut slopes. Phase II : test plot construction and performance monitoring

DOT National Transportation Integrated Search

2007-04-01

Erosion of steep highway cut slopes in Montana is often times the consequence of poor vegetation development in nutrient-poor growth media resulting from highway construction where topsoil cannot physically be replaced due to slope steepness. Topsoil...

Evaluation of organic matter addition and incorporation on steep cut slopes : phase II, test plot construction and performance monitoring.

DOT National Transportation Integrated Search

2007-04-01

Erosion of steep highway cut slopes in Montana is often times the consequence of poor vegetation development : in nutrient-poor growth media resulting from highway construction where topsoil cannot physically be replaced : due to slope steepness. Top...

Poorly cited articles in peer-reviewed cardiovascular journals from 1997 to 2007: analysis of 5-year citation rates.

PubMed

Ranasinghe, Isuru; Shojaee, Abbas; Bikdeli, Behnood; Gupta, Aakriti; Chen, Ruijun; Ross, Joseph S; Masoudi, Frederick A; Spertus, John A; Nallamothu, Brahmajee K; Krumholz, Harlan M

2015-05-19

The extent to which articles are cited is a surrogate of the impact and importance of the research conducted; poorly cited articles may identify research of limited use and potential wasted investments. We assessed trends in the rates of poorly cited articles and journals in the cardiovascular literature from 1997 to 2007. We identified original articles published in cardiovascular journals and indexed in the Scopus citation database from 1997 to 2007. We defined poorly cited articles as those with ≤5 citations in the 5 years following publication and poorly cited journals as those with >75% of journal content poorly cited. We identified 164 377 articles in 222 cardiovascular journals from 1997 to 2007. From 1997 to 2007, the number of cardiovascular articles and journals increased by 56.9% and 75.2%, respectively. Of all the articles, 75 550 (46.0%) were poorly cited, of which 25 650 (15.6% overall) had no citations. From 1997 to 2007, the proportion of poorly cited articles declined slightly (52.1%-46.2%, trend P<0.001), although the absolute number of poorly cited articles increased by 2595 (trend P<0.001). At a journal level, 44% of cardiovascular journals had more than three-fourths of the journal's content poorly cited at 5 years. Nearly half of all peer-reviewed articles published in cardiovascular journals are poorly cited 5 years after publication, and many are not cited at all. The cardiovascular literature and the number of poorly cited articles both increased substantially from 1997 to 2007. The high proportion of poorly cited articles and journals suggests inefficiencies in the cardiovascular research enterprise. © 2015 American Heart Association, Inc.

Poorly Cited Articles in Peer-Reviewed Cardiovascular Journals from 1997–2007: Analysis of 5-Year Citation Rates

PubMed Central

Ranasinghe, Isuru; Shojaee, Abbas; Bikdeli, Behnood; Gupta, Aakriti; Chen, Ruijun; Ross, Joseph S.; Masoudi, Frederick; Spertus, John A.; Nallamothu, Brahmajee K.; Krumholz, Harlan M.

2015-01-01

Background The extent to which articles are cited is a surrogate of the impact and importance of the research conducted; poorly cited papers may identify research of limited use and potential wasted investments. We assessed trends in the rates of poorly cited articles and journals in the cardiovascular literature from 1997–2007. Methods and Results We identified original articles published in cardiovascular journals and indexed in the Scopus citation database from 1997–2007. We defined poorly cited articles as those with ≤5 citations in the 5 years following publication and poorly cited journals as those with >75% of journal content poorly cited. We identified 164,377 articles in 222 cardiovascular journals from 1997–2007. From 1997–2007, the number of cardiovascular articles and journals increased by 56.9% and 75.2% respectively. Of all the articles, 75,550 (46.0%) were poorly cited, of which 25,650 (15.6% overall) had no citations. From 1997–2007, the proportion of poorly cited articles declined slightly (52.1% to 46.2%, trend P<0.001), although the absolute number of poorly cited articles increased by 2,595 (trend P<0.001). At a journal level, 44% of cardiovascular journals had more than three quarters of the journal’s content poorly cited at 5 years. Conclusion Nearly half of all peer-reviewed articles published in cardiovascular journals are poorly cited 5 years after publication, and many are not cited at all. The cardiovascular literature, and the number of poorly cited articles, have both increased substantially from 1997–2007. The high proportion of poorly cited articles and journals suggest inefficiencies in the cardiovascular research enterprise. PMID:25812573

Factors associated with poor control of 9/11-related asthma 10–11 years after the 2001 World Trade Center terrorist attacks

PubMed Central

Jordan, Hannah T.; Stellman, Steven D.; Reibman, Joan; Farfel, Mark R.; Brackbill, Robert M.; Friedman, Stephen M.; Li, Jiehui; Cone, James E.

2015-01-01

Abstract Objective: To identify key factors associated with poor asthma control among adults in the World Trade Center (WTC) Health Registry, a longitudinal study of rescue/recovery workers and community members who were directly exposed to the 2001 WTC terrorist attacks and their aftermath. Methods: We studied incident asthma diagnosed by a physician from 12 September 2001 through 31 December 2003 among participants aged ≥18 on 11 September 2001, as reported on an enrollment (2003–2004) or follow-up questionnaire. Based on modified National Asthma Education and Prevention Program criteria, asthma was considered controlled, poorly-controlled, or very poorly-controlled at the time of a 2011–2012 follow-up questionnaire. Probable post-traumatic stress disorder, depression, and generalized anxiety disorder were defined using validated scales. Self-reported gastroesophageal reflux symptoms (GERS) and obstructive sleep apnea (OSA) were obtained from questionnaire responses. Multinomial logistic regression was used to examine factors associated with poor or very poor asthma control. Results: Among 2445 participants, 33.7% had poorly-controlled symptoms and 34.6% had very poorly-controlled symptoms in 2011–2012. Accounting for factors including age, education, body mass index, and smoking, there was a dose–response relationship between the number of mental health conditions and poorer asthma control. Participants with three mental health conditions had five times the odds of poor control and 13 times the odds of very poor control compared to participants without mental health comorbidities. GERS and OSA were significantly associated with poor or very poor control. Conclusions: Rates of poor asthma control were very high in this group with post-9/11 diagnosed asthma. Comprehensive care of 9/11-related asthma should include management of mental and physical health comorbidities. PMID:25539137

Crisis Communication Plans: Poor Predictors of Excellent Crisis Public Relations.

ERIC Educational Resources Information Center

Marra, Francis J.

1998-01-01

Argues that newly developed theory in crisis public relations suggests a shift is necessary in the way practitioners view crises. Notes that the new paradigm defines excellent crisis public relations very differently from the literature of the past 20 years. (RS)

Needs and Wants. The Iconoclast.

ERIC Educational Resources Information Center

McMurtry, John

1997-01-01

Sharply criticizes current free market practices especially in light of the globalization of capitalism. Maintains that a laissez-faire approach to the allocation of resources and consumer choices is no longer relevant in a world defined by an increasing disparity between rich and poor. (MJP)

School Leadership Lessons from England

ERIC Educational Resources Information Center

Supovitz, Jonathan

2015-01-01

The flat structure of American schools is ill-suited to meeting today's demands for education improvement. Historically, American schools have addressed this instructional support deficit with a patchwork of poorly defined roles and responsibilities--underused department chairs, fitful coaching models, and informal teacher leaders who generally…

Identification of Mycobacterium avium subsp. hominissuis Isolated From Drinking Water

EPA Science Inventory

Mycobacterium avium (MA) is divided into four subspecies based primarily on host-range and consists of MA subsp. avium (birds), MA subsp. silvaticum (wood pigeons), MA subsp. paratuberculosis (broad, poorly-defined host range), and the recently described MA subsp. hominissuis (hu...

Characteristics of hydrothermal alteration mineralogy and geochemistry of igneous rocks from the epithermal Co-O mine and district, Eastern Mindanao (Philippines)

NASA Astrophysics Data System (ADS)

Sonntag, Iris; Hagemann, Steffen

2010-05-01

Detailed petrographic as well as hyperspectral analyses using PIMA (Portable Infrared Mineral Analyser) and geochemical (major, trace and rare earth elements) studies were conducted on samples of the epithermal, low sulfidation Co-O mine (47,869 ounces gold produced in 2009 with an average grade of 13.3 g/t gold) and district in Eastern Mindanao (Philippines). The aims of the study were to unravel the petrogenetic origin of the various volcanic (host rocks) and intrusive rocks (potential fluid driver) as well as their relationship and influence on the hydrothermal alteration zoning and fluid chemistry. The auriferous veins at the Co-O mine were formed during two hydrothermal stages associated with the district wide D1 and D2 deformation events. Gold in stage 1 quartz veins is in equilibrium with galena and sphalerite, whereas in stage 2 it is associated with pyrite. Auriferous quartz veins of stage 1 reflect temperatures below 250° C or strong variations in pH and fO2 at higher temperatures, due to potential involvement of acidic gas or meteoric water. Cathodoluminescense studies revealed strong zonation of quartz associated with Au, presumably related to changes in the Al content, which is influenced by the pH. Plumose textures indicate times of rapid deposition, whereas saccharoidal quartz grains are related to potential calcite replacement. The geology of the Co-O mine and district is dominated by Miocene volcanic rocks (basic to intermediate flows and pyroclastics units), which are partly covered by Pliocene volcanic rocks and late Oligocene to Miocene limestones. The Miocene units are intruded by diorite (presumably Miocene in age). The epithermal mineralization event may be related to diorite intrusions. The geochemistry of all igneous rocks in the district is defined by a sub-alkaline affinity and is low to medium K in composition. Most units are related to a Miocene subduction zone with westward subduction, whereas the younger Pliocene rocks are related to the currently active east dipping subduction zone. At the Co-O mine the proximal hydrothermal alteration zone is defined by phyllic to argillic alteration displayed in sericitized to carbonated feldspar, quartz and chloritized amphiboles surrounded by a distal alteration halo displaying propylitic alteration. The alteration geochemistry of these hydrothermal altered rocks is defined by an increase in K2O and Na2O and decrease in Al2O3. However, adularia usually associated with hydrothermal alteration in low epithermal Au quartz veins, has so far not been described, which points to a K-poor magma system. PIMA hydrothermal alteration studies indicate the dominant presence of smectite rather than white mica, which supports the involvement of a K-poor hydrothermal fluid. The epithermal Co-O mine and district displays low to medium potassic magma series and a hydrothermal alteration mineralogy that is K-poor. However, the Co-O mine hosts significant amounts of epithermal gold mineralization. The recognition of poor K melts and hydrothermal alteration mineralogy associated with distinct low-sulfidation epithermal gold mineralization has important implication for exploration in the Co-O district and, potentially, also in other areas in the Philippines and worldwide.

Family-based intervention in adolescent restrictive eating disorders: early treatment response and low weight suppression is associated with favourable one-year outcome.

PubMed

Swenne, Ingemar; Parling, Thomas; Salonen Ros, Helena

2017-09-15

Family-based treatments are first-line treatments for adolescents with restrictive eating disorders (ED) but have to be improved since outcome is poor for some. We have investigated the one-year outcome of a family-based intervention programme with defined and decisive interventions at the start of treatment. Data pertaining 201 adolescents with restrictive ED with features of anorexia nervosa but not fulfilling the weight criterion starting treatment 2010-2015, had a wide range of body mass index (BMI) and of weight loss at presentation, and completed a one-year follow-up was analysed. Recovery from the ED was defined as an Eating Disorder Examination-questionnaire (EDE-Q) score < 2.0 or as not fulfilling criteria for an ED at a clinical interview. By EDE-Q 130 (65%) had recovered at 1 year and by clinical interview 106 (53%). According to the EDE-Q criterion recovery was independently associated with lower EDE-Q score at presentation, higher weight gain after 3 months of treatment and lower weight suppression at follow-up, weight suppression being defined as the difference between premorbid and current BMI. Not fulfilling criteria for an ED was associated with the same factors and also by higher BMI at presentation. The observations that low weight and high ED cognitions confer a poor prognosis but that rapid weight gain at the start of treatment predicts a better prognosis are presently extended to adolescents with restrictive ED with a wide range of BMI at presentation. High weight suppression at follow-up is associated with a poor prognosis and indicates the importance of taking premorbid BMI into account when setting weight targets for treatment.

A multi-tracer approach coupled to numerical models to improve understanding of mountain block processes in a high elevation, semi-humid catchment

NASA Astrophysics Data System (ADS)

Dwivedi, R.; McIntosh, J. C.; Meixner, T.; Ferré, T. P. A.; Chorover, J.

2016-12-01

Mountain systems are critical sources of recharge to adjacent alluvial basins in dryland regions. Yet, mountain systems face poorly defined threats due to climate change in terms of reduced snowpack, precipitation changes, and increased temperatures. Fundamentally, the climate risks to mountain systems are uncertain due to our limited understanding of natural recharge processes. Our goal is to combine measurements and models to provide improved spatial and temporal descriptions of groundwater flow paths and transit times in a headwater catchment located in a sub-humid region. This information is important to quantifying groundwater age and, thereby, to providing more accurate assessments of the vulnerability of these systems to climate change. We are using: (a) combination of geochemical composition, along with 2H/18O and 3H isotopes to improve an existing conceptual model for mountain block recharge (MBR) for the Marshall Gulch Catchment (MGC) located within the Santa Catalina Mountains. The current model only focuses on shallow flow paths through the upper unconfined aquifer with no representation of the catchment's fractured-bedrock aquifer. Groundwater flow, solute transport, and groundwater age will be modeled throughout MGC using COMSOL Multiphysics® software. Competing models in terms of spatial distribution of required hydrologic parameters, e.g. hydraulic conductivity and porosity, will be proposed and these models will be used to design discriminatory data collection efforts based on multi-tracer methods. Initial end-member mixing results indicate that baseflow in MGC, if considered the same as the streamflow during the dry periods, is not represented by the chemistry of deep groundwater in the mountain system. In the ternary mixing space, most of the samples plot outside the mixing curve. Therefore, to further constrain the contributions of water from various reservoirs we are collecting stable water isotopes, tritium, and solute chemistry of precipitation, shallow groundwater, local spring water, MGC streamflow, and at a drainage location much lower than MGC outlet to better define and characterize each end-member of the ternary mixing model. Consequently, the end-member mixing results are expected to facilitate us in better understanding the MBR processes in and beyond MGC. Mountain systems are critical sources of recharge to adjacent alluvial basins in dryland regions. Yet, mountain systems face poorly defined threats due to climate change in terms of reduced snowpack, precipitation changes, and increased temperatures. Fundamentally, the climate risks to mountain systems are uncertain due to our limited understanding of natural recharge processes. Our goal is to combine measurements and models to provide improved spatial and temporal descriptions of groundwater flow paths and transit times in a headwater catchment located in a sub-humid region. This information is important to quantifying groundwater age and, thereby, to providing more accurate assessments of the vulnerability of these systems to climate change. We are using: (a) combination of geochemical composition, along with 2H/18O and 3H isotopes to improve an existing conceptual model for mountain block recharge (MBR) for the Marshall Gulch Catchment (MGC) located within the Santa Catalina Mountains. The current model only focuses on shallow flow paths through the upper unconfined aquifer with no representation of the catchment's fractured-bedrock aquifer. Groundwater flow, solute transport, and groundwater age will be modeled throughout MGC using COMSOL Multiphysics® software. Competing models in terms of spatial distribution of required hydrologic parameters, e.g. hydraulic conductivity and porosity, will be proposed and these models will be used to design discriminatory data collection efforts based on multi-tracer methods. Initial end-member mixing results indicate that baseflow in MGC, if considered the same as the streamflow during the dry periods, is not represented by the chemistry of deep groundwater in the mountain system. In the ternary mixing space, most of the samples plot outside the mixing curve. Therefore, to further constrain the contributions of water from various reservoirs we are collecting stable water isotopes, tritium, and solute chemistry of precipitation, shallow groundwater, local spring water, MGC streamflow, and at a drainage location much lower than MGC outlet to better define and characterize each end-member of the ternary mixing model. Consequently, the end-member mixing results are expected to facilitate us in better understanding the MBR processes in and beyond MGC.

The metal-poor knee in the Fornax dwarf spheroidal galaxy

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

Hendricks, Benjamin; Koch, Andreas; Lanfranchi, Gustavo A.

2014-04-20

We present α-element abundances of Mg, Si, and Ti for a large sample of field stars in two outer fields of the Fornax dwarf spheroidal (dSph) galaxy, obtained with Very Large Telescope/GIRAFFE (R ∼ 16, 000). Due to the large fraction of metal-poor (MP) stars in our sample, we are able to follow the α-element evolution from [Fe/H] ≈ –2.5 continuously to [Fe/H] ≈ –0.7. For the first time we are able to resolve the turnover from the Type II supernovae (SNe) dominated, α-enhanced plateau down to subsolar [α/Fe] values, due to the onset of SNe Ia, and thus tomore » trace the chemical enrichment efficiency of the galaxy. Our data support the general concept of an α-enhanced plateau at early epochs, followed by a well-defined 'knee' caused by the onset of SNe Ia, and finally a second plateau with sub-solar [α/Fe] values. We find the position of this knee to be at [Fe/H] ≈ –1.9 and therefore significantly more MP than expected from comparison with other dSphs and standard evolutionary models. Surprisingly, this value is rather comparable to the knee in Sculptor, a dSph ∼10 times less luminous than Fornax. Using chemical evolution models, we find that the position of the knee and the subsequent plateau at the sub-solar level can hardly be explained unless the galaxy experienced several discrete star formation (SF) events with a drastic variation in SF efficiency, while a uniform SF can be ruled out. One possible evolutionary scenario is that Fornax experienced one or several major accretion events from gas-rich systems in the past, so that its current stellar mass is not indicative of the chemical evolution environment at ancient times. If Fornax is the product of several smaller buildings blocks, this may also have implications for the understanding of the formation process of dSphs in general.« less

A study on the sleep quality of incoming university students.

PubMed

Cheng, Shu Hui; Shih, Chi-Chen; Lee, I Hui; Hou, Yi-Wen; Chen, Kao Chin; Chen, Kow-Tong; Yang, Yen Kuang; Yang, Yi Ching

2012-05-30

This study was designed to examine the prevalence and the risk factors of poor sleep quality in 4318 incoming university students in Taiwan. The test battery comprised a self-administered structured questionnaire, including items related to personal medical history and lifestyle habits, the Measurement of Support Functions (MSF), Pittsburgh Sleep Quality Index (PSQI), Chinese Internet Addiction Scale-Revision (CIAS-R), neuroticism subscale of the Maudsley Personality Inventory (MPI), and the 12-item Chinese Health Questionnaire (CHQ-12). Of the total study population, 2360 students (54.7%) were classified into the poor sleep quality group, as defined by a PSQI score ≥6. Based on the results of multivariate logistic regression analysis, poor sleep quality was significantly associated with undergraduate students, female gender, skipping breakfast, tea drinking, a higher tendency toward internet addition, poor social support, higher neuroticism, and higher CHQ scores. Poor sleep quality is prevalent among incoming university students in Taiwan, and more work is needed on the identification of the factors influencing poor sleep, and in providing systematic education in the importance of sleep and time management skills to university students. Copyright © 2012 Elsevier Ltd. All rights reserved.

Temperature variability during targeted temperature management is not associated with neurological outcomes following cardiac arrest.

PubMed

Nayeri, Arash; Bhatia, Nirmanmoh; Holmes, Benjamin; Borges, Nyal; Armstrong, William; Xu, Meng; Farber-Eger, Eric; Wells, Quinn S; McPherson, John A

2017-06-01

Recent studies on comatose survivors of cardiac arrest undergoing targeted temperature management (TTM) have shown similar outcomes at multiple target temperatures. However, details regarding core temperature variability during TTM and its prognostic implications remain largely unknown. We sought to assess the association between core temperature variability and neurological outcomes in patients undergoing TTM following cardiac arrest. We analyzed a prospectively collected cohort of 242 patients treated with TTM following cardiac arrest at a tertiary care hospital between 2007 and 2014. Core temperature variability was defined as the statistical variance (i.e. standard deviation squared) amongst all core temperature recordings during the maintenance phase of TTM. Poor neurological outcome at hospital discharge, defined as a Cerebral Performance Category (CPC) score>2, was the primary outcome. Death prior to hospital discharge was assessed as the secondary outcome. Multivariable logistic regression was used to examine the association between temperature variability and neurological outcome or death at hospital discharge. A poor neurological outcome was observed in 147 (61%) patients and 136 (56%) patients died prior to hospital discharge. In multivariable logistic regression, increased core temperature variability was not associated with increased odds of poor neurological outcomes (OR 0.38, 95% CI 0.11-1.38, p=0.142) or death (OR 0.43, 95% CI 0.12-1.53, p=0.193) at hospital discharge. In this study, individual core temperature variability during TTM was not associated with poor neurological outcomes or death at hospital discharge. Copyright © 2017 Elsevier Inc. All rights reserved.

On the precision of experimentally determined protein folding rates and φ-values

PubMed Central

De Los Rios, Miguel A.; Muralidhara, B.K.; Wildes, David; Sosnick, Tobin R.; Marqusee, Susan; Wittung-Stafshede, Pernilla; Plaxco, Kevin W.; Ruczinski, Ingo

2006-01-01

φ-Values, a relatively direct probe of transition-state structure, are an important benchmark in both experimental and theoretical studies of protein folding. Recently, however, significant controversy has emerged regarding the reliability with which φ-values can be determined experimentally: Because φ is a ratio of differences between experimental observables it is extremely sensitive to errors in those observations when the differences are small. Here we address this issue directly by performing blind, replicate measurements in three laboratories. By monitoring within- and between-laboratory variability, we have determined the precision with which folding rates and φ-values are measured using generally accepted laboratory practices and under conditions typical of our laboratories. We find that, unless the change in free energy associated with the probing mutation is quite large, the precision of φ-values is relatively poor when determined using rates extrapolated to the absence of denaturant. In contrast, when we employ rates estimated at nonzero denaturant concentrations or assume that the slopes of the chevron arms (mf and mu) are invariant upon mutation, the precision of our estimates of φ is significantly improved. Nevertheless, the reproducibility we thus obtain still compares poorly with the confidence intervals typically reported in the literature. This discrepancy appears to arise due to differences in how precision is calculated, the dependence of precision on the number of data points employed in defining a chevron, and interlaboratory sources of variability that may have been largely ignored in the prior literature. PMID:16501226

Integrating biomass quality variability in stochastic supply chain modeling and optimization for large-scale biofuel production

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

Castillo-Villar, Krystel K.; Eksioglu, Sandra; Taherkhorsandi, Milad

The production of biofuels using second-generation feedstocks has been recognized as an important alternative source of sustainable energy and its demand is expected to increase due to regulations such as the Renewable Fuel Standard. However, the pathway to biofuel industry maturity faces unique, unaddressed challenges. Here, to address this challenges, this article presents an optimization model which quantifies and controls the impact of biomass quality variability on supply chain related decisions and technology selection. We propose a two-stage stochastic programming model and associated efficient solution procedures for solving large-scale problems to (1) better represent the random nature of the biomassmore » quality (defined by moisture and ash contents) in supply chain modeling, and (2) assess the impact of these uncertainties on the supply chain design and planning. The proposed model is then applied to a case study in the state of Tennessee. Results show that high moisture and ash contents negatively impact the unit delivery cost since poor biomass quality requires the addition of quality control activities. Experimental results indicate that supply chain cost could increase as much as 27%–31% when biomass quality is poor. We assess the impact of the biomass quality on the topological supply chain. Our case study indicates that biomass quality impacts supply chain costs; thus, it is important to consider the impact of biomass quality in supply chain design and management decisions.« less

Ocular melanoma: an overview of the current status

PubMed Central

Jovanovic, Predrag; Mihajlovic, Marija; Djordjevic-Jocic, Jasmina; Vlajkovic, Slobodan; Cekic, Sonja; Stefanovic, Vladisav

2013-01-01

Ocular melanoma is the second most common type of melanoma after cutaneous and the most common primary intraocular malignant tumor in adults. Large majority of ocular melanomas originate from uvea, while conjunctival melanomas are far less frequent. Incidence of uveal melanoma has remained stable over last three decades. Diagnosis is in most cases established by clinical examination with great accuracy. Local treatment of uveal melanoma has improved, with increased use of conservative methods and preservation of the eye, but survival rates have remained unchanged. Recent advances in cytogenetics and genetics enhanced prognostication and enabled to determine tumors with high metastatic potential. However, due to lack of effective systemic therapy, prognosis of patients with metastasis remains poor and metastatic disease remains the leading cause of death among patients with uveal melanoma. Conjunctival melanoma is rare, but its incidence is increasing. It mostly occurs among white adults. In majority of cases it originates from preceding primary acquired melanosis. Current standard treatment for conjunctival melanoma is wide local excision with adjuvant therapy, including brachytherapy, cryotherapy and topical application of chemotherapeutic agent. Rarity of this tumor limits conduction of controlled trials to define the best treatment modality. As well as for uveal melanoma, prognosis of patients with metastasis is poor because there is no effective systemic therapy. Better understanding of underlying genetic and molecular abnormalities implicated in development and progression of ocular melanomas provides a great opportunity for development of targeted therapy, which will hopefully improve prognosis of patients with metastatic disease. PMID:23826405

Symptomatic BK Virus Infection Is Associated with Kidney Function Decline and Poor Overall Survival in Allogeneic Hematopoietic Stem Cell Recipients

PubMed Central

Abudayyeh, Ala; Hamdi, Amir; Lin, Heather; Abdelrahim, Maen; Rondon, Gabriela; Andersson, Borje S; Afrough, Aimaz; Martinez, Charles S; Tarrand, Jeffrey J; Kontoyiannis, Dimitrios P.; Marin, David; Gaber, A. Osama; Salahudeen, Abdulla; Oran, Betul; Chemaly, Roy F.; Olson, Amanda; Jones, Roy; Popat, Uday; Champlin, Richard E; Shpall, Elizabeth J.; Winkelmayer, Wolfgang C.; Rezvani, Katayoun

2017-01-01

Nephropathy due to BK virus infection is an evolving challenge in patients undergoing hematopoietic stem cell transplantation. We hypothesized that BKV infection was a marker of Kidney Function Decline and a poor prognostic factor in HSCT recipients who experience this complication. In this retrospective study, we analyzed all patients who underwent their first allogeneic hematopoietic stem cell transplantation at our institution between 2004 and 2012. We evaluated the incidence of persistent kidney function decline, which was defined as a confirmed reduction in estimated glomerular filtration rate of at least 25% from baseline using the CKD-EPI equation. Cox proportional hazard regression was used to model the cause-specific hazard of kidney function decline and Fine and Gray’s method was used to account for the competing risks of death. Among 2477 recipients of a first allogeneic hematopoietic stem cell transplantation, BK viruria was detected in 25% (n=629) and kidney function decline in 944 (38.1%). On multivariate analysis, after adjusting for age, sex, acute graft-versus-host disease, chronic graft versus host disease, preparative conditioning regimen, and graft source, BK viruria remained a significant risk factor for kidney function decline (P <0.001). In addition, patients with BKV infection and kidney function decline experienced worse overall survival. Post-allogeneic hematopoietic stem cell transplantation, BKV infection was strongly and independently associated with subsequent kidney function decline and worse patient survival after HSCT. PMID:26608093

CXCR1-mediated Neutrophil Degranulation and Fungal Killing Promotes Candida Clearance and Host Survival

PubMed Central

Swamydas, Muthulekha; Gao, Ji-Liang; Break, Timothy J.; Johnson, Melissa D.; Jaeger, Martin; Rodriguez, Carlos A.; Lim, Jean K.; Green, Nathaniel M.; Collar, Amanda L.; Fischer, Brett G.; Lee, Chyi-Chia Richard; Perfect, John R.; Alexander, Barbara D.; Kullberg, Bart-Jan; Netea, Mihai G.; Murphy, Philip M.; Lionakis, Michail S.

2016-01-01

Systemic Candida albicans infection causes high morbidity and mortality and is now the leading cause of nosocomial bloodstream infection in the US. Neutropenia is a major risk factor for poor outcome in infected patients; however, the molecular factors that mediate neutrophil trafficking and effector function during infection are poorly defined. Here, using a mouse model of systemic candidiasis, we found that the neutrophil-selective CXC chemokine receptor Cxcr1 and its ligand, Cxcl5, are highly induced in the Candida-infected kidney, the target organ in the model. To investigate the role of Cxcr1 in antifungal host defense in vivo, we generated Cxcr1−/− mice and analyzed their immune response to Candida. Mice lacking Cxcr1 exhibited decreased survival with enhanced Candida growth in the kidney and renal failure. Surprisingly, increased susceptibility of Cxcr1−/− mice to systemic candidiasis was not due to impaired neutrophil trafficking from the blood into the infected kidney but was the result of defective killing of the fungus by neutrophils that exhibited a cell-intrinsic decrease in degranulation. In humans, the mutant CXCR1 allele CXCR1-T276 results in impaired neutrophil degranulation and fungal killing and was associated with increased risk of disseminated candidiasis in infected patients. Together, our data demonstrate a biological function for mouse Cxcr1 in vivo and indicate that CXCR1-dependent neutrophil effector function is a critical innate protective mechanism of fungal clearance and host survival in systemic candidiasis. PMID:26791948

Integrating biomass quality variability in stochastic supply chain modeling and optimization for large-scale biofuel production

DOE PAGES

Castillo-Villar, Krystel K.; Eksioglu, Sandra; Taherkhorsandi, Milad

2017-02-20

The production of biofuels using second-generation feedstocks has been recognized as an important alternative source of sustainable energy and its demand is expected to increase due to regulations such as the Renewable Fuel Standard. However, the pathway to biofuel industry maturity faces unique, unaddressed challenges. Here, to address this challenges, this article presents an optimization model which quantifies and controls the impact of biomass quality variability on supply chain related decisions and technology selection. We propose a two-stage stochastic programming model and associated efficient solution procedures for solving large-scale problems to (1) better represent the random nature of the biomassmore » quality (defined by moisture and ash contents) in supply chain modeling, and (2) assess the impact of these uncertainties on the supply chain design and planning. The proposed model is then applied to a case study in the state of Tennessee. Results show that high moisture and ash contents negatively impact the unit delivery cost since poor biomass quality requires the addition of quality control activities. Experimental results indicate that supply chain cost could increase as much as 27%–31% when biomass quality is poor. We assess the impact of the biomass quality on the topological supply chain. Our case study indicates that biomass quality impacts supply chain costs; thus, it is important to consider the impact of biomass quality in supply chain design and management decisions.« less

Complex patchy colloids shaped from deformable seed particles through capillary interactions.

PubMed

Meester, V; Kraft, D J

2018-02-14

We investigate the mechanisms underlying the reconfiguration of random aggregates of spheres through capillary interactions, the so-called "colloidal recycling" method, to fabricate a wide variety of patchy particles. We explore the influence of capillary forces on clusters of deformable seed particles by systematically varying the crosslink density of the spherical seeds. Spheres with a poorly crosslinked polymer network strongly deform due to capillary forces and merge into large spheres. With increasing crosslink density and therefore rigidity, the shape of the spheres is increasingly preserved during reconfiguration, yielding patchy particles of well-defined shape for up to five spheres. In particular, we find that the aspect ratio between the length and width of dumbbells, L/W, increases with the crosslink density (cd) as L/W = B - A·exp(-cd/C). For clusters consisting of more than five spheres, the particle deformability furthermore determines the patch arrangement of the resulting particles. The reconfiguration pathway of clusters of six densely or poorly crosslinked seeds leads to octahedral and polytetrahedral shaped patchy particles, respectively. For seven particles several geometries were obtained with a preference for pentagonal dipyramids by the rigid spheres, while the soft spheres do rarely arrive in these structures. Even larger clusters of over 15 particles form non-uniform often aspherical shapes. We discuss that the reconfiguration pathway is largely influenced by confinement and geometric constraints. The key factor which dominates during reconfiguration depends on the deformability of the spherical seed particles.

Nuclear localisation of LASP-1 correlates with poor long-term survival in female breast cancer.

PubMed

Frietsch, J J; Grunewald, T G P; Jasper, S; Kammerer, U; Herterich, S; Kapp, M; Honig, A; Butt, E

2010-05-25

LIM and SH3 protein 1 (LASP-1) is a nucleo-cytoplasmatic signalling protein involved in cell proliferation and migration and is upregulated in breast cancer in vitro studies have shown that LASP-1 might be regulated by prostate-derived ETS factor (PDEF), p53 and/or LASP1 gene amplification. This current study analysed the prognostic significance of LASP-1 on overall survival (OS) in 177 breast cancer patients and addressed the suggested mechanisms of LASP-1-regulation. Nucleo-cytoplasmatic LASP-1-positivity of breast carcinoma samples was correlated with long-term survival, clinicopathological parameters, Ki67-positivity and PDEF expression. Rate of LASP1 amplification was determined in micro-dissected primary breast cancer cells using quantitative RT-PCR. Cell-phase dependency of nuclear LASP-1-localisation was studied in synchronised cells. In addition, LASP-1, PDEF and p53 expression was compared in cell lines of different tumour entities to define principles for LASP-1-regulation. We showed that LASP-1 overexpression is not due to LASP1 gene amplification. Moreover, no correlation between p53-mutations or PDEF-expression and LASP-1-status was observed. However, nuclear LASP-1-localisation in breast carcinomas is increased during proliferation with peak in G2/M-phase and correlated significantly with Ki67-positivity and poor OS. Our results provide evidence that nuclear LASP-1-positivity may serve as a negative prognostic indicator for long-term survival of breast cancer patients.

A case of rectal carcinoma with skin and bone marrow metastasis with concurrent extensive visceral involvement; unusual and dismal co-incidence.

PubMed

Arslan, Cagatay; Sen, Cenk Ahmet; Ortac, Ragip

2015-06-01

Novel systemic therapies and modern surgical and ablative approaches have improved the survival rates for the patients with metastatic colorectal cancer. However, there are still patients with poor prognosis and underlying mechanisms that could not be defined clearly. Metastatic colorectal cancer patients with skin metastasis have a poor prognosis. A 45-year-old man, who presented with large bowel obstruction, was diagnosed with metastatic rectal adenocarcinoma. Unresectable liver metastases were found at diagnosis. FOLFOX plus bevacizumab treatment was started, but the patient developed bowel obstruction after the third cycle. Therefore, ileostomy was performed. Multiple skin, lung, liver and bone metastases appeared during that time. Bone marrow biopsy demonstrated diffuse infiltration by adenocarcinoma cells. Even though partial remission was achieved after 4 cycles of FOLFIRI-cetuximab, the disease progressed after the 8th cycle. The patient lost his life due to disease progression 8 months after the diagnosis. Bone marrow and skin are unusual sites of metastasis for colorectal carcinoma. Metastases in bone marrow and skin develop at later stages of metastatic disease. This patient lived only 4 months after the development of skin and bone marrow metastases. Skin and bone marrow metastases may be the harbingers of short survival. Biopsy of metastatic sites is crucial for diagnosis and detailed molecular analysis. Molecular pathway alterations underlying worse disease course may be found, and hence probable targets for drug improvement may be indicated.

Hyperthyroidism secondary to disseminated mucormycosis in a child with acute lymphoblastic leukemia: case report and a review of published reports.

PubMed

Irga, Ninela; Kosiak, Wojciech; Jaworski, Radoslaw; Komarnicka, Jolanta; Birkholz, Dorota

2013-02-01

Thyroiditis due to fungal infection is an extremely rare cause of hyperthyroidism. The most common etiological factor of thyroiditis is Aspergillus. Infections due to members of the Mucorales have been an increasing clinical problem in recent years, and the prognosis in generalized infections due to those fungi is usually very poor. No hyperthyroidism in a child with thyroiditis due to mucormycosis has been reported in the literature so far. We describe a clinical course of generalized mucormycosis with thyroid involvement in a 12-year-old girl treated for acute lymphoblastic leukemia. The child underwent a hyperthyroidism connected with thyroid involvement due to a fungal process. The diagnosis was based on the clinical signs, laboratory findings and typical ultrasound scan; however, later attempt to amplify the fungi DNA from the tissue block has failed. The child died because of multiorgan failure due to general fungal infection 49 days after the invasive fungal infection was diagnosed. The generalized mucormycosis is always connected with poor prognosis and the mortality is high.

Brain gut microbiome interactions and functional bowel disorders

USDA-ARS?s Scientific Manuscript database

Alterations in the bidirectional interactions between the intestine and the nervous system have important roles in the pathogenesis of irritable bowel syndrome (IBS). A body of largely preclinical evidence suggests that the gut microbiota can modulate these interactions. A small and poorly defined r...

Promoting Positive Special Education Practices

ERIC Educational Resources Information Center

Conderman, Greg; Pedersen, Theresa

2005-01-01

Special education is defined as specialized instruction for students with disabilities. Sometimes, however, legal requirements as well as the day-to-day demands of teaching secondary students with disabilities cloud the real intent of special education. This article acknowledges some poor practices occurring in secondary special education and…

The geography of spatial synchrony

Treesearch

Jonathan A. Walter; Lawrence W. Sheppard; Thomas L. Anderson; Jude H. Kastens; Ottar N. Bjørnstad; Andrew M. Liebhold; Daniel C. Reuman; Bernd Blasius

2017-01-01

Spatial synchrony, defined as correlated temporal fluctuations among populations, is a fundamental feature of population dynamics, but many aspects of synchrony remain poorly understood. Few studies have examined detailed geographical patterns of synchrony; instead most focus on how synchrony declines with increasing linear distance between locations, making the...

78 FR 691 - Guarantee Fee Rates for Guaranteed Loans for Fiscal Year 2013; Maximum Portion of Guarantee...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-04

... benefiting financially or must be a high impact business investment as defined in 7 CFR 4279.155(b)(5) and be... persistently poor, are experiencing trauma as a result of natural disaster, or are experiencing fundamental...

Working Memory Compensates for Hearing Related Phonological Processing Deficit

ERIC Educational Resources Information Center

Classon, Elisabet; Rudner, Mary; Ronnberg, Jerker

2013-01-01

Acquired hearing impairment is associated with gradually declining phonological representations. According to the Ease of Language Understanding (ELU) model, poorly defined representations lead to mismatch in phonologically challenging tasks. To resolve the mismatch, reliance on working memory capacity (WMC) increases. This study investigated…

Health Seeking in Men: A Concept Analysis.

PubMed

Hooper, Gwendolyn L; Quallich, Susanne A

2016-01-01

This article describes the analysis of the concept of health seeking in men. Men have shorter life expectancies and utilize health services less often than women, leading to poor health outcomes, but a gendered basis for health seeking remains poorly defined. Walker and Avant’s framework was used to guide this concept analysis. Literature published in English from 1990-2015 was reviewed. Thematic analysis identified attributes, antecedents, and consequences of the concept. Based on the analysis, a contemporary definition for health seeking in men was constructed, rooted in the concept of health. The definition is based on the concept analysis and the defining attributes that were identified. This analysis provides a definition specifically for health seeking in American men, making it more specific and gender-based than the parent concept of “health.” This concept analysis provides conceptual clarity that can guide development of a conceptual framework that may be uniquely relevant to providers in urology. Further exploration will uncover specific cultural, social, sexual, and geographic perspectives.

Primary Teachers' Attitudes toward Science: A New Theoretical Framework

ERIC Educational Resources Information Center

van Aalderen-Smeets, Sandra I.; Walma van der Molen, Juliette H.; Asma, Lieke J. F.

2012-01-01

Attention to the attitudes of preservice and inservice primary teachers toward science is of fundamental importance to research on primary science education. However, progress in this field of research has been slow due to the poor definition and conceptualization of the construct of primary teachers' attitude toward science. This poor theoretical…

USASOC Injury Prevention/Performance Optimization Musculoskeletal Screening Initiative

DTIC Science & Technology

2012-11-01

gluteus medius) Poor gait pattern/ Overpronation Tibial Stress Fracture Overloading the bone due to excessive running...Excessively tight iliotibial band Hip musculature weakness (e.g. gluteus medius) Poor gait pattern/ Overpronation Tibial Stress Fracture ...Anatomic Location Specific Injuries Probable Causes All lower extremity is at risk for injury during this exercise Foot fractures Improper

La ensenanza de idiomas en Puerto Rico (Language Teaching in Puerto Rico)

ERIC Educational Resources Information Center

Llorens, Washington

1976-01-01

The poor command of Spanish common to many Puerto Ricans is due, not to the teaching of English as a second language, but to the poor instruction of the native language and the lack of emphasis on reading good Spanish literature. The two languages can coexist. (Text is in Spanish.) (CHK)

Preparation for Parenthood. Evaluation Plan and Program Evaluation.

ERIC Educational Resources Information Center

Blackmon, Michael E.

Preparation for Parenthood is a city-wide program designed for the purpose of: (1) decreasing the complication of pregnancy for school-age girls due to poor nutrition and poor prenatal care, and consequently reducing infant mortality, mental retardation, and birth defects; and (2) enabling the girls to continue their educational ambitions, thus…

"Without money you're nothing": poverty and health in Mexico from women's perspective.

PubMed

Tezoquipa, Isabel Hernández; Monreal, Luz Arenas; Treviño-Siller, Sandra

2005-01-01

The objective of this qualitative study was to get to know poor Mexican women's experience of poverty in relation to health care. Forty-nine interviews were carried out with poor adult women in Mexico (between 35 and 65 years old). Three central elements were detected in relation to the women's experience of poverty and health care: their socio-economic dependence on their family; the notion of social belonging in their experience with health care rights, reflected in the idea and acceptance that, due to their poverty, they can only be attended at philanthropic institutions; and the existence of survival mechanisms when facing an illness. In recovering the experience of poor women in relation to their health care, we identified that there is a clear idea that, if women had had economic resources, their health problem would have been solved differently. They are also convinced that, due to being poor, they have to content themselves with bad-quality medical care. This conformity finally makes them resign to the fact of either loosing a part of their own body, or even just waiting for death.

Prognostic indicators of poor short-term outcome of physiotherapy intervention in women with stress urinary incontinence.

PubMed

Hendriks, Erik J M; Kessels, Alfons G H; de Vet, Henrica C W; Bernards, Arnold T M; de Bie, Rob A

2010-03-01

To identify prognostic indicators independently associated with poor outcome of physiotherapy intervention in women with primary or recurrent stress urinary incontinence (stress UI). A prospective cohort study was performed in physiotherapy practices in primary care to identify prognostic indicators 12 weeks after initiation of physiotherapy intervention. Patients were referred by general practitioners or urogynecologists. Risk factors for stress UI were examined as potential prognostic indicators of poor outcome. The primary outcomes were defined as poor outcome on the binary Leakage Severity scale (LS scale) and the binary global perceived effectiveness (GPE) score. Two hundred sixty-seven women, with a mean age of 47.7 (SD = 8.3), with stress UI for at least 6 months were included. At 12 weeks, 43% and 59% of the women were considered recovered on the binary LS scale and the binary GPE score, respectively. Prognostic indicators associated with poor outcome included 11 indicators based on the binary LS scale and 8 based on the binary GPE score. The prognostic indicators shared by both models show that poor recovery was associated with women with severe stress UI, POP-Q stage > II, poor outcome of physiotherapy intervention for a previous UI episode, prolonged second stage of labor, BMI > 30, high psychological distress, and poor physical health. This study provides robust evidence of clinically meaningful prognostic indicators of poor short-term outcome. These findings need to be confirmed by replication studies. (c) 2009 Wiley-Liss, Inc.

Defining the light emitting area for displays in the unipolar regime of highly efficient light emitting transistors

PubMed Central

Ullah, Mujeeb; Armin, Ardalan; Tandy, Kristen; Yambem, Soniya D.; Burn, Paul L.; Meredith, Paul; Namdas, Ebinazar B.

2015-01-01

Light-emitting field effect transistors (LEFETs) are an emerging class of multifunctional optoelectronic devices. It combines the light emitting function of an OLED with the switching function of a transistor in a single device architecture. The dual functionality of LEFETs has the potential applications in active matrix displays. However, the key problem of existing LEFETs thus far has been their low EQEs at high brightness, poor ON/OFF and poorly defined light emitting area - a thin emissive zone at the edge of the electrodes. Here we report heterostructure LEFETs based on solution processed unipolar charge transport and an emissive polymer that have an EQE of up to 1% at a brightness of 1350 cd/m2, ON/OFF ratio > 104 and a well-defined light emitting zone suitable for display pixel design. We show that a non-planar hole-injecting electrode combined with a semi-transparent electron-injecting electrode enables to achieve high EQE at high brightness and high ON/OFF ratio. Furthermore, we demonstrate that heterostructure LEFETs have a better frequency response (fcut-off = 2.6 kHz) compared to single layer LEFETs. The results presented here therefore are a major step along the pathway towards the realization of LEFETs for display applications. PMID:25743444

Due Process in the Realm of Higher Education: Considerations for Dealing with Students Rights

ERIC Educational Resources Information Center

Fishner, Jason T.

2006-01-01

Court decisions have laid out expectations of what due process procedures need to be followed in student disciplinary cases and academic dismissal cases due to poor academic performance. This paper will give show where due process comes from and how it found its way into higher education. It will show that there are differences in the ways public…

Sarcopenia Screened by the SARC-F Questionnaire and Physical Performances of Elderly Women: A Cross-Sectional Study.

PubMed

Rolland, Yves; Dupuy, Charlotte; Abellan Van Kan, Gabor; Cesari, Matteo; Vellas, Bruno; Faruch, Marie; Dray, Cedric; de Souto Barreto, Philipe

2017-10-01

Screening for sarcopenia in daily practice can be challenging. Our objective was to explore whether the SARC-F questionnaire is a valid screening tool for sarcopenia (defined by the Foundation for the National Institutes of Health [FNIH] criteria). Moreover, we evaluated the physical performance of older women according to the SARC-F questionnaire. Cross-sectional study. Data from the Toulouse and Lyon EPIDémiologie de l'OStéoporose study (EPIDOS) on 3025 women living in the community (mean age: 80.5 ± 3.9 years), without a previous history of hip fracture, were assessed. The SARC-F self-report questionnaire score ranges from 0 to 10: a score ≥4 defines sarcopenia. The FNIH criteria uses handgrip strength (GS) and appendicular lean mass (ALM; assessed by DXA) divided by body mass index (BMI) to define sarcopenia. Outcome measures were the following performance-based tests: knee-extension strength, 6-m gait speed, and a repeated chair-stand test. The associations of sarcopenia with performance-based tests was examined using bootstrap multiple linear-regression models; adjusted R 2 determined the percentage variation for each outcome explained by the model. Prevalence of sarcopenia was 16.7% (n = 504) according to the SARC-F questionnaire and 1.8% (n = 49) using the FNIH criteria. Sensibility and specificity of the SARC-F to diagnose sarcopenia (defined by FNIH criteria) were 34% and 85%, respectively. Sarcopenic women defined by SARC-F had significantly lower physical performance than nonsarcopenic women. The SARC-F improved the ability to predict poor physical performance. The validity of the SARC-F questionnaire to screen for sarcopenia, when compared with the FNIH criteria, was limited. However, sarcopenia defined by the SARC-F questionnaire substantially improved the predictive value of clinical characteristics of patients to predict poor physical performance. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

The management of pregnancy in maple syrup urine disease: experience with two patients.

PubMed

Tchan, Michel; Westbrook, M; Wilcox, G; Cutler, R; Smith, N; Penman, R; Strauss, B J G; Wilcken, B

2013-01-01

We describe the management and outcomes of pregnancy in two women affected with Maple syrup urine disease (MSUD). Both patients had classical disease diagnosed in the newborn period and were managed with low-protein diets and supplements, although compliance was moderately poor throughout life. Both pregnancies were complicated by poor compliance and one patient had a metabolic decompensation, which included seizures and profound encephalopathy, at the end of the first trimester. Peri-partum management required a coordinated team approach including a high-calorie and low-protein diet. Both patients had elevated leucine levels in the post-partum period - one due to mastitis and the other due to poor dietary and supplement compliance combined with uterine involution. On later review, leucine had returned to pre-pregnancy levels. Both infants were unaffected and have made normal developmental progress in the subsequent 1 to 2 years.

An application of an ecological framework to understand risk factors of PTSD due to prolonged conflict exposure: Israeli and Palestinian adolescents in the Line of Fire

PubMed Central

Rosshandler, Yasmin; Hall, Brian J.; Canetti, Daphna

2016-01-01

Objective Adolescents living in Israel and the Palestinian authority are exposed to political violence. This review examines psychosocial risk factors for posttraumatic stress disorder (PTSD) organized within an ecological framework. Method Relevant articles were identified through PubMed and PsycINFO. Studies measuring risk and/or protective factors for PTSD in the Palestinian and/or Israeli adolescent populations due to conflict exposure from 1990 to present were included. Results A total of 20 studies met inclusion criteria. Greater violence exposure, poor economic resources, living in rural compared to urban areas, poor family and peer relations and poor coping skills were associated with PTSD symptoms. Conclusions The ecological framework is a useful approach to understanding factors affecting adolescent PTSD. Future research should focus on socio-ecological levels that have received limited attention. PMID:26950012

2-Way k-Means as a Model for Microbiome Samples.

PubMed

Jackson, Weston J; Agarwal, Ipsita; Pe'er, Itsik

2017-01-01

Motivation . Microbiome sequencing allows defining clusters of samples with shared composition. However, this paradigm poorly accounts for samples whose composition is a mixture of cluster-characterizing ones and which therefore lie in between them in the cluster space. This paper addresses unsupervised learning of 2-way clusters. It defines a mixture model that allows 2-way cluster assignment and describes a variant of generalized k -means for learning such a model. We demonstrate applicability to microbial 16S rDNA sequencing data from the Human Vaginal Microbiome Project.

2-Way k-Means as a Model for Microbiome Samples

PubMed Central

2017-01-01

Motivation. Microbiome sequencing allows defining clusters of samples with shared composition. However, this paradigm poorly accounts for samples whose composition is a mixture of cluster-characterizing ones and which therefore lie in between them in the cluster space. This paper addresses unsupervised learning of 2-way clusters. It defines a mixture model that allows 2-way cluster assignment and describes a variant of generalized k-means for learning such a model. We demonstrate applicability to microbial 16S rDNA sequencing data from the Human Vaginal Microbiome Project. PMID:29177026

Moving Beyond 2% Uncertainty: A New Framework for Quantifying Lidar Uncertainty

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

Newman, Jennifer F.; Clifton, Andrew

2017-03-08

Remote sensing of wind using lidar is revolutionizing wind energy. However, current generations of wind lidar are ascribed a climatic value of uncertainty, which is based on a poor description of lidar sensitivity to external conditions. In this presentation, we show how it is important to consider the complete lidar measurement process to define the measurement uncertainty, which in turn offers the ability to define a much more granular and dynamic measurement uncertainty. This approach is a progression from the 'white box' lidar uncertainty method.

Inner Speech's Relationship With Overt Speech in Poststroke Aphasia.

PubMed

Stark, Brielle C; Geva, Sharon; Warburton, Elizabeth A

2017-09-18

Relatively preserved inner speech alongside poor overt speech has been documented in some persons with aphasia (PWA), but the relationship of overt speech with inner speech is still largely unclear, as few studies have directly investigated these factors. The present study investigates the relationship of relatively preserved inner speech in aphasia with selected measures of language and cognition. Thirty-eight persons with chronic aphasia (27 men, 11 women; average age 64.53 ± 13.29 years, time since stroke 8-111 months) were classified as having relatively preserved inner and overt speech (n = 21), relatively preserved inner speech with poor overt speech (n = 8), or not classified due to insufficient measurements of inner and/or overt speech (n = 9). Inner speech scores (by group) were correlated with selected measures of language and cognition from the Comprehensive Aphasia Test (Swinburn, Porter, & Al, 2004). The group with poor overt speech showed a significant relationship of inner speech with overt naming (r = .95, p < .01) and with mean length of utterance produced during a written picture description (r = .96, p < .01). Correlations between inner speech and language and cognition factors were not significant for the group with relatively good overt speech. As in previous research, we show that relatively preserved inner speech is found alongside otherwise severe production deficits in PWA. PWA with poor overt speech may rely more on preserved inner speech for overt picture naming (perhaps due to shared resources with verbal working memory) and for written picture description (perhaps due to reliance on inner speech due to perceived task difficulty). Assessments of inner speech may be useful as a standard component of aphasia screening, and therapy focused on improving and using inner speech may prove clinically worthwhile. https://doi.org/10.23641/asha.5303542.

In utero phthalate effects in the female rat: a model for MRKH syndrome##

EPA Science Inventory

Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is characterized by uterine and vaginal canal aplasia in normal karyotype human females and is a syndrome with poorly defined etiology. Reproductive toxicity of phthalate esters (PEs) occurs in rat offspring exposed in utero, a phen...

In Utero Phthalate Effects in the Female Rat: A Model for MRKH Syndrome

EPA Science Inventory

Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is characterized by uterine and vaginal canal aplasia in normal karyotype human females and is a syndrome with poorly define etiology. Reproductive toxicity of phthlate esters (PEs) occurs in rat offspring exposed in utero. a phenome...

Dose and Effect Thresholds for Early Key Events in a Mode of PPARa-Mediated Action

EPA Science Inventory

ABSTRACT Strategies for predicting adverse health outcomes of environmental chemicals are centered on early key events in toxicity pathways. However, quantitative relationships between early molecular changes in a given pathway and later health effects are often poorly defined. T...

Health Science Education in Elementary Schools.

ERIC Educational Resources Information Center

Stier, William F., Jr.

Concern surrounding the status of health education in elementary schools centers around (1) a lack of agreement concerning content, scope, and sequence, (2) its interdisciplinary character, (3) poor teacher preparation, and (4) reliance on incidental teaching and learning situations. Improvement depends upon: (1) defining the areas of concern for…

Towards bioavailability-based soil criteria: Past, present and future perspectives

USDA-ARS?s Scientific Manuscript database

Bioavailability has been used as a key indicator in chemical risk assessment, yet it is a poorly quantified risk factor. Worldwide, the framework used to assess potentially contaminated sites is similar and the decisions are based on threshold contaminant concentration. The uncertainty in the defin...

Why is control of hypertension in sub-Saharan Africa poor?

PubMed Central

Seedat, YK

2015-01-01

In sub-Saharan Africa (SSA) in 2010, hypertension (defined as systolic blood pressure ≥ 115 mmHg) was the leading cause of death, increasing 67% since 1990. It was also the sixth leading cause of disability, contributing more than 11 million adjusted life years. In SSA, stroke was the main outcome of uncontrolled hypertension. Poverty is the major underlying factor for hypertension and cardiovascular disease. This article analyses the causes of poor compliance in the treatment of hypertension in SSA and provides suggestions on the treatment of hypertension in a poverty-stricken continent. PMID:26407222

Poor social support as a risk factor for antenatal depressive symptoms among women attending public antennal clinics in Penang, Malaysia.

PubMed

Rashid, Abdul; Mohd, Rokiah

2017-11-02

Depression, a type of mental disorder which is portrayed by marked alterations in mood, is associated with distress and/or impaired functioning. Poor social support is an important risk factor for depression in pregnancy. An extensive literature search failed to show any published study conducted in Malaysia on antenatal depressive symptoms and the risk of poor social support on it. The aim of the study was to determine the risk of antenatal depressive symptoms due to poor social support. This cross sectional study was conducted among 3000 pregnant women attending antenatal clinics in Penang, Malaysia. Edinburgh Postnatal Depression Scale (EPDS) was used to screen for antenatal depressive symptoms and the Oslo-3 Social Support Scale (OSS-3) was used to measure social support. Odds ratio and adjusted odds ratio were used to quantify the risk of antenatal depressive symptoms due to poor social support. The prevalence of depressive symptoms was 20%. Using OSS-3 scale to gauge social support, most of the participants had moderate support (61.3%) followed by poor support (22%) and strong support (16.7%). Social support was found to be significantly associated with depressive symptoms in this study (OR 2.2, aOR 2.1, AR 45%). Considering that an expecting mother's psychological factors are important in the wellbeing of the mother and child, antenatal depression must be quickly identified. Screening pregnant women for social support can help identify women with higher risk of depression.

Fear of falling predicts incidence of functional disability two years later: A perspective from an international cohort study.

PubMed

Auais, Mohammad; French, Simon; Alvarado, Beatriz; Pirkle, Catherine; Belanger, Emmanuelle; Guralnik, Jack

2017-12-06

To study the extent to which fear of falling (FOF) is associated with the onset of functional disability over a 2-year period in older adults using self-reported and performance-based measures. In 2012, 1,601 participants (aged 65-74) were recruited from four sites: Kingston and Saint-Hyacinthe, Canada; Manizales, Colombia; and Natal, Brazil. They were re-assessed in 2014. We quantified FOF using the Fall Efficacy Scale-International (FES-I; range: 16-64). Functional disability measures were 1) self-reported incident mobility disability, defined as difficulty climbing a flight of stairs or walking 400 meters and 2) incident poor physical performance, defined as a score <9 on the Short Physical Performance Battery. In the Poisson regression analysis, we included only those participants without functional disability at baseline to calculate incident risk ratios in 2014. 1,355 participants completed the 2014 assessment, of which 917 and 1,078 had no mobility disability and poor physical performance at baseline, respectively. In 2014, 131 (14.3%), and 166 (15.4%) participants reported incident mobility disability and poor physical performance, respectively. After adjusting for age, sex, socioeconomic, and health covariates, a one-point increase in FES-I at baseline was associated with a 4% increase in the risk of reporting incident mobility disability (95% CI: 1.02-1.05) and a 3% increase in the risk of developing poor physical performance at follow up in the overall sample (95%CI: 1.01-1.05). FOF is associated with a higher risk of incident mobility disability and poor physical performance in a cohort of older adults. It is increasingly important to study FOF's effect on functional disability and to take necessary measures to prevent the transition to end-stage disability. © The Author(s) 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Sleep Duration and Quality in Pregnant Women: A Cross-Sectional Survey in China.

PubMed

Xu, Xianglong; Liu, Dengyuan; Zhang, Zhangyi; Sharma, Manoj; Zhao, Yong

2017-07-20

Objectives: Good maternal health and fetal development require sufficient and good quality of sleep during pregnancy. This study investigated sleep duration and quality in pregnant women, assessing factors with possibly influence on sleep. Method: A cross-sectional survey was conducted on pregnant women between June and August in 2015 in 16 hospitals in five provinces in China. A total of 2345 pregnant women aged 18 years and older were surveyed. Insufficient sleeping duration was defined as sleeping of less than 7 h per day. Excessive sleep duration was defined as sleeping of more than 9 h per day. Results: A total of 561 (23.9%) participants reported insufficient sleeping duration, whereas 485 (20.9%) claimed excessive sleep duration. A total of 358 (15.2%) of pregnant women reported problems regarding sleep quality. Compared to pregnant women with sufficient sleeping duration, those with insufficient sleeping duration were prone to have poor sleep quality, whereas those with excessive sleeping duration featured low possibility of poor sleep quality. High-risk groups of insufficient sleep duration include women of Han nationality, with siblings, in their first trimester of pregnancy, receiving care in low-capacity/quality hospital settings, and with daily or 1-3 days of secondhand smoke exposure. High-risk groups of excessive sleep duration include women living in rural areas, unemployed, in their third trimester of pregnancy, and receiving care in medium-capacity/quality hospital settings. High-risk groups of poor sleep quality include women of non-Han nationality, low income level, in their third trimester of pregnancy, and with insufficient sleep duration. Conclusions: Insufficient/excessive sleep duration and poor sleep quality commonly occur during pregnancy in China. Findings provide a better understanding of the influencing factors of insufficient/excessive sleep duration and poor quality of sleep. These findings have some implications for future interventions on sleep among pregnant women.

Sleep Duration and Quality in Pregnant Women: A Cross-Sectional Survey in China

PubMed Central

Liu, Dengyuan; Zhang, Zhangyi; Zhao, Yong

2017-01-01

Objectives: Good maternal health and fetal development require sufficient and good quality of sleep during pregnancy. This study investigated sleep duration and quality in pregnant women, assessing factors with possibly influence on sleep. Method: A cross-sectional survey was conducted on pregnant women between June and August in 2015 in 16 hospitals in five provinces in China. A total of 2345 pregnant women aged 18 years and older were surveyed. Insufficient sleeping duration was defined as sleeping of less than 7 h per day. Excessive sleep duration was defined as sleeping of more than 9 h per day. Results: A total of 561 (23.9%) participants reported insufficient sleeping duration, whereas 485 (20.9%) claimed excessive sleep duration. A total of 358 (15.2%) of pregnant women reported problems regarding sleep quality. Compared to pregnant women with sufficient sleeping duration, those with insufficient sleeping duration were prone to have poor sleep quality, whereas those with excessive sleeping duration featured low possibility of poor sleep quality. High-risk groups of insufficient sleep duration include women of Han nationality, with siblings, in their first trimester of pregnancy, receiving care in low-capacity/quality hospital settings, and with daily or 1–3 days of secondhand smoke exposure. High-risk groups of excessive sleep duration include women living in rural areas, unemployed, in their third trimester of pregnancy, and receiving care in medium-capacity/quality hospital settings. High-risk groups of poor sleep quality include women of non-Han nationality, low income level, in their third trimester of pregnancy, and with insufficient sleep duration. Conclusions: Insufficient/excessive sleep duration and poor sleep quality commonly occur during pregnancy in China. Findings provide a better understanding of the influencing factors of insufficient/excessive sleep duration and poor quality of sleep. These findings have some implications for future interventions on sleep among pregnant women. PMID:28726747

Putting Motion in Emotion: Do Dynamic Presentations Increase Preschooler's Recognition of Emotion?

ERIC Educational Resources Information Center

Nelson, Nicole L.; Russell, James A.

2011-01-01

In prior research, preschoolers were surprisingly poor at naming the emotion purportedly signaled by prototypical facial expressions--when shown as static images. To determine whether this poor performance is due to the use of static stimuli, rather than dynamic, we presented preschoolers (3-5 years) with facial expressions as either static images…

The role of bedrock groundwater in rainfall-runoff response at hillslope and catchment scales

Treesearch

C. Gabrielli; J.J. McDonnell; W.T. Jarvis

2012-01-01

Bedrock groundwater dynamics in headwater catchments are poorly understood and poorly characterized. Direct hydrometric measurements have been limited due to the logistical challenges associated with drilling through hard rock in steep, remote and often roadless terrain. We used a new portable bedrock drilling system to explore bedrock groundwater dynamics aimed at...

Building Better Bridges: Teaching Adolescents Who Are Poor Readers in Eighth Grade to Comprehend History Text

ERIC Educational Resources Information Center

O'Connor, Rollanda E.; Beach, Kristen D.; Sanchez, Victoria; Bocian, Kathleen M.; Roberts, Sarana; Chan, Olivia

2017-01-01

Helping struggling readers to learn history content in middle school can be difficult due to heavy reading demands. In this study, researchers taught poor readers with and without disabilities in eighth grade to generate main idea statements; create, compare, and contrast paragraphs; and identify cause and effect relations, along with relevant…

Multidimensional poverty, household environment and short-term morbidity in India.

PubMed

Dehury, Bidyadhar; Mohanty, Sanjay K

2017-01-01

Using the unit data from the second round of the Indian Human Development Survey (IHDS-II), 2011-2012, which covered 42,152 households, this paper examines the association between multidimensional poverty, household environmental deprivation and short-term morbidities (fever, cough and diarrhoea) in India. Poverty is measured in a multidimensional framework that includes the dimensions of education, health and income, while household environmental deprivation is defined as lack of access to improved sanitation, drinking water and cooking fuel. A composite index combining multidimensional poverty and household environmental deprivation has been computed, and households are classified as follows: multidimensional poor and living in a poor household environment, multidimensional non-poor and living in a poor household environment, multidimensional poor and living in a good household environment and multidimensional non-poor and living in a good household environment. Results suggest that about 23% of the population belonging to multidimensional poor households and living in a poor household environment had experienced short-term morbidities in a reference period of 30 days compared to 20% of the population belonging to multidimensional non-poor households and living in a poor household environment, 19% of the population belonging to multidimensional poor households and living in a good household environment and 15% of the population belonging to multidimensional non-poor households and living in a good household environment. Controlling for socioeconomic covariates, the odds of short-term morbidity was 1.47 [CI 1.40-1.53] among the multidimensional poor and living in a poor household environment, 1.28 [CI 1.21-1.37] among the multidimensional non-poor and living in a poor household environment and 1.21 [CI 1.64-1.28] among the multidimensional poor and living in a good household environment compared to the multidimensional non-poor and living in a good household environment. Results are robust across states and hold good for each of the three morbidities: fever, cough and diarrhoea. This establishes that along with poverty, household environmental conditions have a significant bearing on short-term morbidities in India. Public investment in sanitation, drinking water and cooking fuel can reduce the morbidity and improve the health of the population.

Access to Mobile Communication Technology and Willingness to Participate in Automated Telemedicine Calls Among Chronically Ill Patients in Honduras

PubMed Central

Mendoza-Avelares, Milton O.; Milton, Evan C.; Lange, Ilta; Fajardo, Roosevelt

2010-01-01

Abstract Objectives: Patients in underdeveloped countries may be left behind by advances in telehealthcare. We surveyed chronically ill patients with low incomes in Honduras to measure their use of mobile technologies and willingness to participate in mobile disease management support. Materials and Methods: 624 chronically ill primary care patients in Honduras were surveyed. We examined variation in telephone access across groups defined by patients' sociodemographic characteristics, diagnoses, and access to care. Logistic regression was used to identify independent correlates of patients' interest in automated telephonic support for disease management. Results: Participants had limited education (mean 4.8 years), and 65% were unemployed. Eighty-four percent had telephone access, and 78% had cell phones. Most respondents had voicemail (61%) and text messaging (58%). Mobile technologies were particularly common among patients who had to forego clinic visits and medications due to cost concerns (each p < 0.05). Most patients (>80%) reported that they would be willing to receive automated calls focused on appointment reminders, medication adherence, health status monitoring, and self-care education. Patients were more likely to be willing to participate in automated telemedicine services if they had to cancel a clinic appointment due to transportation problems or forego medication due to cost pressures. Conclusions: Even in this poor region of Honduras, most chronically ill patients have access to mobile technology, and most are willing to participate in automated telephone disease management support. Given barriers to in-person care, new models of mobile healthcare should be developed for chronically ill patients in developing countries. PMID:21062234

Impaired Associative Taste Learning and Abnormal Brain Activation in Kinase-Defective eEF2K Mice

ERIC Educational Resources Information Center

Gildish, Iness; Manor, David; David, Orit; Sharma, Vijendra; Williams, David; Agarwala, Usha; Wang, Xuemin; Kenney, Justin W.; Proud, Chris G.; Rosenblum, Kobi

2012-01-01

Memory consolidation is defined temporally based on pharmacological interventions such as inhibitors of mRNA translation (molecular consolidation) or post-acquisition deactivation of specific brain regions (systems level consolidation). However, the relationship between molecular and systems consolidation are poorly understood. Molecular…

Academic Buoyancy: Towards an Understanding of Students' Everyday Academic Resilience

ERIC Educational Resources Information Center

Martin, Andrew J.; Marsh, Herbert W.

2008-01-01

Academic buoyancy is developed as a construct reflecting everyday academic resilience within a positive psychology context and is defined as students' ability to successfully deal with academic setbacks and challenges that are typical of the ordinary course of school life (e.g., poor grades, competing deadlines, exam pressure, difficult…

Developing Employability in Higher Education Music

ERIC Educational Resources Information Center

Bennett, Dawn

2016-01-01

The development of employability in higher music education concerns students, musicians, educators, administrators and funding bodies, and yet employability is both impossible to measure and poorly defined. This paper sets the context for a set of short papers that explore employability from the perspective of music. Because many of the issues…

Area of Concern: a new paradigm in life cycle assessment for the development of footprint metrics

EPA Science Inventory

Purpose: As a class of environmental metrics, footprints have been poorly defined, have shared an unclear relationship to life cycle assessment (LCA), and the variety of approaches to quantification have sometimes resulted in confusing and contradictory messages in the marketplac...

Least-mean-square spatial filter for IR sensors.

PubMed

Takken, E H; Friedman, D; Milton, A F; Nitzberg, R

1979-12-15

A new least-mean-square filter is defined for signal-detection problems. The technique is proposed for scanning IR surveillance systems operating in poorly characterized but primarily low-frequency clutter interference. Near-optimal detection of point-source targets is predicted both for continuous-time and sampled-data systems.

Inequality, Segregation and Poor Performance: The Education System in Northern Ireland

ERIC Educational Resources Information Center

Borooah, Vani K.; Knox, Colin

2017-01-01

Northern Ireland is now a post-conflict society but one of the legacies of the "troubles" is an education system which is defined by religious affiliation/identity. A parallel system of schools continues to exist where Catholics largely attend "maintained" schools and Protestants "controlled" or state schools. While…

Straussian Grounded-Theory Method: An Illustration

ERIC Educational Resources Information Center

Thai, Mai Thi Thanh; Chong, Li Choy; Agrawal, Narendra M.

2012-01-01

This paper demonstrates the benefits and application of Straussian Grounded Theory method in conducting research in complex settings where parameters are poorly defined. It provides a detailed illustration on how this method can be used to build an internationalization theory. To be specific, this paper exposes readers to the behind-the-scene work…

Self-Rated Estimates of Multiple Intelligences Based on Approaches to Learning

ERIC Educational Resources Information Center

Bowles, Terry

2008-01-01

To date questionnaires that measure Multiple Intelligences (MIs) have typically not been systematically developed, have poor psychometric properties, and relatively low reliability. The aim of this research was to define the factor structure, and reliability of nine talents which are the behavioural outcomes of MIs, using items representing…

Alkaloid profiling as an approach to differentiate Lupinus garfieldensis, Lupinus sabinianus, and Lupinus sericeus

USDA-ARS?s Scientific Manuscript database

Introduction – Many species in the Lupinus genus are poorly defined resulting in improper taxonomic identification. Lupine species may contain quinolizidine and/or piperidine alkaloids that can be acutely toxic and/or teratogenic resulting in crooked calf disease. Objective – To identify any char...

Building software tools to help contextualize and interpret monitoring data

USDA-ARS?s Scientific Manuscript database

Even modest monitoring efforts at landscape scales produce large volumes of data.These are most useful if they can be interpreted relative to land potential or other similar sites. However, for many ecological systems reference conditions may not be defined or are poorly described, which hinders und...

Associations among gut permeability, inflammatory markers, and symptoms in patients with irritable bowel syndrome

USDA-ARS?s Scientific Manuscript database

Alterations in gastrointestinal (GI) permeability and immune measures are present in some patients with irritable bowel syndrome (IBS) but the relationship to symptoms is poorly defined. In adults with IBS, we compared permeability, unstimulated peripheral blood monocyte (PBMC) interleukin-10 (IL-10...

A Conceptual Analysis of Key Concepts in Inclusive Education

ERIC Educational Resources Information Center

Boston-Kemple, Thomas Ernest

2012-01-01

The concepts of an inclusive classroom, inclusion, co-teaching, and disability have been called poorly defined and in need of fresh conceptual analyses. In Chapter 1, I respond to this call for further analysis and then demonstrate, using current educational headlines, that these concepts of "an inclusive classroom,"…

Contacting the Government among College Students

ERIC Educational Resources Information Center

Yaghi, Abdulfattah

2009-01-01

The literature on political participation indicates that initiating contacts with the government is a vital form of civic engagement. Using this criterion to define participation, some researchers claim that students in general are apathetic about government and have poor efficacy about public affairs. The present study examines this assumption by…

The "Developing" Achievement Gap: Colombian Voucher Reform

ERIC Educational Resources Information Center

Stern, Jonathan M. B.

2014-01-01

The achievement gap in many developing countries is defined in terms of rich/poor and public/private. The prevailing explanation for the "developing" achievement gap is an underfunded, inefficient, and/or inadequately supplied public school sector. Via an analysis of a Colombian voucher experiment, this article examines the extent to…

Antibiotic growth promoter-induced changes in the chicken intestine: A metabolomics analysis of virginiamycin and bacitracin methylene disalicylate

USDA-ARS?s Scientific Manuscript database

Abstract Although dietary antibiotic growth promoters have long been used to increase growth performance in commercial food animal production, the biochemical details associated with these effects remain poorly defined. A metabolomics approach was used to characterize and identify the biochemical co...

Understanding the carotenoid biosynthetic pathway through observation of four color variants of developing watermelon (Citrullus lanatus (Thunb.) Matsum. & Nanai)

USDA-ARS?s Scientific Manuscript database

The carotenoid biosynthetic pathway regulatory mechanisms leading to lycopene accumulation are well defined in the model fruit, tomato (Lycopersicon esculentum L.). The regulatory mechanisms leading to accumulation of other carotenoids and flesh colors, however, are poorly understood. The variety ...

Toward Programmatic Research on Virtue Assessment: Challenges and Prospects

ERIC Educational Resources Information Center

Fowers, Blaine J.

2014-01-01

Poor construct definition has characterized research on virtue, beginning with Hartshorne and May's honesty studies and continuing to the present. Recently, scholars have begun to define virtues in ways that improve the prospects for measuring virtue constructs, but a coordinated, programmatic approach is necessary for success in virtue…

A Simple View of Linguistic Complexity

ERIC Educational Resources Information Center

Pallotti, Gabriele

2015-01-01

Although a growing number of second language acquisition (SLA) studies take linguistic complexity as a dependent variable, the term is still poorly defined and often used with different meanings, thus posing serious problems for research synthesis and knowledge accumulation. This article proposes a simple, coherent view of the construct, which is…

Trends in Labor Force Participation: How Much is Due to Changes in Pensions?

PubMed Central

Rohwedder, Susann

2011-01-01

In the United States, beginning in the late 1980s there was a substantial increase in the labor force participation of men and women in their 60s. Over the same time period the type of pension plans offered by employers shifted strongly from defined benefit plans to defined contribution plans. Defined benefit plans typically have optimal retirement ages embedded in their structure which induce early retirement, whereas defined contribution plans do not favor any particular retirement age. Based on panel data, this paper quantifies the increase in participation due to the change in pension structure. The main result is that the pension changes account for a considerable part of the increase, but other factors also made a contribution. PMID:21857886

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

Kubicek, Gregory J., E-mail: kubicek-gregory@cooperhealth.edu; Turtz, Alan; Xue, Jinyu

Purpose: Patients with poor performance status (PS), usually defined as a Karnofsky Performance Status of 60 or less, were not eligible for randomized stereotactic radiosurgery (SRS) studies, and many guidelines suggest that whole-brain radiation therapy (WBRT) is the most appropriate treatment for poor PS patients. Methods and Materials: In this retrospective review of our SRS database, we identified 36 patients with PS of 60 or less treated with SRS for central nervous system (CNS) metastatic disease. PS, as defined by the Karnofsky Performance Status, was 60 (27 patients), 50 (8 patients), or 40 (1 patient). The median number of CNSmore » lesions treated was 3. Results: Median overall survival (OS) was 7.2 months (range, 0.73-25.6 months). Fifteen patients (41%) were alive at 6 months, and 6 patients (16.6%) were alive at 1 year. There was no difference in OS in patients who underwent previous WBRT. There were no local failures or cases of radiation toxicity. Distant CNS failures were seen in 9 patients (25%). Conclusions: Our patients with poor PS had reasonable median OS and relatively low distant CNS failure rates. Patients in this patient population may be ideal candidates for SRS compared with WBRT given the low incidence of distant failure over their remaining lives and the favorable logistics of single-fraction treatment for these patients with debility and their caregivers.« less

Trends in financial satisfaction: does poverty make a difference?

PubMed

Hsieh, Chang-Ming

2002-01-01

Gerontological studies on financial satisfaction have been limited by the dearth of longitudinal research and the lack of research that includes the concept of poverty. In order to bridge these gaps, this longitudinal study examines and compares the intracohort and intercohort effects on financial satisfaction trends by poverty status among Americans age 45 and above, using data from the General Social Surveys. The results suggest that for both the poor and the non-poor, changes in financial satisfaction trends are mostly due to strong negative intercohort effects, indicating that younger cohorts are less satisfied financially than the older ones. There appears to be a significant difference in the intercohort effects of financial satisfaction trends between the poor and the non-poor. However, such difference can be accounted for by the differences in the effects of education and social comparison (or relative deprivation) on financial satisfaction between the poor and the non-poor.

Certain and possible rules for decision making using rough set theory extended to fuzzy sets

NASA Technical Reports Server (NTRS)

Dekorvin, Andre; Shipley, Margaret F.

1993-01-01

Uncertainty may be caused by the ambiguity in the terms used to describe a specific situation. It may also be caused by skepticism of rules used to describe a course of action or by missing and/or erroneous data. To deal with uncertainty, techniques other than classical logic need to be developed. Although, statistics may be the best tool available for handling likelihood, it is not always adequate for dealing with knowledge acquisition under uncertainty. Inadequacies caused by estimating probabilities in statistical processes can be alleviated through use of the Dempster-Shafer theory of evidence. Fuzzy set theory is another tool used to deal with uncertainty where ambiguous terms are present. Other methods include rough sets, the theory of endorsements and nonmonotonic logic. J. Grzymala-Busse has defined the concept of lower and upper approximation of a (crisp) set and has used that concept to extract rules from a set of examples. We will define the fuzzy analogs of lower and upper approximations and use these to obtain certain and possible rules from a set of examples where the data is fuzzy. Central to these concepts will be the idea of the degree to which a fuzzy set A is contained in another fuzzy set B, and the degree of intersection of a set A with set B. These concepts will also give meaning to the statement; A implies B. The two meanings will be: (1) if x is certainly in A then it is certainly in B, and (2) if x is possibly in A then it is possibly in B. Next, classification will be looked at and it will be shown that if a classification will be looked at and it will be shown that if a classification is well externally definable then it is well internally definable, and if it is poorly externally definable then it is poorly internally definable, thus generalizing a result of Grzymala-Busse. Finally, some ideas of how to define consensus and group options to form clusters of rules will be given.

The effect of zolpidem on sleep quality, stress status, and nondipping hypertension.

PubMed

Huang, Yuli; Mai, Weiyi; Cai, Xiaoyan; Hu, Yunzhao; Song, Yuanbin; Qiu, Ruofeng; Wu, Yanxian; Kuang, Jian

2012-03-01

Poor sleep quality and stress status have previously been shown to be closely associated with higher activation of the sympathetic nervous system and to be independent predictors of nondipping hypertension. This study aimed to evaluate the effects of the non-hypotensive sedative zolpidem on sleep quality, stress status, and nondipping hypertension. A total of 103 nondippers were defined as poor or good sleepers by the Pittsburgh Sleep Quality Index. They were randomized to receive zolpidem or placebo treatment for 30 days. Stress status was assessed by the Perceived Stress Scale, and levels of epinephrine and norepinephrine were examined to investigate the underlying mechanisms. Poor sleepers treated with zolpidem for 30 days showed significant improvements in sleep quality and stress levels (P<0.01). More nondippers were converted to dippers in the group of poor sleepers treated with zolpidem (11 of 22 patients, 50.0%) than in the placebo (2 of 23, 8.7%) (P<0.01). Epinephrine and norepinephrine levels were significantly reduced in poor sleepers treated with zolpidem (P<0.05). The results of this study suggest that zolpidem can improve sleep quality and stress status, and can convert nondippers with poor sleep quality into dippers. It may be an option for treating nondipping hypertensive patients with poor sleep quality. Copyright © 2011 Elsevier B.V. All rights reserved.

Power quality improvement by using STATCOM control scheme in wind energy generation interface to grid

NASA Astrophysics Data System (ADS)

Kirmani, Sheeraz; Kumar, Brijesh

2018-01-01

“Electric Power Quality (EPQ) is a term that refers to maintaining the near sinusoidal waveform of power distribution bus voltages and currents at rated magnitude and frequency”. Today customers are more aware of the seriousness that the power quality possesses, this prompt the utilities to assure good quality of power to their customer. The power quality is basically customer centric. Increased focus of utilities toward maintaining reliable power supply by employing power quality improvement tools has reduced the power outages and black out considerably. Good power quality is the characteristic of reliable power supply. Low power factor, harmonic pollution, load imbalance, fast voltage variations are some common parameters which are used to define the power quality. If the power quality issues are not checked i.e. the parameters that define power quality doesn't fall within the predefined standards than it will lead into high electricity bill, high running cost in industries, malfunctioning of equipments, challenges in connecting renewable. Capacitor banks, FACTS devices, harmonic filters, SVC’s (static voltage compensators), STATCOM (Static-Compensator) are the solutions to achieve the power quality. The performance of Wind turbine generators is affected by poor quality power, at the same time these wind power generating plant affects the power quality negatively. This paper presents the STATCOM-BESS (battery energy storage system) system and studies its impact on the power quality in a system which consists of wind turbine generator, non linear load, hysteresis controller for controlling the operation of STATCOM and grid. The model is simulated in the MATLAB/Simulink. This scheme mitigates the power quality issues, improves voltage profile and also reduces harmonic distortion of the waveforms. BESS level out the imbalances caused in real power due to intermittent nature of wind power available due to varying wind speeds.

Live birth rates in the different combinations of the Bologna criteria poor ovarian responders: a validation study.

PubMed

La Marca, Antonio; Grisendi, Valentina; Giulini, Simone; Sighinolfi, Giovanna; Tirelli, Alessandra; Argento, Cindy; Re, Claudia; Tagliasacchi, Daniela; Marsella, Tiziana; Sunkara, Sesh Kamal

2015-06-01

to compare the baseline characteristics and chance of live birth in the different categories of poor responders identified by the combinations of the Bologna criteria and establish whether these groups comprise a homogenous population. database containing clinical and laboratory information on IVF treatment cycles carried out at the Mother-Infant Department of the University Hospital of Modena between year 2007 and 2011 was analysed. This data was collected prospectively and recorded in the registered database of the fertility centre. Eight hundred and thirty women fulfilled the inclusion/ exclusion criteria of the study and 210 women fulfilled the Bologna criteria definition for poor ovarian response (POR). Five categories of poor responders were identified by different combinations of the Bologna criteria. There were no significant differences in female age, AFC, AMH, cycle cancellation rate and number of retrieved oocytes between the five groups. The live birth rate ranged between 5.5 and 7.4 % and was not statistically different in the five different categories of women defined as poor responders according to the Bologna criteria. The study demonstrates that the different groups of poor responders based on the Bologna criteria have similar IVF outcomes. This information validates the Bologna criteria definition as women having a uniform poor prognosis and also demonstrates that the Bologna criteria poor responders in the various subgroups represent a homogenous population with similar pre-clinical and clinical outcomes.

Comparison of the Diagnostic Accuracy of Three Rapid Tests for the Serodiagnosis of Hepatic Cystic Echinococcosis in Humans

PubMed Central

Tamarozzi, Francesca; Covini, Ilaria; Mariconti, Mara; Narra, Roberta; Tinelli, Carmine; De Silvestri, Annalisa; Manzoni, Federica; Casulli, Adriano; Ito, Akira; Neumayr, Andreas; Brunetti, Enrico

2016-01-01

Background The diagnosis of cystic echinococcosis (CE) is based primarily on imaging, in particular with ultrasound for abdominal CE, complemented by serology when imaging results are unclear. In rural endemic areas, where expertise in ultrasound may be scant and conventional serology techniques are unavailable due to lack of laboratory equipment, Rapid Diagnostic Tests (RDTs) are appealing. Methodology/Principal Findings We evaluated the diagnostic accuracy of 3 commercial RDTs for the diagnosis of hepatic CE. Sera from 59 patients with single hepatic CE cysts in well-defined ultrasound stages (gold standard) and 25 patients with non-parasitic cysts were analyzed by RDTs VIRapid HYDATIDOSIS (Vircell, Spain), Echinococcus DIGFA (Unibiotest, China), ADAMU-CE (ICST, Japan), and by RIDASCREEN Echinococcus IgG ELISA (R-Biopharm, Germany). Sensitivity, specificity and ROC curves were compared with McNemar and t-test. For VIRapid and DIGFA, correlation between semiquantitative results and ELISA OD values were evaluated by Spearman’s coefficient. Reproducibility was assessed on 16 randomly selected sera with Cohen’s Kappa coefficient. Sensitivity and Specificity of VIRapid (74%, 96%) and ADAMU-CE (57%, 100%) did not differ from ELISA (69%, 96%) while DIGFA (72%, 72%) did (p = 0.045). ADAMU-CE was significantly less sensitive in the diagnosis of active cysts (p = 0.019) while DIGFA was significantly less specific (p = 0.014) compared to ELISA. All tests were poorly sensitive in diagnosing inactive cysts (33.3% ELISA and ADAMU-CE, 42.8% DIGFA, 47.6% VIRapid). The reproducibility of all RDTs was good-very good. Band intensity of VIRapid and DIGFA correlated with ELISA OD values (r = 0.76 and r = 0.79 respectively, p<0.001). Conclusions/Significance RDTs may be useful in resource-poor settings to complement ultrasound diagnosis of CE in uncertain cases. VIRapid test appears to perform best among the examined kits, but all tests are poorly sensitive in the presence of inactive cysts, which may pose problems with accurate diagnosis. PMID:26871432

Different effectiveness of closed embryo culture system with time-lapse imaging (EmbryoScope(TM)) in comparison to standard manual embryology in good and poor prognosis patients: a prospectively randomized pilot study.

PubMed

Wu, Yan-Guang; Lazzaroni-Tealdi, Emanuela; Wang, Qi; Zhang, Lin; Barad, David H; Kushnir, Vitaly A; Darmon, Sarah K; Albertini, David F; Gleicher, Norbert

2016-08-24

Previously manual human embryology in many in vitro fertilization (IVF) centers is rapidly being replaced by closed embryo incubation systems with time-lapse imaging. Whether such systems perform comparably to manual embryology in different IVF patient populations has, however, never before been investigated. We, therefore, prospectively compared embryo quality following closed system culture with time-lapse photography (EmbryoScope™) and standard embryology. We performed a two-part prospectively randomized study in IVF (clinical trial # NCT92256309). Part A involved 31 infertile poor prognosis patients prospectively randomized to EmbryoScope™ and standard embryology. Part B involved embryos from 17 egg donor-recipient cycles resulting in large egg/embryo numbers, thus permitting prospectively alternative embryo assignments to EmbryoScope™ and standard embryology. We then compared pregnancy rates and embryo quality on day-3 after fertilization and embryologist time utilized per processed embryo. Part A revealed in poor prognosis patients no differences in day-3 embryo scores, implantation and clinical pregnancy rates between EmbryoScope™ and standard embryology. The EmbryoScope™, however, more than doubled embryology staff time (P < 0.0001). In Part B, embryos grown in the EmbyoScope™ demonstrated significantly poorer day-3 quality (depending on embryo parameter between P = 0.005 and P = 0.01). Suspicion that conical culture dishes of the EmbryoScope™ (EmbryoSlide™) may be the cause was disproven when standard culture dishes demonstrated no outcome difference in standard incubation. Though due to small patient numbers preliminary, this study raises concerns about the mostly uncontrolled introduction of closed incubation systems with time lapse imaging into routine clinical embryology. Appropriately designed and powered prospectively randomized studies appear urgently needed in well-defined patient populations before the uncontrolled utilization of these instruments further expands. NCT02246309 Registered September 18, 2014.

Predicting dementia in primary care patients with a cardiovascular health metric: a prospective population-based study.

PubMed

Hessler, Johannes Baltasar; Ander, Karl-Heinz; Brönner, Monika; Etgen, Thorleif; Förstl, Hans; Poppert, Holger; Sander, Dirk; Bickel, Horst

2016-07-26

Improving cardiovascular health possibly decreases the risk of dementia. Primary care practices offer a suitable setting for monitoring and controlling cardiovascular risk factors in the older population. The purpose of the study is to examine the association of a cardiovascular health metric including six behaviors and blood parameters with the risk of dementia in primary care patients. Participants (N = 3547) were insurants aged ≥55 of the largest German statutory health insurance company, who were enrolled in a six-year prospective population-based study. Smoking, physical activity, body mass index, blood pressure, total cholesterol, and fasting glucose were assessed by general practitioners at routine examinations. Using recommended cut-offs for each factor, the patients' cardiovascular health was classified as ideal, moderate, or poor. Behaviors and blood parameters sub-scores, as well as a total score, were calculated. Dementia diagnoses were retrieved from health insurance claims data. Results are presented as hazard ratios (HRs) and 95% confidence intervals (95% CIs). Over the course of the study 296 new cases of dementia occurred. Adjusted for age, sex, and education, current smoking (HR = 1.77, 95% CI 1.09-2.85), moderate (1.38, 1.05-1.81) or poor (1.81, 1.32-2.47) levels of physical activity, and poor fasting glucose levels (1.43, 1.02-2.02) were associated with an increased risk of dementia. Body mass index, blood pressure, and cholesterol were not associated with dementia. Separate summary scores for behaviors and blood values, as well as a total score showed no association with dementia. Sensitivity analyses with differently defined endpoints led to similar results. Due to complex relationships of body-mass index and blood pressure with dementia individual components cancelled each other out and rendered the sum-scores meaningless for the prediction of dementia.

Prevalence and determinants of cigarette smoking among adolescents in secondary schools in Port Harcourt, Southern Nigeria.

PubMed

Okagua, Joyce; Opara, Peace; Alex-Hart, Balafama A

2016-02-01

Cigarette smoking remains a major preventable public health problem associated with premature deaths worldwide. Adolescence is a unique developmental stage between childhood and adulthood. Smoking is a lifestyle habit acquired during adolescence and into adulthood, with its associated morbidity and mortality. It is therefore important to determine the factors associated with cigarette smoking in these adolescents in order to institute preventive measures and health policies to protect these adolescents early. This study aims to determine the prevalence of smoking, factors associated with smoking, and knowledge of the harmful effects of smoking in these adolescents. A cross-sectional study of 1120 adolescents aged 10-19 years selected from 10 secondary schools in Port Harcourt was conducted using a multistage sampling technique. The Global Youth Tobacco Survey (GYTS) core questionnaire was used to collect data from the subjects. A smoker was defined as one who had ever smoked a cigarette or who had one or two puffs, while a current smoker was defined as one who had taken a puff or smoked cigarettes in the last 30 days preceding the day of the questionnaire's completion. Eighty subjects (7.1%) were smokers. This was significantly (p=<0.001) higher in males (9.7%) than in females (4%). Thirty seven (3.3%) subjects were current smokers. The mean age at which smoking was initiated was 12.47±3.0 years. Twenty six (32.5%) of the smokers reported that they were initiated into cigarette smoking by their friends, 36 (45%) just wanted to experiment, 7 (8.8%) were influenced by media advertisements while 5 (6.3%) were due to parental exposure. Parental history of smoking and poor knowledge of cancer of the lungs as a harmful effect of smoking, was significantly (p=<0.05) associated with cigarette smoking. The prevalence of smoking in adolescents in Port Harcourt is high and is associated with parental smoking and poor knowledge of cancer of the lungs as a harmful effect. We recommend that adolescent health education with an emphasis on the harmful effects of smoking be included in the curriculum of all secondary schools.

Prospective clinical study to evaluate an oscillometric blood pressure monitor in pet rabbits.

PubMed

Bellini, Luca; Veladiano, Irene A; Schrank, Magdalena; Candaten, Matteo; Mollo, Antonio

2018-02-27

Rabbits are particularly sensitive to develop hypotension during sedation or anaesthesia. Values of systolic or mean non-invasive arterial blood pressure below 80 or 60 mmHg respectively are common under anaesthesia despite an ongoing surgery. A reliable method of monitoring arterial blood pressure is extremely important, although invasive technique is not always possible due to the anatomy and dimension of the artery. The aim of this study was to evaluate the agreement between a new oscillometric device for non-invasive arterial blood pressure measurement and the invasive method. Moreover the trending ability of the device, ability to identify changes in the same direction with the invasive methods, was evaluated as well as the sensibility of the device in identifying hypotension arbitrarily defined as invasive arterial blood pressure below 80 or 60 mmHg. Bland-Altman analysis for repeated measurements showed a poor agreement between the two methods; the oscillometric device overestimated the invasive arterial blood pressure, particularly at high arterial pressure values. The same analysis repeated considering oscillometric measurement that match invasive mean pressure lower or equal to 60 mmHg showed a decrease in biases and limits of agreement between methods. The trending ability of the device, evaluated with both the 4-quadrant plot and the polar plot was poor. Concordance rate of mean arterial blood pressure was higher than systolic and diastolic pressure although inferior to 90%. The sensibility of the device in detecting hypotension defined as systolic or mean invasive arterial blood pressure lower than 80 or 60 mmHg was superior for mean oscillometric pressure rather than systolic. A sensitivity of 92% was achieved with an oscillometric measurement for mean pressure below 65 mmHg instead of 60 mmHg. Non-invasive systolic blood pressure is less sensitive as indicator of hypotension regardless of the cutoff limit considered. Although mean invasive arterial blood pressure is overestimated by the device, the sensitivity of this non-invasive oscillometric monitor in detecting invasive mean pressure below 60 mmHg is acceptable but a cutoff value of 65 mmHg needs to be used.

Endophthalmitis in eyes presenting with orbital signs: a case-control study.

PubMed

Rishi, Pukhraj; Rishi, Ekta; Nandi, Krishnendu; Khan, Balbir

2010-03-01

The purpose of this study was to assess the clinical profile and treatment outcomes in eyes with endophthalmitis presenting with orbital signs. A case-control study of 24 eyes with endophthalmitis and orbital signs at presentation (defined as ocular motility restriction and/or presence of " inverted perpendicular" sign on ultrasonography) was conducted between January 2000 and December 2006. The control group was constituted of 40 age- and sex-matched eyes with endophthalmitis presenting without orbital signs. Optimal structural outcome was defined as resolution of inflammation and infection. Adverse structural outcome was defined as development of phthisis bulbi or need for evisceration or development of retinal detachment. Optimal functional outcome was defined as improvement in postoperative visual acuity to 3/60 or better. The Pearson chi-square test was used with appropriate significance (P < or = 0.05) to compare the mean visual acuity before and after treatment. Twenty-four patients with a mean age of 46.4 years and a mean follow-up of 14.6 months were included. Treatment options included intravitreal antibiotics, vitrectomy, evisceration, and systemic antibiotics. Optimal structural outcome was achieved in 6 (25%) eyes. A total of 70.8% eyes had no light perception, whereas 4 (16.66%) patients regained ambulatory vision (>3/60). There was a statistically significant poor visual (P = 0.05) and structural outcome (P = 0.004), whereas in the control group, 25 patients (62.5%) had vision 3/60 or better (P = 0.001). Orbital signs are independent risk factors for poor structural and visual outcomes in eyes with endophthalmitis.

Measurement of the controlled variable during heating of Ti6Al4V for thixoforging

NASA Astrophysics Data System (ADS)

Gerlach, O.; Lechler, A.; Verl, A.

2018-02-01

Controlled heating of metal billets into the semi-solid state for thixoforming is a challenging task, mainly due to the difficulties in measuring the liquid fraction of the billet during heating. Past research primarily focused on methods measuring the liquid fraction during heating of low-melting aluminium alloys. One of these methods is time constant measurement, a contactless measurement method that uses the heating coil as a sensor. The current through the coil is used to determine the electrical time constant of the heating circuit, which itself is influenced by the specific resistance of the billet inside the coil. While previous works focused on the suitability of this method for industrial applications using aluminum alloys, this paper extends this research to the high-melting titanium alloy Ti6Al4V. This alloys shows high strength, low density and excellent corrosion resistance. It is therefore used to produce light-weight and durable components for medical and aerospace applications. Ti6Al4V is an expensive and difficult to machine alloy. Thus, it is an interesting alloy for thixoforging. However, heating of the billet into a homogeneous state of defined liquid fraction is difficult due to the poor thermal conductivity of Ti6Al4V. This paper analyses the potential of using time constant measurement for controlled heating of Ti6Al4V into the semi-solid state.

The behavioral phenotype of the idic(15) syndrome.

PubMed

Battaglia, Agatino; Parrini, Barbara; Tancredi, Raffaella

2010-11-15

Idic(15) syndrome is a neurogenetic disorder clinically delineated by early central hypotonia, developmental delay and intellectual disability (ID), epilepsy, absent or very poor speech, and autistic or autistic-like behavior. It is due to the presence of a supernumerary marker chromosome formed by the inverted duplication of proximal chromosome 15, resulting in tetrasomy 15p and partial tetrasomy 15q, and containing the Prader-Willi/Angelman syndrome critical region (PWS/ASCR). The vast majority of these idic(15) derives from the two homologous maternal chromosomes at meiosis. To better define the behavior profile, we studied 22 idic(15) children (15 males and 7 females) observed at our institute between 1986 and 2010, and present, in detail, case studies of five of them. We have been able to perform standardized and semi-standardized measures of intelligence, and psychopathology in only 13 of our 22 patients, due to the limitations of chronological age, and to the severity of ID (ranging from mild-moderate, in 15%, to severe-profound, in 85% of our sample). The results show a distinct developmental profile in idic(15) patients, that may provide a behavioral signature for autism spectrum disorder (ASD)/ASD-like arising from the susceptibility locus on proximal 15q; and suggest that idic(15) individuals are not "true autistic," but distinct "autistic-like" persons with high score in the third ADOS-G and ADI-R area. © 2010 Wiley-Liss, Inc.

Is it me? Verbal self-monitoring neural network and clinical insight in schizophrenia

PubMed Central

Sapara, Adegboyega; ffytche, Dominic H.; Cooke, Michael A.; Williams, Steven C.R.; Kumari, Veena

2015-01-01

Self-monitoring, defined as the ability to distinguish between self-generated stimuli from other-generated ones, is known to be impaired in schizophrenia. This impairment has been theorised as the basis for many of the core psychotic symptoms, in particular, poor clinical insight. This study aimed to investigate verbal self-monitoring related neural substrates of preserved and poor clinical insight in schizophrenia. It involved 40 stable schizophrenia outpatients, 20 with preserved and 20 with poor insight, and 20 healthy participants. All participants underwent functional magnetic resonance imaging with brain coverage covering key areas in the self-monitoring network during a verbal self-monitoring task. Healthy participants showed higher performance accuracy and greater thalamic activity than both preserved and poor insight patient groups. Preserved insight patients showed higher activity in the putamen extending into the caudate, insula and inferior frontal gyrus, compared to poor insight patients, and in the anterior cingulate and medial frontal gyrus, compared to healthy participants. Poor insight patients did not show greater activity in any brain area compared to preserved insight patients or healthy participants. Future studies may pursue therapeutic avenues, such as meta-cognitive therapies to promote self-monitoring or targeted stimulation of relevant brain areas, as means of enhancing insight in schizophrenia. PMID:26549744

Adherence to isoniazid preventive therapy in Indonesian children: A quantitative and qualitative investigation

PubMed Central

2012-01-01

Background It is recommended that young child contacts of sputum smear positive tuberculosis cases receive isoniazid preventive therapy (IPT) but reported adherence is low and risk factors for poor adherence in children are largely unknown. Methods We prospectively determined rates of IPT adherence in children < 5 yrs in an Indonesian lung clinic. Possible risk factors for poor adherence, defined as ≤3 months prescription collection, were calculated using logistic regression. To further investigate adherence barriers in-depth interviews were conducted with caregivers of children with good and poor adherence. Results Eighty-two children eligible for IPT were included, 61 (74.4%) of which had poor adherence. High transport costs (OR 3.3, 95% CI 1.1-10.2) and medication costs (OR 20.0, 95% CI 2.7-414.5) were significantly associated with poor adherence in univariate analysis. Access, medication barriers, disease and health service experience and caregiver TB and IPT knowledge and beliefs were found to be important determinants of adherence in qualitative analysis. Conclusion Adherence to IPT in this setting in Indonesia is extremely low and may result from a combination of financial, knowledge, health service and medication related barriers. Successful reduction of childhood TB urgently requires evidence-based interventions that address poor adherence to IPT. PMID:22221424

Copy number losses define subgroups of dedifferentiated liposarcoma with poor prognosis and genomic instability.

PubMed

Crago, Aimee M; Socci, Nicholas D; DeCarolis, Penelope; O'Connor, Rachael; Taylor, Barry S; Qin, Li-Xuan; Antonescu, Cristina R; Singer, Samuel

2012-03-01

Molecular events underlying progression of well-differentiated liposarcoma (WDLS) to dedifferentiated liposarcoma (DDLS) are poorly defined. This study sought to identify copy number alterations (CNA) associated with dedifferentiation of WDLS, with DDLS morphology, and with patient outcomes. Fifty-five WDLS and 52 DDLS were analyzed using Agilent 244K comparative genomic hybridization and Affymetrix U133A expression arrays. CNAs were identified by RAE analysis. Thirty-nine of the DDLS specimens were categorized morphologically by a single pathologist. Nine regions of CNA were identified as recurrent in DDLS but not WDLS; 79% of DDLS had at least one of these CNAs. Loss of the chromosome segment 11q23-24, the most common event, was observed only in DDLS that morphologically resembled the genomically complex sarcomas, undifferentiated pleomorphic sarcoma and myxofibrosarcoma. 11q23-24 loss was itself associated with increased genomic complexity in DDLS. Loss of 19q13, but not 11q23-24, was associated with poor prognosis. Median disease-specific survival was shorter for patients with19q13 loss (27 months) than for patients with diploid 19q13 (>90 months; P < 0.0025), and 19q13 loss was associated with local recurrence (HR, 2.86; P = 0.013). Common copy number losses were associated with transcriptional downregulation of potential tumor suppressors and adipogenesis-related genes (e.g., EI24 and CEBPA). Dedifferentiation of WDLS is associated with recurrent CNAs in 79% of tumors. In DDLS, loss of 11q23-24 is associated with genomic complexity and distinct morphology whereas loss of 19q13 predicts poor prognosis. CNAs in liposarcoma improve risk stratification for patients and will help identify potential tumor suppressors driving liposarcoma progression.

Copy number losses define subgroups of dedifferentiated liposarcoma with poor prognosis and genomic instability

PubMed Central

Crago, Aimee M.; Socci, Nicholas D.; DeCarolis, Penelope; O'Connor, Rachael; Taylor, Barry S.; Qin, Li-Xuan; Antonescu, Cristina R.; Singer, Samuel

2012-01-01

Purpose Molecular events underlying progression of well-differentiated liposarcoma (WDLS) to dedifferentiated liposarcoma (DDLS) are poorly defined. This study sought to identify copy number alterations (CNAs) associated with dedifferentiation of WDLS, with DDLS morphology, and with patient outcomes. Experimental Design 55 WDLS and 52 DDLS were analyzed using Agilent 244K comparative genomic hybridization and Affymetrix U133A expression arrays. CNAs were identified by RAE analysis. Thirty-nine of the DDLS specimens were categorized morphologically by a single pathologist. Results Nine regions of CNA were identified as recurrent in DDLS but not WDLS; 79% of DDLS had at least one of these CNAs. Loss of the chromosome segment 11q23–24, the most common event, was observed only in DDLS that morphologically resembled the genomically complex sarcomas undifferentiated pleomorphic sarcoma and myxofibrosarcoma. 11q23–24 loss was itself associated with increased genomic complexity in DDLS. Loss of 19q13, but not 11q23–24, was associated with poor prognosis. Median disease-specific survival was shorter for patients with19q13 loss (27 months) than for patients with diploid 19q13 (>90 months; p<0.0025), and 19q13 loss was associated with local recurrence (HR 2.86, p=0.013). Common copy number losses were associated with transcriptional downregulation of potential tumor suppressors and adipogenesis-related genes (e.g., EI24 and CEBPA). Conclusions Dedifferentiation of WDLS is associated with recurrent CNAs in 79% of tumors. In DDLS, loss of 11q23–24 is associated with genomic complexity and distinct morphology while loss of 19q13 predicts poor prognosis. CNAs in liposarcoma improve risk stratification for patients and will help identify potential tumor suppressors driving liposarcoma progression. PMID:22241790

Refining the Association of Fever with Functional Outcome in Aneurysmal Subarachnoid Hemorrhage.

PubMed

Kramer, Christopher L; Pegoli, Marianna; Mandrekar, Jay; Lanzino, Giuseppe; Rabinstein, Alejandro A

2017-02-01

We analyzed the impact of cause, severity, and duration of fever on functional outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). Fever characteristics were analyzed in 584 consecutive patients with aSAH. Fever was defined as core body temperature ≥38.3 °C on ≥2 consecutive days. Subfebrile measurements were those between 37 and 38.2 °C. Febrile and subfebrile loads were the number of hours with fever or subfebrile measurements, respectively. Univariate and multivariate logistic regression models were developed to define predictors of outcome using various categorizations of fever cause, severity, and duration. Febrile measurements were observed in 281/584 (48.1 %) patients, recurring over a mean duration of 2.1 ± 3.0 days. Early fever within 24 and 72 h was encountered in 69 (11.9 %) and 110 (18.9 %) of patients, respectively. An infectious source was discovered in 126 (44.8 %) febrile patients. On univariate analysis, days of fever, febrile load, and fever onset within 24 and 72 h were associated with poor outcome (all p < 0.001); but subfebrile load was not (p = 0.56). On multivariate model constructed with all variables associated with outcome on univariate analyses, days of fever remained independently associated with poor outcome (OR 1.14 of poor outcome per day of fever, 95 % CI 1.06-1.22; p = 0.0006) displacing all other fever measures from the final model. Early onset of fever, number of hours with fever, and especially days of fever are associated with poor functional outcome. Conversely, subfebrile load does not influence clinical outcome. These data suggest prolonged fever should be avoided, but subfebrile temperatures may not justify intervention.

Comorbidity amplifies the effects of post-9/11 posttraumatic stress disorder trajectories on health-related quality of life.

PubMed

Li, Jiehui; Zweig, Kimberly Caramanica; Brackbill, Robert M; Farfel, Mark R; Cone, James E

2018-03-01

The present study aims to examine the impact of physical and mental health comorbidities on the association between post-9/11 posttraumatic stress disorder (PTSD) trajectories over 10 years and health-related quality of life (HRQOL) among 9/11-exposed persons. 30,002 responding adult World Trade Center Health Registry enrollees reporting no pre-9/11 PTSD were studied. PTSD trajectories (chronic, delayed, remitted, no PTSD) were defined based on a 17-item PTSD Checklist-Specific to 9/11 across three waves of survey data. Three indicators of poor HRQOL were defined based on CDC HRQOL-4 measures. We computed age-adjusted prevalence of physical and mental health comorbidity (depression/anxiety) by PTSD trajectory and used modified Poisson regression to assess the effect of PTSD trajectory on poor HRQOL prevalence, accounting for comorbidity. Age-adjusted prevalence of overall comorbid conditions was 95.8 and 61.4% among the chronic and no-PTSD groups, respectively. Associations between 9/11-related PTSD trajectories and poor HRQOL were significant and became greater when comorbidity was included. Adjusted prevalence ratios were elevated for fair/poor health status (APR 7.3, 95% CI 6.5, 8.2), ≥ 14 unhealthy days (4.7; 95% CI 4.4, 5.1), and ≥ 14 activity limitation days during the last 30 days (9.6; 95% CI 8.1, 11.4) in the chronic PTSD group with physical and mental health comorbidity compared to those without PTSD and comorbidity; similar associations were observed for delayed PTSD. Ten years post-9/11 physical and mental health comorbidities have a substantial impact on the PTSD trajectories and HRQOL association. The need for early identification and treatment of PTSD and comorbidity should be emphasized to potentially improve HRQOL.

Identification of novel cytogenetic markers with prognostic significance in a series of 968 patients with primary myelodysplastic syndromes.

PubMed

Solé, Francesc; Luño, Elisa; Sanzo, Carmen; Espinet, Blanca; Sanz, Guillermo F; Cervera, José; Calasanz, María José; Cigudosa, Juan Cruz; Millà, Fuensanta; Ribera, Josep Maria; Bureo, Encarna; Marquez, Maria Luisa; Arranz, Eva; Florensa, Lourdes

2005-09-01

The main prognostic factors in myelodysplastic syndromes (MDS) are chromosomal abnormalities, the proportion of blasts in bone marrow and number and degree of cytopenias. A consensus-defined International Prognostic Scoring System (IPSS) for predicting outcome and planning therapy in MDS has been developed, but its prognostic value in a large and independent series remains unproven. Furthermore, the intermediate-risk cytogenetic subgroup defined by the IPSS includes a miscellaneous number of different single abnormalities of uncertain prognostic significance at present. The main aim of the present study was to identify chromosomal abnormalities with a previously unrecognized good or poor prognosis in order to find new cytogenetic markers with predictive value. We report the cytogenetic findings in a series of 968 patients with primary MDS from the Spanish Cytogenetics Working Group, Grupo Cooperativo Español de Citogenética Hematológica (GCECGH). In this series of 968 MDS patients, we found various cytogenetic aberrations with a new prognostic impact. Complex karyotype, -7/7q- and i(17q) had a poor prognosis; normal karyotype, loss of Y chromosome, deletion 11q, deletion 12p and deletion 20q as single alterations had a good prognosis. Intermediate prognosis aberrations were rearrangements of 3q21q26, trisomy 8, trisomy 9, translocations of 11q and del(17p). Finally, a new group of single or double cytogenetic abnormalities, most of which are considered rare cytogenetic events and are usually included in the intermediate category of the IPSS, showed a trend to poor prognosis. This study suggests that some specific chromosomal abnormalities could be segregated from the IPSS intermediate-risk cytogenetic prognostic subgroup and included in the low risk or in the poor risk groups.

A concept analysis of nursing overtime.

PubMed

Lobo, Vanessa M; Fisher, Anita; Ploeg, Jenny; Peachey, Gladys; Akhtar-Danesh, Noori

2013-11-01

To report a concept analysis of nursing overtime. Economic constraints have resulted in hospital restructuring with the aim of reducing costs. These processes often target nurse staffing (the largest organizational expense) by increasing usage of alternative staffing strategies including overtime hours. Overtime is a multifaceted, poorly defined, and indiscriminately used concept. Analysis of nursing overtime is an important step towards development and propagation of appropriate staffing strategies and rigorous research. Concept analysis. The search of electronic literature included indexes, grey literature, dictionaries, policy statements, contracts, glossaries and ancestry searching. Sources included were published between 1993-2012; dates were chosen in relation to increases in overtime hours used as a result of the healthcare structuring in the early 1990s. Approximately 65 documents met the inclusion criteria. Walker and Avant's methodology guided the analysis. Nursing overtime can be defined by four attributes: perception of choice or control over overtime hours worked; rewards or lack thereof; time off duty counts equally as much as time on duty; and disruption due to a lack of preparation. Antecedents of overtime arise from societal, organizational, and individual levels. The consequences of nursing overtime can be positive and negative, affecting organizations, nurses, and the patients they care for. This concept analysis clarifies the intricacies surrounding nursing overtime with recommendations to advance nursing research, practice, and policies. A nursing-specific middle-range theory was proposed to guide the understanding and study of nursing overtime. © 2013 Blackwell Publishing Ltd.

Conceptualisation of patient satisfaction: a systematic narrative literature review.

PubMed

Batbaatar, Enkhjargal; Dorjdagva, Javkhlanbayar; Luvsannyam, Ariunbat; Amenta, Pietro

2015-09-01

Patient satisfaction concept is widely measured due to its appropriateness to health service; however, evidence suggests that it is a poorly developed concept. This article is a first part of a two-part series of research with a goal to review a current conceptual framework of patient satisfaction and to bring the concept for further operationalisation procedures. The current article aimed to review a theoretical framework that helps the next article to review determinants of patient satisfaction for designing a measurement system. The study used a systematic review method, meta-narrative review, based on the RAMESES guideline with the phases of screening evidence, appraisal evidence, data extraction and synthesis. Patient satisfaction theoretical articles were searched on the two databases MEDLINE and CINAHL. Inclusion criteria were articles published between 1980 and 2014, and English language papers only. There were 36 articles selected for the synthesis. Results showed that most of the patient satisfaction theories and formulations are based on marketing theories and defined as how well health service fulfils patient expectations. However, review demonstrated that a relationship between expectation and satisfaction is unclear and the concept expectation itself is not distinctly theorised as well. Researchers brought satisfaction theories from other fields to the current healthcare literature without much adaptation. Thus, there is a need to attempt to define the patient satisfaction concept from other perspectives or to learn how patients evaluate the care rather than struggling to describe it by consumerist theories. © Royal Society for Public Health 2015.

Extreme weather events and environmental contamination are associated with case-clusters of melioidosis in the Northern Territory of Australia.

PubMed

Cheng, Allen C; Jacups, Susan P; Gal, Daniel; Mayo, Mark; Currie, Bart J

2006-04-01

Melioidosis, the infection due to the environmental organism Burkholderia pseudomallei, is endemic to northern Australia and South East Asia. It is associated with exposure to mud and pooled surface water, but environmental determinants of this disease are poorly understood. We defined case-clusters in northern Australia, determined their contribution to the observed rate of melioidosis, and explored clinical features and associated environmental factors. Using geographical information systems data, we examined clustering of melioidosis cases in time and geographical space in the Top End of the Northern Territory of Australia between 1990 and 2002 using a scan statistic. DNA macrorestriction analysis, resolved by pulsed field gel electrophoresis, was performed on isolates from patients. We defined five case-clusters involving 27 patients that occurred within 7-28 days and/or a radius of 100-300 km. Clustered cases were associated with extreme weather events or environmental contamination; no difference in the clinical pattern of disease was noted from other patients not involved in clusters. Isolates from patients linked to environmental contamination were caused by isolates with similar DNA macrorestriction patterns, but isolates from patients linked to severe weather events had more diverse DNA macrorestriction patterns. Case-clusters of melioidosis where isolates exhibit diverse DNA macrorestriction patterns in our region are linked to extreme weather events and outbreaks where isolates are predominantly of the same DNA macrorestriction pattern are linked with contamination of an environmental source.

Investigation and treatment for iron deficiency in heart failure: the unmet need in Lower and Middle Income Countries.

PubMed

Makubi, Abel; Roberts, David J

2017-06-01

Frank iron deficiency has been associated with a wide range of cardiac and pulmonary abnormalities including non-ischaemic cardiomyopathy. Iron deficiency anaemia and isolated iron deficiency are well-defined adverse prognostic factors in non-ischaemic cardiac failure. Furthermore, iron-deficient patients in chronic heart failure with a serum ferritin of <100 μg/l or <300 μg/l with reduced transferrin saturation of <20%, who were given intravenous iron showed improved clinical outcomes. Iron deficiency with or without anaemia affects over a quarter of the world's population, but the impact of iron deficiency in heart failure and the effective management of iron deficiency in heart failure in Lower and Middle Income Countries (LMICs) is not well described. Heart failure in African cohorts occurs at a younger age than in North America and Europe and is more likely to be due to hypertension. Recent studies suggest that iron deficiency anaemia, which is very common in heart failure patients in Africa, and iron deficiency are independently associated with a poor prognosis in heart failure. Preliminary data suggest that iron deficiency in patients with heart failure can be treated with oral iron, with significant beneficial effects on haematological and physiological variables. Cost may prohibit the use of intravenous iron on a large scale in LMICs and optimal regimes to treat iron deficiency in heart failure patients with oral iron therapy remain to be defined. © 2017 John Wiley & Sons Ltd.

Defining Bladder Health in Women and Girls: Implications for Research, Clinical Practice, and Public Health Promotion.

PubMed

Lukacz, Emily S; Bavendam, Tamara G; Berry, Amanda; Fok, Cynthia S; Gahagan, Sheila; Goode, Patricia S; Hardacker, Cecilia T; Hebert-Beirne, Jeni; Lewis, Cora E; Lewis, Jessica; Low, Lisa Kane; Lowder, Jerry L; Palmer, Mary H; Smith, Ariana L; Brady, Sonya S

2018-05-24

Bladder health in women and girls is poorly understood, in part, due to absence of a definition for clinical or research purposes. This article describes the process used by a National Institutes of Health funded transdisciplinary research team (The Prevention of Lower Urinary Tract Symptoms [PLUS] Consortium) to develop a definition of bladder health. The PLUS Consortium identified currently accepted lower urinary tract symptoms (LUTS) and outlined elements of storage and emptying functions of the bladder. Consistent with the World Health Organization's definition of health, PLUS concluded that absence of LUTS was insufficient and emphasizes the bladder's ability to adapt to short-term physical, psychosocial, and environmental challenges for the final definition. Definitions for subjective experiences and objective measures of bladder dysfunction and health were drafted. An additional bioregulatory function to protect against infection, neoplasia, chemical, or biologic threats was proposed. PLUS proposes that bladder health be defined as: "A complete state of physical, mental, and social well-being related to bladder function and not merely the absence of LUTS. Healthy bladder function permits daily activities, adapts to short-term physical or environmental stressors, and allows optimal well-being (e.g., travel, exercise, social, occupational, or other activities)." Definitions for each element of bladder function are reported with suggested subjective and objective measures. PLUS used a comprehensive transdisciplinary process to develop a bladder health definition. This will inform instrument development for evaluation of bladder health promotion and prevention of LUTS in research, practice, and public health initiatives.

Poor Appetite and Dietary Intake in Community-Dwelling Older Adults.

PubMed

van der Meij, Barbara S; Wijnhoven, Hanneke A H; Lee, Jung S; Houston, Denise K; Hue, Trisha; Harris, Tamara B; Kritchevsky, Stephen B; Newman, Anne B; Visser, Marjolein

2017-10-01

Poor appetite in older adults leads to sub-optimal food intake and increases the risk of undernutrition. The impact of poor appetite on food intake in older adults is unknown. The aim of this study was to examine the differences in food intake among older community-dwelling adults with different reported appetite levels. Cross-sectional analysis of data from a longitudinal prospective study. Health, aging, and body composition study performed in the USA. 2,597 community-dwelling adults aged 70-79. A semi-quantitative, interviewer-administered, 108-item food frequency questionnaire designed to estimate dietary intake. Poor appetite was defined as the report of a moderate, poor, or very poor appetite in the past month and was compared with good or very good appetite. The mean age of the study sample was 74.5 ± 2.8 years; 48.2% were men, 37.7% were black, and 21.8% reported a poor appetite. After adjustment for total energy intake and potential confounders (including biting/chewing problems), participants with a poor appetite had a significantly lower consumption of protein and dietary fiber, solid foods, protein rich foods, whole grains, fruits, and vegetables, but a higher consumption of dairy foods, fats, oils, sweets, and sodas compared to participants with very good appetite. In addition, they were less likely to report consumption of significant larger portion sizes. Older adults reporting a poor appetite showed a different dietary intake pattern compared to those with (very) good appetite. Better understanding of the specific dietary intake pattern related to a poor appetite in older adults can be used for nutrition interventions to enhance food intake, diet variety, and diet quality. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Addressing poverty through disease control programmes: examples from Tuberculosis control in India.

PubMed

Kamineni, Vishnu Vardhan; Wilson, Nevin; Das, Anand; Satyanarayana, Srinath; Chadha, Sarabjit; Sachdeva, Kuldeep Singh; Chauhan, Lakbir Singh

2012-03-26

Tuberculosis remains a major public health problem in India with the country accounting for one-fifth or 21% of all tuberculosis cases reported globally. The purpose of the study was to obtain an understanding on pro-poor initiatives within the framework of tuberculosis control programme in India and to identify mechanisms to improve the uptake and access to TB services among the poor. A national level workshop was held with participation from all relevant stakeholder groups. This study conducted during the stakeholder workshop adopted participatory research methods. The data was elicited through consultative and collegiate processes. The research study also factored information from primary and secondary sources that included literature review examining poverty headcount ratios and below poverty line population in the country; and quasi-profiling assessments to identify poor, backward and tribal districts as defined by the TB programme in India. Results revealed that current pro-poor initiatives in TB control included collaboration with private providers and engaging community to improve access among the poor to TB diagnostic and treatment services. The participants identified gaps in existing pro-poor strategies that related to implementation of advocacy, communication and social mobilisation; decentralisation of DOT; and incentives for the poor through the available schemes for public-private partnerships and provided key recommendations for action. Synergies between TB control programme and centrally sponsored social welfare schemes and state specific social welfare programmes aimed at benefitting the poor were unclear. Further in-depth analysis and systems/policy/operations research exploring pro-poor initiatives, in particular examining service delivery synergies between existing poverty alleviation schemes and TB control programme is essential. The understanding, reflection and knowledge of the key stakeholders during this participatory workshop provides recommendations for action, further planning and research on pro-poor TB centric interventions in the country.

A multicomponent nutrient bar promotes weight loss and improves dyslipidemia and insulin resistance in the overweight/obese: Chronic inflammation blunts these improvements

USDA-ARS?s Scientific Manuscript database

Poor diets are a major cause of obesity-associated metabolic dysregulation. It is difficult for many people to change dietary patterns. We hypothesized that dietary-induced metabolic dysregulation, and consequent increased risk of disease, is due in large part to what poor diets are lacking; a nutri...

Building Better Bridges: Teaching Adolescents Who Are Poor Readers in 8th Grade to Comprehend History Text

ERIC Educational Resources Information Center

O'Connor, Rollanda E.; Beach, Kristen D.; Sanchez, Victoria; Bocian, Kathleen M.; Roberts, Sarana; Chan, Olivia

2017-01-01

Helping struggling readers to learn history content in middle school can be difficult due to heavy reading demands. In this study, researchers taught poor readers with and without disabilities in 8th grade to generate main idea statements, create compare and contrast paragraphs, and identify cause and effect relationships, along with relevant…

Calcium inputs and transport in a base-poor forest ecosystem as interpreted by Sr isotopes

Treesearch

Scott W. Bailey; James W. Hornbeck; Charles T. Driscoll; Henri E. Gaudette

1996-01-01

Depletion of Ca in forests and its effects on forest health are poorly quantified. Depletion has been difficult to document due to limitations in determining rates at which Ca becomes available for ecosystem processes through weathering, and difficulty in determining changes in ecosystem storage. We coupled a detailed analysis of Sr isotopic composition with a mass...

Demand-Side Financing in Education: a Critical Examination of a Girls' Scholarship Program in Malawi--(Case Study)

ERIC Educational Resources Information Center

Sineta, Abraham

2012-01-01

Despite the push for universal education, many disadvantaged and poor children in developing countries still do not have access to basic education. This among other reasons is due to poverty where poor families cannot afford the cost of basic education even when it is "free" of tuition (McDonald, 2007). Demand-side financing…

Risk of low Apgar scores and socioeconomic status over a 30-year period.

PubMed

Odd, D; Lewis, G; Gunnell, D; Rasmussen, Finn

2014-04-01

The aim of this study was to investigate the stability of associations between social factors, as assessed by maternal occupation and education, and poor birth condition (an Apgar score of below 7 at 1 and 5 minutes) over a 30-year period in Sweden. The dataset was based on infants born in Sweden between 1973 and 2002. Poor birth condition was defined as an Apgar score below 7 at 1 and 5 minutes. Logistic regression was used to investigate the association of between socioeconomic status and poor birth condition. In the adjusted model, mothers in non-manual occupations (OR 0.91 (0.88, 0.95)) or with higher educational status (OR 0.88 (0.84, 0.93)) were less likely to have an infant born in poor condition than the reference group. Limiting the analysis to the last decade showed less evidence for an association (OR 0.94 (0.86, 1.02) and OR 0.94 (0.82, 1.09), respectively). While maternity, delivery and child healthcare are free of charge in Sweden, poor birth condition was more common among infants of mothers in manual occupations or low levels of education. However, this association appeared to attenuate over the calendar period studied.

Extraskeletal multiple myeloma presenting with an atrial mass: a case report and a review of the literature.

PubMed

Vigo, Federica; Ciammella, Patrizia; Valli, Riccardo; Cagni, Elisabetta; Iotti, Cinzia

2012-08-10

Extraskeletal presentation at diagnosis or during the course of multiple myeloma is a rare event. The prognosis is usually very poor. At the moment there is no agreed gold standard for the treatment of this presentation. A 79-year-old Caucasian woman was treated at our hospital for right atrial myeloma localization. Our patient showed the following signs and symptoms of congestive heart failure: dyspnea, hypotension, cyanosis and facial edema. Surgery was not considered feasible due to the extent of the disease. Our patient underwent external-beam radiation therapy using an intensity modulated technique, thus obtaining a persistent complete remission. Our patient has been in continuous complete local remission for 25 months since the end of radiotherapy. The role of radiotherapy is not defined in multiple myeloma with extraskeletal presentation. Our regimen seems to be effective in controlling the disease in this patient.This case report adds to the existing literature as it describes an unusual presentation of the disease and a new therapeutic approach to this rare presentation of multiple myeloma.

Mechanisms of amyloid formation revealed by solution NMR

PubMed Central

Karamanos, Theodoros K.; Kalverda, Arnout P.; Thompson, Gary S.; Radford, Sheena E.

2015-01-01

Amyloid fibrils are proteinaceous elongated aggregates involved in more than fifty human diseases. Recent advances in electron microscopy and solid state NMR have allowed the characterization of fibril structures to different extents of refinement. However, structural details about the mechanism of fibril formation remain relatively poorly defined. This is mainly due to the complex, heterogeneous and transient nature of the species responsible for assembly; properties that make them difficult to detect and characterize in structural detail using biophysical techniques. The ability of solution NMR spectroscopy to investigate exchange between multiple protein states, to characterize transient and low-population species, and to study high molecular weight assemblies, render NMR an invaluable technique for studies of amyloid assembly. In this article we review state-of-the-art solution NMR methods for investigations of: (a) protein dynamics that lead to the formation of aggregation-prone species; (b) amyloidogenic intrinsically disordered proteins; and (c) protein–protein interactions on pathway to fibril formation. Together, these topics highlight the power and potential of NMR to provide atomic level information about the molecular mechanisms of one of the most fascinating problems in structural biology. PMID:26282197

ESCMID and ECMM joint guidelines on diagnosis and management of hyalohyphomycosis: Fusarium spp., Scedosporium spp. and others.

PubMed

Tortorano, A M; Richardson, M; Roilides, E; van Diepeningen, A; Caira, M; Munoz, P; Johnson, E; Meletiadis, J; Pana, Z-D; Lackner, M; Verweij, P; Freiberger, T; Cornely, O A; Arikan-Akdagli, S; Dannaoui, E; Groll, A H; Lagrou, K; Chakrabarti, A; Lanternier, F; Pagano, L; Skiada, A; Akova, M; Arendrup, M C; Boekhout, T; Chowdhary, A; Cuenca-Estrella, M; Guinea, J; Guarro, J; de Hoog, S; Hope, W; Kathuria, S; Lortholary, O; Meis, J F; Ullmann, A J; Petrikkos, G; Lass-Flörl, C

2014-04-01

Mycoses summarized in the hyalohyphomycosis group are heterogeneous, defined by the presence of hyaline (non-dematiaceous) hyphae. The number of organisms implicated in hyalohyphomycosis is increasing and the most clinically important species belong to the genera Fusarium, Scedosporium, Acremonium, Scopulariopsis, Purpureocillium and Paecilomyces. Severely immunocompromised patients are particularly vulnerable to infection, and clinical manifestations range from colonization to chronic localized lesions to acute invasive and/or disseminated diseases. Diagnosis usually requires isolation and identification of the infecting pathogen. A poor prognosis is associated with fusariosis and early therapy of localized disease is important to prevent progression to a more aggressive or disseminated infection. Therapy should include voriconazole and surgical debridement where possible or posaconazole as salvage treatment. Voriconazole represents the first-line treatment of infections due to members of the genus Scedosporium. For Acremonium spp., Scopulariopsis spp., Purpureocillium spp. and Paecilomyces spp. the optimal antifungal treatment has not been established. Management usually consists of surgery and antifungal treatment, depending on the clinical presentation. © 2014 The Authors Clinical Microbiology and Infection © 2014 European Society of Clinical Microbiology and Infectious Diseases.

Use of Frankia and Actinorhizal Plants for Degraded Lands Reclamation

PubMed Central

Diagne, Nathalie; Ngom, Mariama; Nambiar-Veetil, Mathish; Franche, Claudine; Narayanan, Krishna Kumar; Laplaze, Laurent

2013-01-01

Degraded lands are defined by soils that have lost primary productivity due to abiotic or biotic stresses. Among the abiotic stresses, drought, salinity, and heavy metals are the main threats in tropical areas. These stresses affect plant growth and reduce their productivity. Nitrogen-fixing plants such as actinorhizal species that are able to grow in poor and disturbed soils are widely planted for the reclamation of such degraded lands. It has been reported that association of soil microbes especially the nitrogen-fixing bacteria Frankia with these actinorhizal plants can mitigate the adverse effects of abiotic and biotic stresses. Inoculation of actinorhizal plants with Frankia significantly improves plant growth, biomass, shoot and root N content, and survival rate after transplanting in fields. However, the success of establishment of actinorhizal plantation in degraded sites depends upon the choice of effective strains of Frankia. Studies related to the beneficial role of Frankia on the establishment of actinorhizal plants in degraded soils are scarce. In this review, we describe some examples of the use of Frankia inoculation to improve actinorhizal plant performances in harsh conditions for reclamation of degraded lands. PMID:24350296

The facial skeleton of the chimpanzee-human last common ancestor

PubMed Central

Cobb, Samuel N

2008-01-01

This review uses the current morphological evidence to evaluate the facial morphology of the hypothetical last common ancestor (LCA) of the chimpanzee/bonobo (panin) and human (hominin) lineages. Some of the problems involved in reconstructing ancestral morphologies so close to the formation of a lineage are discussed. These include the prevalence of homoplasy and poor phylogenetic resolution due to a lack of defining derived features. Consequently the list of hypothetical features expected in the face of the LCA is very limited beyond its hypothesized similarity to extant Pan. It is not possible to determine with any confidence whether the facial morphology of any of the current candidate LCA taxa (Ardipithecus kadabba, Ardipithecus ramidus, Orrorin tugenensis and Sahelanthropus tchadensis) is representative of the LCA, or a stem hominin, or a stem panin or, in some cases, a hominid predating the emergence of the hominin lineage. The major evolutionary trends in the hominin lineage subsequent to the LCA are discussed in relation to the dental arcade and dentition, subnasal morphology and the size, position and prognathism of the facial skeleton. PMID:18380866

TRIF Licenses Caspase-11-Dependent NLRP3 Inflammasome Activation by Gram-Negative Bacteria

PubMed Central

Rathinam, Vijay A.K.; Vanaja, Sivapriya Kailasan; Waggoner, Lisa; Sokolovska, Anna; Becker, Christine; Stuart, Lynda M.; Leong, John M.; Fitzgerald, Katherine A.

2013-01-01

SUMMARY Systemic infections with Gram-negative bacteria are characterized by high mortality rates due to the “sepsis syndrome,” a widespread and uncontrolled inflammatory response. Though it is well recognized that the immune response during Gram-negative bacterial infection is initiated after the recognition of endotoxin by Toll-like receptor 4, the molecular mechanisms underlying the detrimental inflammatory response during Gram-negative bacteremia remain poorly defined. Here, we identify a TRIF pathway that licenses NLRP3 inflammasome activation by all Gram-negative bacteria. By engaging TRIF, Gram-negative bacteria activate caspase-11. TRIF activates caspase-11 via type I IFN signaling, an event that is both necessary and sufficient for caspase-11 induction and autoactivation. Caspase-11 subsequently synergizes with the assembled NLRP3 inflammasome to regulate caspase-1 activation and leads to caspase-1-independent cell death. These events occur specifically during infection with Gram-negative, but not Gram-positive, bacteria. The identification of TRIF as a regulator of caspase-11 underscores the importance of TLRs as master regulators of inflammasomes during Gram-negative bacterial infection. PMID:22819539

Pollen morphology and plant taxonomy of red oaks in eastern North America

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

Solomon, A.M.

Identification of Quercus (oak) pollen taxa could enhance Quaternary palynological interpretations from eastern North America. A first step is to determine a morphological and taxonomic basis for such identifications. Scanning electron microscopy was utilized to examine exine-surface features of 266 specimens representing 21 red oak (subgen. Erythrobalanus) species from eastern North America, and two intermediate oak (subgen. Protobalanus) species from the desert southwest. Twenty pollen morphological characteristics defined previously were tabulated for each of 324 pollen grains. The data were subjected to cluster analyses. Cluster diagrams were compared with traditional oak systematics. Pollen morphology and plant taxonomy compared poorly withmore » respect to series and species relationships among the red oaks, apparently due as much to high intraspecific and low interspecific variability in pollen-morphological characters as to the uncertain taxonomy of red oaks. Pollen morphology, however, does support the hypothesis of subgeneric oak evolution from intermediate oaks to the series Virentes of white oaks, and from more advanced white oaks to the red oak species. 19 references, 25 figures, 1 table.« less

Centromeric DNA replication reconstitution reveals DNA loops and ATR checkpoint suppression

PubMed Central

Aze, Antoine; Sannino, Vincenzo; Soffientini, Paolo; Bachi, Angela; Costanzo, Vincenzo

2016-01-01

Half of human genome is made of repetitive DNA. However, mechanisms underlying replication of chromosome regions containing repetitive DNA are poorly understood. We reconstituted replication of defined human chromosome segments using Bacterial Artificial Chromosomes (BACs) in Xenopus laevis egg extract. Using this approach we characterized chromatin assembly and replication dynamics of centromeric alpha-satellite DNA. Proteomic analysis of centromeric chromatin revealed replication dependent enrichment of a network of DNA repair factors among which the MSH2-6 complex, which was required for efficient centromeric DNA replication. However, contrary to expectations, the ATR dependent checkpoint monitoring DNA replication fork arrest could not be activated on highly repetitive DNA due to inability of single stranded DNA binding protein RPA to accumulate on chromatin. Electron microscopy of centromeric DNA and supercoil mapping revealed the presence of Topoisomerase I dependent DNA loops embedded in a protein matrix enriched for SMC2-4 proteins. This arrangement suppressed ATR signalling by preventing RPA hyper-loading, facilitating replication of centromeric DNA. These findings have important implications on our understanding of repetitive DNA metabolism and centromere organization under normal and stressful conditions. PMID:27111843

Radioligand Recognition of Insecticide Targets.

PubMed

Casida, John E

2018-04-04

Insecticide radioligands allow the direct recognition and analysis of the targets and mechanisms of toxic action critical to effective and safe pest control. These radioligands are either the insecticides themselves or analogs that bind at the same or coupled sites. Preferred radioligands and their targets, often in both insects and mammals, are trioxabicyclooctanes for the γ-aminobutyric acid (GABA) receptor, avermectin for the glutamate receptor, imidacloprid for the nicotinic receptor, ryanodine and chlorantraniliprole for the ryanodine receptor, and rotenone or pyridaben for NADH + ubiquinone oxidoreductase. Pyrethroids and other Na + channel modulator insecticides are generally poor radioligands due to lipophilicity and high nonspecific binding. For target site validation, the structure-activity relationships competing with the radioligand in the binding assays should be the same as that for insecticidal activity or toxicity except for rapidly detoxified or proinsecticide analogs. Once the radioligand assay is validated for relevance, it will often help define target site modifications on selection of resistant pest strains, selectivity between insects and mammals, and interaction with antidotes and other chemicals at modulator sites. Binding assays also serve for receptor isolation and photoaffinity labeling to characterize the interactions involved.

Rise and Fall: Poly(phenyl vinyl ketone) Photopolymerization and Photodegradation under Visible and UV Radiation.

PubMed

Reeves, Jennifer A; Allegrezza, Michael L; Konkolewicz, Dominik

2017-07-01

Vinyl ketone polymers, including phenyl vinyl ketone (PVK), are an important class of polymers due to their ability to degrade upon irradiation with ultraviolet light which makes them useful for a variety of applications. However, traditional radical methods for synthesizing PVK polymers give rise to poor control or are unable to produce block copolymers. This work uses reversible addition-fragmentation chain transfer polymerization (RAFT) and photochemistry to polymerize PVK. When visible blue radiation of 440 ± 10 nm is used as the light source for the photopolymerization, rapid polymerization and well-defined polymers are created. This RAFT method uses PVK as both monomer and radical initiator, exciting the PVK mono-mer by 440 ± 10 nm irradiation to avoid the use of an additional radical initiator. Once the poly-mer is synthesized, it is stable against degradation by blue light (440 ± 10 nm), but upon exposure to ultraviolet (UV) radiation (310 ± 20 nm) significant decrease in molecular weight is observed. The degradation is observed for all poly(PVK) materials synthesized. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Virtual reality technology and surgical training--a survey of general surgeons in Ireland.

PubMed

Early, S A; Roche-Nagle, G

2006-01-01

Virtual Reality Technology (VRT) is a validated method of training in industry but only recently has found a place in the postgraduate surgical curriculum. We surveyed 143 Irish consultant surgeons to ascertain their opinions on this topical issue. The survey consisted of 22 questions to which the consultants were asked to respond by choosing from a 5-point Likert scale. Sixty-five per cent responded. A majority of 72% had seen VRT but only 47% had 'hands on' experience. Forty-six per cent believed that they were poorly informed regarding available technologies. As consultants became more informed about VRT significant differences were seen with regard to attitudes regarding the role of VR in skills in surgical training (p<0.05) and in the ability to define teaching objectives (p<0.005). Our survey suggests that the underuse of the current offerings is not due to a perceived lack of interest on the part of the surgical trainers. Suppliers of these programmes have a responsibility to adequately educate and collaborate with all parties involved to improve overall benefit from these simulators.

Characterizing patients with multiple chromosomal aberrations detected by FISH in chronic lymphocytic leukemia.

PubMed

González-Gascón Y Marín, Isabel; Hernández-Sanchez, María; Rodríguez-Vicente, Ana Eugenia; Puiggros, Anna; Collado, Rosa; Luño, Elisa; González, Teresa; Ruiz-Xivillé, Neus; Ortega, Margarita; Gimeno, Eva; Muñoz, Carolina; Infante, Maria Stefania; Delgado, Julio; Vargas, María Teresa; González, Marcos; Bosch, Francesc; Espinet, Blanca; Hernández-Rivas, Jesús María; Hernández, José Ángel

2018-03-01

We analyzed the features of chronic lymphocytic leukemia (CLL) with multiple abnormalities (MA) detected by FISH. A local database including 2095 CLL cases was used and 323 with MA (15.4%) were selected. MA was defined by the presence of two or more alterations (deletions of 13q14 (13q-), 11q22 (11q-), 17p13 (17p-) or trisomy 12 (+12)). The combination of 13q- with 11q- and 13q- with 17p-, accounted for 58.2% of the series, in contrast to 11q- with 17p- (3.7%). Patients carrying MA since diagnosis presented a short time to first therapy(TTFT) (27 months) and overall survival (OS) (76 months). The combinations including 17p- had a shorter OS (58 months) than the ones without 17p- (not reached, p = .002). Patients with a complex-FISH were the ones with worse OS (34 months). MA imply poor prognosis when they emerge at diagnosis, probably due to the high incidence of bad prognosis markers, which may be a reflection of a more complex karyotype.

Telangiectatic hyperplastic nodule associated with vascular malformation in a patient with chronic hepatitis B: radiologic and pathologic features.

PubMed

Carrasco, Gonzalo; Besa, Cecilia; Lewis, Sara C; Kadri, Hena S; Hiotis, Spiros; Thung, Swan N

2013-05-01

Recognizing hepatocellular nodules that cannot be classified as typical for hepatocellular carcinoma, hepatocellular adenoma, or focal nodular hyperplasia is important, especially in a patient with high risk for hepatocellular carcinoma. The authors report a case of a 53-year-old man with chronic hepatitis B, who was referred to the hospital with a liver mass found on routine imaging follow-up. Abdominal ultrasound revealed a 2.4-cm hypoechoic lesion. Contrast computed tomography showed homogeneous arterial enhancement and mild hyperdensity on portal venous phase images. Due to the high risk for hepatocellular carcinoma, the patient underwent laparoscopic left lateral segmentectomy that revealed a 2.2-cm poorly defined red-brown lesion. The nodule was diagnosed as a hypervascular/telangiectatic hyperplastic hepatocellular nodule based on histopathologic findings and immunostaining profile with negative glutamine synthetase, diffuse positive CD34 highlighting hyperplastic endothelial cells along the telangiectatic sinusoids and dilated vascular channels, and CK7 and CK19 reactive normal bile ducts within the lesion. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

High-Quality CrO2 Nanowires for Dissipation-less Spintronics

NASA Astrophysics Data System (ADS)

Singh, Amrita; Jansen, Charlotte; Lahabi, Kaveh; Aarts, Jan

2016-10-01

Superconductor-ferromagnet (S-F) hybrids based on half-metallic ferromagnets, such as CrO2 , are ideal candidates for superconducting spintronic applications. This is primarily due to the fully spin-polarized nature of CrO2 , which produces enhanced long-range triplet proximity effects. However, reliable production of CrO2 -based Josephson junctions (JJs) has proved to be extremely challenging because of a poorly controlled interface transparency and an incomplete knowledge of the local magnetization of the CrO2 films. To address these issues, we use a bottom-up approach to grow CrO2 nanowires on prepatterned substrates via chemical-vapor deposition. A comprehensive study of the growth mechanism enables us to reliably synthesize faceted, homogeneous CrO2 wires with a well-defined magnetization state. Combining these high-quality wires with a superconductor produces JJs with a high interface transparency, leading to exceptionally large 100% spin-polarized supercurrents, with critical current densities exceeding 109 Am-2 over distances as long as 600 nm. These CrO2 -nanowire-based JJs thus provide a realistic route to creating a scalable device platform for dissipation-less spintronics.

Point-of-Care Diagnostics for Improving Maternal Health in South Africa

PubMed Central

Mashamba-Thompson, Tivani P.; Sartorius, Benn; Drain, Paul K.

2016-01-01

Improving maternal health is a global priority, particularly in high HIV-endemic, resource-limited settings. Failure to use health care facilities due to poor access is one of the main causes of maternal deaths in South Africa. “Point-of-care” (POC) diagnostics are an innovative healthcare approach to improve healthcare access and health outcomes in remote and resource-limited settings. In this review, POC testing is defined as a diagnostic test that is carried out near patients and leads to rapid clinical decisions. We review the current and emerging POC diagnostics for maternal health, with a specific focus on the World Health Organization (WHO) quality-ASSURED (Affordability, Sensitivity, Specificity, User friendly, Rapid and robust, Equipment free and Delivered) criteria for an ideal point-of-care test in resource-limited settings. The performance of POC diagnostics, barriers and challenges related to implementing POC diagnostics for maternal health in rural and resource-limited settings are reviewed. Innovative strategies for overcoming these barriers are recommended to achieve substantial progress on improving maternal health outcomes in these settings. PMID:27589808

Engineering of biotin-prototrophy in Pichia pastoris for robust production processes.

PubMed

Gasser, Brigitte; Dragosits, Martin; Mattanovich, Diethard

2010-11-01

Biotin plays an essential role as cofactor for biotin-dependent carboxylases involved in essential metabolic pathways. The cultivation of Pichia pastoris, a methylotrophic yeast that is successfully used as host for the production of recombinant proteins, requires addition of high dosage of biotin. As biotin is the only non-salt media component used during P. pastoris fermentation (apart from the carbon source), nonconformities during protein production processes are usually attributed to poor quality of the added biotin. In order to avoid dismissed production runs due to biotin quality issues, we engineered the biotin-requiring yeast P. pastoris to become a biotin-prototrophic yeast. Integration of four genes involved in the biotin biosynthesis from brewing yeast into the P. pastoris genome rendered P. pastoris biotin-prototrophic. The engineered strain has successfully been used as production host for both intracellular and secreted heterologous proteins in fed-batch processes, employing mineral media without vitamins. Another field of application for these truly prototrophic hosts is the production of biochemicals and small metabolites, where defined mineral media leads to easier purification procedures. Copyright © 2010 Elsevier Inc. All rights reserved.

Overcoming myelosuppression due to synthetic lethal toxicity for FLT3-targeted acute myeloid leukemia therapy

PubMed Central

Warkentin, Alexander A; Lopez, Michael S; Lasater, Elisabeth A; Lin, Kimberly; He, Bai-Liang; Leung, Anskar YH; Smith, Catherine C; Shah, Neil P; Shokat, Kevan M

2014-01-01

Activating mutations in FLT3 confer poor prognosis for individuals with acute myeloid leukemia (AML). Clinically active investigational FLT3 inhibitors can achieve complete remissions but their utility has been hampered by acquired resistance and myelosuppression attributed to a ‘synthetic lethal toxicity’ arising from simultaneous inhibition of FLT3 and KIT. We report a novel chemical strategy for selective FLT3 inhibition while avoiding KIT inhibition with the staurosporine analog, Star 27. Star 27 maintains potency against FLT3 in proliferation assays of FLT3-transformed cells compared with KIT-transformed cells, shows no toxicity towards normal human hematopoiesis at concentrations that inhibit primary FLT3-mutant AML blast growth, and is active against mutations that confer resistance to clinical inhibitors. As a more complete understanding of kinase networks emerges, it may be possible to define anti-targets such as KIT in the case of AML to allow improved kinase inhibitor design of clinical agents with enhanced efficacy and reduced toxicity. DOI: http://dx.doi.org/10.7554/eLife.03445.001 PMID:25531068

Drinking Water Quality Assessment Studies for an Urbanized Part of the Nagpur District, Central India.

PubMed

Varade, Abhay M; Yenkie, Rajshree; Shende, Rahul; Kodate, Jaya

2014-01-01

The water quality of Hingna area of Nagpur district, Central India was assessed for its suitability as drinking water. 22 water samples, representing both the surface and groundwater sources, were collected and analysed for different inorganic constituents by using the standard procedures. The result depicted abundance of major ions; Ca2+ > Mg2+ > Na+ > K+ = HCO3- > Cl- > SO4(2-) > NO3-. The concentrations of different elements in water were compared with the drinking water standards defined by World Health Organization (WHO). The hydro-chemical results reveal that most of the samples were within the desirable limits of the drinking water quality. However, few samples of the area, showed higher values of total dissolved solids (TDS), total hardness (TH), and magnesium (Mg) indicating their 'hard water type' nature and found to be unfit for the drinking purpose. Such poor water quality of these samples is found due to the combined effect of urbanization and industrial activities. The potential health risks associated with various water parameters have also been documented in this paper.

Position-dependent effects of locked nucleic acid (LNA) on DNA sequencing and PCR primers

PubMed Central

Levin, Joshua D.; Fiala, Dean; Samala, Meinrado F.; Kahn, Jason D.; Peterson, Raymond J.

2006-01-01

Genomes are becoming heavily annotated with important features. Analysis of these features often employs oligonucleotides that hybridize at defined locations. When the defined location lies in a poor sequence context, traditional design strategies may fail. Locked Nucleic Acid (LNA) can enhance oligonucleotide affinity and specificity. Though LNA has been used in many applications, formal design rules are still being defined. To further this effort we have investigated the effect of LNA on the performance of sequencing and PCR primers in AT-rich regions, where short primers yield poor sequencing reads or PCR yields. LNA was used in three positional patterns: near the 5′ end (LNA-5′), near the 3′ end (LNA-3′) and distributed throughout (LNA-Even). Quantitative measures of sequencing read length (Phred Q30 count) and real-time PCR signal (cycle threshold, CT) were characterized using two-way ANOVA. LNA-5′ increased the average Phred Q30 score by 60% and it was never observed to decrease performance. LNA-5′ generated cycle thresholds in quantitative PCR that were comparable to high-yielding conventional primers. In contrast, LNA-3′ and LNA-Even did not improve read lengths or CT. ANOVA demonstrated the statistical significance of these results and identified significant interaction between the positional design rule and primer sequence. PMID:17071964

Symptoms and Character Traits in Patients Selected for Long-term Psychodynamic Psychotherapy

PubMed Central

Wilczek, Alexander; Weinryb, Robert M.; Gustavsson, Petter J.; Barber, Jacques P.; Schubert, Johan; ÅSBERG, Marie

1998-01-01

In this naturalistic study of 55 outpatients selected for long-term psychodynamic psychotherapy, two Swedish assessment instruments are presented (the Karolinska Psychodynamic Profile and the Karolinska Scales of Personality), and the significance of psychodynamic criteria for the selection of patients is discussed. Thirty patients (55%) fulfilled criteria for a DSM-III-R diagnosis. The most prominent psychodynamically defined character pathology was found in the areas of coping with aggressive affects; dependency and separation; frustration tolerance; and impulse control. Some psychodynamically defined character traits, particularly poor frustration tolerance, were related to symptomatic suffering. PMID:9407473

U-shaped associations between time in bed and the physical and mental functioning of Japanese civil servants: the roles of work, family, behavioral and sleep quality characteristics.

PubMed

Sekine, M; Tatsuse, T; Cable, N; Chandola, T; Marmot, M

2014-09-01

This study aimed to evaluate (i) whether work, family, behavioral and sleep quality characteristics differ among individuals with different time in bed (TIB), and (ii) whether and how much the U-shaped associations between TIB and health can be explained by these characteristics. Participants were 3510 employees (2371 males and 1139 females) aged 20-65 years working in local government in Japan. They completed a questionnaire regarding work, family, and behavioral characteristics. Sleep quality and physical and mental functioning were evaluated using the Pittsburgh Sleep Quality Index and the Short Form 36. High job demands, long work hours, and high work-family conflict were more prevalent among those with short TIB. Those with long TIB had daily drinking habits. Whereas those with short TIB had poor sleep, mainly due to poor subjective sleep quality and daytime dysfunction, those with long TIB had poor sleep, mainly due to long sleep latency, poor sleep efficiency and sleep disturbances. The U-shaped associations between TIB and poor physical and mental health, with the best health observed in those spending ~8 h in bed, weakened considerably after adjustment for sleep quality, followed by work and family characteristics. After adjusting for behavioral characteristics and long-standing illnesses, the associations hardly changed. The U-shaped associations between TIB and health may be explained by U-shaped associations between TIB and poor sleep and psychosocial stress in work and family life. Copyright © 2014 Elsevier B.V. All rights reserved.

Too cold may not be so cool: spontaneous hypothermia as a marker of poor outcome after cardiac arrest.

PubMed

Wörner, Jakobea; Oddo, Mauro

2010-01-01

In a recent issue of Critical Care, den Hartog and colleagues show an association between spontaneous hypothermia, defined by an admission body temperature < 35°C, and poor outcome in patients with coma after cardiac arrest (CA) treated with therapeutic hypothermia (TH). Given that TH alters neurological prognostication, studies aiming to identify early markers of injury severity and outcome are welcome, since they may contribute overall to optimize the management of comatose CA patients. This study provides an important message to clinicians involved in post-resuscitation care and raises important questions that need to be taken into account in future studies.

Health psychology: It's not what you do, it's the way that you do it.

PubMed

Hilton, Charlotte Emma; Johnston, Lynne Halley

2017-01-01

Despite the growth in theoretical understandings of health behaviour and standardised approaches to health interventions (e.g. behaviour change taxonomies), health psychology has paid comparatively less attention to the importance of the implementation processes - 'how to' rather than 'what to' of such interventions. The clinical and interpersonal skills that often reflect these implementation processes are poorly defined within the health psychology literature. The level of proficiency in such skills expected of Health and Care Professions Council registered practitioner health psychologists is unclear and poorly documented within the UK training requirements. This article explores the potential impact of this and offers some pragmatic solutions.

The Challenge of Teacher Retention in Urban Schools: Evidence of Variation from a Cross-Site Analysis

ERIC Educational Resources Information Center

Papay, John P.; Bacher-Hicks, Andrew; Page, Lindsay C.; Marinell, William H.

2017-01-01

Substantial teacher turnover poses a challenge to staffing public schools with effective teachers. The scope of the teacher retention challenge across school districts, however, remains poorly defined. Applying consistent data practices and analytical techniques to administrative data sets from 16 urban districts, we document substantial…

Strategies for Reducing Math Anxiety. Information Capsule. Volume 1102

ERIC Educational Resources Information Center

Blazer, Christie

2011-01-01

Approximately 93 percent of Americans indicate that they experience some level of math anxiety. Math anxiety is defined as negative emotions that interfere with the solving of mathematical problems. Studies have found that some students who perform poorly on math assessments actually have a full understanding of the concepts being tested; however,…

Planning and Articulation in Incremental Word Production: Syllable-Frequency Effects in English

ERIC Educational Resources Information Center

Cholin, Joana; Dell, Gary S.; Levelt, Willem J. M.

2011-01-01

We investigated the role of syllables during speech planning in English by measuring syllable-frequency effects. So far, syllable-frequency effects in English have not been reported. English has poorly defined syllable boundaries, and thus the syllable might not function as a prominent unit in English speech production. Speakers produced either…

Health Plan Performance Measurement within Medicare Subvention.

DTIC Science & Technology

1998-06-01

the causes of poor performance (Siren & Laffel, 1996). Although outcomes measures such as nosocomial infection rates, admission rates for select...defined. Traditional outcomes measures include infection rates, morbidity, and mortality. The problem with these traditional measures is... Maternal /Child Care Indicators Nursing Staffing Indicators Outcome Indicators Technical Outcomes Plan Performance Stability of Health Plan

Subjective Poverty and Its Relation to Objective Poverty Concepts in Hungary

ERIC Educational Resources Information Center

Nandori, Eszter Siposne

2011-01-01

The paper analyzes subjective poverty in Hungary and compares it to the objective poverty concepts. Subjective poverty is defined by examining who people consider to be poor. Based on the Easterlin paradox, the initial hypothesis states that subjective and absolute poverty concepts are highly correlated. Taking into account that Hungary is a…

Exploration of Critical Consciousness and Its Relationship to Teaching Perspectives and Attitudes

ERIC Educational Resources Information Center

Weis, Lisa Kaye Hamling

2012-01-01

This study explored the relationships of educators' levels of critical consciousness, attitudes about poverty and poor people, and teaching perspectives. Critical consciousness was defined by Freire (2000) as the ability of individuals to assess their own identities related to the sociopolitical realities that surround them and critically…

First Nations and Higher Education: The Four R's--Respect, Relevance, Reciprocity, Responsibility

ERIC Educational Resources Information Center

Kirkness, Verna J.; Barnhardt, Ray

2016-01-01

American Indian/First Nations/Native People have been historically under-represented in the ranks of college and university graduates in Canada and the United States. From an institutional perspective, the problem has been typically defined in terms of low achievement, high attrition, poor retention, weak persistence, etc., thus placing the onus…

Calculating the configurational entropy of a landscape mosaic

Treesearch

Samuel A. Cushman

2016-01-01

Applications of entropy and the second law of thermodynamics in landscape ecology are rare and poorly developed. This is a fundamental limitation given the centrally important role the second law plays in all physical and biological processes. A critical first step to exploring the utility of thermodynamics in landscape ecology is to define the configurational...

Cognitive impairment in folate-deficient rats corresponds to depleted brain phosphatidylcholine and is prevented by methionine without lowering homocysteine

USDA-ARS?s Scientific Manuscript database

Poor folate status is associated with cognitive decline and dementia in older adults. Although impaired brain methylation activity and homocysteine toxicity are widely believed to account for this association, how folate deficiency impairs cognition is uncertain. To better define the role of folate ...

Hypnotic Relaxation and Yoga to Improve Sleep and School Functioning

ERIC Educational Resources Information Center

Perfect, Michelle M.; Smith, Bradley

2016-01-01

Sleep insufficiency, defined as inadequate sleep duration, poor sleep quality, and daytime sleepiness, has been linked with students' learning and behavioral outcomes at school. However, there is limited research on interventions designed to improve the sleep of school-age children. In order to promote more interest on this critical topic, we…

Self versus Others' Perception of Youths' Mental Health

ERIC Educational Resources Information Center

Viviano, Thomas A.

2010-01-01

Data was analyzed in the National Longitudinal Survey Study from 1997 specifically relating to questions regarding depression in youth. In the analysis it was found that how the respondent defined their own depression and poor mental health was different than the perceptions about their mental health from those that live with them in the same…

Time Poverty Thresholds and Rates for the US Population

ERIC Educational Resources Information Center

Kalenkoski, Charlene M.; Hamrick, Karen S.; Andrews, Margaret

2011-01-01

Time constraints, like money constraints, affect Americans' well-being. This paper defines what it means to be time poor based on the concepts of necessary and committed time and presents time poverty thresholds and rates for the US population and certain subgroups. Multivariate regression techniques are used to identify the key variables…

Timing of short-day exposure influences diapause response of western tarnished plant bug

USDA-ARS?s Scientific Manuscript database

The western tarnished plant bug, Lygus hesperus, enters adult diapause in response to short photoperiods. However, the instars or stages responsive to the photoperiodic cue are poorly defined. Lygus were reared under short days (10 h) until they were dissected to determine diapause status as 10-d-o...

Is Maternal Fatigue Mediating the Relationship between Maternal Depression and Child Outcomes?

ERIC Educational Resources Information Center

White, Carmel Parker; King, Kathleen

2011-01-01

Fatigue, a subjective state that has been defined as a decreased capacity for physical or mental activity, has many behavioral similarities to depression (e.g., weariness, difficulty concentrating, diminished motivation). We hypothesized that fatigue might mediate the relationship between depression and poor child outcomes. A sample of mothers (14…

The Effectiveness of a High School Mathematics Remediation Program on Student Achievement

ERIC Educational Resources Information Center

Kingsborough, Joseph

2011-01-01

The landmark educational reform legislation known as the No Child Left Behind Act (2001) brought sweeping change to the educational establishment through clearly defined learning goals and equally clear consequences for poorly performing schools. The present study sought to determine the impact of a remediation program in mathematics at a suburban…

Special Report on Dental Care for Handicapped People.

ERIC Educational Resources Information Center

Rehabilitation Services Administration (DHEW), Washington, DC.

The document presents a Department of Health, Education and Welfare (HEW) special report on dental care for the handicapped. The nature and extent of the problem of providing dental services to the handicapped population is examined. The handicapped population is defined and their oral health status reviewed. Factors contributing to the poor oral…

Test differences in diagnosing reading comprehension deficits.

PubMed

Keenan, Janice M; Meenan, Chelsea E

2014-01-01

The authors examined the implications of test differences for defining and diagnosing comprehension deficits using reading comprehension tests. They had 995 children complete the Gray Oral Reading Test-3, the Qualitative Reading Inventory-3, the Woodcock-Johnson Passage Comprehension-3, and the Peabody Individual Achievement Test and compared which children were identified by each test as being in the lowest 10%. Although a child who performs so poorly might be expected to do poorly on all tests, the authors found that the average overlap between tests in diagnosing comprehension difficulties was only 43%. Consistency in diagnosis was greater for younger children, when comprehension deficits are the result of weaker decoding skills, than for older children. Inconsistencies between tests were just as evident when identifying the top performers. The different children identified as having a comprehension deficit by each test were compared on four profile variables-word decoding skill, IQ, ADHD symptoms, and working memory skill-to understand the nature of the different deficits assessed by each test. Theoretical and practical implications of these test differences in defining and diagnosing comprehension deficits are discussed.

Dedifferentiated endometrial cancer: an atypical case diagnosed from cerebellar and adrenal metastasis: case presentation and review of literature.

PubMed

Berretta, Roberto; Patrelli, Tito Silvio; Faioli, Raffaele; Mautone, Daniele; Gizzo, Salvatore; Mezzogiorno, Antonio; Giordano, Giovanna; Modena, Alberto Bacchi

2013-01-01

Dedifferentiated endometrial cancer (DEC) is microscopically characterized by the presence of high-grade areas emerging from low-grade tumour. DEC is an aggressive tumour even when the dedifferentiated component represents only 20% of the entire neoplasm. A proper histological diagnosis is essential to define the most appropriate therapeutic approach for these tumors, since they are characterized by a particularly aggressive trend and by an extremely poor prognosis. We report a single case of DEC associated with dedifferentiated and adrenal metastasis, for which the patient underwent both abdominal-pelvic and cerebellar surgery. Dedifferentiated carcinoma of the endometrium is a poorly recognized neoplasm since they have not been clearly defined the histological features discriminating this neoplasm from high-grade endometrioid adenocarcinoma. Revising existing literature we found 79 described cases of central nervous system secondary involvement and 13 cases where the onset of the disease was characterized by neurological signs and symptoms. We could only find two reported cases of adrenal metastases originating from endometrial neoplasia but in no case of dedifferentiated endometrial carcinoma previously described has been reported the concomitant adrenal-cerebellar involvement.

Stakeholder's perspective: Sustainability of a community health worker program in Afghanistan.

PubMed

Najafizada, Said Ahmad Maisam; Labonté, Ronald; Bourgeault, Ivy Lynn

2017-02-01

The objectives of this study were two-fold: 1) to examine how different stakeholders define sustainability, and 2) to identify barriers to and facilitators of the sustainability of the Afghan CHW program. We interviewed 63 individual key informants, and conducted 11 focus groups [35 people] with policymakers, health managers, community health workers, and community members across Afghanistan. The participants were purposefully selected to provide a wide range of perspectives. Different stakeholders define sustainability differently. Policymakers emphasize financial resources; health managers, organizational operations; and community-level stakeholders, routine frontline activities. The facilitators they identify include integration into the health system, community support, and capable human resources. Barriers they noted include lack of financial resources, poor program design and implementation, and poor quality of services. Measures to ensure sustainability could be national revenue allocation, health-specific taxation, and community financing. Sustainability is complicated and has multiple facets. The plurality of understanding of sustainability among stakeholders should be addressed explicitly in the program design. To ensure sustainability, there is a need for a coordinated effort amongst all stakeholders. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cervical carcinoma in the European Union: an update on disease burden, screening program state of activation, and coverage as of March 2014.

PubMed

Altobelli, Emma; Lattanzi, Amedeo

2015-03-01

Cervical cancer (CC) is defined as a disease of disparity. This is due to marked differences in CC incidence and mortality between developed and developing countries. As a continent, Europe is no exception. This study examines the state of activation of CC screening in the European Union as of March 2014, reviews CC incidence and mortality data, and highlights the initiatives adopted to extend program coverage to nonresponders. The present study is based on the most recent data available from PubMed-indexed journals, the Web sites of the health ministries of each member state, and the Web sites of national cancer observatories; failing these sources, information was sought in scientific journals published in the local language. In 2003, the European Council recommended that priority be given to organized screening program activation. Nonetheless, a number of European Union member states still lack population-based organized screening programs, and few have implemented programs directed at disadvantaged populations. Several investigations have demonstrated that the women at higher CC risk are unscreened and underscreened ones. Since then, several member states have made significant efforts to set up effective prevention programs by adopting international quality standards and centralizing screening organization and result evaluation. Several developed countries and some new central-eastern European member states have poorly organized prevention programs that result in poor women's health. Diagnosis of CC is emotionally traumatic, but it is highly preventable. When CC is found early, it is highly treatable and associated with long survival and good quality of life.

Death or Neurodevelopmental Impairment at 18 To 22 Months in a Randomized Trial of Early Dexamethasone to Prevent Death or Chronic Lung Disease in Extremely Low Birth Weight Infants

PubMed Central

Stark, Ann R.; Carlo, Waldemar A.; Vohr, Betty R; Papile, Lu Ann; Saha, Shampa; Bauer, Charles R.; Donovan, Edward F.; Oh, William; Shankaran, Seetha; Tyson, Jon E.; Wright, Linda L.; Poole, W. Kenneth; Das, Abhik; Stoll, Barbara J.; Fanaroff, Avroy A.; Korones, Sheldon B.; Ehrenkranz, Richard A.; Stevenson, David K.; Peralta-Carcelen, Myriam; Adams-Chapman, Ira; Wilson-Costello, Deanne E.; Bada, Henrietta S.; Heyne, Roy J.; Johnson, Yvette R.; Lee, Kimberly Gronsman; Steichen, Jean J.; Hintz, Susan R.

2014-01-01

Objective To evaluate the incidence of death or neurodevelopmental impairment (NDI) at 18 to 22 months corrected age in subjects enrolled in a trial of early dexamethasone treatment to prevent death or chronic lung disease in extremely low birth weight infants. Methods Evaluation of infants at 18 to 22 months corrected age included anthropomorphic measurements, a standard neurological examination, and the Bayley Scales of Infant Development-II, including the Mental Developmental Index (MDI) and the Psychomotor Developmental Index (PDI). NDI was defined as moderate or severe cerebral palsy, MDI or PDI less than 70, blindness, or hearing impairment. Results Death or NDI at 18 to 22 months corrected age was similar in the dexamethasone and placebo groups (65 vs 66 percent, p= 0.99 among those with known outcome). The proportion of survivors with NDI was also similar, as were mean values for weight, length, and head circumference and the proportion of infants with poor growth (50 vs 41 percent, p=0.42 for weight less than 10th percentile). Forty nine percent of infants in the placebo group received treatment with corticosteroid compared to 32% in the dexamethasone group (p=0.02). Conclusion The risk of death or NDI and rate of poor growth were high but similar in the dexamethasone and placebo groups. The lack of a discernible effect of early dexamethasone on neurodevelopmental outcome may be due to frequent clinical corticosteroid use in the placebo group. PMID:23992673

Critical issues in the clinical application of liquid biopsy in non-small cell lung cancer.

PubMed

Manicone, Mariangela; Poggiana, Cristina; Facchinetti, Antonella; Zamarchi, Rita

2017-10-01

Current therapeutic options for non-small cell lung cancer (NSCLC) patients are chemotherapy and targeted therapy directed mainly against epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) rearrangements. Targeted therapy relies on the availability of tumor biopsies for molecular profiling at diagnosis and to longitudinally monitor treatment response and resistance development. Unfortunately, tumor biopsy might be invasive, recover poor material of suboptimal quality, and cause sample bias due to tumor heterogeneity. Many studies have illustrated the potential of liquid biopsy as minimal invasive approach to respond to the urgent need for real time monitoring, stratification, and personalized optimized treatment in NSCLC patients. In principle, the liquid biopsy could provide the genetic landscape of primary and metastatic cancerous lesions, detecting "druggable" genomic alterations or associated with treatment resistance. Moreover, it would guarantee the prognostic/predictive biomarkers evaluation in patients for whom biopsies are inaccessible or difficult to repeat. At this regard, the prognostic value of circulating tumor cells (CTCs) in NSCLC patients has been largely investigated, but still their clinical utility as tumor biomarker is hampered by the lack of a consensus on the criteria necessary and sufficient to define them and on the standard operating procedures (SOPs) for their assessment. This review will summarize current developments on liquid biopsy in NSCLC, addressing the technology issues that contribute to the poor ability to track CTCs in the blood of NSCLC patients, thus limiting their extensive use in the clinical practice, and analyzing the solutions adopted to overcome such limits, on the road towards the clinical validation.

Microbiological risk infection assessment using QMRA in agriculture systems in Côte d'Ivoire, West Africa.

PubMed

Kouamé, Parfait K; Nguyen-Viet, Hung; Dongo, Kouassi; Zurbrügg, Christian; Biémi, Jean; Bonfoh, Bassirou

2017-10-28

Poor wastewater management that results from a lack of appropriate sanitation infrastructure contributes to increasing health risks in urban areas in Côte d'Ivoire. We assessed the health risks associated with the use of wastewater for watering salad destined for human consumption, to help local authorities in developing appropriate risk mitigation measures for Yamoussoukro, the political capital of Côte d'Ivoire. We applied a stochastic approach based on quantitative microbiological risk assessment (QMRA), focusing on wastewater for farming activities and salad consumption at the household level. Farming activities rely on a large degree on contaminated water and are conducted without any protection. The QMRA highlights that the poor quality of watering water increased the microbiological risk of the two assessed groups of urban farmers and individual households. The annual risk of infection due to watering wastewater in the city is estimated at 0.01 per person per year (pppy) for Giardia lamblia and 0.2 pppy for Escherichia coli O157:H7. The annual risk from salad consumption is 0.01 pppy for G. lamblia and 0.9 pppy for E. coli O157:H7. Both the annual risks from farming activities and salad consumption were higher than the tolerable standard of risk of 10 -4 pppy as defined by the World Health Organization. There is a need to conduct a risk analysis and a cost-effectiveness study on intervention to improve public health and the livelihoods of the producers which are women in majority in Yamoussoukro.

Heritability and Temporal Stability of Ambulatory Autonomic Stress Reactivity in Unstructured 24-Hour Recordings.

PubMed

Neijts, Melanie; van Lien, Rene; Kupper, Nina; Boomsma, Dorret; Willemsen, Gonneke; de Geus, Eco J C

2015-10-01

Measurements of ambulatory autonomic reactivity can help with our understanding of the long-term health consequences of exposure to psychosocial stress in real-life settings. In this study, unstructured 24-hour ambulatory recordings of cardiac parasympathetic and sympathetic control were obtained in 1288 twins and siblings, spanning both work time and leisure time. These data were used to define two ambulatory baseline (sleep, leisure) and four stress conditions (wake, work, work_sitting, work_peak) from which six ambulatory stress reactivity measures were derived. The use of twin families allowed for estimation of heritability and testing for the amplification of existing or emergence of new genetic variance during stress compared with baseline conditions. Temporal stability of ambulatory reactivity was assessed in 62 participants and was moderate to high over a 3-year period (0.36 < r < 0.91). Depending on the definition of ambulatory reactivity used, significant heritability was found, ranging from 29% to 40% for heart rate, 34% to 47% for cardiac parasympathetic control (indexed as respiratory sinus arrhythmia), and 10% to 19% for cardiac sympathetic control (indexed as the preejection period). Heritability of ambulatory reactivity was largely due to newly emerging genetic variance during stress compared with periods of rest. Interestingly, reactivity to short standardized stressors was poorly correlated with the ambulatory reactivity measures implying poor laboratory-real-life correspondence. Ambulatory autonomic reactivity extracted from an unstructured real-life setting shows reliable, stable, and heritable individual differences. Real-life situations uncover a new and different genetic variation compared with that seen in resting baseline conditions, including sleep.

Social capital and resilience among people living on antiretroviral therapy in resource-poor Uganda.

PubMed

Nanfuka, Esther Kalule; Kyaddondo, David; Ssali, Sarah N; Asingwire, Narathius

2018-01-01

Despite the national roll-out of free HIV medicines in Uganda and other sub-Saharan African countries, many HIV positive patients on antiretroviral therapy (ART) are at risk of non-adherence due to poverty and other structural and health system related constraints. However, several patients exhibit resilience by attaining and sustaining high levels of adherence amid adversity. Social capital, defined as resources embedded within social networks, is key in facilitating resilience but the mechanism through which it operates remains understudied. This article provides insights into mechanisms through which social capital enables patients on ART in a resource-poor setting to overcome risk and sustain adherence to treatment. The article draws from an ethnographic study of 50 adult male and female HIV patients enrolled at two treatment sites in Uganda, 15 of whom were followed-up for an extended period of six months for narrative interviews and observation. The patients were selected purposively on the basis of socio-demographic and treatment related criteria. Social capital protects patients on ART against the risk of non-adherence in three ways. 1) It facilitates access to scarce resources; 2) encourages HIV patients to continue on treatment; and 3) averts risk for non-adherence. Social capital is a key resource that can be harnessed to promote resilience among HIV patients in a resource-limited setting amid individual, structural and health system related barriers to ART adherence. Invigoration and maintenance of collectivist norms may however be necessary if its protective benefits are to be fully realized.

The state of health hardware in Aboriginal communities in rural and remote Australia.

PubMed

Torzillo, Paul J; Pholeros, Paul; Rainow, Stephan; Barker, Geoffrey; Sowerbutts, Tim; Short, Tim; Irvine, Andrew

2008-02-01

Many of the health problems faced by rural and remote Aboriginal people have been attributed to a poor living environment. In the mid 1980s we began a process of defining problems with the immediate living environment that would affect health. These related particularly to safety, washing and hygiene practice. Between January 1999 and November 2006 we undertook a standardised and detailed assessment of housing in Aboriginal communities. This involved an initial assessment of 250 items in each house and living area, focusing on performance and their impact on these healthy living practices. At the first survey-fix we implemented a limited cost repair of non-functioning health hardware and then six months later returned to the communities for a repeat assessment to examine improvement in performance. Between January 1999 and November 2006 we assessed 4,343 houses in 132 communities in four States and the Northern Territory during survey-fix 1 (SF1) and have repeated that survey-fix assessment (SF2) in 3,448 houses in 112 of those communities. This survey demonstrates extraordinarily poor performance of Aboriginal houses. In the survey period, 71,869 items referred for repair by survey teams were inspected by licensed electricians or plumbers and 49,499 of these have so far been fixed. Only 10% of these house items requiring repair were due to vandalism or misuse. Improvements in the living environment for Aboriginal people will require a sustained commitment to the planning, funding and implementation of maintenance programs in addition to adherence to the design, construction and supervision detail outlined in the National Indigenous Housing Guide.

Area racism and birth outcomes among Blacks in the United States.

PubMed

Chae, David H; Clouston, Sean; Martz, Connor D; Hatzenbuehler, Mark L; Cooper, Hannah L F; Turpin, Rodman; Stephens-Davidowitz, Seth; Kramer, Michael R

2018-02-01

There is increasing evidence that racism is a cause of poor health outcomes in the United States, including adverse birth outcomes among Blacks. However, research on the health consequences of racism has faced measurement challenges due to the more subtle nature of contemporary racism, which is not necessarily amenable to assessment through traditionally used survey methods. In this study, we circumvent some of these limitations by examining a previously developed Internet query-based proxy of area racism (Stephens-Davidowitz, 2014) in relation to preterm birth and low birthweight among Blacks. Area racism was measured in 196 designated market areas as the proportion of total Google searches conducted between 2004 and 2007 containing the "n-word." This measure was linked to county-level birth data among Blacks between 2005 and 2008, which were compiled by the National Center for Health Statistics; preterm birth and low birthweight were defined as <37 weeks gestation and <2500 g, respectively. After adjustment for maternal age, Census region, and county-level measures of urbanicity, percent of the Black population, education, and poverty, we found that each standard deviation increase in area racism was associated with relative increases of 5% in the prevalence of preterm birth and 5% in the prevalence of low birthweight among Blacks. Our study provides evidence for the utility of an Internet query-based measure as a proxy for racism at the area-level in epidemiologic studies, and is also suggestive of the role of racism in contributing to poor birth outcomes among Blacks. Copyright © 2017 Elsevier Ltd. All rights reserved.

NGC 6273: Towards Defining A New Class of Galactic Globular Clusters?

NASA Astrophysics Data System (ADS)

Johnson, Christian I.; Rich, Robert Michael; Pilachowski, Catherine A.; Caldwell, Nelson; Mateo, Mario L.; Ira Bailey, John; Crane, Jeffrey D.

2016-01-01

A growing number of observations have found that several Galactic globular clusters exhibit abundance dispersions beyond the well-known light element (anti-)correlations. These clusters tend to be very massive, have >0.1 dex intrinsic metallicity dispersions, have complex sub-giant branch morphologies, and have correlated [Fe/H] and s-process element enhancements. Interestingly, nearly all of these clusters discovered so far have [Fe/H]~-1.7. In this context, we have examined the chemical composition of 18 red giant branch (RGB) stars in the massive, metal-poor Galactic bulge globular cluster NGC 6273 using high signal-to-noise, high resolution (R~27,000) spectra obtained with the Michigan/Magellan Fiber System (M2FS) and MSpec spectrograph mounted on the Magellan-Clay 6.5m telescope at Las Campanas Observatory. We find that the cluster exhibits a metallicity range from [Fe/H]=-1.80 to -1.30 and is composed of two dominant populations separated in [Fe/H] and [La/Fe] abundance. The increase in [La/Eu] as a function of [La/H] suggests that the increase in [La/Fe] with [Fe/H] is due to almost pure s-process enrichment. The most metal-rich star in our sample is not strongly La-enhanced, but is α-poor and may belong to a third "anomalous" stellar population. The two dominant populations exhibit the same [Na/Fe]-[Al/Fe] correlation found in other "normal" globular clusters. Therefore, NGC 6273 joins ω Centauri, M 22, M 2, and NGC 5286 as a possible new class of Galactic globular clusters.

Enhancing Psychosis-Spectrum Nosology Through an International Data Sharing Initiative.

PubMed

Docherty, Anna R; Fonseca-Pedrero, Eduardo; Debbané, Martin; Chan, Raymond C K; Linscott, Richard J; Jonas, Katherine G; Cicero, David C; Green, Melissa J; Simms, Leonard J; Mason, Oliver; Watson, David; Ettinger, Ulrich; Waszczuk, Monika; Rapp, Alexander; Grant, Phillip; Kotov, Roman; DeYoung, Colin G; Ruggero, Camilo J; Eaton, Nicolas R; Krueger, Robert F; Patrick, Christopher; Hopwood, Christopher; O'Neill, F Anthony; Zald, David H; Conway, Christopher C; Adkins, Daniel E; Waldman, Irwin D; van Os, Jim; Sullivan, Patrick F; Anderson, John S; Shabalin, Andrey A; Sponheim, Scott R; Taylor, Stephan F; Grazioplene, Rachel G; Bacanu, Silviu A; Bigdeli, Tim B; Haenschel, Corinna; Malaspina, Dolores; Gooding, Diane C; Nicodemus, Kristin; Schultze-Lutter, Frauke; Barrantes-Vidal, Neus; Mohr, Christine; Carpenter, William T; Cohen, Alex S

2018-05-16

The latent structure of schizotypy and psychosis-spectrum symptoms remains poorly understood. Furthermore, molecular genetic substrates are poorly defined, largely due to the substantial resources required to collect rich phenotypic data across diverse populations. Sample sizes of phenotypic studies are often insufficient for advanced structural equation modeling approaches. In the last 50 years, efforts in both psychiatry and psychological science have moved toward (1) a dimensional model of psychopathology (eg, the current Hierarchical Taxonomy of Psychopathology [HiTOP] initiative), (2) an integration of methods and measures across traits and units of analysis (eg, the RDoC initiative), and (3) powerful, impactful study designs maximizing sample size to detect subtle genomic variation relating to complex traits (the Psychiatric Genomics Consortium [PGC]). These movements are important to the future study of the psychosis spectrum, and to resolving heterogeneity with respect to instrument and population. The International Consortium of Schizotypy Research is composed of over 40 laboratories in 12 countries, and to date, members have compiled a body of schizotypy- and psychosis-related phenotype data from more than 30000 individuals. It has become apparent that compiling data into a protected, relational database and crowdsourcing analytic and data science expertise will result in significant enhancement of current research on the structure and biological substrates of the psychosis spectrum. The authors present a data-sharing infrastructure similar to that of the PGC, and a resource-sharing infrastructure similar to that of HiTOP. This report details the rationale and benefits of the phenotypic data collective and presents an open invitation for participation.

[Hepatomegaly due to glycogen storage disease and type 1 diabetes mellitus].

PubMed

Flotats Bastardas, M; Miserachs Barba, M; Ricart Cumeras, A; Clemente León, M; Gussinyer Canadell, M; Yeste Fernández, D; Albisu Aparicio, María A; Carrascosa Lezcano, A

2007-08-01

Patients with type 1 diabetes and poor metabolic control can develop hepatomegaly due to intrahepatic glycogen deposition. If these patients also have elevated liver enzymes, dyslipidemia, cushingoid features and delayed growth or sexual maturation, Mauriac syndrome can be diagnosed. This disorder is common and reversible with optimization of insulin therapy. We report three adolescents with type 1 diabetes and a long-standing history of poor glycemic control, who developed hepatomegaly, elevated liver enzymes and dyslipidemia with preserved liver function. One of these patients also had delayed growth and another had hypogonadotropic hypogonadism. Liver ultrasound showed changes suggestive of glycogenosis. In all three patients, optimization of insulin therapy achieved good glycemic control and reversed the manifestations within 2 weeks. The etiology of Mauriac syndrome is controversial since both prolonged hyperglycemia and hyperinsulinization produce glycogen accumulation in the liver. Hypercortisolism (due to ketosis or hypoglycemia) contributes to glycogen storage and also causes growth and sexual maturation delay.

Factors affecting low summer dissolved oxygen concentrations in Mississippi Delta bayous

USDA-ARS?s Scientific Manuscript database

Streams in watersheds supporting intensive row-crop agriculture are vulnerable to ecological degradation due to non-point source discharge of pollutants such as nutrients. Low gradient streams such as bayous are especially susceptible due to increased water residence time, and often result in poor w...

Reinventing School Finance: Falling Forward

ERIC Educational Resources Information Center

Picus, Lawrence O.; Odden, Allan R.

2011-01-01

States and school districts are facing unprecedented financial pressure due to the continued poor performance of the United States's economy. Dramatic shortfalls in funding due to reduced tax collections were held off for 2 years thanks to federal stimulus funds, but with these revenues already consumed and little likelihood of more in the near…

Poverty, health & intellectual property rights with special reference to India.

PubMed

Satyanarayana, K; Srivastava, S

2007-10-01

This paper examines the nexus between poverty and global health with specific focus on IPR protection and attempts to highlight the current global endeavours to overcome barriers to access to medicines for diseases of the poor. The number of very poor people in the world has increased by 10.4 per cent between 1987 and 2001 to 2735 million. India is now home to the largest number of millionaires in the developing countries. But over 800 million Indians who still survive on Rs 20.0 (US$0.5) a day, and rural poverty is on the rise. The link between poverty and health is well established with the underprivileged are more vulnerable to major health risks due to poor nutrition, inadequate access to clean drinking water, sanitation, exposure to indoor smoke, etc. all of which contribute to the huge and growing burden of disease in the poor countries. The global disease burden is not just huge but growing: over 10 million children die of preventable conditions including vaccine-preventable diseases, about 14 million are killed by infectious diseases every year, 90-95 per cent in poor countries. An estimated third of global population has limited or no access to essential medicines. While the number of poor and unhealthy is growing, Government expenditure on health is dwindling. Many of the diseases of the poor require new medicines and none are forthcoming as there is little R&D for these infections. There are several barriers to access to existing and the newly discovered drugs. One major reason is the general lack of interest by the pharma industry to discover new medicines for diseases of the poor due to very limited market in developing countries. In addition, global intellectual property rights (IPR) protection regimes like the Trade Related Intellectual Property Rights (TRIPS) are considered a major obstacle for the poor access to medicines. There have been some global initiatives on the need to improve affordability and accessibility of medicines. Some strategies to promote R&D on diseases of the poor such as Prize Fund Model, the Medical R&D Treaty and steps to invoke flexibilities in TRIPS read with Doha Declaration are discussed. Health of the poor is a global problem that requires global solutions with global participation and commitment.

Survival and growth of restored Piedmont riparian forests as affected by site preparation, planting stock, and planting aids

Treesearch

Chelsea M. Curtis; W. Michael Aust; John R. Seiler; Brian D. Strahm

2015-01-01

Forest mitigation sites may have poor survival and growth of planted trees due to poor drainage, compacted soils, and lack of microtopography. The effects of five replications of five forestry mechanical site preparation techniques (Flat, Rip, Bed, Pit, and Mound), four regeneration sources (Direct seed, Bare root, Tubelings, and Gallon), and three planting aids (None...

Comparing cold-stored and freshly lifted water oak (Quercus nigra) seedlings based on physiological parameters

Treesearch

Rosa C. Goodman; Kent G. Apostol; Douglass F. Jacobs; Barrett C. Wilson; Emile S. Gardiner

2007-01-01

Water oak is often used in afforestation projects in the Lower Mississippi Alluvial Valley, but its field performance is often poor due to low survival rates and severe top dieback immediately after planting. The poor physiological quality of planting stock may be a contributing factor to this transplanting problem. In this study, cold storage was investigated to...

Using Asset Poverty Measures to Understand Poverty Dynamics, Poverty Traps and Farmer Behavior in Sub-Saharan Africa: A Focus on Rural Ethiopia

ERIC Educational Resources Information Center

Liverpool, Lenis Saweda

2009-01-01

Effective poverty reduction programs require careful measurement of poverty status. Commonly used consumption or income-based classifications of poverty aggregate together households that are persistently poor with those who are only in poverty due to passing conditions. They also classify as non-poor households that are at risk of falling into…

Is There a Private Schooling Market in Poor Neighbourhoods in Maputo, Mozambique? Exploring the Role of the Non-State Education Sector

ERIC Educational Resources Information Center

Härmä, Joanna

2016-01-01

In some low-income countries, low-fee private schools targeting relatively poor communities have sprung up in considerable numbers meeting growing demand. This is often the case where government is not providing enough school places, but also where parents could access government schools for their children but choose not to, due to perceived low…

Decomposing the gap in childhood undernutrition between poor and non-poor in urban India, 2005-06.

PubMed

Kumar, Abhishek; Singh, Aditya

2013-01-01

Despite the growing evidence from other developing countries, intra-urban inequality in childhood undernutrition is poorly researched in India. Additionally, the factors contributing to the poor/non-poor gap in childhood undernutrition have not been explored. This study aims to quantify the contribution of factors that explain the poor/non-poor gap in underweight, stunting, and wasting among children aged less than five years in urban India. We used cross-sectional data from the third round of the National Family Health Survey conducted during 2005-06. Descriptive statistics were used to understand the gap in childhood undernutrition between the urban poor and non-poor, and across the selected covariates. Blinder-Oaxaca decomposition technique was used to explain the factors contributing to the average gap in undernutrition between poor and non-poor children in urban India. Considerable proportions of urban children were found to be underweight (33%), stunted (40%), and wasted (17%) in 2005-06. The undernutrition gap between the poor and non-poor was stark in urban India. For all the three indicators, the main contributing factors were underutilization of health care services, poor body mass index of the mothers, and lower level of parental education among those living in poverty. The findings indicate that children belonging to poor households are undernourished due to limited use of health care services, poor health of mothers, and poor educational status of their parents. Based on the findings the study suggests that improving the public services such as basic health care and the education level of the mothers among urban poor can ameliorate the negative impact of poverty on childhood undernutrition.

Decomposing the Gap in Childhood Undernutrition between Poor and Non–Poor in Urban India, 2005–06

PubMed Central

Kumar, Abhishek; Singh, Aditya

2013-01-01

Background Despite the growing evidence from other developing countries, intra-urban inequality in childhood undernutrition is poorly researched in India. Additionally, the factors contributing to the poor/non-poor gap in childhood undernutrition have not been explored. This study aims to quantify the contribution of factors that explain the poor/non-poor gap in underweight, stunting, and wasting among children aged less than five years in urban India. Methods We used cross-sectional data from the third round of the National Family Health Survey conducted during 2005–06. Descriptive statistics were used to understand the gap in childhood undernutrition between the urban poor and non-poor, and across the selected covariates. Blinder–Oaxaca decomposition technique was used to explain the factors contributing to the average gap in undernutrition between poor and non-poor children in urban India. Result Considerable proportions of urban children were found to be underweight (33%), stunted (40%), and wasted (17%) in 2005–06. The undernutrition gap between the poor and non-poor was stark in urban India. For all the three indicators, the main contributing factors were underutilization of health care services, poor body mass index of the mothers, and lower level of parental education among those living in poverty. Conclusions The findings indicate that children belonging to poor households are undernourished due to limited use of health care services, poor health of mothers, and poor educational status of their parents. Based on the findings the study suggests that improving the public services such as basic health care and the education level of the mothers among urban poor can ameliorate the negative impact of poverty on childhood undernutrition. PMID:23734231

Behaviour planning and problem solving deficiencies in children with symptoms of attention deficit hyperactivity disorder from the Balobedu culture, Limpopo province, South Africa.

PubMed

Pila-Nemutandani, Refilwe Gloria; Meyer, Anneke

2016-07-01

To compare planning behaviour (frontal lobe functioning) in children with and without symptoms of attention deficit hyperactivity disorder (ADHD). A total of 90 children (45 with symptoms of ADHD and 45 matched controls without ADHD symptoms) of both genders, who were medication naïve, from the Balobedu culture (Limpopo province, South Africa), aged 7-13 years, participated in the study. The performance of the two groups was compared on a test of planning and problem solving, the Tower of London (ToL) task. The results were analysed as a function of gender and ADHD subtype. The Finger Tapping test (testing fine motor skills) was used as a control test to verify that the expected differences were not due to poor motor skills. The children with ADHD symptoms scored significantly lower than the non-ADHD comparison group which indicated deficiency in frontal lobe functioning (p = 0.00). The difference in performance was not due to poor motor control (p = 0.70). Children with ADHD symptoms show deficits in behavioural planning which indicates impairment of functions of the frontal areas supplied by the mesocortical dopamine branch. More so than others, the ADHD Inattentive and Combined subtypes showed poor performance in the Tower of London task, indicating poor organisational and planning skills in these groups. The results also did show that the difference was not due to problems with motor control and that the ToL task is a culture-fair instrument for testing planning behaviour.

The Association between Sleep and Theory of Mind in School Aged Children with ADHD

PubMed Central

Tesfaye, Rackeb; Gruber, Reut

2017-01-01

Theory of Mind (ToM) is defined as the ability to infer a range of internal mental states of others, including beliefs, intentions, desires, and emotions. These abilities are associated with children’s ability to socialize effectively with peers. ToM impairments are associated with peer rejection and psychiatric disorders such as Attention-Deficit/Hyperactivity Disorder (ADHD). Previous studies have found poor sleep negatively impacts executive functioning (EF) and emotional information processing, which are essential for the effective use of ToM. Youth with ADHD have EF deficits and sleep problems. However, the relationship between sleep, executive functioning, and ToM in children with ADHD has not been studied. In this review, we propose that the poor social and interpersonal skills characterizing individuals with ADHD could be explained by the impact of poor sleep on the emotional and cognitive mechanisms underlying ToM. PMID:29099034

Shift Work and Sleep Quality Among Urban Police Officers

PubMed Central

Fekedulegn, Desta; Burchfiel, Cecil M.; Charles, Luenda E.; Hartley, Tara A.; Andrew, Michael E.; Violanti, John M.

2016-01-01

Objective The aim of the study was to examine association of shift work with sleep quality in police officers. Methods Data were obtained from the Buffalo Cardio-Metabolic Occupational Police Stress study (n =363). An electronic work history database was used to define shift as day, afternoon, or night for three durations: past month, 1 year, and 15 years. Sleep quality was determined using the Pittsburgh Sleep Quality Index. Results The overall prevalence of poor sleep quality was 54%; 44% for day, 60% for afternoon, and 69% for night shift. Poor sleep quality was 70% more prevalent among night-shift officers (P <0.001) and 49% higher among those on the afternoon shift (P =0.003) relative to officers working on the day shift. Conclusions Night and evening work schedules are associated with elevated prevalence of poor sleep quality among police officers. PMID:26949891

Shift Work and Sleep Quality Among Urban Police Officers: The BCOPS Study.

PubMed

Fekedulegn, Desta; Burchfiel, Cecil M; Charles, Luenda E; Hartley, Tara A; Andrew, Michael E; Violanti, John M

2016-03-01

The aim of the study was to examine association of shift work with sleep quality in police officers. Data were obtained from the Buffalo Cardio-Metabolic Occupational Police Stress study (n = 363). An electronic work history database was used to define shift as day, afternoon, or night for three durations: past month, 1 year, and 15 years. Sleep quality was determined using the Pittsburgh Sleep Quality Index. The overall prevalence of poor sleep quality was 54%; 44% for day, 60% for afternoon, and 69% for night shift. Poor sleep quality was 70% more prevalent among night-shift officers (P < 0.001) and 49% higher among those on the afternoon shift (P = 0.003) relative to officers working on the day shift. Night and evening work schedules are associated with elevated prevalence of poor sleep quality among police officers.

Facies Distribution and Petrophysical Properties of Shoreface-Offshore Transition Environment in Sandakan Formation, NE Sabah Basin

NASA Astrophysics Data System (ADS)

Majid, M. Firdaus A.; Suhaili Ismail, M.; Rahman, A. Hadi A.; Azfar Mohamed, M.

2017-10-01

Newly exposed outcrop of Miocene shallow marine sandstone in Sandakan Formation, allows characterization of the facies distribution and petrophysical properties of shoreface to offshore transition environment. Six facies are defined: (1) Poorly bioturbated Hummocky Cross Stratified (HCS) sandstone (F1), (2) Moderately bioturbated HCS sandstone (F2), (3) Well bioturbated HCS sandstone (F3), (4) Poorly bioturbated Swaley Cross Stratified (SCS) sandstone (F4), (5) Interbedded HCS sandstone with sand-silt mudstone, (6) Heterolithic mudstone. The sedimentary successions were deposited in upper to lower shoreface, and offshore transition environment. Facies F3, F4 and F5 shows good reservoir quality with good porosity and fair permeability values from 20% to 21% and 14 mD to 33 mD respectively. While Facies F1 exhibits poor reservoir quality with low permeability values 3.13 mD.

Educational attainment in poor comprehenders

PubMed Central

Ricketts, Jessie; Sperring, Rachael; Nation, Kate

2014-01-01

To date, only one study has investigated educational attainment in poor (reading) comprehenders, providing evidence of poor performance on national UK school tests at age 11 years relative to peers (Cain and Oakhill, 2006). In the present study, we adopted a longitudinal approach, tracking attainment on such tests from 11 years to the end of compulsory schooling in the UK (age 16 years). We aimed to investigate the proposal that educational weaknesses (defined as poor performance on national assessments) might become more pronounced over time, as the curriculum places increasing demands on reading comprehension. Participants comprised 15 poor comprehenders and 15 controls; groups were matched for chronological age, nonverbal reasoning ability and decoding skill. Children were identified at age 9 years using standardized measures of nonverbal reasoning, decoding and reading comprehension. These measures, along with a measure of oral vocabulary knowledge, were repeated at age 11 years. Data on educational attainment were collected from all participants (n = 30) at age 11 and from a subgroup (n = 21) at 16 years. Compared to controls, educational attainment in poor comprehenders was lower at ages 11 and 16 years, an effect that was significant at 11 years. When poor comprehenders were compared to national performance levels, they showed significantly lower performance at both time points. Low educational attainment was not evident for all poor comprehenders. Nonetheless, our findings point to a link between reading comprehension difficulties in mid to late childhood and poor educational outcomes at ages 11 and 16 years. At these ages, pupils in the UK are making key transitions: they move from primary to secondary schools at 11, and out of compulsory schooling at 16. PMID:24904464

Proteomic analysis of serum and sputum analytes distinguishes controlled and poorly controlled asthmatics.

PubMed

Kasaian, M T; Lee, J; Brennan, A; Danto, S I; Black, K E; Fitz, L; Dixon, A E

2018-04-17

A major goal of asthma therapy is to achieve disease control, with maintenance of lung function, reduced need for rescue medication, and prevention of exacerbation. Despite current standard of care, up to 70% of patients with asthma remain poorly controlled. Analysis of serum and sputum biomarkers could offer insights into parameters associated with poor asthma control. To identify signatures as determinants of asthma disease control, we performed proteomics using Olink proximity extension analysis. Up to 3 longitudinal serum samples were collected from 23 controlled and 25 poorly controlled asthmatics. Nine of the controlled and 8 of the poorly controlled subjects also provided 2 longitudinal sputum samples. The study included an additional cohort of 9 subjects whose serum was collected within 48 hours of asthma exacerbation. Two separate pre-defined Proseek Multiplex panels (INF and CVDIII) were run to quantify 181 separate protein analytes in serum and sputum. Panels consisting of 9 markers in serum (CCL19, CCL25, CDCP1, CCL11, FGF21, FGF23, Flt3L, IL-10Rβ, IL-6) and 16 markers in sputum (tPA, KLK6, RETN, ADA, MMP9, Chit1, GRN, PGLYRP1, MPO, HGF, PRTN3, DNER, PI3, Chi3L1, AZU1, and OPG) distinguished controlled and poorly controlled asthmatics. The sputum analytes were consistent with a pattern of neutrophil activation associated with poor asthma control. The serum analyte profile of the exacerbation cohort resembled that of the controlled group rather than that of the poorly controlled asthmatics, possibly reflecting a therapeutic response to systemic corticosteroids. Proteomic profiles in serum and sputum distinguished controlled and poorly controlled asthmatics, and were maintained over time. Findings support a link between sputum neutrophil markers and loss of asthma control. © 2018 John Wiley & Sons Ltd.

The prevalence of poor sleep quality and its association with depression and anxiety scores in patients admitted for cardiovascular disease: A cross-sectional designed study.

PubMed

Matsuda, Risa; Kohno, Takashi; Kohsaka, Shun; Fukuoka, Ryoma; Maekawa, Yuichiro; Sano, Motoaki; Takatsuki, Seiji; Fukuda, Keiichi

2017-02-01

Poor sleep quality contributes to the development of various cardiovascular conditions. However, its real-world prevalence among cardiovascular inpatients and association with psychological disturbance is unknown. This study aimed to assess the prevalence of poor sleep quality and its association with depression and anxiety in cardiovascular patients, and explored whether sex and cardiovascular comorbidities modified these associations. A total of 1071 patients hospitalized for a broad spectrum of cardiovascular diseases at a single university hospital were assessed (790 men, mean age 64±14years). We assessed sleep quality during their index hospitalization period using the Pittsburgh Sleep Quality Index (PSQI); poor sleep quality was defined as PSQI>5. Depression and anxiety were assessed with the Hospital Anxiety and Depression Scale (HADS). The median PSQI score was 5.0 [3.0-7.0], and 461 inpatients (43%) had poor sleep quality. Multivariate regression analysis adjusting for patient background, medical risk factors, and laboratory data revealed that poor sleep quality was associated with higher HADS subscores for depression (HADS-depression; odds ratio [OR]: 1.09, 95% confidence interval [CI]: 1.03-1.15) and anxiety (HADS-anxiety; OR: 1.17, 95% CI: 1.11-1.24). Poor sleep quality was associated with markedly higher HADS-depression among women than men (p value for interaction: 0.008). The association between poor sleep quality and HADS-anxiety was more significant among patients without coronary artery diseases (p value for interaction: 0.017). Poor sleep quality was highly prevalent and associated with depression and anxiety in cardiovascular patients. These associations may be modified by sex and the presence of coronary artery diseases. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Poor Pre-Pregnancy and Antepartum Mental Health Predicts Postpartum Mental Health Problems among US Women: A Nationally Representative Population-Based Study

PubMed Central

Witt, Whitney P.; Wisk, Lauren E.; Cheng, Erika R.; Hampton, John M.; Creswell, Paul; Hagen, Erika W.; Spear, Hilary A.; Maddox, Torsheika; DeLeire, Thomas

2011-01-01

Purpose Mental health problems disproportionately affect women, particularly during childbearing years. However, there is a paucity of research on the determinants of postpartum mental health problems using representative US populations. Taking a life course perspective, we determined the potential risk factors for postpartum mental health problems, with a particular focus on the role of mental health before and during pregnancy. Methods We examined data on 1,863 mothers from eleven panels of the 1996-2006 Medical Expenditure Panel Survey (MEPS). Poor postpartum mental health was defined using self-reports of mental health conditions, symptoms of mental health conditions, or global mental health ratings of “fair” or “poor.” Results 9.5% of women reported experiencing postpartum mental health problems, with over half of these women reporting a history of poor mental health. Poor pre-pregnancy mental health and poor antepartum mental health both independently increased the odds of having postpartum mental health problems. Staged multivariate analyses revealed that poor antepartum mental health attenuated the relationship between pre-pregnancy and postpartum mental health problems. Additionally, significant disparities exist in women's report of postpartum mental health status. Conclusions While poor antepartum mental health is the strongest predictor of postpartum mental health problems, pre-pregnancy mental health is also important. Accordingly, health care providers should identify, treat, and follow women with a history of poor mental health, as they are particularly susceptible to postpartum mental health problems. This will ensure that women and their children are in the best possible health and mental health during the postpartum period and beyond. PMID:21349740

The influence of community and individual health literacy on self-reported health status.

PubMed

Sentell, Tetine; Zhang, Wei; Davis, James; Baker, Kathleen Kromer; Braun, Kathryn L

2014-02-01

Individual health literacy is an established predictor of individual health outcomes. Community-level health literacy may also impact individual health, yet limited research has simultaneously considered the influence of individual and community health literacy on individual health. The study goal was to determine if community health literacy had an independent relationship with individual self-reported health beyond individual health literacy. We used data from the 2008 and 2010 Hawai'i Health Survey, a representative statewide telephone survey. Multilevel models predicted individual self-reported health by both individual and community health literacy, controlling for relevant individual-level (education, race/ethnicity, gender, poverty, insurance status, age, and marital status) and community-level variables (community poverty and community education). The sample included 11,779 individuals within 37 communities. Individual health literacy was defined by validated self-reported measurement. Communities were defined by zip code combinations. Community health literacy was defined as the percentage of individuals within a community reporting low health literacy. Census data by ZIP Code Tabulation Areas provided community-level variables. In descriptive results, 18.2 % self-reported low health literacy, and 14.7 % reported self-reported poor health. Community-level low health literacy ranged from 5.37 % to 35.99 %. In final, multilevel models, both individual (OR: 2.00; 95 % CI: 1.63-2.44) and community low health literacy (OR: 1.02; 95 % CI: 1.00-1.03) were significantly positively associated with self-reported poor health status. Each percentage increase of average low health literacy within a community was associated with an approximately 2 % increase in poor self-reported health for individuals in that community. Also associated with poorer health were lower educational attainment, older age, poverty, and non-White race. Both individual and community health literacy are significant, distinct correlates of individual general health status. Primary care providers and facilities should consider and address health literacy at both community and individual levels.

Quality of Vitamin K Antagonist Anticoagulation in Spain: Prevalence of Poor Control and Associated Factors.

PubMed

Anguita Sánchez, Manuel; Bertomeu Martínez, Vicente; Cequier Fillat, Ángel

2015-09-01

To study the prevalence of poorly controlled vitamin K antagonist anticoagulation in Spain in patients with nonvalvular atrial fibrillation, and to identify associated factors. We studied 1056 consecutive patients seen at 120 cardiology clinics in Spain between November 2013 and March 2014. We analyzed the international normalized ratio from the 6 months prior to the patient's visit, calculating the prevalence of poorly controlled anticoagulation, defined as < 65% time in therapeutic range using the Rosendaal method. Mean age was 73.6 years (standard deviation, 9.8 years); women accounted for 42% of patients. The prevalence of poorly controlled anticoagulation was 47.3%. Mean time in therapeutic range was 63.8% (25.9%). The following factors were independently associated with poorly controlled anticoagulation: kidney disease (odds ratio = 1.53; 95% confidence interval, 1.08-2.18; P = .018), routine nonsteroidal anti-inflammatory drugs (odds ratio = 1.79; 95% confidence interval, 1.20-2.79; P = .004), antiplatelet therapy (odds ratio = 2.16; 95% confidence interval, 1.49-3.12; P < .0001) and absence of angiotensin receptor blockers (odds ratio = 1.39; 95% confidence interval, 1.08-1.79; P = .011). There is a high prevalence of poorly controlled vitamin K antagonist anticoagulation in Spain. Factors associated with poor control are kidney disease, routine nonsteroidal anti-inflammatory drugs, antiplatelet use, and absence of angiotensin receptor blockers. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Mental state attribution in schizophrenia: what distinguishes patients with "poor" from patients with "fair" mentalising skills?

PubMed

Brüne, M; Schaub, D

2012-07-01

Although many patients with schizophrenia are impaired in mental states attribution abilities, a significant number perform within normal or near-normal ranges in mental state attribution tasks. No studies have analysed cognitive or behavioural differences between patients with - to some extent - preserved mental state attribution skills and those with poor mentalising abilities. To examine characteristics of "poor" and "fair" mentalisers, 58 patients with schizophrenia performed a mental state attribution task, a test of general intelligence, and two executive functioning tests. "Poor" and "fair" mentalising skills were defined according to a median-split procedure; the median score in the patient group was also within two standard deviations of the control group. In addition, patients' social behavioural skills and psychopathological profiles were rated. Patients performing within normal or near normal ranges on the mental state attribution task had fewer social behavioural abnormalities than patients with poor mentalising abilities (even when controlled for intelligence), but did not differ in executive functioning. Fair mental state performers showed less disorganisation and excitement symptoms than poor performers. The degree of disorganisation mediated the influence of mental state attribution on social behavioural skills. Schizophrenia patients with (partially) preserved mentalising skills have fewer behavioural problems in the social domain than patients with poor mentalising abilities. Conceptual disorganisation mediates the prediction of social behavioural skills through mentalising skills, suggesting that disorganised patients may require special attention regarding social-cognitive skills training. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Nursing Under the Old Poor Law in Midland and Eastern England 1780-1834.

PubMed

King, Steven

2015-10-01

This article uses data drawn from the overseers' accounts and supporting documentation in thirty-six parishes spread over four English counties, to answer three basic questions. First, what was the character, extent, structure, range of activities, and remuneration of the nursing labor force under the Old Poor Law between the late eighteenth century and the implementation of the New Poor Law in the 1830s? Second, were there regional and intra-regional differences in the scale and nature of spending on nursing care for the sick poor? Third, how might one explain such differences? The article suggests that nursing became an increasingly important category of spending for the poor law from the later eighteenth century, but that there were significant variations within and (particularly) between English counties in parochial attitudes toward the provision of nursing for the sick poor. These variations can be explained by applying a matrix of explanatory variables ranging from the minor (differences in how parishes defined "nursing") through to the major (long-standing cultural attitudes toward the responsibility of parishioners to their sick compatriots and the ingrained expectations of the sick poor). The article also throws new light on the hidden aspects of female labor force participation, pointing to the development of professional nursing networks long before the later nineteenth century. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Association between Facebook dependence and poor sleep quality: a study in a sample of undergraduate students in Peru.

PubMed

Wolniczak, Isabella; Cáceres-DelAguila, José Alonso; Palma-Ardiles, Gabriela; Arroyo, Karen J; Solís-Visscher, Rodrigo; Paredes-Yauri, Stephania; Mego-Aquije, Karina; Bernabe-Ortiz, Antonio

2013-01-01

Internet can accelerate information exchange. Social networks are the most accessed especially Facebook. This kind of networks might create dependency with several negative consequences in people's life. The aim of this study was to assess potential association between Facebook dependence and poor sleep quality. A cross sectional study was performed enrolling undergraduate students of the Universidad Peruana de Ciencias Aplicadas, Lima, Peru. The Internet Addiction Questionnaire, adapted to the Facebook case, and the Pittsburgh Sleep Quality Index, were used. A global score of 6 or greater was defined as the cutoff to determine poor sleep quality. Generalized linear model were used to determine prevalence ratios (PR) and 95% confidence intervals (95%CI). A total of 418 students were analyzed; of them, 322 (77.0%) were women, with a mean age of 20.1 (SD: 2.5) years. Facebook dependence was found in 8.6% (95% CI: 5.9%-11.3%), whereas poor sleep quality was present in 55.0% (95% CI: 50.2%-59.8%). A significant association between Facebook dependence and poor sleep quality mainly explained by daytime dysfunction was found (PR = 1.31; IC95%: 1.04-1.67) after adjusting for age, sex and years in the faculty. There is a relationship between Facebook dependence and poor quality of sleep. More than half of students reported poor sleep quality. Strategies to moderate the use of this social network and to improve sleep quality in this population are needed.

Prevalence and Predictive Factors of Chronic Postsurgical Pain and Poor Global Recovery 1 Year After Outpatient Surgery.

PubMed

Hoofwijk, Daisy M N; Fiddelers, Audrey A A; Peters, Madelon L; Stessel, Björn; Kessels, Alfons G H; Joosten, Elbert A; Gramke, Hans-Fritz; Marcus, Marco A E

2015-12-01

To prospectively describe the prevalence and predictive factors of chronic postsurgical pain (CPSP) and poor global recovery in a large outpatient population at a university hospital, 1 year after outpatient surgery. A prospective longitudinal cohort study was performed. During 18 months, patients presenting for preoperative assessment were invited to participate. Outcome parameters were measured by using questionnaires at 3 timepoints: 1 week preoperatively, 4 days postoperatively, and 1 year postoperatively. A value of >3 on an 11-point numeric rating scale was considered to indicate moderate to severe pain. A score of ≤80% on the Global Surgical Recovery Index was defined as poor global recovery. A total of 908 patients were included. The prevalence of moderate to severe preoperative pain was 37.7%, acute postsurgical pain 26.7%, and CPSP 15.3%. Risk factors for the development of CPSP were surgical specialty, preoperative pain, preoperative analgesic use, acute postoperative pain, surgical fear, lack of optimism, and poor preoperative quality of life. The prevalence of poor global recovery was 22.3%. Risk factors for poor global recovery were recurrent surgery because of the same pathology, preoperative pain, preoperative analgesic use, surgical fear, lack of optimism, poor preoperative and acute postoperative quality of life, and follow-up surgery during the first postoperative year. Moderate to severe CPSP after outpatient surgery is common, and should not be underestimated. Patients at risk for developing CPSP can be identified during the preoperative phase.

Modern soil system constraints on reconstructing deep-time atmospheric CO2

NASA Astrophysics Data System (ADS)

Montañez, Isabel P.

2013-01-01

Paleosol carbonate-based estimates of paleo-atmospheric CO2 play a prominent role in constraining radiative-forcing and climate sensitivity in the deep-time. Large uncertainty in paleo-CO2 estimates made using the paleosol-carbonate CO2-barometer, however, arises primarily from their sensitivity to soil-respired CO2 (S(z)). This parameter is poorly constrained due to a paucity of soil CO2 measurements during carbonate formation in modern soils and a lack of widely applicable proxies of paleo-soil CO2. Here the δ13C values of carbonate and soil organic matter (SOM) pairs from 130 Holocene soils are applied to a two-component CO2-mixing equation to define soil order-specific ranges of soil CO2 applicable for constraining S(z) in their corresponding paleosol analogs. Equilibrium carbonate-SOM pairs, characterized by Δ13Ccarb-SOM values of 12.2-15.8‰, define a mean effective fractionation of 14.1‰ and overall inferred total soil CO2 contents during calcite formation of <1000-10,000 ppmv. For those Aridisols and Alfisols, characterized by a net soil-moisture deficit, and their paleosol analogs (Calcisols and Argillisols), a best estimate of S(z) during calcite formation is 1500-2000 ppmv (range of 500-2500 ppmv). Overall higher values (2000-5000 ppmv) are indicated by the subset of these soils characterized by higher moisture content and productivity. Near atmospheric levels (400 ± 200 ppmv) of estimated S(z) are indicated by immature soils, recording their low soil productivity. Vertisols define the largest range in total soil CO2 (<1000 to >25,000 ppmv) reflecting their seasonally driven dynamic hydrochemistry. A S(z) range of 1000-10,000 ppmv is suggested for paleo-Vertisols for which calcite precipitation can be constrained to have occurred in an open system with two-component CO2 mixing, with a best estimate of 2000 ppmv ± 1000 ppmv appropriate for paleo-Vertisols for which evidence of protracted water saturation is lacking. Mollisol pairs define a best estimate of S(z) of 2500 ppmv (range of 600-4000 ppmv) for late Cretaceous and Cenozoic analogs. Non-equilibrium pairs with Δ13C values >16‰ make up 51% of the dataset, lending support to the hypothesis that pedogenic carbonate precipitation occurs during periods of low productivity in a soil atmosphere with a large component of atmospheric CO2. Predictable scaling between estimated soil CO2 and the difference in δ13C between measured pedogenic carbonate and that predicted to have formed from soil-respired CO2 (inferred from measured SOM) can be used to further constrain appropriate ranges of S(z) for reconstruction of paleo-atmospheric pCO2. Soil CO2 estimates are poorly correlated to mean annual precipitation likely reflecting that for carbonate-bearing soils, where moisture limits CO2 production, total soil CO2 is most strongly influenced by actual evapotranspiration.

An investigation into the relationship between age and physiological function in highly active older adults

PubMed Central

Pollock, Ross D; Carter, Scott; Velloso, Cristiana P; Duggal, Niharika A; Lord, Janet M; Lazarus, Norman R; Harridge, Stephen D R

2015-01-01

Despite extensive research, the relationship between age and physiological function remains poorly characterised and there are currently no reliable markers of human ageing. This is probably due to a number of confounding factors, particularly in studies of a cross-sectional nature. These include inter-subject genetic variation, as well as inter-generational differences in nutrition, healthcare and insufficient levels of physical activity as well as other environmental factors. We have studied a cohort of highly and homogeneously active older male (n = 84) and female (n = 41) cyclists aged 55–79 years who it is proposed represent a model for the study of human ageing free from the majority of confounding factors, especially inactivity. The aim of the study was to identify physiological markers of ageing by assessing the relationship between function and age across a wide range of indices. Each participant underwent a detailed physiological profiling which included measures of cardiovascular, respiratory, neuromuscular, metabolic, endocrine and cognitive functions, bone strength, and health and well-being. Significant associations between age and function were observed for many functions. The maximal rate of oxygen consumption ( showed the closest association with age (r = −0.443 to −0.664; P < 0.001), but even here the variance in age for any given level was high, precluding the clear identification of the age of any individual. The results of this cross-sectional study suggest that even when many confounding variables are removed the relationship between function and healthy ageing is complex and likely to be highly individualistic and that physical activity levels must be taken into account in ageing studies. Key Points The relationship between age and physiological function remains poorly defined and there are no physiological markers that can be used to reliably predict the age of an individual. This could be due to a variety of confounding genetic and lifestyle factors, and in particular to ill-defined and low levels of physical activity. This study assessed the relationship between age and a diverse range of physiological functions in a cohort of highly active older individuals (cyclists) aged 55–79 years in whom the effects of lifestyle factors would be ameliorated. Significant associations between age and function were observed for many functions. was most closely associated with age, but even here the variance in age for any given level was high, precluding the clear identification of the age of any individual. The data suggest that the relationship between human ageing and physiological function is highly individualistic and modified by inactivity. PMID:25565071

An investigation into the relationship between age and physiological function in highly active older adults.

PubMed

Pollock, Ross D; Carter, Scott; Velloso, Cristiana P; Duggal, Niharika A; Lord, Janet M; Lazarus, Norman R; Harridge, Stephen D R

2015-02-01

The relationship between age and physiological function remains poorly defined and there are no physiological markers that can be used to reliably predict the age of an individual. This could be due to a variety of confounding genetic and lifestyle factors, and in particular to ill-defined and low levels of physical activity. This study assessed the relationship between age and a diverse range of physiological functions in a cohort of highly active older individuals (cyclists) aged 55-79 years in whom the effects of lifestyle factors would be ameliorated. Significant associations between age and function were observed for many functions. V̇O2max was most closely associated with age, but even here the variance in age for any given level was high, precluding the clear identification of the age of any individual. The data suggest that the relationship between human ageing and physiological function is highly individualistic and modified by inactivity. Despite extensive research, the relationship between age and physiological function remains poorly characterised and there are currently no reliable markers of human ageing. This is probably due to a number of confounding factors, particularly in studies of a cross-sectional nature. These include inter-subject genetic variation, as well as inter-generational differences in nutrition, healthcare and insufficient levels of physical activity as well as other environmental factors. We have studied a cohort of highly and homogeneously active older male (n = 84) and female (n = 41) cyclists aged 55-79 years who it is proposed represent a model for the study of human ageing free from the majority of confounding factors, especially inactivity. The aim of the study was to identify physiological markers of ageing by assessing the relationship between function and age across a wide range of indices. Each participant underwent a detailed physiological profiling which included measures of cardiovascular, respiratory, neuromuscular, metabolic, endocrine and cognitive functions, bone strength, and health and well-being. Significant associations between age and function were observed for many functions. The maximal rate of oxygen consumption (V̇O2max) showed the closest association with age (r = -0.443 to -0.664; P < 0.001), but even here the variance in age for any given level was high, precluding the clear identification of the age of any individual. The results of this cross-sectional study suggest that even when many confounding variables are removed the relationship between function and healthy ageing is complex and likely to be highly individualistic and that physical activity levels must be taken into account in ageing studies. © 2014 The Authors. The Journal of Physiology © 2014 The Physiological Society.

Sleep Patterns as Predictors for Disability Pension Due to Low Back Diagnoses: A 23-Year Longitudinal Study of Finnish Twins

PubMed Central

Ropponen, Annina; Silventoinen, Karri; Hublin, Christer; Svedberg, Pia; Koskenvuo, Markku; Kaprio, Jaakko

2013-01-01

Study Objectives: Impaired sleep patterns are known to be associated with many chronic conditions and ultimately they may lead to permanent work incapacity. Less is known about the associations between sleep patterns and cause-specific disability pensions, such as low back diagnoses, or whether familial factors (genetics and family environment) can affect the associations. The objective of this study was to investigate sleep patterns as predictors of disability pension due to low back diagnoses with a 23-year follow-up. Design and Setting: A prospective cohort study with comprehensive mailed questionnaires about sleep patterns, e.g., quality and length of sleep in 1975 and 1981. Follow-up from the national disability pension register data until 2004. Interventions: Not applicable. Participants: There were 18,979 individuals (7,722 complete twin pairs) born before 1958. Measurements and Results: Cox proportional hazards regression was used to calculate hazard ratios (HR) with 95% confidence intervals (95% CI). Disability pension due to low back diagnoses had been granted to 467 individuals during the follow-up. Sleeping moderately well (HR 1.25; 95% CI 1.02, 1.53), or fairly poorly/poorly (HR 2.05; 95% CI 1.53, 2.73) at baseline predicted a significantly higher risk for disability pension. Stable patterns of sleeping either fairly well (HR 1.29; 95% CI 1.01, 1.64), or stably fairly poorly/poorly (HR 2.29; 95% CI 1.49, 3.52) between 1975 and 1981 were associated with a higher risk as compared to a stable pattern of sleeping well. Furthermore, a decrease in quality of sleep from 1975 to 1981 was associated (HR 1.34; 95% CI 1.03, 1.76) with an increased risk of disability pension. Conclusions: Sleep quality and changes in sleep quality appear to be early predictors for disability pension due to low back diagnoses independently from other confounding factors. Citation: Ropponen A; Silventoinen K; Hublin C; Svedberg P; Koskenvuo M; Kaprio J. Sleep patterns as predictors for disability pension due to low back diagnoses: a 23-year longitudinal study of Finnish twins. SLEEP 2013;36(6):891-897. PMID:23729932

Measurement of host-to-activator transfer efficiency in nano-crystalline Y{sub 2}O{sub 3}:Eu{sup 3+} under VUV excitation

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

Waite, Christopher; Mann, Rusty; Diaz, Anthony L., E-mail: DiazA@cwu.edu

2013-02-15

We have conducted a systematic study of the excitation and reflectance spectra of nano-crystalline Y{sub 2}O{sub 3}:Eu prepared by combustion synthesis. Excitation through the host lattice becomes relatively more efficient as the firing temperature of the precursor is increased, while reflectance properties remain essentially unchanged. Using these data, host-to-activator transfer efficiencies were calculated for excitation at the band edge of Y{sub 2}O{sub 3}, and evaluated using a competition kinetics model. From this analysis we conclude that the relatively low luminous efficiency of these materials is due more to poor bulk crystallinity than to surface loss effects. - Graphical abstract: Themore » low luminous efficiency of nano-crystalline Y{sub 2}O{sub 3}:Eu{sup 3+} prepared by combustion synthesis is due to poor bulk crystallinity rather than surface loss effects. Highlights: Black-Right-Pointing-Pointer We report on the optical properties of Y{sub 2}O{sub 3}:Eu{sup 3+} prepared by combustion synthesis. Black-Right-Pointing-Pointer Host-to-activator transfer efficiencies under VUV excitation were calculated. Black-Right-Pointing-Pointer The low luminous efficiency of these materials is due to poor bulk crystallinity.« less

An exploration of the socio-economic profile of women and costs of receiving abortion services at public health facilities of Madhya Pradesh, India.

PubMed

Banerjee, Sushanta K; Kumar, Rakesh; Warvadekar, Janardan; Manning, Vinoj; Andersen, Kathryn Louise

2017-03-21

Maternal mortality, which primarily burdens developing countries, reflects the greatest health divide between rich and poor. This is especially pronounced for access to safe abortion services which alone avert 1 of every 10 maternal deaths in India. Primarily due to confidentiality concerns, poor women in India prefer private services which are often offered by untrained providers and may be expensive. In 2006 the state government of Madhya Pradesh (population 73 million) began a concerted effort to ensure access to safe abortion services at public health facilities to both rural and urban poor women. This study aims to understand the socio-economic profile of women seeking abortion services in public health facilities across this state and out of pocket cost accessing abortion services. In particular, we examine the level of access that poor women have to safe abortion services in Madhya Pradesh. This study consisted of a cross-sectional client follow-up design. A total of 19 facilities were selected using two-stage random sampling and 1036 women presenting to chosen facilities with abortion and post-abortion complications were interviewed between May and December 2014. A structured data collection tool was developed. A composite wealth index computed using principal component analysis derived weights from consumer durables and asset holding and classified women into three categories, poor, moderate, and rich. Findings highlight that overall 57% of women who received abortion care at public health facilities were poor, followed by 21% moderate and 22% rich. More poor women sought care at primary level facilities (58%) than secondary level facilities and among women presenting for postabortion complications (67%) than induced abortion. Women reported spending no money to access abortion services as abortion services are free of cost at public facilities. However, poor women spend INR 64 (1 USD) while visiting primary level facilities and INR 256 (USD 4) while visiting urban hospitals, primarily for transportation and food. Improved availability of safe abortion services at the primary level in Madhya Pradesh has helped meeting the need of safe abortion services among poor, which eventually will help reducing the maternal mortality and morbidity due to unsafe abortion.

Poverty and transitions in health in later life.

PubMed

Adena, Maja; Myck, Michal

2014-09-01

Using a sample of Europeans aged 50+ from 12 countries in the Survey of Health, Ageing and Retirement in Europe (SHARE), we analyse the role of poor material conditions as a determinant of changes in health over a four- to five-year period. We find that poverty defined with respect to relative income has no effect on changes in health. However, broader measures of poor material conditions, such as subjective poverty or low wealth, significantly increase the probability of transition to poor health among the healthy and reduce the chance of recovery from poor health over the time interval analysed. In addition to this, the subjective measure of poverty has a significant effect on mortality, increasing it by 65% among men and by 68% among those aged 50-64. Material conditions affect health among older people. We suggest that if attempts to reduce poverty in later life and corresponding policy targets are to focus on the relevant measures, they should take into account broader definitions of poverty than those based only on relative incomes. Copyright © 2014 Elsevier Ltd. All rights reserved.

Long-term outcomes following laparoscopic adjustable gastric banding: postoperative psychological sequelae predict outcome at 5-year follow-up.

PubMed

Scholtz, Samantha; Bidlake, Louise; Morgan, John; Fiennes, Alberic; El-Etar, Ashraf; Lacey, John Hubert; McCluskey, Sara

2007-09-01

NICE guidelines state that patients with psychological contra-indications should not be considered for bariatric surgery, including Laparoscopic Adjustable Gastric Banding (LAGB) surgery as treatment of morbid obesity, although no consistent correlation between psychiatric illness and long-term outcome in LAGB has been established. This is to our knowledge the first study to evaluate long-term outcomes in LAGB for a full range of DSM-IV defined psychiatric and eating disorders, and forms part of a research portfolio developed by the authors aimed at defining psychological predictors of bariatric surgery in the short-, medium- and long-term. Case notes of 37 subjects operated on between April 1997 and June 2000, who had undergone structured clinical interview during pre-surgical assessment to yield diagnoses of mental and eating disorders according to DSM-IV criteria were analyzed according to a set of operationally defined criteria. Statistical analysis was carried out to compare those with a poor outcome and those considered to have a good outcome in terms of psychiatric profile. In this group of mainly female, Caucasian subjects, ranging in age from 27 to 60 years, one-third were diagnosed with a mental disorder according to DSM-IV criteria. The development of postoperative DSM-IV defined binge eating disorder (BED) or depression strongly predicted poor surgical outcome, but pre-surgical psychiatric factors alone did not. Although pre-surgical psychiatric assessment alone cannot predict outcome, an absence of preoperative psychiatric illness should not reassure surgeons who should be mindful of postoperative psychiatric sequelae, particularly BED. The importance of providing an integrated biopsychosocial model of care in bariatric teams is highlighted.

Perception of overweight is associated with poor academic performance in US adolescents.

PubMed

Florin, Todd A; Shults, Justine; Stettler, Nicolas

2011-11-01

To improve understanding of the mechanisms affecting the relationship between adolescent obesity and poor academic performance, we examined the association of overweight or perceived weight status with academic achievement. We performed a cross-sectional study of 14-17-year-olds (N = 11,012) from the nationally representative 2003 Youth Risk Behavior Survey. The main outcome measure was self-reported grades (mostly A, B, C, D, or F). The primary independent variables were medically defined overweight (body mass index [BMI] ≥ 85th percentile), obesity (BMI ≥ 95th percentile), and participants' perception of their weight status. Medically defined overweight youth were less likely to report higher grades in unadjusted analysis (OR 0.67, 95% CI: 0.60-0.76, p < .001) and after adjustment for demographics, depression, television and video game use, and physical activity (OR 0.83, 95% CI: 0.74-0.94, p = .003). Statistically significant results also were seen with medically defined obese participants. Youth who perceived themselves as overweight were less likely to report higher grades (OR 0.82, 95% CI: 0.73-0.92, p = .001) in unadjusted analysis and after adjustment for the same variables (OR 0.79, 95% CI: 0.68-0.91, p = .002). The perception of overweight was a more significant determinant of academic performance (OR 0.81, 95% CI: 0.69-0.95, p = .012) compared to medically defined obesity (OR 0.90, 95% CI: 0.77-1.05, p = .174). Perceived overweight status is negatively associated with academic performance, regardless of actual weight status. These findings suggest that perception of overweight may be a mechanism for prior results indicating a negative association of obesity and academic achievements, and have implications for the academic health of these adolescents. © 2011, American School Health Association.

Is bruxism a disorder or a behaviour? Rethinking the international consensus on defining and grading of bruxism.

PubMed

Raphael, K G; Santiago, V; Lobbezoo, F

2016-10-01

Inspired by the international consensus on defining and grading of bruxism (Lobbezoo F, Ahlberg J, Glaros AG, Kato T, Koyano K, Lavigne GJ et al. J Oral Rehabil. 2013;40:2), this commentary examines its contribution and underlying assumptions for defining sleep bruxism (SB). The consensus' parsimonious redefinition of bruxism as a behaviour is an advance, but we explore an implied question: might SB be more than behaviour? Behaviours do not inherently require clinical treatment, making the consensus-proposed 'diagnostic grading system' inappropriate. However, diagnostic grading might be useful, if SB were considered a disorder. Therefore, to fully appreciate the contribution of the consensus statement, we first consider standards and evidence for determining whether SB is a disorder characterised by harmful dysfunction or a risk factor increasing probability of a disorder. Second, the strengths and weaknesses of the consensus statement's proposed 'diagnostic grading system' are examined. The strongest evidence-to-date does not support SB as disorder as implied by 'diagnosis'. Behaviour alone is not diagnosed; disorders are. Considered even as a grading system of behaviour, the proposed system is weakened by poor sensitivity of self-report for direct polysomnographic (PSG)-classified SB and poor associations between clinical judgments of SB and portable PSG; reliance on dichotomised reports; and failure to consider SB behaviour on a continuum, measurable and definable through valid behavioural observation. To date, evidence for validity of self-report or clinician report in placing SB behaviour on a continuum is lacking, raising concerns about their potential utility in any bruxism behavioural grading system, and handicapping future study of whether SB may be a useful risk factor for, or itself a disorder requiring treatment. © 2016 John Wiley & Sons Ltd.

Is bruxism a disorder or a behaviour? Rethinking the international consensus on defining and grading of bruxism

PubMed Central

RAPHAEL, K. G.; SANTIAGO, V.; LOBBEZOO, F.

2017-01-01

Summary Inspired by the international consensus on defining and grading of bruxism (Lobbezoo F, Ahlberg J, Glaros AG, Kato T, Koyano K, Lavigne GJ et al. J Oral Rehabil. 2013;40:2), this commentary examines its contribution and underlying assumptions for defining sleep bruxism (SB). The consensus’ parsimonious redefinition of bruxism as a behaviour is an advance, but we explore an implied question: might SB be more than behaviour? Behaviours do not inherently require clinical treatment, making the consensus-proposed ‘diagnostic grading system’ inappropriate. However, diagnostic grading might be useful, if SB were considered a disorder. Therefore, to fully appreciate the contribution of the consensus statement, we first consider standards and evidence for determining whether SB is a disorder characterised by harmful dysfunction or a risk factor increasing probability of a disorder. Second, the strengths and weaknesses of the consensus statement’s proposed ‘diagnostic grading system’ are examined. The strongest evidence-to-date does not support SB as disorder as implied by ‘diagnosis’. Behaviour alone is not diagnosed; disorders are. Considered even as a grading system of behaviour, the proposed system is weakened by poor sensitivity of self-report for direct polysomnographic (PSG)-classified SB and poor associations between clinical judgments of SB and portable PSG; reliance on dichotomised reports; and failure to consider SB behaviour on a continuum, measurable and definable through valid behavioural observation. To date, evidence for validity of self-report or clinician report in placing SB behaviour on a continuum is lacking, raising concerns about their potential utility in any bruxism behavioural grading system, and handicapping future study of whether SB may be a useful risk factor for, or itself a disorder requiring treatment. PMID:27283599

The frontotemporal syndrome of ALS is associated with poor survival.

PubMed

Govaarts, Rosanne; Beeldman, Emma; Kampelmacher, Mike J; van Tol, Marie-Jose; van den Berg, Leonard H; van der Kooi, Anneke J; Wijkstra, Peter J; Zijnen-Suyker, Marianne; Cobben, Nicolle A M; Schmand, Ben A; de Haan, Rob J; de Visser, Marianne; Raaphorst, Joost

2016-12-01

Thirty percent of ALS patients have a frontotemporal syndrome (FS), defined as behavioral changes or cognitive impairment. Despite previous studies, there are no firm conclusions on the effect of the FS on survival and the use of non-invasive ventilation (NIV) in ALS. We examined the effect of the FS on survival and the start and duration of NIV in ALS. Behavioral changes were defined as >22 points on the ALS-Frontotemporal-Dementia-Questionnaire or ≥3 points on ≥2 items of the Neuropsychiatric Inventory. Cognitive impairment was defined as below the fifth percentile on ≥2 tests of executive function, memory or language. Classic ALS was defined as ALS without the frontotemporal syndrome. We performed survival analyses from symptom onset and time from NIV initiation, respectively, to death. The impact of the explanatory variables on survival and NIV initiation were examined using Cox proportional hazards models. We included 110 ALS patients (76 men) with a mean age of 62 years. Median survival time was 4.3 years (95 % CI 3.53-5.13). Forty-seven patients (43 %) had an FS. Factors associated with shorter survival were FS, bulbar onset, older age at onset, short time to diagnosis and a C9orf72 repeat expansion. The adjusted hazard ratio (HR) for the FS was 2.29 (95 % CI 1.44-3.65, p < 0.001) in a multivariate model. Patients with an FS had a shorter survival after NIV initiation (adjusted HR 2.70, 95 % CI 1.04-4.67, p = 0.04). In conclusion, there is an association between the frontotemporal syndrome and poor survival in ALS, which remains present after initiation of NIV.

INSOMNIA WITH OBJECTIVE SHORT SLEEP DURATION AND INCIDENT HYPERTENSION: THE PENN STATE COHORT

PubMed Central

Fernandez-Mendoza, Julio; Vgontzas, Alexandros N.; Liao, Duanping; Shaffer, Michele L.; Vela-Bueno, Antonio; Basta, Maria; Bixler, Edward O.

2013-01-01

Insomnia with objective short sleep duration appears to be a biologically more severe phenotype of the disorder. No longitudinal study to date has examined the association of this type of insomnia with incident hypertension using polysomnography. From a random, general population sample of 1741 adults of the Penn State Cohort, 1395 were followed-up after 7.5 years and 786 did not have hypertension at baseline. Hypertension was determined by a self-report of receiving treatment for high blood pressure. Chronic insomnia was defined as a complaint of insomnia lasting ≥ 1 year, while poor sleep was defined as moderate-to-severe sleep difficulties. All subjects underwent 8-hour polysomnography. Sleep disordered breathing (SDB) was defined as an obstructive apnea/hypopnea index ≥ 5. We used the median polysomnographic percent of sleep time to define short sleep duration (i.e., < 6 hours). We controlled for gender, race, age, caffeine, cigarettes, alcohol consumption, depression, SDB, diabetes, obesity, and blood pressure in our analyses. Compared to normal sleepers who slept ≥ 6 hours, the highest risk for incident hypertension was in chronic insomniacs with short sleep duration (OR= 3.8, 95% CI=1.6–9.0). The risk for incident hypertension in poor sleepers with short sleep duration was significantly increased but became marginally significant after controlling for obesity (OR= 1.6, 95% CI=0.9–2.8). Chronic insomnia with short sleep duration is associated with an increased risk for incident hypertension in a degree comparable to SDB. Objective short sleep duration in insomnia may serve as a useful predictor of the biological severity of the disorder. PMID:22892811

Flat inferior vena cava: indicator of poor prognosis in trauma and acute care surgery patients.

PubMed

Ferrada, Paula; Vanguri, Poornima; Anand, Rahul J; Whelan, James; Duane, Therese; Wolfe, Luke; Ivatury, Rao

2012-12-01

Flat inferior vena cava (IVC) on ultrasound examination has been shown to correlate with hypovolemic status. We hypothesize that a flat IVC on limited echocardiogram (LTTE) performed in the emergency room (ER) correlates with poor prognosis in acutely ill surgical patients. We conducted a retrospective review of all patients undergoing LTTE in the ER from September 2010 until June 2011. IVC diameter was estimated by subxiphoid window. Flat IVC was defined as diameter less than 2 cm. Fat IVC was defined as diameter greater than 2 cm. Need for intensive care unit admission, blood transfusion requirement, mortality, and need for emergent operation between patients with flat versus Fat IVC were compared. One hundred one hypotensive patients had LTTE performed in the ER. Average age was 38 years. Admission diagnosis was blunt trauma (n = 80), penetrating trauma (n = 13), acute care surgery pathology (n = 7), and burn (n = 1). Seventy-four patients had flat IVC on initial LTTE. Compared with those with fat IVC, flat patients were found have higher rates of intensive care unit admission (51.3 vs 14.8%; P = 0.001), blood transfusion requirement (12.2 vs 3.7%), and mortality (13.5 vs 3.7%). This population also underwent emergent surgery on hospital Day 1 more often (16.2 vs 0%; P = 0.033). Initial flat IVC on LTTE is an indicator of hypovolemia and a predictor of poor outcome.

Prospective Predictors of Suicidal Behavior in BPD at 6 Year Follow-up

PubMed Central

Soloff, Paul H.; Chiappetta, Laurel

2012-01-01

Objective Recurrent suicidal behavior is a defining characteristic of BPD. Although most patients achieve remission of suicidal behaviors over time, 3% to 10% die by suicide, raising the question of whether there is a high risk suicidal subtype in BPD. We are conducting the first longitudinal study of suicidal behavior in BPD to identify prospective predictors of suicide attempts, and characterize BPD patients at highest risk for suicide completion. Method Demographic, diagnostic, clinical and psychosocial risk factors assessed at baseline were examined for predictive association with medically significant suicide attempts using Cox proportional hazards models. Prospective predictors were defined for subjects completing 6 or more years in the study and compared to earlier intervals. Results Among 90 subjects, 25 (27.8%) made at least one suicide attempt in the interval, most occurring in the first two years. Risk of attempt was increased by: a.) low socioeconomic status, b.) poor psychosocial adjustment, c.) a family history of suicide d.) prior psychiatric hospitalization; e.) absence of any outpatient treatment prior to the attempt. Higher global functioning at baseline decreased risk. Conclusion Risk factors predictive of suicide attempts change over time. Acute stressors such as MDD were predictive only in the short term (12 mos.), while poor psychosocial functioning had persistent and long term effects on suicide risk. Half of BPD patients have poor psychosocial outcomes despite symptomatic improvement. A social and vocational rehabilitation model of treatment is needed to decrease suicide risk and optimize long term outcomes in BPD. PMID:22549208

Use of preventive care by the working poor in the United States

PubMed Central

Ross, Joseph S.; Bernheim, Susannah M.; Bradley, Elizabeth H.; Teng, Hsun-Mei; Gallo, William T.

2007-01-01

Objective Examine the association between poverty and preventive care use among older working adults. Method Cross-sectional analysis of the pooled 1996, 1998 and 2000 waves of the Health and Retirement Study, a nationally representative sample of older community-dwelling adults, studying self-reported use of cervical, breast, and prostate cancer screening, as well as serum cholesterol screening and influenza vaccination. Adults with incomes within 200% of the federal poverty level were defined as poor. Results Among 10,088 older working adults, overall preventive care use ranged from 38% (influenza vaccination) to 76% (breast cancer screening). In unadjusted analyses, the working poor were significantly less likely to receive preventive care. After adjustment for insurance coverage, education, and other socio-demographic characteristics, the working poor remained significantly less likely to receive breast cancer (RR 0.92, 95% CI, 0.86–0.96), prostate cancer (RR 0.89, 95% CI, 0.81–0.97), and cholesterol screening (RR 0.91, 95% CI, 0.86–0.96) than the working non-poor, but were not significantly less likely to receive cervical cancer screening (RR 0.96, 95% CI, 0.90–1.01) or influenza vaccination (RR 0.92, 95% CI, 0.84–1.01). Conclusion The older working poor are at modestly increased risk for not receiving preventive care. PMID:17196642

Adverse psychosocial working conditions and poor quality of life among financial service employees in Brazil.

PubMed

Silva, Luiz Sergio; Barreto, Sandhi Maria

2012-01-01

Workers in the financial services sector are exposed to great stress at work. This study investigates whether exposure to adverse psychosocial work conditions is independently associated with poor health-related physical and mental quality of life among financial services workers. We studied a nationwide representative sample of 2,054 workers of a large Brazilian state bank in 2008. Adverse psychosocial work conditions were investigated by the Effort-reward imbalance (ERI) scale and the Job content questionnaire (JCQ). Health-related quality of life (HRQL) was assessed using the Medical Outcomes Study Short-Form General Health Survey (SF-12). Poor mental and physical HRQL was defined by the lowest quartiles of the SF-12 final score distributions. Associations were investigated using multiple logistic regression analysis. In the multivariate analysis, exposures to low control and lack of social support at work (JCQ) were associated with poor HRQL in the physical domain. Increasing effort-reward imbalance and overcommitment (ERI), on the other hand, were associated with poor HRQL in the mental domain, with a significant statistical trend. Overcommitment was also associated with poor physical HRQL. The results suggest that exposure to adverse psychosocial work conditions has a negative impact on both domains of HRQL among financial service workers. They also indicate that ERI and DC models capture different aspects of job strain.

Is it me? Verbal self-monitoring neural network and clinical insight in schizophrenia.

PubMed

Sapara, Adegboyega; Ffytche, Dominic H; Cooke, Michael A; Williams, Steven C R; Kumari, Veena

2015-12-30

Self-monitoring, defined as the ability to distinguish between self-generated stimuli from other-generated ones, is known to be impaired in schizophrenia. This impairment has been theorised as the basis for many of the core psychotic symptoms, in particular, poor clinical insight. This study aimed to investigate verbal self-monitoring related neural substrates of preserved and poor clinical insight in schizophrenia. It involved 40 stable schizophrenia outpatients, 20 with preserved and 20 with poor insight, and 20 healthy participants. All participants underwent functional magnetic resonance imaging with brain coverage covering key areas in the self-monitoring network during a verbal self-monitoring task. Healthy participants showed higher performance accuracy and greater thalamic activity than both preserved and poor insight patient groups. Preserved insight patients showed higher activity in the putamen extending into the caudate, insula and inferior frontal gyrus, compared to poor insight patients, and in the anterior cingulate and medial frontal gyrus, compared to healthy participants. Poor insight patients did not show greater activity in any brain area compared to preserved insight patients or healthy participants. Future studies may pursue therapeutic avenues, such as meta-cognitive therapies to promote self-monitoring or targeted stimulation of relevant brain areas, as means of enhancing insight in schizophrenia. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Factors associated with glycemic control among diabetic adult out-patients in Northeast Ethiopia.

PubMed

Fiseha, Temesgen; Alemayehu, Ermiyas; Kassahun, Wongelawit; Adamu, Aderaw; Gebreweld, Angesom

2018-05-18

The aim of this study was to determine the status of glycemic control and identify factors associated with poor glycemic control among diabetic out-patients. A hospital based cross-sectional study was conducted among randomly selected 384 (126 type 1 and 258 type 2) diabetic adults attending a hospital in Northeast Ethiopia from January 1 to April 30, 2017. Of the total participants, 70.8% had poor status of glycemic control (defined as mean fasting blood glucose level above 130 mg/dl). In the multivariate analysis, rural residence (AOR = 2.61, 95% CI 1.37-4.96), low educational level (AOR = 7.10, 95% CI 2.94-17.17) and longer duration of diabetes (AOR = 2.20, 95% CI 1.18-4.08) were significantly associated with increased odds of poor glycemic control. Moreover, merchants (AOR = 3.39, 95% CI 1.16-9.96) were significantly more likely to have poor glycemic control compared to government employee. Diabetic patients receiving oral anti-diabetics (AOR = 5.12, 95% CI 2.10-12.52) or insulin (AOR = 3.26, 95% CI 1.26-8.48) were more likely to be poorly controlled. These results highlight the needed for appropriate management of patients focusing on associated factors identified for poor glycemic control to maintain good glycemic control and improve adverse outcomes of the disease in this study setting.

Employment Precariousness and Poor Mental Health: Evidence from Spain on a New Social Determinant of Health

PubMed Central

Vives, Alejandra; Amable, Marcelo; Ferrer, Montserrat; Moncada, Salvador; Llorens, Clara; Muntaner, Carles; Benavides, Fernando G.; Benach, Joan

2013-01-01

Background. Evidence on the health-damaging effects of precarious employment is limited by the use of one-dimensional approaches focused on employment instability. This study assesses the association between precarious employment and poor mental health using the multidimensional Employment Precariousness Scale. Methods. Cross-sectional study of 5679 temporary and permanent workers from the population-based Psychosocial Factors Survey was carried out in 2004-2005 in Spain. Poor mental health was defined as SF-36 mental health scores below the 25th percentile of the Spanish reference for each respondent's sex and age. Prevalence proportion ratios (PPRs) of poor mental health across quintiles of employment precariousness (reference: 1st quintile) were calculated with log-binomial regressions, separately for women and men. Results. Crude PPRs showed a gradient association with poor mental health and remained generally unchanged after adjustments for age, immigrant status, socioeconomic position, and previous unemployment. Fully adjusted PPRs for the 5th quintile were 2.54 (95% CI: 1.95–3.31) for women and 2.23 (95% CI: 1.86–2.68) for men. Conclusion. The study finds a gradient association between employment precariousness and poor mental health, which was somewhat stronger among women, suggesting an interaction with gender-related power asymmetries. Further research is needed to strengthen the epidemiological evidence base and to inform labour market policy-making. PMID:23431322

Sleep patterns as predictors for disability pension due to low back diagnoses: a 23-year longitudinal study of Finnish twins.

PubMed

Ropponen, Annina; Silventoinen, Karri; Hublin, Christer; Svedberg, Pia; Koskenvuo, Markku; Kaprio, Jaakko

2013-06-01

Impaired sleep patterns are known to be associated with many chronic conditions and ultimately they may lead to permanent work incapacity. Less is known about the associations between sleep patterns and cause-specific disability pensions, such as low back diagnoses, or whether familial factors (genetics and family environment) can affect the associations. The objective of this study was to investigate sleep patterns as predictors of disability pension due to low back diagnoses with a 23-year follow-up. A prospective cohort study with comprehensive mailed questionnaires about sleep patterns, e.g., quality and length of sleep in 1975 and 1981. Follow-up from the national disability pension register data until 2004. Not applicable. There were 18,979 individuals (7,722 complete twin pairs) born before 1958. Cox proportional hazards regression was used to calculate hazard ratios (HR) with 95% confidence intervals (95% CI). Disability pension due to low back diagnoses had been granted to 467 individuals during the follow-up. Sleeping moderately well (HR 1.25; 95% CI 1.02, 1.53), or fairly poorly/poorly (HR 2.05; 95% CI 1.53, 2.73) at baseline predicted a significantly higher risk for disability pension. Stable patterns of sleeping either fairly well (HR 1.29; 95% CI 1.01, 1.64), or stably fairly poorly/poorly (HR 2.29; 95% CI 1.49, 3.52) between 1975 and 1981 were associated with a higher risk as compared to a stable pattern of sleeping well. Furthermore, a decrease in quality of sleep from 1975 to 1981 was associated (HR 1.34; 95% CI 1.03, 1.76) with an increased risk of disability pension. Sleep quality and changes in sleep quality appear to be early predictors for disability pension due to low back diagnoses independently from other confounding factors.

SU-F-T-301: Planar Dose Pass Rate Inflation Due to the MapCHECK Measurement Uncertainty Function

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

Bailey, D; Spaans, J; Kumaraswamy, L

Purpose: To quantify the effect of the Measurement Uncertainty function on planar dosimetry pass rates, as analyzed with Sun Nuclear Corporation analytic software (“MapCHECK” or “SNC Patient”). This optional function is toggled on by default upon software installation, and automatically increases the user-defined dose percent difference (%Diff) tolerance for each planar dose comparison. Methods: Dose planes from 109 IMRT fields and 40 VMAT arcs were measured with the MapCHECK 2 diode array, and compared to calculated planes from a commercial treatment planning system. Pass rates were calculated within the SNC analytic software using varying calculation parameters, including Measurement Uncertainty onmore » and off. By varying the %Diff criterion for each dose comparison performed with Measurement Uncertainty turned off, an effective %Diff criterion was defined for each field/arc corresponding to the pass rate achieved with MapCHECK Uncertainty turned on. Results: For 3%/3mm analysis, the Measurement Uncertainty function increases the user-defined %Diff by 0.8–1.1% average, depending on plan type and calculation technique, for an average pass rate increase of 1.0–3.5% (maximum +8.7%). For 2%, 2 mm analysis, the Measurement Uncertainty function increases the user-defined %Diff by 0.7–1.2% average, for an average pass rate increase of 3.5–8.1% (maximum +14.2%). The largest increases in pass rate are generally seen with poorly-matched planar dose comparisons; the MapCHECK Uncertainty effect is markedly smaller as pass rates approach 100%. Conclusion: The Measurement Uncertainty function may substantially inflate planar dose comparison pass rates for typical IMRT and VMAT planes. The types of uncertainties incorporated into the function (and their associated quantitative estimates) as described in the software user’s manual may not accurately estimate realistic measurement uncertainty for the user’s measurement conditions. Pass rates listed in published reports or otherwise compared to the results of other users or vendors should clearly indicate whether the Measurement Uncertainty function is used.« less

Net alkalinity and net acidity 1: Theoretical considerations

USGS Publications Warehouse

Kirby, C.S.; Cravotta, C.A.

2005-01-01

Net acidity and net alkalinity are widely used, poorly defined, and commonly misunderstood parameters for the characterization of mine drainage. The authors explain theoretical expressions of 3 types of alkalinity (caustic, phenolphthalein, and total) and acidity (mineral, CO2, and total). Except for rarely-invoked negative alkalinity, theoretically defined total alkalinity is closely analogous to measured alkalinity and presents few practical interpretation problems. Theoretically defined "CO 2-acidity" is closely related to most standard titration methods with an endpoint pH of 8.3 used for determining acidity in mine drainage, but it is unfortunately named because CO2 is intentionally driven off during titration of mine-drainage samples. Using the proton condition/mass- action approach and employing graphs to illustrate speciation with changes in pH, the authors explore the concept of principal components and how to assign acidity contributions to aqueous species commonly present in mine drainage. Acidity is defined in mine drainage based on aqueous speciation at the sample pH and on the capacity of these species to undergo hydrolysis to pH 8.3. Application of this definition shows that the computed acidity in mg L -1 as CaCO3 (based on pH and analytical concentrations of dissolved FeII, FeIII, Mn, and Al in mg L -1):aciditycalculated=50{1000(10-pH)+[2(FeII)+3(FeIII)]/56+2(Mn)/ 55+3(Al)/27}underestimates contributions from HSO4- and H+, but overestimates the acidity due to Fe3+ and Al3+. However, these errors tend to approximately cancel each other. It is demonstrated that "net alkalinity" is a valid mathematical construction based on theoretical definitions of alkalinity and acidity. Further, it is shown that, for most mine-drainage solutions, a useful net alkalinity value can be derived from: (1) alkalinity and acidity values based on aqueous speciation, (2) measured alkalinity minus calculated acidity, or (3) taking the negative of the value obtained in a standard method "hot peroxide" acidity titration, provided that labs report negative values. The authors recommend the third approach; i.e., net alkalinity = -Hot Acidity. ?? 2005 Elsevier Ltd. All rights reserved.