Sample records for positive abnormal returns

  1. Stock market returns and clinical trial results of investigational compounds: an event study analysis of large biopharmaceutical companies.

    PubMed

    Hwang, Thomas J

    2013-01-01

    For biopharmaceutical companies, investments in research and development are risky, and the results from clinical trials are key inflection points in the process. Few studies have explored how and to what extent the public equity market values clinical trial results. Our study dataset matched announcements of clinical trial results for investigational compounds from January 2011 to May 2013 with daily stock market returns of large United States-listed pharmaceutical and biotechnology companies. Event study methodology was used to examine the relationship between clinical research events and changes in stock returns. We identified public announcements for clinical trials of 24 investigational compounds, including 16 (67%) positive and 8 (33%) negative events. The majority of announcements were for Phase 3 clinical trials (N = 13, 54%), and for oncologic (N = 7, 29%) and neurologic (N = 6, 24%) indications. The median cumulative abnormal returns on the day of the announcement were 0.8% (95% confidence interval [CI]: -2.3, 13.4%; P = 0.02) for positive events and -2.0% (95% CI: -9.1, 0.7%; P = 0.04) for negative events, with statistically significant differences from zero. In the day immediately following the announcement, firms with positive events were associated with stock price corrections, with median cumulative abnormal returns falling to 0.4% (95% CI: -3.8, 12.3%; P = 0.33). For firms with negative announcements, the median cumulative abnormal returns were -1.7% (95% CI: -9.5, 1.0%; P = 0.03), and remained significantly negative over the two day event window. The magnitude of abnormal returns did not differ statistically by indication, by trial phase, or between biotechnology and pharmaceutical firms. The release of clinical trial results is an economically significant event and has meaningful effects on market value for large biopharmaceutical companies. Stock return underperformance due to negative events is greater in magnitude and persists longer than abnormal returns due to positive events, suggesting asymmetric market reactions.

  2. Stock Market Returns and Clinical Trial Results of Investigational Compounds: An Event Study Analysis of Large Biopharmaceutical Companies

    PubMed Central

    Hwang, Thomas J.

    2013-01-01

    Background For biopharmaceutical companies, investments in research and development are risky, and the results from clinical trials are key inflection points in the process. Few studies have explored how and to what extent the public equity market values clinical trial results. Methods Our study dataset matched announcements of clinical trial results for investigational compounds from January 2011 to May 2013 with daily stock market returns of large United States-listed pharmaceutical and biotechnology companies. Event study methodology was used to examine the relationship between clinical research events and changes in stock returns. Results We identified public announcements for clinical trials of 24 investigational compounds, including 16 (67%) positive and 8 (33%) negative events. The majority of announcements were for Phase 3 clinical trials (N = 13, 54%), and for oncologic (N = 7, 29%) and neurologic (N = 6, 24%) indications. The median cumulative abnormal returns on the day of the announcement were 0.8% (95% confidence interval [CI]: –2.3, 13.4%; P = 0.02) for positive events and –2.0% (95% CI: –9.1, 0.7%; P = 0.04) for negative events, with statistically significant differences from zero. In the day immediately following the announcement, firms with positive events were associated with stock price corrections, with median cumulative abnormal returns falling to 0.4% (95% CI: –3.8, 12.3%; P = 0.33). For firms with negative announcements, the median cumulative abnormal returns were –1.7% (95% CI: –9.5, 1.0%; P = 0.03), and remained significantly negative over the two day event window. The magnitude of abnormal returns did not differ statistically by indication, by trial phase, or between biotechnology and pharmaceutical firms. Conclusions The release of clinical trial results is an economically significant event and has meaningful effects on market value for large biopharmaceutical companies. Stock return underperformance due to negative events is greater in magnitude and persists longer than abnormal returns due to positive events, suggesting asymmetric market reactions. PMID:23951273

  3. The Effects of Twitter Sentiment on Stock Price Returns.

    PubMed

    Ranco, Gabriele; Aleksovski, Darko; Caldarelli, Guido; Grčar, Miha; Mozetič, Igor

    2015-01-01

    Social media are increasingly reflecting and influencing behavior of other complex systems. In this paper we investigate the relations between a well-known micro-blogging platform Twitter and financial markets. In particular, we consider, in a period of 15 months, the Twitter volume and sentiment about the 30 stock companies that form the Dow Jones Industrial Average (DJIA) index. We find a relatively low Pearson correlation and Granger causality between the corresponding time series over the entire time period. However, we find a significant dependence between the Twitter sentiment and abnormal returns during the peaks of Twitter volume. This is valid not only for the expected Twitter volume peaks (e.g., quarterly announcements), but also for peaks corresponding to less obvious events. We formalize the procedure by adapting the well-known "event study" from economics and finance to the analysis of Twitter data. The procedure allows to automatically identify events as Twitter volume peaks, to compute the prevailing sentiment (positive or negative) expressed in tweets at these peaks, and finally to apply the "event study" methodology to relate them to stock returns. We show that sentiment polarity of Twitter peaks implies the direction of cumulative abnormal returns. The amount of cumulative abnormal returns is relatively low (about 1-2%), but the dependence is statistically significant for several days after the events.

  4. The Effects of Twitter Sentiment on Stock Price Returns

    PubMed Central

    Ranco, Gabriele; Aleksovski, Darko; Caldarelli, Guido; Grčar, Miha; Mozetič, Igor

    2015-01-01

    Social media are increasingly reflecting and influencing behavior of other complex systems. In this paper we investigate the relations between a well-known micro-blogging platform Twitter and financial markets. In particular, we consider, in a period of 15 months, the Twitter volume and sentiment about the 30 stock companies that form the Dow Jones Industrial Average (DJIA) index. We find a relatively low Pearson correlation and Granger causality between the corresponding time series over the entire time period. However, we find a significant dependence between the Twitter sentiment and abnormal returns during the peaks of Twitter volume. This is valid not only for the expected Twitter volume peaks (e.g., quarterly announcements), but also for peaks corresponding to less obvious events. We formalize the procedure by adapting the well-known “event study” from economics and finance to the analysis of Twitter data. The procedure allows to automatically identify events as Twitter volume peaks, to compute the prevailing sentiment (positive or negative) expressed in tweets at these peaks, and finally to apply the “event study” methodology to relate them to stock returns. We show that sentiment polarity of Twitter peaks implies the direction of cumulative abnormal returns. The amount of cumulative abnormal returns is relatively low (about 1–2%), but the dependence is statistically significant for several days after the events. PMID:26390434

  5. Impact of the FTSE4Good Index on firm price: an event study.

    PubMed

    Martin Curran, M; Moran, Dominic

    2007-03-01

    This paper examines whether corporate financial performance is affected by public endorsement of environmental and social performance. Event study methodology, which relies on the notion of market efficiency, is used to examine the relationship between positive and negative announcements and changes in share prices or daily returns. Inclusion in and deletion from the FTSE4Good UK Index is used as a proxy measure for good (poor) corporate social responsibility. The abnormal or unexpected daily returns associated with an event are calculated and their significance tested. The results show a trend towards positive and negative announcements having the expected effects on daily returns. But these movements are not significant and the data do not suggest that a firm's presence on the index brings it any significant financial return for signalling its corporate social responsibility.

  6. Femoroacetabular Impingement in Professional Football Players: Return to Play and Predictors of Career Length After Hip Arthroscopy.

    PubMed

    Menge, Travis J; Bhatia, Sanjeev; McNamara, Shannen C; Briggs, Karen K; Philippon, Marc J

    2017-07-01

    Previous studies have shown hip arthroscopy to be a highly effective treatment for symptomatic femoroacetabular impingement (FAI) in a wide range of athletes; however, the rate of return to play and length of career after hip arthroscopy in professional football players are unknown. To determine how many athletes returned to professional football and the number of seasons they played after surgery. Case series; Level of evidence, 4. Fifty-one professional football players (60 hips) underwent hip arthroscopy for FAI between 2000 and 2014 by a single surgeon. Return to play was defined as competing in a preseason or regular season professional football game after surgery. Data were retrospectively obtained for each player from NFL.com , ESPN.com , individual team websites, and/or CFL.ca . We found that 87% (52/60) of the arthroscopic procedures allowed professional football players to return to play in a preseason or regular season game. Athletes who returned played an average of 38 games during 3.2 seasons after arthroscopy, with an average total career length of 7.4 seasons. Ninety-two percent (48/52) of players who returned had a minimum total career length of 3 years. When participants were analyzed by position, linemen were less likely to return after hip arthroscopy compared with other players (odds ratio 5.6; 95% CI, 1.1-35; P = .04). All quarterbacks and tight ends returned to play after surgery. No significant difference in return to play rate was found between athletes who underwent microfracture and those who did not (25% vs 38%, P = .698). Hip arthroscopy for treatment of FAI and associated pathologic abnormalities in professional football players resulted in a high rate of return to play. The study's findings demonstrate that 87% of the arthroscopic procedures allowed professional football players to return to play, linemen were less likely to return compared with other positions, and the presence of microfracture did not significantly affect the return to play rate. These findings support hip arthroscopy as an effective procedure to treat FAI and related pathologic abnormalities in the professional football player, and this information is important for proper counseling of athletes with FAI.

  7. Prevalence of posterior elbow problems in Japanese high school baseball players.

    PubMed

    Kida, Yoshikazu; Morihara, Toru; Furukawa, Ryuhei; Sukenari, Tsuyoshi; Kotoura, Yoshihiro; Yoshioka, Naoki; Hojo, Tatsuya; Oda, Ryo; Arai, Yuji; Sawada, Koshiro; Fujiwara, Hiroyoshi; Kubo, Toshikazu

    2016-09-01

    Various posterior elbow problems cause posterior elbow pain among baseball players. We aimed to determine the prevalence and diagnoses associated with posterior elbow problems and post-treatment recovery time for returning to sports in Japanese high school baseball players when treated in the off-season. A total of 576 Japanese high school baseball players who participated in baseball skill training camp during the off-season were enrolled in the study. The elbow of each player's throwing arm was assessed by use of a questionnaire and physical examination. Players with abnormal results were advised to visit the hospital. Players who visited the hospital were initially treated conservatively and underwent surgery if necessary. Retrospectively, players with positive physical examination results associated with posterior elbow pain, defined as olecranon tenderness and/or a positive elbow extension impingement test, were selected. Information about their position, elbow pain, physical examination results, diagnosis, treatment, and recovery time before returning to playing sports was assessed. Olecranon tenderness and/or positive elbow extension impingement test results were found in 76 players (13.2%). Of these, 33 agreed to visit the hospital for further diagnostic imaging and 25 players (75.8%) were diagnosed with posteromedial elbow impingement. By the next spring, 87.9% of players returned to sport, and 100% of players returned to sport before the next summer. The average recovery period was 77 ± 47 days. Physical examinations related to posterior elbow injuries were positive in 13.2% of high school baseball players. The most common diagnosis for posterior elbow pain was posteromedial elbow impingement. All players returned to competitive sports activity levels within 77 ± 47 days. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  8. Aftermarket Performance of Health Care and Biopharmaceutical IPOs: Evidence From ASEAN Countries

    PubMed Central

    Komenkul, Kulabutr; Kiranand, Santi

    2017-01-01

    We examine the evidence from the long-run abnormal returns using data for 76 health care and biopharmaceutical initial public offerings (IPOs) listed in a 29-year period between 1986 and 2014 in the Association of Southeast Asian Nations (ASEAN) countries such as Indonesia, Malaysia, Singapore, Thailand, the Philippines, Vietnam, Myanmar, and Laos. Based on the event-time approach, the 3-year stock returns of the IPOs are investigated using cumulative abnormal return (CAR) and buy-and-hold abnormal return (BHAR). As a robustness check, the calendar-time approach, related to the market model as well as Fama-French and Carhart models, was applied for verifying long-run abnormal returns. We found evidence that the health care IPOs overperform in the long-run, irrespective of the alternative benchmarks and methods. In addition, when we divide our sample into 5 groups by listing countries, our results show that the health care stock prices of the Singaporean firms behaved differently from those of most of the other firms in ASEAN. The Singaporean IPOs are characterized by a worse post-offering performance, whereas the IPOs of Malaysian and Thai health care companies performed better in the long-run. PMID:28853306

  9. Aftermarket Performance of Health Care and Biopharmaceutical IPOs: Evidence From ASEAN Countries.

    PubMed

    Komenkul, Kulabutr; Kiranand, Santi

    2017-01-01

    We examine the evidence from the long-run abnormal returns using data for 76 health care and biopharmaceutical initial public offerings (IPOs) listed in a 29-year period between 1986 and 2014 in the Association of Southeast Asian Nations (ASEAN) countries such as Indonesia, Malaysia, Singapore, Thailand, the Philippines, Vietnam, Myanmar, and Laos. Based on the event-time approach, the 3-year stock returns of the IPOs are investigated using cumulative abnormal return (CAR) and buy-and-hold abnormal return (BHAR). As a robustness check, the calendar-time approach, related to the market model as well as Fama-French and Carhart models, was applied for verifying long-run abnormal returns. We found evidence that the health care IPOs overperform in the long-run, irrespective of the alternative benchmarks and methods. In addition, when we divide our sample into 5 groups by listing countries, our results show that the health care stock prices of the Singaporean firms behaved differently from those of most of the other firms in ASEAN. The Singaporean IPOs are characterized by a worse post-offering performance, whereas the IPOs of Malaysian and Thai health care companies performed better in the long-run.

  10. Utility of antenatal clinical factors for prediction of postpartum outcomes in women with gestational diabetes mellitus (GDM).

    PubMed

    Ingram, Emily R; Robertson, Iain K; Ogden, Kathryn J; Dennis, Amanda E; Campbell, Joanne E; Corbould, Anne M

    2017-06-01

    Gestational diabetes mellitus (GDM) is associated with life-long increased risk of type 2 diabetes: affected women are advised to undergo oral glucose tolerance testing (OGTT) at 6-12 weeks postpartum, then glucose screening every 1-3 years. We investigated whether in women with GDM, antenatal clinical factors predicted postpartum abnormal glucose tolerance and compliance with screening. In women with GDM delivering 2007 to mid-2009 in a single hospital, antenatal/obstetric data and glucose tests at 6-12 weeks postpartum and during 5.5 years post-pregnancy were retrospectively collected. Predictors of return for testing and abnormal glucose tolerance were identified using multivariate analysis. Of 165 women, 117 (70.9%) returned for 6-12 week postpartum OGTT: 23 (19.6%) were abnormal. Smoking and parity, independent of socioeconomic status, were associated with non-return for testing. Fasting glucose ≥5.4 mmol/L on pregnancy OGTT predicted both non-return for testing and abnormal OGTT. During 5.5 years post-pregnancy, 148 (89.7%) women accessed glucose screening: nine (6.1%) developed diabetes, 33 (22.3%) had impaired fasting glucose / impaired glucose tolerance. Predictors of abnormal glucose tolerance were fasting glucose ≥5.4 mmol/L and 2-h glucose ≥9.3 mmol/L on pregnancy OGTT (~2.5-fold increased risk), and polycystic ovary syndrome (~3.4 fold increased risk). Risk score calculation, based on combined antenatal factors, did not improve predictions. Antenatal clinical factors were modestly predictive of return for testing and abnormal glucose tolerance post-pregnancy in women with GDM. Risk score calculations were ineffective in predicting outcomes: risk scores developed in other populations require validation. Ongoing glucose screening is indicated for all women with GDM. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  11. Performing an Event Study: An Exercise for Finance Students

    ERIC Educational Resources Information Center

    Reese, William A., Jr.; Robins, Russell P.

    2017-01-01

    This exercise helps instructors teach students how to perform a simple event study. The study tests to see if stocks earn abnormal returns when added to the S&P 500. Students select a random sample of stocks that were added to the index between January 2000 and July 2015. The accompanying spreadsheet calculates cumulative abnormal returns and…

  12. Wind turbine generator with improved operating subassemblies

    DOEpatents

    Cheney, Jr., Marvin C.

    1985-01-01

    A wind turbine includes a yaw spring return assembly to return the nacelle from a position to which it has been rotated by yawing forces, thus preventing excessive twisting of the power cables and control cables. It also includes negative coning restrainers to limit the bending of the flexible arms of the rotor towards the tower, and stop means on the rotor shaft to orient the blades in a vertical position during periods when the unit is upwind when the wind commences. A pendulum pitch control mechanism is improved by orienting the pivot axis for the pendulum arm at an angle to the longitudinal axis of its support arm, and excessive creep is of the synthetic resin flexible beam support for the blades is prevented by a restraining cable which limits the extent of pivoting of the pendulum during normal operation but which will permit further pivoting under abnormal conditions to cause the rotor to stall.

  13. Obesity, Gynecological Factors, and Abnormal Mammography Follow-Up in Minority and Medically Underserved Women

    PubMed Central

    Wujcik, Debra; Lin, Jin-Mann S.; Grau, Ana; Wilson, Veronica; Champion, Victoria; Zheng, Wei; Egan, Kathleen M.

    2009-01-01

    Abstract Background The relationship between obesity and screening mammography adherence has been examined previously, yet few studies have investigated obesity as a potential mediator of timely follow-up of abnormal (Breast Imaging Reporting and Data System [BIRADS-0]) mammography results in minority and medically underserved patients. Methods We conducted a retrospective cohort study of 35 women who did not return for follow-up >6 months from index abnormal mammography and 41 who returned for follow-up ≤6 months in Nashville, Tennessee. Patients with a BIRADS-0 mammography event in 2003–2004 were identified by chart review. Breast cancer risk factors were collected by telephone interview. Multivariate logistic regression was performed on selected factors with return for diagnostic follow-up. Results Obesity and gynecological history were significant predictors of abnormal mammography resolution. A significantly higher frequency of obese women delayed return for mammography resolution compared with nonobese women (64.7% vs. 35.3%). A greater number of hysterectomized women returned for diagnostic follow-up compared with their counterparts without a hysterectomy (77.8% vs. 22.2%). Obese patients were more likely to delay follow-up >6 months (adjusted OR 4.09, p = 0.02). Conversely, hysterectomized women were significantly more likely to return for timely mammography follow-up ≤6 months (adjusted OR 7.95, p = 0.007). Conclusions Study results suggest that weight status and gynecological history influence patients' decisions to participate in mammography follow-up studies. Strategies are necessary to reduce weight-related barriers to mammography follow-up in the healthcare system including provider training related to mammography screening of obese women. PMID:19558307

  14. A combination SMS and transportation reimbursement intervention to improve HIV care following abnormal CD4 test results in rural Uganda: a prospective observational cohort study.

    PubMed

    Siedner, Mark J; Santorino, Data; Lankowski, Alexander J; Kanyesigye, Michael; Bwana, Mwebesa B; Haberer, Jessica E; Bangsberg, David R

    2015-07-06

    Up to 50 % of HIV-infected persons in sub-Saharan Africa are lost from care between HIV diagnosis and antiretroviral therapy (ART) initiation. Structural barriers, including cost of transportation to clinic and poor communication systems, are major contributors. We conducted a prospective, pragmatic, before-and-after clinical trial to evaluate a combination mobile health and transportation reimbursement intervention to improve care at a publicly operated HIV clinic in Uganda. Patients undergoing CD4 count testing were enrolled, and clinicians selected a result threshold that would prompt early return for ART initiation or further care. Participants enrolled in the pre-intervention period (January - August 2012) served as a control group. Participants in the intervention period (September 2012 - November 2013) were randomized to receive daily short message service (SMS) messages for up to seven days in one of three formats: 1) messages reporting an abnormal result directly, 2) personal identification number-protected messages reporting an abnormal result, or 3) messages reading "ABCDEFG" to confidentially convey an abnormal result. Participants returning within seven days of their first message received transportation reimbursements (about $6USD). Our primary outcomes of interest were time to return to clinic and time to ART initiation. There were 45 participants in the pre-intervention period and 138 participants in the intervention period (46, 49, and 43 in the direct, PIN, and coded groups, respectively) with low CD4 count results. Median time to clinic return was 33 days (IQR 11-49) in the pre-intervention period and 6 days (IQR 3-16) in the intervention period (P < 0.001); and median time to ART initiation was 47 days (IQR 11-75) versus 12 days (IQR 5-19), (P < 0.001). In multivariable models, participants in the intervention period had earlier return to clinic (AHR 2.32, 95 %CI 1.53 to 3.51) and earlier time to ART initiation (AHR 2.27, 95 %CI 1.38 to 3.72). All three randomized message formats improved time to return to clinic and time to ART initiation (P < 0.01 for all comparisons versus the pre-intervention period). A combination of an SMS laboratory result communication system and transportation reimbursements significantly decreased time to clinic return and time to ART initiation after abnormal CD4 test results. Clinicaltrials.gov NCT01579214 , approved 13 April 2012.

  15. Atlantoaxial Rotatory Subluxation: A Review for the Pediatric Emergency Physician.

    PubMed

    Kinon, Merritt D; Nasser, Rani; Nakhla, Jonathan; Desai, Rupen; Moreno, Jessica R; Yassari, Reza; Bagley, Carlos A

    2016-10-01

    Pediatric emergency physicians must have a high clinical suspicion for atlantoaxial rotatory subluxation (AARS), particularly when a child presents with neck pain and an abnormal head posture without the ability to return to a neutral position. As shown in the neurosurgical literature, timely diagnosis and swift initiation of treatment have a greater chance of treatment success for the patient. However, timely treatment is complicated because torticollis can result from a variety of maladies, including: congenital abnormalities involving the C1-C2 joint or the surrounding supporting muscles and ligaments, central nervous system abnormalities, obstetric palsies from brachial plexus injuries, clavicle fractures, head and neck surgery, and infection. The treating pediatrician must discern the etiology of the underlying problem to determine both timing and treatment paradigms, which vary widely between these illnesses. We present a comprehensive review of AARS that is intended for pediatric emergency physicians. Management of AARS can vary widely bases on factors, such as duration of symptoms, as well as the patient's history. The goal of this review is to streamline the management paradigms and provide an inclusive review for pediatric emergency first responders.

  16. A practical indoor context-aware surveillance system with multi-Kinect sensors

    NASA Astrophysics Data System (ADS)

    Jia, Lili; You, Ying; Li, Tiezhu; Zhang, Shun

    2014-11-01

    In this paper we develop a novel practical application, which give scalable services to the end users when abnormal actives are happening. Architecture of the application has been presented consisting of network infrared cameras and a communication module. In this intelligent surveillance system we use Kinect sensors as the input cameras. Kinect is an infrared laser camera which its user can access the raw infrared sensor stream. We install several Kinect sensors in one room to track the human skeletons. Each sensor returns the body positions with 15 coordinates in its own coordinate system. We use calibration algorithms to calibrate all the body positions points into one unified coordinate system. With the body positions points, we can infer the surveillance context. Furthermore, the messages from the metadata index matrix will be sent to mobile phone through communication module. User will instantly be aware of an abnormal case happened in the room without having to check the website. In conclusion, theoretical analysis and experimental results in this paper show that the proposed system is reasonable and efficient. And the application method introduced in this paper is not only to discourage the criminals and assist police in the apprehension of suspects, but also can enabled the end-users monitor the indoor environments anywhere and anytime by their phones.

  17. Positional and positioning down-beating nystagmus without central nervous system findings.

    PubMed

    Ogawa, Yasuo; Suzuki, Mamoru; Otsuka, Koji; Shimizu, Shigetaka; Inagaki, Taro; Hayashi, Mami; Hagiwara, Akira; Kitajima, Naoharu

    2009-12-01

    We report the clinical features of 4 cases with positional or positioning down-beating nystagmus in a head-hanging or supine position without any obvious central nervous system disorder. The 4 cases had some findings in common. There were no abnormal findings on neurological tests or brain MRI. They did not have gaze nystagmus. Their nystagmus was observed only in a supine or head-hanging position and it was never observed upon returning to a sitting position and never reversed. The nystagmus had no or little torsional component, had latency and tended to decrease with time. The positional DBN (p-DBN) is known to be indicative of a central nervous system disorder. Recently there were some reports that canalithiasis of the anterior semicircular canal (ASC) causes p-DBN and that patients who have p-DBN without obvious CNS dysfunction are dealt with anterior semicircular canal (ASC) benign paroxysmal positional vertigo (BPPV). There are some doubts as to the validity of making a diagnosis of ASC-BPPV in a case of p-DBN without CNS findings. It is hard to determine the cause of p-DBN in these cases.

  18. Effect of intravaginal clindamycin cream on pregnancy outcome and on abnormal vaginal microbial flora of pregnant women.

    PubMed

    Rosenstein, I J; Morgan, D J; Lamont, R F; Sheehan, M; Doré, C J; Hay, P E; Taylor-Robinson, D

    2000-01-01

    To determine whether intravaginal clindamycin cream reduces the incidence of abnormal pregnancy outcome in women with abnormal vaginal microbial flora graded as intermediate or BV and to investigate the effect of the antibiotic on vaginal microbial flora. A prospective cohort study of pregnant women in an antenatal clinic of a district general hospital. The subjects were 268 women who had abnormal vaginal microbial flora at first clinic visit by examination of a Gram-stained vaginal smear and 34 women with a normal vaginal flora. Two hundred and thirty-seven women were evaluable. Women with abnormal Gram-stained smears (graded as II or III) on clinic recall were randomised to receive treatment (intravaginal clindamycin cream) or placebo and followed to assess outcome of pregnancy, vaginal flora, and detection of Mycoplasma hominis and Ureaplasma urealyticum after treatment. Abnormal outcomes of pregnancy were not significantly different in treated and placebo groups by Chi square (P = 0.2). However, women with grade III flora responded better to clindamycin than women with grade II flora by numbers of abnormal outcomes (P = 0.03) and return to normal vaginal flora (P = 0.01) (logistic regression analysis model). This may be due to differences in vaginal bacterial species in these grades. Women whose abnormal vaginal flora had spontaneously returned to normal on follow-up and were therefore not treated (revertants) had as many abnormal outcomes as placebos suggesting that damage by abnormal bacterial species occurred early in pregnancy. Gram-stain screening distinguishing grade II from grade III flora may be helpful in prescribing treatment other than clindamycin for women with grade II flora. Earlier diagnosis and treatment may be more effective in preventing an abnormal outcome, possibly as soon as pregnancy is diagnosed or even offered as a pre-conception screen.

  19. Which stocks are profitable? A network method to investigate the effects of network structure on stock returns

    NASA Astrophysics Data System (ADS)

    Chen, Kun; Luo, Peng; Sun, Bianxia; Wang, Huaiqing

    2015-10-01

    According to asset pricing theory, a stock's expected returns are determined by its exposure to systematic risk. In this paper, we propose a new method for analyzing the interaction effects among industries and stocks on stock returns. We construct a complex network based on correlations of abnormal stock returns and use centrality and modularity, two popular measures in social science, to determine the effect of interconnections on industry and stock returns. Supported by previous studies, our findings indicate that a relationship exists between inter-industry closeness and industry returns and between stock centrality and stock returns. The theoretical and practical contributions of these findings are discussed.

  20. Risk Perceptions on Hurricanes: Evidence from the U.S. Stock Market

    PubMed Central

    Feria-Domínguez, José Manuel; Paneque, Pilar; Gil-Hurtado, María

    2017-01-01

    This article examines the market reaction of the main Property and Casualty (P & C) insurance companies listed in the New York Stock Exchange (NYSE) to seven most recent hurricanes that hit the East Coast of the United States from 2005 to 2012. For this purpose, we run a standard short horizon event study in order to test the existence of abnormal returns around the landfalls. P & C companies are one of the most affected sectors by such events because of the huge losses to rebuild, help and compensate the inhabitants of the affected areas. From the financial investors’ perception, this kind of events implies severe losses, which could influence the expected returns. Our research highlights the existence of significant cumulative abnormal returns around the landfall event window in most of the hurricanes analyzed, except for the Katrina and Sandy Hurricanes. PMID:28587237

  1. Risk Perceptions on Hurricanes: Evidence from the U.S. Stock Market.

    PubMed

    Feria-Domínguez, José Manuel; Paneque, Pilar; Gil-Hurtado, María

    2017-06-05

    This article examines the market reaction of the main Property and Casualty (P & C) insurance companies listed in the New York Stock Exchange (NYSE) to seven most recent hurricanes that hit the East Coast of the United States from 2005 to 2012. For this purpose, we run a standard short horizon event study in order to test the existence of abnormal returns around the landfalls. P & C companies are one of the most affected sectors by such events because of the huge losses to rebuild, help and compensate the inhabitants of the affected areas. From the financial investors' perception, this kind of events implies severe losses, which could influence the expected returns. Our research highlights the existence of significant cumulative abnormal returns around the landfall event window in most of the hurricanes analyzed, except for the Katrina and Sandy Hurricanes.

  2. Influence of combined iron supplementation and simulated hypoxia on the haematological module of the athlete biological passport.

    PubMed

    Garvican-Lewis, Laura A; Vuong, Victor L; Govus, Andrew D; Schumacher, Yorck Olaf; Hughes, David; Lovell, Greg; Eichner, Daniel; Gore, Christopher J

    2018-04-01

    The integrity of the athlete biological passport (ABP) is underpinned by understanding normal fluctuations of its biomarkers to environmental or medical conditions, for example, altitude training or iron deficiency. The combined impact of altitude and iron supplementation on the ABP was evaluated in endurance-trained athletes (n = 34) undertaking 3 weeks of simulated live-high: train-low (14 h.d -1 , 3000 m). Athletes received either oral, intravenous (IV) or placebo iron supplementation, commencing 2 weeks prior and continuing throughout hypoxic exposure. Venous blood was sampled twice prior, weekly during, and up to 6 weeks after altitude. Individual ABP thresholds for haemoglobin concentration ([Hb]), reticulocyte percentage (%retic), and OFF score were calculated using the adaptive model and assessed at 99% and 99.9% specificity. Eleven athletes returned values outside of the calculated reference ranges at 99%, with 8 at 99.9%. The percentage of athletes exceeding the thresholds in each group was similar, but IV returned the most individual occurrences. A similar frequency of abnormalities occurred across the 3 biomarkers, with abnormal [Hb] and OFF score values arising mainly during-, and %retic values mainly post- altitude. Removing samples collected during altitude from the model resulted in 10 athletes returning abnormal values at 99% specificity, 2 of whom had not triggered the model previously. In summary, the abnormalities observed in response to iron supplementation and hypoxia were not systematic and mostly in line with expected physiological adaptations. They do not represent a uniform weakness in the ABP. Nevertheless, altitude training and iron supplementation should be carefully considered by experts evaluating abnormal ABP profiles. Copyright © 2017 John Wiley & Sons, Ltd.

  3. Effect of intravaginal clindamycin cream on pregnancy outcome and on abnormal vaginal microbial flora of pregnant women.

    PubMed Central

    Rosenstein, I J; Morgan, D J; Lamont, R F; Sheehan, M; Doré, C J; Hay, P E; Taylor-Robinson, D

    2000-01-01

    OBJECTIVES: To determine whether intravaginal clindamycin cream reduces the incidence of abnormal pregnancy outcome in women with abnormal vaginal microbial flora graded as intermediate or BV and to investigate the effect of the antibiotic on vaginal microbial flora. METHODS: A prospective cohort study of pregnant women in an antenatal clinic of a district general hospital. The subjects were 268 women who had abnormal vaginal microbial flora at first clinic visit by examination of a Gram-stained vaginal smear and 34 women with a normal vaginal flora. Two hundred and thirty-seven women were evaluable. Women with abnormal Gram-stained smears (graded as II or III) on clinic recall were randomised to receive treatment (intravaginal clindamycin cream) or placebo and followed to assess outcome of pregnancy, vaginal flora, and detection of Mycoplasma hominis and Ureaplasma urealyticum after treatment. RESULTS: Abnormal outcomes of pregnancy were not significantly different in treated and placebo groups by Chi square (P = 0.2). However, women with grade III flora responded better to clindamycin than women with grade II flora by numbers of abnormal outcomes (P = 0.03) and return to normal vaginal flora (P = 0.01) (logistic regression analysis model). This may be due to differences in vaginal bacterial species in these grades. Women whose abnormal vaginal flora had spontaneously returned to normal on follow-up and were therefore not treated (revertants) had as many abnormal outcomes as placebos suggesting that damage by abnormal bacterial species occurred early in pregnancy. CONCLUSIONS: Gram-stain screening distinguishing grade II from grade III flora may be helpful in prescribing treatment other than clindamycin for women with grade II flora. Earlier diagnosis and treatment may be more effective in preventing an abnormal outcome, possibly as soon as pregnancy is diagnosed or even offered as a pre-conception screen. PMID:10968599

  4. Neural autonomic control in orthostatic intolerance.

    PubMed

    Furlan, Raffaello; Barbic, Franca; Casella, Francesco; Severgnini, Giorgio; Zenoni, Luca; Mercieri, Angelo; Mangili, Ruggero; Costantino, Giorgio; Porta, Alberto

    2009-10-01

    Inability to maintain the upright position is manifested by a number of symptoms shared by either human pathophysiology and conditions following weightlessness or bed rest. Alterations of the neural sympathetic cardiovascular control have been suggested to be one of the potential underlying etiopathogenetic mechanisms in these conditions. We hypothesize that the study of the autonomic profile of human orthostatic intolerance syndromes may furnish a valuable insight into the complexity of the sympathetic alterations leading to a reduced gravitational tolerance. In the present paper we describe abnormalities both in the magnitude and in the pattern of the sympathetic neural firing observed in patients affected by orthostatic intolerance, attending the upright position. Also, we discuss similarity and differences in the neural sympathetic mechanisms regulating the cardiovascular system during the gravitational stimulus both in clinical syndromes and in subjects returning from space.

  5. The Forsyth County Cervical Cancer Prevention Project--II. Compliance with screening follow-up of abnormal cervical smears.

    PubMed

    Michielutte, R; Dignan, M; Bahnson, J; Wells, H B

    1994-12-01

    The Forsyth County Cervical Cancer Prevention Project was a community-wide cancer education program to address the problem of cervical cancer incidence and mortality among minority women in Forsyth County, North Carolina. This paper reports program results with regard to increasing compliance with follow-up for abnormal cervical smears. An analysis of trends prior to and after implementation of the educational program was conducted in one private and two public health primary care clinics to provide an assessment of impact of the project in improving compliance with follow-up among black women. A similar analysis also was conducted for white women. The results of medical record reviews of follow-up procedures for 878 abnormal cervical smears suggested a modest program effect among black women. The percentage of black women who returned for follow-up and treatment of an abnormal cervical smear significantly increased during the time the program was in effect. The trend analysis further indicated that the decline did not begin prior to the intervention period and was maintained throughout the duration of the intervention. No significant change in the percentage who returned for follow-up was found for white women.

  6. HPV DNA testing in population-based cervical screening (VUSA-Screen study): results and implications

    PubMed Central

    Rijkaart, D C; Berkhof, J; van Kemenade, F J; Coupe, V M H; Rozendaal, L; Heideman, D A M; Verheijen, R H M; Bulk, S; Verweij, W; Snijders, P J F; Meijer, C J L M

    2012-01-01

    Background: Human papillomavirus (HPV) testing is more sensitive than cytology for detecting high-grade cervical intraepithelial neoplasia (CIN). We evaluated the performance of high-risk HPV (hrHPV) testing in routine screening. Methods: In all, 25 871 women (29–61) enrolled in our population-based cohort study were offered both cytology and hrHPV testing. High-risk HPV-positive women with normal cytology and an age-matched subcohort of hrHPV-negative women with normal cytology were invited for repeat testing after 1 and/or 2 years and were referred for colposcopy if they presented with abnormal cytology and/or a positive hrHPV test. The hrHPV-positive women with borderline or mild dyskaryosis (BMD) and all women with moderate dyskaryosis or worse (>BMD) were directly referred for colposcopy. Women with BMD and an hrHPV-negative test were advised to repeat cytology at 6 and 18 months and were referred for colposcopy if the repeat cytology test was abnormal. The main outcome measure was CIN grade 3 or worse (CIN3+). Results were adjusted for non-attendance at repeat testing. Results: The hrHPV-positive women with abnormal cytology had a CIN3+ risk of 42.2% (95% confidence interval (CI): 36.4–48.2), whereas the hrHPV-positive women with normal cytology had a much lower risk of 5.22% (95% CI: 3.72–7.91). In hrHPV-positive women with normal cytology, an additional cytology step after 1 year reduced the CIN3+ risk to only 1.6% (95% CI: 0.6–4.9) if the repeat test was normal. The CIN3+ risk in women with hrHPV-positive normal cytology was higher among women invited for the first time (29–33 years of age) (9.1% 95% CI: 5.6–14.3) than among older women (3.0% 95% CI: 1.5–5.5). Conclusion: Primary hrHPV screening with cytology triage in women aged ⩾30 years is an effective way to stratify women on CIN3+ risk and seems a feasible alternative to cytological screening. Repeat cytology after 1 year for hrHPV-positive women with normal cytology is however necessary before returning women to routine screening. PMID:22251922

  7. HPV testing as a triage for borderline or mild dyskaryosis on cervical cytology: results from the Sentinel Sites study.

    PubMed

    Kelly, R S; Patnick, J; Kitchener, H C; Moss, S M

    2011-09-27

    Earlier pilot studies of human papillomavirus (HPV) triage concluded that HPV triage was feasible and cost-effective. The aim of the present study was to study the impact of wider rollout of HPV triage for women with low-grade cytology on colposcopy referral and outcomes. Human papillomavirus testing of liquid-based cytology (LBC) samples showing low-grade abnormalities was used to select women for colposcopy referral at six sites in England. Samples from 10,051 women aged 25-64 years with routine call or recall cytology reported as borderline or mild dyskaryosis were included. Human papillomavirus-positive rates were 53.7% in women with borderline cytology and 83.9% in those with mild dyskaryosis. The range between sites was 34.8-73.3% for borderline cytology, and 73.4-91.6% for mild dyskaryosis. In the single site using both LBC technologies there was no difference in rates between the two technologies. The positive predictive value of an HPV test was 16.3% for CIN2 or worse and 6.1% for CIN3 or worse, although there was considerable variation between sites. Triaging women with borderline cytological abnormalities and mild dyskaryosis with HPV testing would allow approximately a third of these women to be returned immediately to routine recall, and for a substantial proportion to be referred for colposcopy without repeat cytology. Variation in HPV-positive rates results in differing colposcopy workload.

  8. An analysis of security price risk and return among publicly traded pharmacy corporations.

    PubMed

    Gilligan, Adrienne M; Skrepnek, Grant H

    2013-01-01

    Community pharmacies have been subject to intense and increasing competition in the past several decades. To determine the security price risk and rate of return of publicly traded pharmacy corporations present on the major U.S. stock exchanges from 1930 to 2009. The Center of Research in Security Prices (CRSP) database was used to examine monthly security-level stock market prices in this observational retrospective study. The primary outcome of interest was the equity risk premium, with analyses focusing upon financial metrics associated with risk and return based upon modern portfolio theory (MPT) including: abnormal returns (i.e., alpha), volatility (i.e., beta), and percentage of returns explained (i.e., adjusted R(2)). Three equilibrium models were estimated using random-effects generalized least squares (GLS): 1) the Capital Asset Pricing Model (CAPM); 2) Fama-French Three-Factor Model; and 3) Carhart Four-Factor Model. Seventy-five companies were examined from 1930 to 2009, with overall adjusted R(2) values ranging from 0.13 with the CAPM to 0.16 with the Four-Factor model. Alpha was not significant within any of the equilibrium models across the entire 80-year time period, though was found from 1999 to 2009 in the Three- and Four-Factor models to be associated with a large, significant, and negative risk-adjusted abnormal returns of -33.84%. Volatility varied across specific time periods based upon the financial model employed. This investigation of risk and return within publicly listed pharmacy corporations from 1930 to 2009 found that substantial losses were incurred particularly from 1999 to 2009, with risk-adjusted security valuations decreasing by one-third. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Pulmonary nocardiosis

    MedlinePlus

    ... you and listen to your lungs using a stethoscope. You may have abnormal lung sounds, called crackles. ... returning. Alternative Names Nocardiosis - pulmonary; Mycetoma; Nocardia Images Respiratory system References Southwick FS. Nocardiosis. In: Goldman L, ...

  10. Market Reactions to Publicly Announced Privacy and Security Breaches Suffered by Companies Listed on the United States Stock Exchanges: A Comparative Empirical Investigation

    ERIC Educational Resources Information Center

    Coronado, Adolfo S.

    2012-01-01

    Using a sample of security and privacy breaches the present research examines the comparative announcement impact between the two types of events. The first part of the dissertation analyzes the impact of publicly announced security and privacy breaches on abnormal stock returns, the change in firm risk, and abnormal trading volume are measured.…

  11. A case of acalculous cholecystitis in the course of dengue fever in a traveller returned from Brazil.

    PubMed

    Kuna, Anna; Wroczyńska, Agnieszka; Gajewski, Michał; Felczak-Korzybska, Iwona; Nahorski, Wacław L

    2016-01-01

    Dengue is the second cause of fever after malaria in travellers returning from the tropics. The infection may be asymptomatic or it may manifest itself with fever only, some patients, however, may develop haemorrhagic symptoms and shock. A 58-year-old woman came to the University Centre of Tropical Medicine in Gdynia after returning from a tourist journey to Brazil because of fever up to 39°C and malaise. She had lived in South America many years and then moved to Europe 3 years before hospitalisation. On admission physical examination revealed fever, dry mucosa, moderate hypotension and tachycardia. In the laboratory test results, leukopoenia, thrombocytopoenia and elevated transaminases were observed. On the second day of the hospitalisation, the patient reported epigastric pain, clinical examination revealed tenderness of the abdomen and macular rash on the skin of the trunk and thighs. The ultrasonography revealed an enlarged gallbladder with thickened walls, with hypoechogenic area surrounding it, a dilated common biliary duct of heterogenic echo, and some free fluid in the peritoneal cavity. An exploratory laparotomy was performed after 24 h because of the persisting strong abdominal pain and high fever. Intraoperatively, enlarged mesenteric lymph nodes were found, with no symptoms of gallbladder pathology. The postoperative course was uncomplicated and the positive result of immunochromatographic assay for dengue was obtained. The acalculous cholecystitis has been described in the course of various diseases and conditions. The typical symptoms include pain in the right hypochondriac region, fever, positive Murphy's sign, and abnormal liver function tests, which were observed in the presented case. Cholecystectomy is not usually indicated in the course of dengue (typically a self-limiting disease) due to a high risk of bleeding. The case provides a rationale for the inclusion of acalculous cholecystitis in the differential diagnosis in patients with abdominal pain returning from dengue endemic areas.

  12. A randomized controlled trial in non-responders from Newcastle upon Tyne invited to return a self-sample for Human Papillomavirus testing versus repeat invitation for cervical screening.

    PubMed

    Cadman, Louise; Wilkes, Scott; Mansour, Diana; Austin, Janet; Ashdown-Barr, Lesley; Edwards, Rob; Kleeman, Michelle; Szarewski, Anne

    2015-03-01

    Non-attenders for cervical screening are at increased risk of cervical cancer. Studies offering self-sampling for high-risk Human Papillomavirus (HrHPV) testing have shown greater uptake than sending another invitation for cytology. To explore whether uptake would increase in a less diverse, more stable population than the previous English study, which demonstrated a lower response rate than other studies. The primary objective was whether non-attenders were more likely to respond to a postal invitation, including kit, to collect a self-sample compared with a further invitation for cytology screening. The secondary objective was whether women with an abnormal result would attend for follow-up. 6000 non-attenders for screening in this pragmatic, randomized (1:1) controlled trial in Newcastle-upon-Tyne were sent an HPV self-sample kit (intervention) or a further invitation for cytology screening (comparator). 411(13%) responded to the intervention, returning a self-sample (247(8%)) or attending for cytology (164(5%)), compared with 183(6%) attending for cytology, relative risk 2.25 (95% CI 1.90-2.65) (comparator arm). Of those testing hrHPV positive (32(13%)), 19(59%) subsequently attended cytology screening. Of those in the intervention group who attended for cytology screening without returning an hrHPV self-sample (n = 164), 5% (n = 8) were referred for colposcopy - all attended. In the comparator group eight of the nine referred for colposcopy attended. Persistent non-responders to invitations for cervical screening are significantly more likely to respond to a postal invitation to return a self-collected sample for HPV testing than a further invitation for cytology screening. However, just over half followed up on this positive HPV result. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  13. How long is the memory of the US stock market?

    NASA Astrophysics Data System (ADS)

    Ferreira, Paulo; Dionísio, Andreia

    2016-06-01

    The Efficient Market Hypothesis (EMH), one of the most important hypothesis in financial economics, argues that return rates have no memory (correlation) which implies that agents cannot make abnormal profits in financial markets, due to the possibility of arbitrage operations. With return rates for the US stock market, we corroborate the fact that with a linear approach, return rates do not show evidence of correlation. However, linear approaches might not be complete or global, since return rates could suffer from nonlinearities. Using detrended cross-correlation analysis and its correlation coefficient, a methodology which analyzes long-range behavior between series, we show that the long-range correlation of return rates only ends in the 149th lag, which corresponds to about seven months. Does this result undermine the EMH?

  14. Current concepts of metabolic abnormalities in HIV patients: focus on lipodystrophy.

    PubMed

    Kolter, Donald P

    2003-12-01

    HIV infection is associated with a number of metabolic abnormalities, including lipodystrophy, a difficult-to-define disorder whose characteristics include hyperlipidemia, insulin resistance, and fat redistribution. Current data suggest that lipodystrophy is caused by multiple factors. Dual-nucleoside reverse transcriptase inhibitor therapy combined with protease inhibitor therapy has been shown to increase the risk of metabolic abnormalities, but susceptibility independent of drug effects has also been shown. While many of the treatments for the broad range of signs and symptoms of lipodystrophy bring about improvements in patient status, none have been demonstrated to bring about a return to baseline levels.

  15. The influence of jumping risk and volatility risk on TAIEX option return

    NASA Astrophysics Data System (ADS)

    Lee, Wei-Long; Hsieh, Ching-Tang; Huang, Jui-Chan; Wu, Tzu-Jung

    2017-06-01

    Due to the low profits in recent years environmental, as well as the development of financial engineering that promote the derivatives trading Volume increased. Moreover, the fastest-growing of selected right and the lack of research about option risk. This study aim to explore the relationship between the risk and reward of selected right in Taiwan index. This study focus on the pricing the jump risk of selected right in Taiwan index. Using cross-sectional data as a 12-month study period, using the iteration method to research the effects of abnormal returns, the result shows that different risk factors of fluctuations affected the abnormal returns obviously will cause risk premium as well as the jump risk which consistent with the theory of behavioral finance. However, according to traditional finance theory, contrary to the results of this study consider that higher risks should generate higher-paying as well. According this study, the investors in behavioral finance in modern financial theory is not rational, and the trading behavior is non-random, moreover, the financial market is non-efficiency. Instead, the high risk low reward.

  16. Financing development stage biotechnology companies: RMs vs. IPOs.

    PubMed

    Ahn, Mark J; Couch, Robert B; Wu, Wei

    2011-01-01

    We examine reverse mergers (RMs) in the biotechnology industry and find that, when compared to initial public offerings (IPOs), RMs are smaller, have significantly lower market valuations relative to size, and generally invest less. We also find that RMs exhibit positive abnormal returns on the announcement date and throughout the first year after the RM event. In looking at liquidity measures, we find that RMs tend to be less liquid than IPOs and that illiquidity is greater during the six-month lock-up period following the RM event. Thus, RMs may be an appropriate alternative financing vehicle in capital intensive, high-risk biotechnology companies which require accessing deeper and larger pools of investors in public capital markets across multiple milestone periods in a "pay for progress" environment.

  17. Abdominal musculature abnormalities as a cause of groin pain in athletes. Inguinal hernias and pubalgia.

    PubMed

    Taylor, D C; Meyers, W C; Moylan, J A; Lohnes, J; Bassett, F H; Garrett, W E

    1991-01-01

    There has been increasing interest within the European sports medicine community regarding the etiology and treatment of groin pain in the athlete. Groin pain is most commonly caused by musculotendinous strains of the adductors and other muscles crossing the hip joint, but may also be related to abdominal wall abnormalities. Cases may be termed "pubalgia" if physical examination does not reveal inguinal hernia and there is an absence of other etiology for groin pain. We present nine cases of patients who underwent herniorrhaphies for groin pain. Two patients had groin pain without evidence of a hernia preoperatively (pubalgia). In the remaining seven patients we determined the presence of a hernia by physical examination. At operation, eight patients were found to have inguinal hernias. One patient had no hernia but had partial avulsion of the internal oblique fibers from their insertion at the public tubercle. The average interval from operation to return to full activity was 11 weeks. All patients returned to full activity within 3 months of surgery. One patient had persistent symptoms of mild incisional tenderness, but otherwise there were no recurrences, complications, or persistence of symptoms. Abnormalities of the abdominal wall, including inguinal hernias and microscopic tears or avulsions of the internal oblique muscle, can be an overlooked source of groin pain in the athlete. Operative treatment of this condition with herniorrhaphy can return the athlete to his sport within 3 months.

  18. Acute schistosomiasis in European students returning from fieldwork at Lake Tanganyika, Tanzania.

    PubMed

    Steiner, Florian; Ignatius, Ralf; Friedrich-Jaenicke, Barbara; Dieckmann, Sebastian; Harms, Gundel; Poppert, Sven; Mockenhaupt, Frank P

    2013-01-01

    Schistosomiasis is common in many African regions and poses a risk for travelers and the local population. So far, schistosomiasis in travelers or expatriates returning from the Tanzanian bank of Lake Tanganyika has not been reported. We report a group of students who sought treatment with signs of acute schistosomiasis after having returned from Lake Tanganyika, Tanzania. Information as to travel and exposure as well as clinical and laboratory data were collected. Schistosomiasis was diagnosed in 8 of 16 students from Berlin, Germany, who had returned from a 2- to 3-month stay of fieldwork in Kigoma District at Lake Tanganyika, Tanzania. All 16 students reported frequent freshwater exposure at the lake. Six patients showed signs of acute schistosomiasis and had fever, and some of them also had cough, weakness, headache, or abdominal pain. Eosinophilia was present in five of the six symptomatic individuals. Notably, two serologically enzyme-linked immunosorbent assay (ELISA)-positive individuals did not report or present with symptoms or abnormal laboratory parameters. Schistosoma mansoni eggs were found in one symptomatic and one asymptomatic individual each. Blood and stool samples from the other eight individuals who were equally exposed to freshwater yielded negative results. This is the first report of an outbreak of acute schistosomiasis imported from the Tanzanian shore of Lake Tanganyika and highlights the risk for travelers and the local population of acquiring the infection in that part of Tanzania. It provides arguments for routine serological screening for schistosomiasis in individuals who had prior freshwater contact in endemic areas, irrespective of symptoms or other laboratory findings. © 2013 International Society of Travel Medicine.

  19. A prospective study of concussions among National Hockey League players during regular season games: the NHL-NHLPA Concussion Program.

    PubMed

    Benson, Brian W; Meeuwisse, Willem H; Rizos, John; Kang, Jian; Burke, Charles J

    2011-05-17

    In 1997, the National Hockey League (NHL) and NHL Players' Association (NHLPA) launched a concussion program to improve the understanding of this injury. We explored initial postconcussion signs, symptoms, physical examination findings and time loss (i.e., time between the injury and medical clearance by the physician to return to competitive play), experienced by male professional ice-hockey players, and assessed the utility of initial postconcussion clinical manifestations in predicting time loss among hockey players. We conducted a prospective case series of concussions over seven NHL regular seasons (1997-2004) using an inclusive cohort of players. The primary outcome was concussion and the secondary outcome was time loss. NHL team physicians documented post-concussion clinical manifestations and recorded the date when a player was medically cleared to return to play. Team physicians reported 559 concussions during regular season games. The estimated incidence was 1.8 concussions per 1000 player-hours. The most common postconcussion symptom was headache (71%). On average, time loss (in days) increased 2.25 times (95% confidence interval [CI] 1.41-3.62) for every subsequent (i.e., recurrent) concussion sustained during the study period. Controlling for age and position, significant predictors of time loss were postconcussion headache (p < 0.001), low energy or fatigue (p = 0.01), amnesia (p = 0.02) and abnormal neurologic examination (p = 0.01). Using a previously suggested time loss cut-point of 10 days, headache (odds ratio [OR] 2.17, 95% CI 1.33-3.54) and low energy or fatigue (OR 1.72, 95% CI 1.04-2.85) were significant predictors of time loss of more than 10 days. Postconcussion headache, low energy or fatigue, amnesia and abnormal neurologic examination were significant predictors of time loss among professional hockey players.

  20. Valuation effects of health cost containment measures.

    PubMed

    Strange, M L; Ezzell, J R

    2000-01-01

    This study reports the findings of research into the valuation effects of health cost containment activities by publicly traded corporations. The motivation for this study was employers' increasing cost of providing health care insurance to their employees and employers' efforts to contain those costs. A 1990 survey of corporate health benefits indicated that these costs represented 25 percent of employers' net earnings and this would rise by the year 2000 if no actions were taken to reduce cost. Health cost containment programs that are implemented by firms should be seen by shareholders as a wealth maximizing effort. As such, this should be reflected in share price. This study employed standard event study methodology where the event is a media announcement or report regarding an attempt by a firm to contain the costs of providing health insurance and other health related benefits to employees. It examined abnormal returns on a number of event days and for a number of event intervals. Of the daily and interval returns that are least significant at the 10 percent level, virtually all are negative. Cross-sectional analysis shows that the abnormal returns are related negatively to a unionization variable.

  1. Evaluation of cardiovascular anomalies in patients with asymptomatic turner syndrome using multidetector computed tomography.

    PubMed

    Lee, Sun Hee; Jung, Ji Mi; Song, Min Seob; Choi, Seok jin; Chung, Woo Yeong

    2013-08-01

    Turner syndrome is well known to be associated with significant cardiovascular abnormalities. This paper studied the incidence of cardiovascular abnormalities in asymptomatic adolescent patients with Turner syndrome using multidetector computed tomography (MDCT) instead of echocardiography. Twenty subjects diagnosed with Turner syndrome who had no cardiac symptoms were included. Blood pressure and electrocardiography (ECG) was checked. Cardiovascular abnormalities were checked by MDCT. According to the ECG results, 11 had a prolonged QTc interval, 5 had a posterior fascicular block, 3 had a ventricular conduction disorder. MDCT revealed vascular abnormalities in 13 patients (65%). Three patients had an aberrant right subclavian artery, 2 had dilatation of left subclavian artery, and others had an aortic root dilatation, aortic diverticulum, and abnormal left vertebral artery. As for venous abnormalities, 3 patients had partial anomalous pulmonary venous return and 2 had a persistent left superior vena cava. This study found cardiovascular abnormalities in 65% of asymptomatic Turner syndrome patients using MDCT. Even though, there are no cardiac symptoms in Turner syndrome patients, a complete evaluation of the heart with echocardiography or MDCT at transition period to adults must be performed.

  2. [Effects of asphyxia on endocochlear direct-current potential in guinea pig].

    PubMed

    Liu, Xiuli; Ren, Zhong; Lü, Mei; Nakashima, Tsutomu

    2006-04-01

    To investigate the mechanism of auditory function disturbance due to asphyxiants. Guinea pigs with nice auricle reflex were selected in the experiment. The changes of endocochlear direct-current potential (EP) were detected when apnea and after artificial respiration, using the stria vascularis method. (1) The original EP of experimental group was (76.4+/-8.4) mV, and the original EP of control group was (80.8+/-8.4) mV, there was no significant difference between them. (2) During apnea, the EP of all the guinea pigs decreased precipitously after incubation period of 8 to 34 seconds. The decreasing rate of EP was positively correlated to the incubation period (P=0.008). (3) After 3 minutes of apnea, the mean minimum of EP was (-17.5+/-4.4) mV, which was positively correlated with decreasing rate and incubation period (P was 0.0002, 0.000 separately). (4) After artificial respiration, it needed the average time of (85.0+/-16.0) s to return original EP, and 7 cases got an overrun. The EP of all the guinea pigs decreased when apnea, which showed the abnormal living circumstance of acoustic hair cells. After 3 minutes of apnea, the EP of all the guinea pigs decreased to negative value, which demonstrated that the functions of acoustic hair cells had not lost within 3 minutes of apnea. After artificial respiration, all the guinea pigs' EP returned to original value, which indicated that the functions of the stria vascularis had not failed irreversibly.

  3. Effects of Early Motor Intervention in the Prone Position of Full-Term Infants through the First Year of Life.

    ERIC Educational Resources Information Center

    Douret, L.

    1993-01-01

    Full-term infants who had slept in the prone position since birth were followed to detect early postural abnormalities and differentiate potential peripheral abnormality from abnormalities of a central origin. Results showed that disappearance of initial signs of abnormality appeared to be muscular, and symptoms disappeared faster when a motor…

  4. Two-dimensional velocity, optical risetime, and peak current estimates for natural positive lightning return strokes

    NASA Technical Reports Server (NTRS)

    Mach, Douglas M.; Rust, W. D.

    1993-01-01

    Velocities, optical risetimes, and transmission line model peak currents for seven natural positive return strokes are reported. The average 2D positive return stroke velocity for channel segments of less than 500 m in length starting near the base of the channel is 0.8 +/- 0.3 x 10 exp 8 m/s, which is slower than the present corresponding average velocity for natural negative first return strokes of 1.7 +/- 0.7 x 10 exp 8/s. It is inferred that positive stroke peak currents in the literature, which assume the same velocity as negative strokes, are low by a factor of 2. The average 2D positive return stroke velocity for channel segments of greater than 500 m starting near the base of the channel is 0.9 +/- 0.4 x 10 exp 8 m/s. The corresponding average velocity for the present natural negative first strokes is 1.2 +/- 0.6 x 10 exp 8 m/s. No significant velocity change with height is found for positive return strokes.

  5. The Role of Heat Tolerance Testing in Recovery and Return to Duty

    DTIC Science & Technology

    2008-10-01

    CV diseases Hyperthyroidism Pheochromocytoma Infectious diseases Diabetes mellitus Psychiatric illness Parkinsonism Congenital abnormalities: CF...environments. To assess the heat tolerance status of prior heat stroke patient. Heat tolerance test (HTT) “HTT was effective in evaluating the heat tolerance

  6. KSC-97PC1363

    NASA Image and Video Library

    1997-09-08

    Workers remove the Huygens probe from the Cassini spacecraft in the Payload Hazardous Servicing Facility (PHSF) at KSC. The spacecraft was returned to the PHSF after damage to thermal insulation was discovered inside Huygens from an abnormally high flow of conditioned air. Further internal inspection, insulation repair and a cleaning of the probe are now required. Mission managers are targeting a mid-October launch date after Cassini returns to the pad and is once again placed atop its Titan IVB expendable launch vehicle at Launch Pad 40 at Cape Canaveral Air Station

  7. KSC-97PC1392

    NASA Image and Video Library

    1997-09-10

    Jet Propulsion Laboratory (JPL) workers examine the Huygens probe after removal from the Cassini spacecraft in the Payload Hazardous Servicing Facility (PHSF) at KSC. The spacecraft was returned to the PHSF after damage to thermal insulation was discovered inside Huygens from an abnormally high flow of conditioned air. Internal inspection, insulation repair and a cleaning of the probe were required. Mission managers are targeting a mid-October launch date after Cassini returns to the pad and is once again placed atop its Titan IVB expendable launch vehicle at Launch Pad 40 at Cape Canaveral Air Station

  8. KSC-97PC1393

    NASA Image and Video Library

    1997-09-10

    Pieces of the Huygens probe internal insulating foam await inspection after removal from the probe in the Payload Hazardous Servicing Facility (PHSF) at KSC. The spacecraft was returned to the PHSF after damage to thermal insulation was discovered inside Huygens from an abnormally high flow of conditioned air. Internal inspection, insulation repair and a cleaning of the probe were required. Mission managers are targeting a mid-October launch date after Cassini returns to the pad and is once again placed atop its Titan IVB expendable launch vehicle at Launch Pad 40 at Cape Canaveral Air Station

  9. KSC-97PC1360

    NASA Image and Video Library

    1997-09-08

    Jet Propulsion Laboratory (JPL) workers remove the Huygens probe from the Cassini spacecraft in the Payload Hazardous Servicing Facility (PHSF) at KSC. The spacecraft was returned to the PHSF after damage to thermal insulation was discovered inside Huygens from an abnormally high flow of conditioned air. Further internal inspection, insulation repair and a cleaning of the probe are now required. Mission managers are targeting a mid-October launch date after Cassini returns to the pad and is once again placed atop its Titan IVB expendable launch vehicle at Launch Pad 40 at Cape Canaveral Air Station

  10. KSC-97PC1362

    NASA Image and Video Library

    1997-09-08

    Workers remove the Huygens probe from the Cassini spacecraft in the Payload Hazardous Servicing Facility (PHSF) at KSC. The spacecraft was returned to the PHSF after damage to thermal insulation was discovered inside Huygens from an abnormally high flow of conditioned air. Further internal inspection, insulation repair and a cleaning of the probe are now required. Mission managers are targeting a mid-October launch date after Cassini returns to the pad and is once again placed atop its Titan IVB expendable launch vehicle at Launch Pad 40 at Cape Canaveral Air Station

  11. KSC-97PC1361

    NASA Image and Video Library

    1997-09-08

    Workers remove the Huygens probe from the Cassini spacecraft in the Payload Hazardous Servicing Facility (PHSF) at KSC. The spacecraft was returned to the PHSF after damage to thermal insulation was discovered inside Huygens from an abnormally high flow of conditioned air. Further internal inspection, insulation repair and a cleaning of the probe are now required. Mission managers are targeting a mid-October launch date after Cassini returns to the pad and is once again placed atop its Titan IVB expendable launch vehicle at Launch Pad 40 at Cape Canaveral Air Station

  12. Abnormal Head Position in Infantile Nystagmus Syndrome

    PubMed Central

    Noval, Susana; González-Manrique, Mar; Rodríguez-Del Valle, José María; Rodríguez-Sánchez, José María

    2011-01-01

    Infantile nystagmus is an involuntary, bilateral, conjugate, and rhythmic oscillation of the eyes which is present at birth or develops within the first 6 months of life. It may be pendular or jerk-like and, its intensity usually increases in lateral gaze, decreasing with convergence. Up to 64% of all patients with nystagmus also present strabismus, and even more patients have an abnormal head position. The abnormal head positions are more often horizontal, but they may also be vertical or take the form of a tilt, even though the nystagmus itself is horizontal. The aim of this article is to review available information about the origin and treatment of the abnormal head position associated to nystagmus, and to describe our treatment strategies. PMID:24533187

  13. Pulmonary Histoplasmosis in a Japanese Man Infected During Travel to Mexico and Management of His Wife's Condition: A Case Report.

    PubMed

    Asahata-Tago, Sayaka; Hirai, Yuji; Ainoda, Yusuke; Fujita, Takahiro; Muraosa, Yasunori; Kamei, Katsuhiko; Wakayama, Megumi; Shibuya, Kazutoshi; Kikuchi, Ken

    2016-01-01

    We report herein on the case of a 33-year-old Japanese man in whom an abnormal shadow was detected on chest radiography during a medical checkup after a 1-year-stay in Mexico. Chest computed tomography showed a nodule in the left lower lobe adjacent to the visceral pleura. Histopathologic examination of a thoracoscopic partial pulmonary resection specimen showed coagulation necrosis with a number of yeast-like forms on Grocott staining. In addition, serum anti-Histoplasma antibody positivity was detected with an enzyme-linked immunosorbent assay, and Histoplasma-specific nested real-time polymerase chain reaction results were positive in the pulmonary region. Finally, pulmonary histoplasmosis was diagnosed, and treatment with itraconazole was initiated. The patient's wife who had accompanied him to Mexico was asymptomatic and was not found to have histoplasmosis based on diagnostic imaging and serological findings. Although rare in Japan, histoplasmosis should be considered in the differential diagnosis of pulmonary lesions in patients who have returned from travel to endemic areas.

  14. Return to football and long-term clinical outcomes after thumb ulnar collateral ligament suture anchor repair in collegiate athletes.

    PubMed

    Werner, Brian C; Hadeed, Michael M; Lyons, Matthew L; Gluck, Joshua S; Diduch, David R; Chhabra, A Bobby

    2014-10-01

    To evaluate return to play after complete thumb ulnar collateral ligament (UCL) injury treated with suture anchor repair for both skill position and non-skill position collegiate football athletes and report minimum 2-year clinical outcomes in this population. For this retrospective study, inclusion criteria were complete rupture of the thumb UCL and suture anchor repair in a collegiate football athlete performed by a single surgeon who used an identical technique for all patients. Data collection included chart review, determination of return to play, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) outcomes. A total of 18 collegiate football athletes were identified, all of whom were evaluated for follow-up by telephone, e-mail, or regular mail at an average 6-year follow-up. Nine were skill position players; the remaining 9 played in nonskill positions. All players returned to at least the same level of play. The average QuickDASH score for the entire cohort was 1 out of 100; QuickDASH work score, 0 out of 100; and sport score, 1 out of 100. Average time to surgery for skill position players was 12 days compared with 43 for non-skill position players. Average return to play for skill position players was 7 weeks postoperatively compared with 4 weeks for non-skill position players. There was no difference in average QuickDASH overall scores or subgroup scores between cohorts. Collegiate football athletes treated for thumb UCL injuries with suture anchor repair had quick return to play, reliable return to the same level of activity, and excellent long-term clinical outcomes. Skill position players had surgery sooner after injury and returned to play later than non-skill position players, with no differences in final level of play or clinical outcomes. Management of thumb UCL injuries in collegiate football athletes can be safely and effectively tailored according to the demands of the player's football position. Therapeutic IV. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  15. CD19-positive acute myeloblastic leukemia with trisomy 21 as a sole acquired karyotypic abnormality

    PubMed Central

    Wang, Hua-feng; Cheng, Yi-zhi; Wang, Huan-ping; Chen, Zhi-mei; Lou, Ji-yu; Jin, Jie

    2009-01-01

    We report that a 63-year-old Chinese female had acute myeloblastic leukemia (AML) in which trisomy 21 (+21) was found as the sole acquired karyotypic abnormality. The blasts were positive for myeloperoxidase, and the immunophenotype was positive for cluster of differentiation 19 (CD19), CD33, CD34, and human leukocyte antigens (HLA)-DR. The chromosomal analysis of bone marrow showed 47,XX,+21[2]/46,XX[18]. Fluorescent in situ hybridization (FISH) showed that three copies of AML1 were situated in separate chromosomes, and that t(8;21) was negative. The patient did not have any features of Down syndrome. A diagnosis of CD19-positive AML-M5 was established with trisomy 21 as a sole acquired karyotypic abnormality. The patient did not respond well to chemotherapy and died three months after the diagnosis. This is the first reported case of CD19-positive AML with trisomy 21 as the sole cytogenetic abnormality. The possible prognostic significance of the finding in AML with +21 as the sole acquired karyotypic abnormality was discussed. PMID:19882758

  16. Hemorrhoids detected at colonoscopy: an infrequent cause of false-positive fecal immunochemical test results.

    PubMed

    van Turenhout, Sietze T; Oort, Frank A; Terhaar sive Droste, Jochim S; Coupé, Veerle M H; van der Hulst, Rene W; Loffeld, Ruud J; Scholten, Pieter; Depla, Annekatrien C T M; Bouman, Anneke A; Meijer, Gerrit A; Mulder, Chris J J; van Rossum, Leo G M

    2012-07-01

    Colorectal cancer screening by fecal immunochemical tests (FITs) is hampered by frequent false-positive (FP) results and thereby the risk of complications and strain on colonoscopy capacity. Hemorrhoids might be a plausible cause of FP results. To determine the contribution of hemorrhoids to the frequency of FP FIT results. Retrospective analysis from prospective cohort study. Five large teaching hospitals, including 1 academic hospital. All subjects scheduled for elective colonoscopy. FIT before bowel preparation. Frequency of FP FIT results in subjects with hemorrhoids as the only relevant abnormality compared with FP FIT results in subjects with no relevant abnormalities. Logistic regression analysis to determine colonic abnormalities influencing FP results. In 2855 patients, 434 had positive FIT results: 213 had advanced neoplasia and 221 had FP results. In 9 individuals (4.1%; 95% CI, 1.4-6.8) with an FP FIT result, hemorrhoids were the only abnormality. In univariate unadjusted analysis, subjects with hemorrhoids as the only abnormality did not have more positive results (9/134; 6.7%) compared with subjects without any abnormalities (43/886; 4.9%; P = .396). Logistic regression identified hemorrhoids, nonadvanced polyps, and a group of miscellaneous abnormalities, all significantly influencing false positivity. Of 1000 subjects with hemorrhoids, 67 would have FP results, of whom 18 would have FP results because of hemorrhoids only. Potential underreporting of hemorrhoids; high-risk individuals. Hemorrhoids in individuals participating in colorectal cancer screening will probably not lead to a substantial number of false-positive test results. Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  17. Liability of emergency physicians for studies ordered in the emergency department: court cases and legal defenses.

    PubMed

    Moore, Gregory P

    2011-02-01

    Laboratory tests are frequently ordered in the Emergency Department (ED), with results returning at a later time. Emergency physicians (EPs) are frequently held liable when the test results are not followed-up. Recent legal malpractice cases are presented to provide examples of the medical-legal risks encountered when poor patient outcomes occur because the results of laboratory tests and other studies done in the ED are not followed-up and communicated to the patient. Emergency physicians are obligated to follow-up with patients when the results of laboratory and radiographic studies ordered in the ED are returned at a later time, and EPs are liable for any poor outcome if there is no follow-up. Appropriate follow-up mechanisms must be in place to improve patient outcomes and reduce the risk for the physician. Knowledge of the legal concepts of contributory negligence and comparative fault allows EPs to place themselves in an optimal position for a legal defense if a challenge is raised. It is imperative that abnormal results of tests done for ED evaluation and orders must be properly noted and followed-up. Optimal communication and relay of information to both the patient and the primary physician will reduce physician liability and enhance patient outcomes. Published by Elsevier Inc.

  18. Postretrieval Extinction in Adolescence Prevents Return of Juvenile Fear

    ERIC Educational Resources Information Center

    Jones, Carolyn E.; Monfils, Marie-H.

    2016-01-01

    Traumatic experiences early in life can contribute to the development of mood and anxiety disorders that manifest during adolescence and young adulthood. In young rats exposed to acute fear or stress, alterations in neural development can lead to enduring behavioral abnormalities. Here, we used a modified extinction intervention…

  19. Facts about Total Anomalous Pulmonary Venous Return or TAPVR

    MedlinePlus

    ... and the right atrium. The goal of the surgical repair of TAPVR is to restore normal blood flow through the heart. To repair this defect, doctors usually connect the pulmonary veins to the left atrium, close off any abnormal connections between blood vessels, and close the atrial septal ...

  20. Antibody against infectious salmon anaemia virus among feral Atlantic salmon (Salmo salar)

    USGS Publications Warehouse

    Cipriano, R.C.

    2009-01-01

    Archived sera from Atlantic salmon (Salmo salar) that returned to the Penobscot River (Maine), Merrimack River (Massachusetts), and Connecticut River (in Massachusetts) from 1995 to 2002 were analysed for antibodies against infectious salmon anaemia virus (ISAV) using an enzyme-linked immunosorbent assay (ELISA). Up to 60 samples were archived per river system per year. In a given year, the number of fish sampled by ELISA for ISAV antibodies in the Penobscot River ranged from 2.9 to 11.2, and the range of salmon sampled in the Merrimack River and the Connecticut River was 31.3-100 and 20.0-67.5, respectively. Archived sera were not available for the 1995 and 2002 year classes from the Connecticut River. In all, 1141 samples were processed; 14 serum samples tested positive for antibodies to ISAV. In the Penobscot River, serum from one fish tested positive in each of the 1995 and 1999 year-class returns, and sera from two fish tested positive in the 1998 returns. In the Merrimack River, sera from four fish tested positive in each of the 1996 and 1997 returns, and sera from two fish were positive in the 2002 return. None of the archived sera from Atlantic salmon that returned to the Connecticut River tested positive. ?? 2009 United States Government, Department of the Interior.

  1. The impact of facial abnormalities and their spatial position on perception of cuteness and attractiveness of infant faces

    PubMed Central

    Lewis, Jennifer; Roberson, Debi

    2017-01-01

    Research has demonstrated that how “cute” an infant is perceived to be has consequences for caregiving. Infants with facial abnormalities receive lower ratings of cuteness, but relatively little is known about how different abnormalities and their location affect these aesthetic judgements. The objective of the current study was to compare the impact of different abnormalities on the perception of infant faces, while controlling for infant identity. In two experiments, adult participants gave ratings of cuteness and attractiveness in response to face images that had been edited to introduce common facial abnormalities. Stimulus faces displayed either a haemangioma (a small, benign birth mark), strabismus (an abnormal alignment of the eyes) or a cleft lip (an abnormal opening in the upper lip). In Experiment 1, haemangioma had less of a detrimental effect on ratings than the more severe abnormalities. In Experiment 2, we manipulated the position of a haemangioma on the face. We found small but robust effects of this position, with abnormalities in the top and on the left of the face receiving lower cuteness ratings. This is consistent with previous research showing that people attend more to the top of the face (particularly the eyes) and to the left hemifield. PMID:28749958

  2. Impact micro-positioning actuator

    NASA Technical Reports Server (NTRS)

    Cuerden, Brian (Inventor); Angel, J. Roger P. (Inventor); Burge, James H. (Inventor); DeRigne, Scott T. (Inventor)

    2006-01-01

    An impact micro-positioning actuator. In one aspect of the invention, a threaded shaft is threadably received in a nut and the nut is impacted by an impacting device, causing the nut first to rotate relative to the shaft by slipping as a result of shaft inertia and subsequently to stick to the shaft as a result of the frictional force therebetween. The nut is returned to its initial position by a return force provided by a return mechanism after impact. The micro-positioning actuator is further improved by controlling at least one and preferably all of the following: the friction, the impact provided by the impacting device, the return force provided by the return mechanism, and the inertia of the shaft. In another aspect of the invention, a threaded shaft is threadably received in a nut and the shaft is impacted by an impacting device, causing the shaft to rotate relative to the nut.

  3. Congenital hypothyroidism in a kitten resulting in decreased IGF-I concentration and abnormal liver function tests.

    PubMed

    Quante, Saskia; Fracassi, Federico; Gorgas, Daniela; Kircher, Patrick R; Boretti, Felicitas S; Ohlerth, Stefanie; Reusch, Claudia E

    2010-06-01

    A 7-month-old male kitten was presented with chronic constipation and retarded growth. Clinical examination revealed disproportional dwarfism with mild skeletal abnormalities and a palpable thyroid gland. The presumptive diagnosis of congenital hypothyroidism was confirmed by low serum total thyroxine (tT(4)) concentration prior to and after the administration of thyroid stimulation hormone (TSH), increased endogenous TSH concentration and abnormal thyroid scintigraphic scan. The kitten had abnormal liver function tests and decreased insulin-like growth factor 1 (IGF-1) concentration, both of which returned to normal in correspondence with an improvement of the clinical signs after 6 weeks of thyroxine therapy. Congenital hypothyroidism is a rare disease that may present with considerable variation in clinical manifestation. In cases in which clinical signs are ambiguous, disorders such as portosystemic shunt and hyposomatotropism have to be taken into account as differential diagnosis. As hypothyroidism may be associated with abnormal liver function tests and low IGF-1 concentrations, test results have to be interpreted carefully. Copyright 2010 ISFM and AAFP. Published by Elsevier Ltd. All rights reserved.

  4. Weibo sentiments and stock return: A time-frequency view

    PubMed Central

    Liu, Zhixin; Zhao, Jichang; Su, Chiwei

    2017-01-01

    This study provides new insights into the relationships between social media sentiments and the stock market in China. Based on machine learning, we classify microblogs posted on Sina Weibo, a Twitter’s variant in China into five detailed sentiments of anger, disgust, fear, joy, and sadness. Using wavelet analysis, we find close positive linkages between sentiments and the stock return, which have both frequency and time-varying features. Five detailed sentiments are positively related to the stock return for certain periods, particularly since October 2014 at medium to high frequencies of less than ten trading days, when the stock return is undergoing significant fluctuations. Sadness appears to have a closer relationship with the stock return than the other four sentiments. As to the lead-lag relationships, the stock return causes Weibo sentiments rather than reverse for most of the periods with significant linkages. Compared with polarity sentiments (negative vs. positive), detailed sentiments provide more information regarding relationships between Weibo sentiments and the stock market. The stock market exerts positive effects on bullishness and agreement of microblogs. Meanwhile, agreement leads the stock return in-phase at the frequency of approximately 40 trading days, indicating that less disagreement improves certainty about the stock market. PMID:28672026

  5. Weibo sentiments and stock return: A time-frequency view.

    PubMed

    Xu, Yingying; Liu, Zhixin; Zhao, Jichang; Su, Chiwei

    2017-01-01

    This study provides new insights into the relationships between social media sentiments and the stock market in China. Based on machine learning, we classify microblogs posted on Sina Weibo, a Twitter's variant in China into five detailed sentiments of anger, disgust, fear, joy, and sadness. Using wavelet analysis, we find close positive linkages between sentiments and the stock return, which have both frequency and time-varying features. Five detailed sentiments are positively related to the stock return for certain periods, particularly since October 2014 at medium to high frequencies of less than ten trading days, when the stock return is undergoing significant fluctuations. Sadness appears to have a closer relationship with the stock return than the other four sentiments. As to the lead-lag relationships, the stock return causes Weibo sentiments rather than reverse for most of the periods with significant linkages. Compared with polarity sentiments (negative vs. positive), detailed sentiments provide more information regarding relationships between Weibo sentiments and the stock market. The stock market exerts positive effects on bullishness and agreement of microblogs. Meanwhile, agreement leads the stock return in-phase at the frequency of approximately 40 trading days, indicating that less disagreement improves certainty about the stock market.

  6. KSC-97PC1347

    NASA Image and Video Library

    1997-09-07

    The Cassini spacecraft, with its attached Huygens probe, is lowered from Launch Pad 40 at Cape Canaveral Air Station for its return trip to the Payload Hazardous Servicing Facility (PHSF). Damage to thermal insulation was discovered inside Huygens from an abnormally high flow of conditioned air. Further internal inspection, insulation repair and a cleaning of the probe are now required. Mission managers are targeting a mid-October launch date after Cassini returns to the pad and is once again placed atop its Titan IVB expendable launch vehicle. Cassini will explore the Saturnian system, including the planet’s rings, while the Huygens probe will explore the moon Titan

  7. KSC-97PC1394

    NASA Image and Video Library

    1997-09-10

    Dornier Satelliten Systeme (DSS) workers lift part of the Huygens probe aft cover assembly in the Payload Hazardous Servicing Facility (PHSF) at KSC. The spacecraft was returned to the PHSF after damage to thermal insulation was discovered inside Huygens from an abnormally high flow of conditioned air. Internal inspection, insulation repair and a cleaning of the probe were required. Mission managers are targeting a mid-October launch date after the Cassini spacecraft, aboard which Huygens will be launched, returns to the pad and is once again placed atop its Titan IVB expendable launch vehicle at Launch Pad 40 at Cape Canaveral Air Station

  8. KSC-97PC1388

    NASA Image and Video Library

    1997-09-12

    Dornier Satelliten Systeme (DSS) workers lift the heat shield of the Huygens probe in the Payload Hazardous Servicing Facility (PHSF) at KSC. The spacecraft was returned to the PHSF after damage to thermal insulation was discovered inside Huygens from an abnormally high flow of conditioned air. Internal inspection, insulation repair and a cleaning of the probe were required. Mission managers are targeting a mid-October launch date after the Cassini spacecraft, aboard which Huygens will be launched, returns to the pad and is once again placed atop its Titan IVB expendable launch vehicle at Launch Pad 40 at Cape Canaveral Air Station

  9. KSC-97PC1391

    NASA Image and Video Library

    1997-09-12

    Dornier Satelliten Systeme (DSS) workers place the back cover of the Huygens probe under its front heat shield in the Payload Hazardous Servicing Facility (PHSF) at KSC. The spacecraft was returned to the PHSF after damage to thermal insulation was discovered inside Huygens from an abnormally high flow of conditioned air. Internal inspection, insulation repair and a cleaning of the probe were required. Mission managers are targeting a mid-October launch date after the Cassini spacecraft, aboard which Huygens will be launched, returns to the pad and is once again placed atop its Titan IVB expendable launch vehicle at Launch Pad 40 at Cape Canaveral Air Station

  10. KSC-97PC1395

    NASA Image and Video Library

    1997-09-10

    Dornier Satelliten Systeme (DSS) workers lift the front heat shield of the Huygens probe in the Payload Hazardous Servicing Facility (PHSF) at KSC. The spacecraft was returned to the PHSF after damage to thermal insulation was discovered inside Huygens from an abnormally high flow of conditioned air. Internal inspection, insulation repair and a cleaning of the probe were required. Mission managers are targeting a mid-October launch date after the Cassini spacecraft, aboard which Huygens will be launched, returns to the pad and is once again placed atop its Titan IVB expendable launch vehicle at Launch Pad 40 at Cape Canaveral Air Station

  11. KSC-97PC1390

    NASA Image and Video Library

    1997-09-12

    Dornier Satelliten Systeme (DSS) workers place the back cover of the Huygens probe under its front heat shield in the Payload Hazardous Servicing Facility (PHSF) at KSC. The spacecraft was returned to the PHSF after damage to thermal insulation was discovered inside Huygens from an abnormally high flow of conditioned air. Internal inspection, insulation repair and a cleaning of the probe were required. Mission managers are targeting a mid-October launch date after the Cassini spacecraft, aboard which Huygens will be launched, returns to the pad and is once again placed atop its Titan IVB expendable launch vehicle at Launch Pad 40 at Cape Canaveral Air Station

  12. KSC-97PC1389

    NASA Image and Video Library

    1997-09-12

    Dornier Satelliten Systeme (DSS) workers lift the heat shield of the Huygens probe in the Payload Hazardous Servicing Facility (PHSF) at KSC. The spacecraft was returned to the PHSF after damage to thermal insulation was discovered inside Huygens from an abnormally high flow of conditioned air. Internal inspection, insulation repair and a cleaning of the probe were required. Mission managers are targeting a mid-October launch date after the Cassini spacecraft, aboard which Huygens will be launched, returns to the pad and is once again placed atop its Titan IVB expendable launch vehicle at Launch Pad 40 at Cape Canaveral Air Station

  13. Association of Systemic Inflammatory Response Syndrome with Clinical Outcomes of Pediatric Patients with Pneumonia.

    PubMed

    Frazier, Steven Barron; Sepanski, Robert; Mangum, Christopher; Bovat, Christine; Zaritsky, Arno; Godambe, Sandip

    2015-11-01

    Systemic inflammatory response syndrome (SIRS) may complicate pneumonia. When present, it suggests that the patient's pneumonia is more severe. As such, recognition of SIRS among patients with pneumonia may be helpful in identifying those requiring more careful evaluation. Our objective was to examine the relation between the presence of SIRS and adverse clinical outcomes among children with pneumonia seen in the emergency department (ED). A retrospective chart review was performed on children diagnosed as having community-acquired pneumonia who presented to a children's hospital ED during a 3-month period. SIRS was determined by using a modification of the International Consensus Conference on Pediatric Sepsis criteria. Specifically, the SIRS criteria require an abnormal temperature-corrected heart rate or respiratory rate and either an abnormal temperature or white blood cell count. The threshold for abnormal vital signs and white blood cell counts used to determine SIRS was adjusted based on the patient's age. Morbidity endpoints included progression to inpatient or observation status or subsequent return to the ED for pneumonia, need for video-assisted thoracoscopic surgery, and total hospital length of stay as measured from ED triage assessment to final discharge from the hospital (ED, observation, or inpatient), and the need for mechanical ventilation. A total of 276 children were included in the analysis. Pneumonia patients with SIRS (n = 38) had a greater rate of hospital admission or ED return compared with SIRS-negative patients (n = 238; 79% vs 34.5%, respectively; P < 0.0001). Children with SIRS-positive pneumonia were at greater risk of requiring video-assisted thoracoscopic surgery (18.4% vs 0.8%; P < 0.0001). In addition, pneumonia patients with SIRS had a significantly longer median length of stay compared with pneumonia patients without SIRS (2.7 vs 0.19 days, P < 0.0001) and also had a significantly higher risk of mechanical ventilation (10.5% vs 0.8%). SIRS in children with community-acquired pneumonia is associated with a significantly higher likelihood of experiencing a more adverse outcome. Based on these observations, a sepsis screening tool in the ED that identifies SIRS in children with pneumonia has the potential to identify those children needing more intense monitoring and treatment.

  14. A prospective study of concussions among National Hockey League players during regular season games: the NHL-NHLPA Concussion Program

    PubMed Central

    Benson, Brian W.; Meeuwisse, Willem H.; Rizos, John; Kang, Jian; Burke, Charles J.

    2011-01-01

    Background In 1997, the National Hockey League (NHL) and NHL Players’ Association (NHLPA) launched a concussion program to improve the understanding of this injury. We explored initial postconcussion signs, symptoms, physical examination findings and time loss (i.e., time between the injury and medical clearance by the physician to return to competitive play), experienced by male professional ice-hockey players, and assessed the utility of initial postconcussion clinical manifestations in predicting time loss among hockey players. Methods We conducted a prospective case series of concussions over seven NHL regular seasons (1997–2004) using an inclusive cohort of players. The primary outcome was concussion and the secondary outcome was time loss. NHL team physicians documented post-concussion clinical manifestations and recorded the date when a player was medically cleared to return to play. Results Team physicians reported 559 concussions during regular season games. The estimated incidence was 1.8 concussions per 1000 player-hours. The most common postconcussion symptom was headache (71%). On average, time loss (in days) increased 2.25 times (95% confidence interval [CI] 1.41–3.62) for every subsequent (i.e., recurrent) concussion sustained during the study period. Controlling for age and position, significant predictors of time loss were postconcussion headache (p < 0.001), low energy or fatigue (p = 0.01), amnesia (p = 0.02) and abnormal neurologic examination (p = 0.01). Using a previously suggested time loss cut-point of 10 days, headache (odds ratio [OR] 2.17, 95% CI 1.33–3.54) and low energy or fatigue (OR 1.72, 95% CI 1.04–2.85) were significant predictors of time loss of more than 10 days. Interpretation Postconcussion headache, low energy or fatigue, amnesia and abnormal neurologic examination were significant predictors of time loss among professional hockey players. PMID:21502355

  15. The diagnostic and prognostic value of ultrasonography in soccer players with acute hamstring injuries.

    PubMed

    Petersen, Jesper; Thorborg, Kristian; Nielsen, Michael Bachmann; Skjødt, Thomas; Bolvig, Lars; Bang, Niels; Hölmich, Per

    2014-02-01

    An injury to the hamstring muscle complex is the most common injury in soccer. Ultrasound of acute hamstring injuries is often used as a clinical tool for diagnosing hamstring injuries and guiding players in when they can return to play. To (1) investigate the characteristic sonographic findings of acute hamstring injuries in soccer players, (2) compare the mean injury severity (time to return to play) in injured players with and without sonographically verified abnormalities, and (3) correlate the length of the injured area and absence from soccer play (time to return to play) to investigate if ultrasonography can be used as a prognostic indicator of time to return to play. Case series; Level of evidence, 4. Players from 50 teams participating in 1 of the top 5 Danish soccer divisions were followed in the period from January to December 2008. Of 67 players with acute hamstring injuries, 51 underwent ultrasonographic examination of the injured thigh and were included in this study. Ultrasonographic examinations were performed 1 to 10 days after injury (mean, 5.2 ± 3.0 days), and sonographic findings were present in 31 of 51 cases (61%). Two thirds of the injuries were to the biceps femoris muscle and one third to the semitendinosus muscle. No total ruptures were documented. The 51 acute hamstring injuries resulted in absence from soccer of a mean 25.4 ± 15.7 days per injury, with no significant difference between players with and without sonographically verified abnormalities (P = .41). No correlation existed between the length of the injured area and injury severity (r = 0.19, P = .29). The biceps femoris is the most commonly injured hamstring muscle detected by ultrasound, and more than half of the injuries are intramuscular. Because neither the presence of sonographic findings nor the size of the findings was correlated with time to return to play in injured soccer players, the prognosis of hamstring injuries should not be guided by these findings alone.

  16. Electrocardiographic abnormalities in opiate addicts.

    PubMed

    Wallner, Christina; Stöllberger, Claudia; Hlavin, Anton; Finsterer, Josef; Hager, Isabella; Hermann, Peter

    2008-12-01

    To determine in a cross-sectional study the prevalence of electrocardiographic (ECG) abnormalities in opiate addicts who were therapy-seeking and its association with demographic, clinical and drug-specific parameters. In consecutive therapy-seeking opiate addicts, a 12-lead ECG was registered within 24 hours after admission and evaluated according to a pre-set protocol between October 2004 and August 2006. Additionally, demographic, clinical and drug-specific parameters were recorded. Included were 511 opiate-addicts, 25% female, with a mean age of 29 years (range 17-59 years). One or more ECG abnormalities were found in 314 patients (61%). In the 511 patients we found most commonly ST abnormalities (19%), QTc prolongation (13%), tall R- and/or S-waves (11%) and missing R progression (10%). ECG abnormalities were more common in males than in females (64 versus 54%, P < 0.05), and in patients with positive than negative urine findings for cannabis (68 versus 57%, P < 0.05). Patients with ST abnormalities were more often males than females (21 versus 11%, P < 0.05), had a history of seizures less often (16 versus 27%, P < 0.05), had positive than negative urine findings for cannabis more often (26 versus 15%, P < 0.01) and had negative than positive urine findings for methadone more often (21 versus 11%, P < 0.05). QTc prolongation was more frequent in patients with high dosages of maintenance drugs than in patients with medium or low dosages (27 versus 12 versus 10%, P < 0.05) and in patients whose urine findings were positive than negative for methadone (23 versus 11%, P < 0.001) as well as for benzodiazepines (17 versus 9%, P < 0.05). Limitations of the data are that in most cases other risk factors for the cardiac abnormalities were not known. ECG abnormalities are frequent in opiate addicts. The most frequent ECG abnormalities are ST abnormalities, QTc prolongation and tall R- and/or S-waves. ST abnormalities are associated with cannabis, and QTc prolongation with methadone and benzodiazepines.

  17. Stent placement for palliation of cor triatriatum dexter in a dog with suspected patent foramen ovale.

    PubMed

    Barncord, Kristin; Stauthammer, Christopher; Moen, Sean L; Hanson, Melissa; Gruenstein, Daniel H

    2016-03-01

    An 11 month old spayed, female dog presented with exercise intolerance and cyanosis upon exertion. Echocardiography revealed an imperforate cor triatriatum dexter with mild tricuspid valve dysplasia, an underfilled right ventricle and significant right to left shunting across a presumptive patent foramen ovale. Balloon dilation of the abnormal atrial membrane was initially successful in creating a communication between the right atrial chambers, but stenosis of the original perforation and persistent clinical signs prompted a second intervention. A balloon expandable biliary stent was placed across the abnormal partition, improving caudal venous return to the right ventricle and reducing the right to left shunt. Three months after stent placement, resting oxygen saturation had normalized. Six months after stent placement, exercise tolerance had improved and exertional cyanosis had resolved. Long term follow up will be necessary to assess for remodeling of the right ventricle with improved venous return. Stent placement can be considered as a palliative treatment option for cor triatriatum dexter, especially for stenosis post-balloon dilation. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. SNIPER: a novel assay for human papillomavirus testing among women in Guizhou, China.

    PubMed

    Belinson, Suzanne E; Wulan, Na; Li, Ruizhen; Zhang, Wei; Rong, Xuan; Zhu, Yasha; Wu, Ruifang; Belinson, Jerome L

    2010-08-01

    Clinically validate the SNIPER human papillomavirus (HPV) DNA assay for the detection of cervical intraepithelial neoplasia (CIN)2 or higher and CIN2 or higher in a prospective cross-sectional screening study in Guizhou Province, China. Between March and April, 2008, 1000 nonpregnant women aged 30 or older were recruited in Guizhou Province, China. Women positive by SNIPER or cytological examination were requested to return for follow-up. A biopsy of all colposcopically detected abnormalities was performed by quadrant. In normal quadrants, biopsies were obtained at the squamocolumnar junction (2-, 4-, 8-, and 10-o'clock positions depending on the quadrant). Samples were placed in 2 mL of saline solution and maintained between 2 degrees C and 30 degrees C for up to 1 week. One milliliter of this suspension was then prepared and tested. For polymerase chain reaction amplification, a pool of HPV primers was designed to amplify HPV DNA from 13 high-risk-HPV genotypes (types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68). Test characteristics were calculated according to standard definitions. One thousand women were screened; 175 tested HPV positive, 36 women tested negative but had positive Papanicolaou test results. All but 21 (90%) returned for follow-up. Median age and proportions having CIN2 or higher and CIN3 or higher differed by HPV status. Twenty-five women had CIN2 or higher and 16 had CIN3 or higher. The SNIPER assay was 93.3% and 94% sensitive and 86% and 85% specific for the detection of CIN2 or higher and CIN3 or higher, respectively. The positive predictive value was 17.4 % and 9.9% for CIN2 or higher and CIN3 or higher, respectively. Negative predictive value approached 100% for CIN2 or higher and CIN3 or higher. The SNIPER assay is functionally competitive and in terms of cost holds an advantage over Hybrid Capture 2 in a Chinese healthcare market, and potentially others, around the world.

  19. Chorionic villus sampling for abnormal screening compared to historical indications: prevalence of abnormal karyotypes.

    PubMed

    Marshall, Nicole E; Fraley, Gwen; Feist, Cori; Burns, Michael J; Pereira, Leonardo

    2012-08-01

    To determine the prevalence of abnormal karyotype results in women undergoing chorionic villus sampling (CVS) for abnormal first trimester screening compared to CVS for historical indications (advanced maternal age (AMA) or prior aneuploidy). Retrospective cohort of all patients undergoing CVS at Oregon Health & Science University from January 2006 to June 2010. Patients were separated based on CVS indication: (1) positive ultrasound (U/S) or serum screening; or (2) AMA or prior aneuploidy with normal or no screening. Prevalence of abnormal karyotype results were compared between groups. Fetal karyotyping was successful in 500 of 506 CVS procedures performed. 203 CVS were performed for positive screening with 69 abnormal karyotypes (34.0%). 264 CVS were performed for historical indications with 11 abnormal karyotypes (4.2%). This difference was statistically significant (χ(2) 71.9, p < 0.001; OR 11.8 [95% CI 5.8, 24.6]). There were two age-related aneuplodies in AMA women without positive screening. 42 out of 44 AMA women diagnosed with aneuploidy (95.5%) had abnormal U/S and/or serum screening (35 U/S, 4 serum, 3 U/S and serum). Combined ultrasound and serum screening should be recommended to all women, including AMA women, prior to undergoing invasive testing to improve risk-based counseling and minimize morbidity.

  20. Clinical accuracy of abnormal cell-free fetal DNA results for the sex chromosomes.

    PubMed

    Scibetta, Emily W; Gaw, Stephanie L; Rao, Rashmi R; Silverman, Neil S; Han, Christina S; Platt, Lawrence D

    2017-12-01

    To investigate factors associated with abnormal cell-free DNA (cfDNA) results for sex chromosomes (SCs). This is a retrospective cohort study of abnormal cfDNA results for SC at a referral practice from March 2013 to July 2015. Cell-free DNA results were abnormal if they were positive for SC aneuploidy (SCA), inconclusive, or discordant with ultrasound (US) findings. Primary outcome was concordance with karyotype or postnatal evaluation. Of 50 abnormal cfDNA results for SC, 31 patients (62%) were positive for SCA, 13 (26%) were inconclusive, and 6 (12%) were sex discordant on US. Of SCA results, 19 (61%) were reported as 45,X and 12 (39%) were SC trisomy. Abnormal karyotypes were confirmed in 8/23 (35%) of SC aneuploidy and 1/5 (20%) of inconclusive results. Abnormal SC cfDNA results were associated with in vitro fertilization (P = .001) and twins (P < .001). Sex discordance between cfDNA and US was associated with twin gestation (P < .001). In our cohort, abnormal SC cfDNA results were associated with in vitro fertilization and twins. Our results indicate cfDNA for sex prediction in twins of limited utility. Positive predictive value and sensitivity for SC determination were lower than previously reported. © 2017 John Wiley & Sons, Ltd.

  1. 75 FR 78160 - Requirement of a Statement Disclosing Uncertain Tax Positions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-15

    ... amendments to the Income Tax Regulations (26 CFR part 1) under section 6012 relating to the returns of income... every person liable for income tax to make the returns required by regulation. Section 6012 requires... corporations to file a schedule disclosing uncertain tax positions related to the tax return as required by the...

  2. Earnings Quality Measures and Excess Returns

    PubMed Central

    Perotti, Pietro; Wagenhofer, Alfred

    2014-01-01

    This paper examines how commonly used earnings quality measures fulfill a key objective of financial reporting, i.e., improving decision usefulness for investors. We propose a stock-price-based measure for assessing the quality of earnings quality measures. We predict that firms with higher earnings quality will be less mispriced than other firms. Mispricing is measured by the difference of the mean absolute excess returns of portfolios formed on high and low values of a measure. We examine persistence, predictability, two measures of smoothness, abnormal accruals, accruals quality, earnings response coefficient and value relevance. For a large sample of US non-financial firms over the period 1988–2007, we show that all measures except for smoothness are negatively associated with absolute excess returns, suggesting that smoothness is generally a favorable attribute of earnings. Accruals measures generate the largest spread in absolute excess returns, followed by smoothness and market-based measures. These results lend support to the widespread use of accruals measures as overall measures of earnings quality in the literature. PMID:26300582

  3. Earnings Quality Measures and Excess Returns.

    PubMed

    Perotti, Pietro; Wagenhofer, Alfred

    2014-06-01

    This paper examines how commonly used earnings quality measures fulfill a key objective of financial reporting, i.e., improving decision usefulness for investors. We propose a stock-price-based measure for assessing the quality of earnings quality measures. We predict that firms with higher earnings quality will be less mispriced than other firms. Mispricing is measured by the difference of the mean absolute excess returns of portfolios formed on high and low values of a measure. We examine persistence, predictability, two measures of smoothness, abnormal accruals, accruals quality, earnings response coefficient and value relevance. For a large sample of US non-financial firms over the period 1988-2007, we show that all measures except for smoothness are negatively associated with absolute excess returns, suggesting that smoothness is generally a favorable attribute of earnings. Accruals measures generate the largest spread in absolute excess returns, followed by smoothness and market-based measures. These results lend support to the widespread use of accruals measures as overall measures of earnings quality in the literature.

  4. The risks and returns of stock investment in a financial market

    NASA Astrophysics Data System (ADS)

    Li, Jiang-Cheng; Mei, Dong-Cheng

    2013-03-01

    The risks and returns of stock investment are discussed via numerically simulating the mean escape time and the probability density function of stock price returns in the modified Heston model with time delay. Through analyzing the effects of delay time and initial position on the risks and returns of stock investment, the results indicate that: (i) There is an optimal delay time matching minimal risks of stock investment, maximal average stock price returns and strongest stability of stock price returns for strong elasticity of demand of stocks (EDS), but the opposite results for weak EDS; (ii) The increment of initial position recedes the risks of stock investment, strengthens the average stock price returns and enhances stability of stock price returns. Finally, the probability density function of stock price returns and the probability density function of volatility and the correlation function of stock price returns are compared with other literatures. In addition, good agreements are found between them.

  5. ANOMALOUS HEAD POSTURES IN STRABISMUS AND NYSTAGMUS - DIAGNOSIS AND MANAGEMENT -

    PubMed Central

    Teodorescu, Luminita

    2015-01-01

    Abnormal head positions are adopted in order to improve visual acuity, to avoid diplopia or to obtain a more comfortable binocular vision. The head can be turned or tilted toward right or left, with the chin rotated up or downwards or combination of these positions. The ophthalmologic examination including the assessment of versions leads to the diagnosis. When versions are free, the cause may be congenital nystagmus or strabismus with large angle. When versions are limited we suspect paralytic or restrictive strabismus. The head tilted to one shoulder suggests cyclotropia (IV Nerve Palsy) or congenital nystagmus. We present few of the above cases. An adequate surgical treatment can improve or correct the ocular deviation, diplopia and the abnormal head posture. Conclusions: The abnormal head posture must be assessed and treated early in order to correct the ocular position and head posture. All patient presenting abnormal head position HAD TO BE investigated by an ophthalmologist. PMID:26978880

  6. Cell-free DNA screening in clinical practice: abnormal autosomal aneuploidy and microdeletion results.

    PubMed

    Valderramos, Stephanie G; Rao, Rashmi R; Scibetta, Emily W; Silverman, Neil S; Han, Christina S; Platt, Lawrence D

    2016-11-01

    Since its commercial release in 2011 cell-free DNA screening has been rapidly adopted as a routine prenatal genetic test. However, little is known about its performance in actual clinical practice. We sought to investigate factors associated with the accuracy of abnormal autosomal cell-free DNA results. We conducted a retrospective cohort study of 121 patients with abnormal cell-free DNA results from a referral maternal-fetal medicine practice from March 2013 through July 2015. Patients were included if cell-free DNA results for trisomy 21, trisomy 18, trisomy 13, or microdeletions (if reported by the laboratory) were positive or nonreportable. The primary outcome was confirmed aneuploidy or microarray abnormality on either prenatal or postnatal karyotype or microarray. Secondary outcomes were identifiable associations with in vitro fertilization, twins, ultrasound findings, testing platform, and testing laboratory. Kruskal-Wallis or Fisher exact tests were used as appropriate. A total of 121 patients had abnormal cell-free DNA results for trisomy 21, trisomy 18, trisomy 13, and/or microdeletions. In all, 105 patients had abnormal cell-free DNA results for trisomy 21, trisomy 18, and trisomy 13. Of these, 92 (87.6%) were positive and 13 (12.4%) were nonreportable. The results of the 92 positive cell-free DNA were for trisomy 21 (48, 52.2%), trisomy 18 (22, 23.9%), trisomy 13 (17, 18.5%), triploidy (2, 2.2%), and positive for >1 parameter (3, 3.3%). Overall, the positive predictive value of cell-free DNA was 73.5% (61/83; 95% confidence interval, 63-82%) for all trisomies (by chromosome: trisomy 21, 83.0% [39/47; 95% confidence interval, 69-92%], trisomy 18, 65.0% [13/20; 95% confidence interval, 41-84%], and trisomy 13, 43.8% [7/16; 95% confidence interval, 21-70%]). Abnormal cell-free DNA results were associated with positive serum screening (by group: trisomy 21 [17/48, 70.8%]; trisomy 18 [7/22, 77.8%]; trisomy 13 [3/17, 37.5%]; nonreportable [2/13, 16.7%]; P = .004), and abnormal first-trimester ultrasound (trisomy 21 [25/45, 55.6%]; trisomy 18 [13/20, 65%]; trisomy 13 [6/14, 42.9%]; nonreportable [1/13, 7.7%]; P = .003). There was no association between false-positive rates and testing platform, but there was a difference between the 4 laboratories (P = .018). In all, 26 patients had positive (n = 9) or nonreportable (n = 17) microdeletion results. Seven of 9 screens positive for microdeletions underwent confirmatory testing; all were false positives. The positive predictive value of 73.5% for cell-free DNA screening for autosomal aneuploidy is lower than reported. The positive predictive value for microdeletion testing was 0%. Diagnostic testing is needed to confirm abnormal cell-free DNA results for aneuploidy and microdeletions. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Equity prices as a simple harmonic oscillator with noise

    NASA Astrophysics Data System (ADS)

    Ataullah, Ali; Tippett, Mark

    2007-08-01

    The centred return on the London Stock Exchange's FTSE All Share Index is modelled as a simple harmonic oscillator with noise over the period from 1 January, 1994 until 30 June 2006. Our empirical results are compatible with the hypothesis that there is a period in the FTSE All Share Index of between two and two and one half years. This means the centred return will on average continue to increase for about a year after reaching the minimum in its oscillatory cycle; alternatively, it will continue on average to decline for about a year after reaching a maximum. Our analysis also shows that there is potential to exploit the harmonic nature of the returns process to earn abnormal profits. Extending our analysis to the low energy states of a quantum harmonic oscillator is also suggested.

  8. SURGICAL CORRECTION OF BILATERAL PATELLAR LUXATION IN AN AMERICAN BLACK BEAR CUB (URSUS AMERICANUS).

    PubMed

    Bennett, Katarina R; Desmarchelier, Marion R; Bailey, Trina R

    2015-06-01

    A wild orphaned male American black bear cub ( Ursus americanus ) presented with hind limb gait abnormalities and was found to have bilateral grade 3 laterally luxating patellas. There were no other significant abnormalities detected on neurologic, radiographic, or hematologic examinations. The trochlear grooves were deepened with a chondroplasty, and the redundant soft tissues imbricated. There was a marked improvement in the bear's gait postoperatively, with an apparent full return to function. To the authors' knowledge, patellar luxation has not been reported in the Ursidae family, and the success in this case suggests that this technique may be used in large wild or captive carnivore cubs.

  9. A Study of Pap Smear in HIV-Positive Females.

    PubMed

    Madan, Apeksha; Patil, Sunita; Nakate, Leena

    2016-12-01

    HIV-positive females are more likely to have abnormal Pap smears than HIV-negative women. These abnormal Pap smears are usually associated with low CD4 cell counts and human papilloma virus infection. This was a prospective hospital-based study from April 2013 till March 2014. A total of 250 (both symptomatic and asymptomatic) HIV-positive females were examined in Gynaecology OPD at R.C.S.M. G.M.C and C.P.R. Hospital, Kolhapur, and their cervical smears were taken. They were categorized as per modified Bethesda system 2001. The findings in HIV-positive women were correlated with risk factors (age, disease duration, CD4 count and ART use). To study the spectrum of cytological abnormalities on Pap smear in HIV-positive females and classify precancerous and cancerous lesions in HIV-positive females according to Bethesda system 2001 and to be familiar with terminology and morphological criteria of Bethesda system 2001. To study the association of Pap smears abnormalities among HIV-positive women with their immune status (CD4 count). NILM is the commonest finding (83.2 %) which is subdivided into non-inflammatory, non-specific and specific inflammatory and atrophic smears. Candida vaginitis was the commonest cause of specific inflammatory condition accounted for (2.52 %) of all inflammatory smears. The percentage of squamous cell abnormalities was 12 %: ASCUS + ASC-H-6.22 %, LSIL-2.10 %, HSIL-3.4 % and SCC-0.8 %. The highest incidence of intraepithelial lesions in HIV-positive females was in the age group 31-40 years. There is no association of Pap smear abnormalities among HIV-positive women with their immune status (CD4 count) and duration of ART. Periodic, regular gynaecologic and Pap smear examination would help in early detection of intraepithelial lesions and their treatment so as to prevent invasive malignancy and mortality.

  10. KSC-97PC1348

    NASA Image and Video Library

    1997-09-07

    A crane lowers a protective transportation cover over the Cassini spacecraft, with its attached Huygens probe, at Launch Pad 40 at Cape Canaveral Air Station for the spacecraft’s return trip to the Payload Hazardous Servicing Facility (PHSF). Damage to thermal insulation was discovered inside Huygens from an abnormally high flow of conditioned air. Further internal inspection, insulation repair and a cleaning of the probe are now required. Mission managers are targeting a mid-October launch date after Cassini returns to the pad and is once again placed atop its Titan IVB expendable launch vehicle. Cassini will explore the Saturnian system, including the planet’s rings, while the Huygens probe will explore the moon Titan

  11. Pieces of the Huygens probe internal insulating foam await inspection after removal from the probe i

    NASA Technical Reports Server (NTRS)

    1997-01-01

    Pieces of the Huygens probe internal insulating foam await inspection after removal from the probe in the Payload Hazardous Servicing Facility (PHSF) at KSC. The spacecraft was returned to the PHSF after damage to thermal insulation was discovered inside Huygens from an abnormally high flow of conditioned air. Internal inspection, insulation repair and a cleaning of the probe were required. Mission managers are targeting a mid-October launch date after Cassini returns to the pad and is once again placed atop its Titan IVB expendable launch vehicle at Launch Pad 40 at Cape Canaveral Air Station.

  12. What positive encounters with healthcare and social insurance staff promotes ability to return to work of long-term sickness absentees?

    PubMed

    Olsson, Daniel; Alexanderson, Kristina; Bottai, Matteo

    2016-02-01

    Previous studies suggest that positive encounters with healthcare and social insurance staff may be important in promoting return to work among long-term sickness absentees. This study aimed to identify more specifically what positive encounters are important for promoting ability to return to work. A questionnaire about different types of encounters was sent to 10,042 people in Sweden on sick leave for 6-8 months (58% responded). For each positive encounter, we estimated the marginal probability difference (PD) of return to work, adjusting for age, sex, education, sick-leave diagnosis, and the sum score of all other encounters. Adjusting for the other encounters is important since of the observed variables these were the strongest confounders. The positive encounters with both healthcare and social insurance staff significantly associated with promoting ability to return to work after adjusting for the other positive encounters were "Believed in my work capacity" PD=16.9 (95% CI: 12.0, 21.9) and 12.0 (6.3, 17.7), respectively; "Supported my suggestions for solutions": 9.5 (3.1, 15.9) and 11.6 (5.7, 17.4); "Was supportive and encouraging": 10.1 (3.6, 16.7) and 7.3 (1.7, 12.8). Additionally, the encounter with healthcare staff most strongly associated with promoting return to work was "Let me take responsibility" 14.8 (7.2, 22.3); and with social security staff: "Showed that she/he liked me" 10.4 (5.4, 15.4). Healthcare and social security staff being supportive, encouraging, and believing in the sickness absentee's work capacity may be very important for increasing the probability for long-term sickness absentees' ability to return to work. © 2015 the Nordic Societies of Public Health.

  13. Liver enzyme abnormalities in taking traditional herbal medicine in Korea: A retrospective large sample cohort study of musculoskeletal disorder patients.

    PubMed

    Lee, Jinho; Shin, Joon-Shik; Kim, Me-Riong; Byun, Jang-Hoon; Lee, Seung-Yeol; Shin, Ye-Sle; Kim, Hyejin; Byung Park, Ki; Shin, Byung-Cheul; Lee, Myeong Soo; Ha, In-Hyuk

    2015-07-01

    The objective of this study is to report the incidence of liver injury from herbal medicine in musculoskeletal disease patients as large-scale studies are scarce. Considering that herbal medicine is frequently used in patients irrespective of liver function in Korea, we investigated the prevalence of liver injury by liver function test results in musculoskeletal disease patients. Of 32675 inpatients taking herbal medicine at 7 locations of a Korean medicine hospital between 2005 and 2013, we screened for liver injury in 6894 patients with liver function tests (LFTs) at admission and discharge. LFTs included t-bilirubin, AST, ALT, and ALP. Liver injury at discharge was assessed by LFT result classifications at admission (liver injury, liver function abnormality, and normal liver function). In analyses for risk factors of liver injury at discharge, we adjusted for age, sex, length of stay, conventional medicine intake, HBs antigen/antibody, and liver function at admission. A total 354 patients (prevalence 5.1%) had liver injury at admission, and 217 (3.1%) at discharge. Of the 354 patients with liver injury at admission, only 9 showed a clinically significant increase after herbal medicine intake, and 225 returned to within normal range or showed significant liver function recovery. Out of 4769 patients with normal liver function at admission, 27 (0.6%) had liver injury at discharge. In multivariate analyses for risk factors, younger age, liver function abnormality at admission, and HBs antigen positive were associated with injury at discharge. The prevalence of liver injury in patients with normal liver function taking herbal medicine for musculoskeletal disease was low, and herbal medicine did not exacerbate liver injury in most patients with injury prior to intake. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. Traumatic diaphragmatic hernia in a clinically normal dog.

    PubMed Central

    Litman, L M

    2001-01-01

    A 3.5-year-old border collie was presented for routine ovariohysterectomy. A preoperative physical examination revealed no abnormalities, but, under anesthesia, the patient became dyspneic and cyanotic. Plain radiography indicated the presence of a diaphragmatic hernia. The herniated structures were returned to the abdomen and the diaphragmatic defect was surgically repaired. Images Figure 1. PMID:11467188

  15. Abnormal location of umbilical venous catheter due to Scimitar syndrome

    PubMed Central

    Mart, Christopher R; Van Dorn, Charlotte S

    2014-01-01

    Scimitar syndrome is a rare congenital anomaly where the right pulmonary veins return to the inferior vena cava (IVC) just below the diaphragm. On chest X-ray (CXR), an IVC catheter will be in a bizarre location outside the heart if it inadvertently passes into the scimitar vein rather than into the right atrium. PMID:25298705

  16. Abnormal branching and regression of the notochord and its relationship to foregut abnormalities.

    PubMed

    Vleesch Dubois, V N; Quan Qi, B; Beasley, S W; Williams, A

    2002-04-01

    An abnormally positioned notochord has been reported in embryos that develop foregut abnormalities, vertebral defects and other abnormalities of the VATER association. This study examines the patterns of regression of the abnormal notochord in the rat model of the VATER association and investigates the relationship between developmental abnormalities of the notochord and those of the vertebra and foregut. Timed-pregnant Sprague-Dawley rats were given daily intraperitoneal injections of 1.75 mg/kg adriamycin on gestational days 6 - 9 inclusive. Rats were sacrificed between days 14 and 20 and their embryos harvested, histologically sectioned and stained and examined serially. The location and appearance of the degenerating notochord and its relationship to regional structural defects were analysed. All 26 embryos exposed to adriamycin developed foregut abnormalities and had an abnormal notochord. The notochord disappeared by a process of apoptotic degeneration that lagged behind that of the normal embryo: the notochord persisted in the abnormal embryo beyond day 17, whereas in the normal rat it had already disappeared. Similarly, formation of the nucleus pulposus was delayed. Vertebral abnormalities occurred when the notochord was ventrally-positioned. The notochord disappears during day 16 in the normal embryo whereas abnormal branches of the notochord persist until day 19 in the adriamycin-treated embryo. Degeneration of the notochord is dominated by apoptosis. An excessively ventrally-placed notochord is closely associated with abnormalities of the vertebral column, especially hemivertebrae.

  17. Femoroacetabular impingement in 45 professional athletes: associated pathologies and return to sport following arthroscopic decompression

    PubMed Central

    Schenker, Mara; Briggs, Karen; Kuppersmith, David

    2007-01-01

    Femoroacetabular impingement (FAI) occurs when an osseous abnormality of the proximal femur (cam) or acetabulum (pincer) triggers damage to the acetabular labrum and articular cartilage in the hip. Although the precise etiology of FAI is not well understood, both types of FAI are common in athletes presenting with hip pain, loss of range-of-motion, and disability in athletics. An open surgical approach to decompressing FAI has shown good clinical outcomes; however, this highly invasive approach inherently may delay or preclude a high level athlete’s return to play. The purpose of this study was to define associated pathologies and determine if an arthroscopic approach to treating FAI can allow professional athletes to return to high-level sport. Hip arthroscopy for the treatment of FAI allows professional athletes to return to professional sport. Between October 2000 and September 2005, 45 professional athletes underwent hip arthroscopy for the decompression of FAI. Operative and return-to-play data were obtained from patient records. Average time to follow-up was 1.6 years (range: 6 months to 5.5 years). Forty two (93%) athletes returned to professional competition following arthroscopic decompression of FAI. Three athletes did not return to play; however, all had diffuse osteoarthritis at the time of arthroscopy. Thirty-five athletes (78%) remain active in professional sport at an average follow-up of 1.6 years. Arthroscopic treatment of FAI allows professional athletes to return to professional sport. PMID:17479250

  18. Cardiac resynchronization therapy with special focus on patency of coronary sinus and its branches: conceptual viewpoint and semi-theoretical considerations on lead-induced obstruction.

    PubMed

    Stirbys, Petras

    2006-01-01

    Cardiac resynchronization therapy appears to be useful for patients with severe chronic congestive heart failure. However, many questions still arise concerning the effectiveness of this kind of therapy since hemodynamic improvement is not observed in all patients. Heterogeneity of conclusions reported by several multicenter clinical trials and prominent experts demonstrates that many uncertainties related to cardiac resynchronization therapy still exist. We tried to reveal some inadequacies in clinical results by focusing on cardiac venous blood return which is likely complicated by the presence of lead inside the coronary sinus and its branches. Downstream traversing lead may occlude (partially or completely) the ostia of minor tributaries and target vein of lead final positioning. Thrombosis may also be incited within the coronary sinus itself. Remaining lumen predetermined by the lead body and subsequent thrombosis may be insufficient to provide adequate blood flow. Resulting detrimental venous return presumably may slightly depress myocardial contractility which may be significant in very sensitive group of patients assigned to the New York Heart Association class III or IV. Cardiac venous blood pumping conditions (or venous drainage) are likely also complicated by abnormal activation of left ventricle. The contributory role of these two subtle causes unfavorably influencing venous drainage is still unknown. It may be treated as a hypothetical attempt to find the clue and needs future studies for verification.

  19. The effect of Malaysia general election on stock market returns.

    PubMed

    Liew, Venus Khim-Sen; Rowland, Racquel

    2016-01-01

    During the latest episode of general election held in Malaysia, it is observed that the FBMKLCI index was lifted 62.52 points in a day soon after the announcement of election outcome. Moreover, the index registered a highest gain of 96.29 points in the middle of the intra-day trade. This suggests that investors who had got the right direction could make profitable intra-day trading the next trading day of the general election date. Results from statistical analysis uncover significant before-election-effect and after-election-effect from the most recent general elections held in Malaysia. Different subsets of macroeconomic variables are found to have significant role on stock market return depending on the market situation. Remarkably, when there was close fight between the two major political parties during the 2008 and 2013 election years, political uncertainty showed up its negative and significant role in influencing the stock market return. The major implication of these findings is that while investors may seek abnormal returns before and after the next general election, which is around the corner, they will have to pay attention on the influence of macroeconomic variables and political uncertainty on stock market return during the election year.

  20. Non-collinear valve actuator

    NASA Technical Reports Server (NTRS)

    Richard, James A. (Inventor)

    2012-01-01

    A non-collinear valve actuator includes a primary actuating system and a return spring system with each applying forces to a linkage system in order to regulate the flow of a quarter-turn valve. The primary actuating system and return spring system are positioned non-collinearly, which simply means the primary actuating system and return spring system are not in line with each other. By positioning the primary actuating system and return spring system in this manner, the primary actuating system can undergo a larger stroke while the return spring system experiences significantly less displacement. This allows the length of the return spring to be reduced due to the minimization of displacement thereby reducing the weight of the return spring system. By allowing the primary actuating system to undergo longer strokes, the weight of the primary actuating system may also be reduced. Accordingly, the weight of the non-collinear valve actuator is reduced.

  1. Persistent left superior vena cava in association with sinus venosus defect type of atrial septal defect and partial pulmonary venous return on 64-MDCT

    PubMed Central

    Disha, Bansal; Prakashini, Koteshwara; Shetty, Ranjan K

    2014-01-01

    The most common venous abnormality of the thorax is persistent left superior vena cava (PLSVC), incidence being less than 0.5%. However, with congenital heart disease, it is about 6.1%. When the coronary sinus is dilated always search for PLSVC. The coronary sinus may communicate with the left atrium. This is known as an unroofed coronary sinus (UCS) and preoperatively documenting it is important. Of all the congenital cardiac anomalies, the sinus venosus defect (SVD) type of atrial septal defect (ASD) is most commonly associated with PLSVC and accounts for 4–11% of all ASDs. Multidetector CT can easily show all these abnormalities along with haemodynamics. On transoesophageal echocardiography it is difficult to characterise SVD and visualise a coronary sinus because of a limited window, contrast resolution and poor patient compliance. The complex of UCS and PLSVC is one such abnormality and its treatment requires careful assessment of other concomitant cardiac abnormalities to prevent post-treatment haemodynamic complications. PMID:24850552

  2. National Football League Skilled and Unskilled Positions Vary in Opportunity and Yield in Return to Play After an Anterior Cruciate Ligament Injury

    PubMed Central

    Yang, JaeWon; Hodax, Jonathan D.; Machan, Jason T.; Secrist, Eric S.; Durand, Wesley M.; Owens, Brett D.; Eltorai, Adam E.M.; Dodson, Christopher C.

    2017-01-01

    Background: Anterior cruciate ligament (ACL) injuries pose a significant risk to the careers of players in the National Football League (NFL). The relationships between draft round and position on return to play (RTP) among NFL players are not well understood, and the ability to return to preinjury performance levels remains unknown for most positions. Purpose: To test for differences in RTP rates and changes in performance after an ACL injury by position and draft round. We hypothesized that skilled positions would return at a lower rate compared to unskilled positions. We further hypothesized that early draft-round status would relate to a greater rate of RTP and that skilled positions and a lower draft round would correlate with decreased performance for players who return to sport. Study Design: Case-control study; Level of evidence, 3. Methods: Utilizing a previously established database of publicly available information regarding ACL tears among NFL players, athletes with ACL tears occurring between the 2010 and 2013 seasons were identified. Generalized linear models and Kaplan-Meier time-to-event models were used to test the study hypotheses. Results: The overall RTP rate was 61.7%, with skilled players and unskilled players returning at rates of 64.1% and 60.4%, respectively (P = .74). Early draft-round players and unskilled late draft-round players had greater rates of RTP compared to skilled late draft-round players and both unskilled and skilled undrafted free agents (UDFAs). Skilled early draft-round players constituted the only cohort that played significantly fewer games after an injury. Unskilled UDFAs constituted the only cohort to show a significant increase in the number of games started and ratio of games started to games played, starting more games in which they played, after an injury. Conclusion: Early draft-round and unskilled players were more likely to return compared to their later draft-round and skilled peers. Skilled early draft-round players, who displayed relatively high rates of RTP, constituted the only cohort to show a decline in performance. Unskilled UDFAs, who exhibited relatively low rates of RTP, constituted the only cohort to show an increase in performance. The significant effect of draft round and position type on RTP may be caused by a combination of differences in talent levels and in opportunities given to returning to play. PMID:28975136

  3. Set-membership fault detection under noisy environment with application to the detection of abnormal aircraft control surface positions

    NASA Astrophysics Data System (ADS)

    El Houda Thabet, Rihab; Combastel, Christophe; Raïssi, Tarek; Zolghadri, Ali

    2015-09-01

    The paper develops a set membership detection methodology which is applied to the detection of abnormal positions of aircraft control surfaces. Robust and early detection of such abnormal positions is an important issue for early system reconfiguration and overall optimisation of aircraft design. In order to improve fault sensitivity while ensuring a high level of robustness, the method combines a data-driven characterisation of noise and a model-driven approach based on interval prediction. The efficiency of the proposed methodology is illustrated through simulation results obtained based on data recorded in several flight scenarios of a highly representative aircraft benchmark.

  4. Patterns of repeated anal cytology results among HIV-positive and HIV-negative men who have sex with men.

    PubMed

    Robbins, Hilary A; Wiley, Dorothy J; Ho, Ken; Plankey, Michael; Reddy, Susheel; Joste, Nancy; Darragh, Teresa M; Breen, Elizabeth C; Young, Stephen; D'Souza, Gypsyamber

    2018-06-01

    Men who have sex with men (MSM) are at increased risk for anal cancer. In cervical cancer screening, patterns of repeated cytology results are used to identify low- and high-risk women, but little is known about these patterns for anal cytology among MSM. We analyzed Multicenter AIDS Cohort Study (MACS) data for MSM who were offered anal cytology testing annually (HIV-positive) or every 2 years (HIV-negative) for 4 years. Following an initial negative (normal) cytology, the frequency of a second negative cytology was lower among HIV-positive MSM with CD4 ≥ 500 (74%) or CD4 < 500 (68%) than HIV-negative MSM (83%) (p < 0.001). After an initial abnormal cytology, the frequency of a second abnormal cytology was highest among HIV-positive MSM with CD4 < 500 (70%) compared to CD4 ≥ 500 (53%) or HIV-negative MSM (46%) (p = 0.003). Among HIV-positive MSM with at least three results, 37% had 3 consecutive negative results; 3 consecutive abnormal results were more frequent among CD4 < 500 (22%) than CD4 ≥ 500 (10%) (p = 0.008). More than one-third of HIV-positive MSM have consistently negative anal cytology over three years. Following abnormal anal cytology, a repeated cytology is commonly negative in HIV-negative or immunocompetent HIV-positive men, while persistent cytological abnormality is more likely among HIV-positive men with CD4 < 500. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

  5. The technique of therapeutic apheresis. Removal of abnormal blood elements may succeed when all else fails.

    PubMed

    McLeod, B C

    1991-05-01

    Therapeutic apheresis is a generic term that refers to removal of abnormal blood cells and plasma constituents. The terms "plasmapheresis," "leukapheresis," and "erythrocytapheresis" describe the specific blood element that is removed. Apheresis therapies can be performed in the ICU to manage a number of neurologic, hematologic, and autoimmune disorders, including myasthenia gravis, Guillain-Barré syndrome, sickle-cell disease, and Goodpasture's syndrome. Apheresis procedures generally require two points of contact with the circulation--one for blood withdrawal and one for return; the withdrawal site should sustain a flow rate of at least 50 mL/min. Although apheresis is generally quite safe, hemodynamic instability, hypocalcemia, and dilutional coagulopathy can occur.

  6. A temporal examination of co-activated emotion valence networks in schizophrenia and schizotypy

    PubMed Central

    Cohen, Alex S.; Callaway, Dallas A.; Mitchell, Kyle R.; Larsen, Jeff T.; Strauss, Gregory P.

    2016-01-01

    Emotional abnormalities are prominent across the schizophrenia spectrum. To better define these abnormalities, we examined state emotional functions across opposing ends of the spectrum, notably in chronic outpatients with schizophrenia (Study 1) and college students with psychometrically defined schizotypy (Study 2). In line with existing studies, we predicted that individuals with schizophrenia would show unusually co-activated positive and negative emotions while college students with schizotypy would show abnormally low positive and abnormally high negative emotions. Drawing from the affective science literature, we employed continuous emotion ratings in response to a dynamic and evocatively “bittersweet” stimulus. Participants included 27 individuals with schizophrenia, 39 individuals with psychometrically defined schizotypy and 26 community and 35 college control participants. Participants continuously rated their state happiness and sadness throughout a six-minute clip from a tragicomic film (i.e., Life is Beautiful). In contrast to expectations as well as the extant literature, there were no state emotional abnormalities noted from either schizophrenia-spectrum group. Of particular note, neither individuals with schizophrenia nor individuals with schizotypy were abnormal in their experience of state negative, positive or coactivated emotions. Conversely, abnormalities in trait emotion were observed in both groups relative to their respective control groups. These results help confirm that the schizophrenia-spectrum is not characterized by deficits in state emotional experience and suggest that sadness is not abnormally co-activated with pleasant emotions. These results are critical for clarifying the “chronometry” of emotional dysfunctions across the schizophrenia-spectrum. PMID:26711714

  7. Functional hypothalamic amenorrhea is associated with elevated ghrelin and disordered eating.

    PubMed

    Schneider, Lisa F; Warren, Michelle P

    2006-12-01

    To determine whether ghrelin, an orexigen released by the stomach, is elevated in women with hypothalamic amenorrhea who are of normal weight and whether this is associated with abnormal eating behaviors. Controlled clinical study. Healthy volunteers in an academic research environment. Twenty-seven women with functional hypothalamic amenorrhea (FHA) and 42 normally menstruating women. None. Ghrelin and eating behavior. Ghrelin was significantly elevated in FHA (648.4 +/- 92.0 pg/mL vs. controls 596.7 +/- 79.0 pg/mL), while leptin, although lower, was not significantly so (FHA 5.4 +/- 2.8 ng/mL vs. controls 6.4 +/- 3 ng/mL). Eating Attitudes Test (EAT) scores were also significantly elevated in FHA (15.3 +/- 10.6 vs. controls 10.3 +/- 8.4), particularly on the subscale that measured bulimic behaviors. However, FHA patients consumed significantly more kilocalories (1,930 kcal/day vs. 1,588 kcal/day). High ghrelin in women with FHA may be linked to abnormal dietary behaviors, as reflected in high EAT scores yet characterized by normal caloric intake. Ghrelin may act as a restraining metabolic signal preventing a return to cyclicity in women with both disordered eating and FHA, prolonging amenorrhea when leptin has returned to normal.

  8. A systematic review of the psychological factors associated with returning to sport following injury.

    PubMed

    Ardern, Clare L; Taylor, Nicholas F; Feller, Julian A; Webster, Kate E

    2013-11-01

    Psychological factors have been shown to be associated with the recovery and rehabilitation period following sports injury, but less is known about the psychological response associated with returning to sport after injury. The aim of this review was to identify psychological factors associated with returning to sport following sports injury evaluated with the self-determination theory framework. Systematic review. Electronic databases were searched from the earliest possible entry to March 2012. Quantitative studies were reviewed that included athletes who had sustained an athletic injury, reported the return to sport rate and measured at least one psychological variable. The risk of bias in each study was appraised with a quality checklist. Eleven studies that evaluated 983 athletes and 15 psychological factors were included for review. The three central elements of self-determination theory-autonomy, competence and relatedness were found to be related to returning to sport following injury. Positive psychological responses including motivation, confidence and low fear were associated with a greater likelihood of returning to the preinjury level of participation and returning to sport more quickly. Fear was a prominent emotional response at the time of returning to sport despite the fact that overall emotions became more positive as recovery and rehabilitation progressed. There is preliminary evidence that positive psychological responses are associated with a higher rate of returning to sport following athletic injury, and should be taken into account by clinicians during rehabilitation.

  9. Positional Magnetic Resonance Imaging for People With Ehlers-Danlos Syndrome or Suspected Craniovertebral or Cervical Spine Abnormalities: An Evidence-Based Analysis

    PubMed Central

    2015-01-01

    Background Ehlers-Danlos syndrome (EDS) is an inherited disorder affecting the connective tissue. EDS can manifest with symptoms attributable to the spine or craniovertebral junction (CVJ). In addition to EDS, numerous congenital, developmental, or acquired disorders can increase ligamentous laxity in the CVJ and cervical spine. Resulting abnormalities can lead to morbidity and serious neurologic complications. Appropriate imaging and diagnosis is needed to determine patient management and need for complex surgery. Some spinal abnormalities cause symptoms or are more pronounced while patients sit, stand, or perform specific movements. Positional magnetic resonance imaging (pMRI) allows imaging of the spine or CVJ with patients in upright, weight-bearing positions and can be combined with dynamic maneuvers, such as flexion, extension, or rotation. Imaging in these positions could allow diagnosticians to better detect spinal or CVJ abnormalities than recumbent MRI or even a combination of other available imaging modalities might allow. Objectives To determine the diagnostic impact and clinical utility of pMRI for the assessment of (a) craniovertebral or spinal abnormalities among people with EDS and (b) major craniovertebral or cervical spine abnormalities among symptomatic people. Data Sources A literature search was performed using Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid Embase, and EBM Reviews, for studies published from January 1, 1998, to September 28, 2014. Review Methods Studies comparing pMRI to recumbent MRI or other available imaging modalities for diagnosis and management of spinal or CVJ abnormalities were reviewed. All studies of spinal or CVJ imaging in people with EDS were included as well as studies among people with suspected major CVJ or cervical spine abnormalities (cervical or craniovertebral spine instability, basilar invagination, cranial settling, cervical stenosis, spinal cord compression, Chiari malformation). Results No studies were identified that met the inclusion criteria. Conclusions We did not identify any evidence that assessed the diagnostic impact or clinical utility of pMRI for (a) craniovertebral or spinal abnormalities among people with EDS or (b) major craniovertebral or cervical spine abnormalities among symptomatic people relative to currently available diagnostic modalities. PMID:26366238

  10. Philanthropy and hospital financing.

    PubMed Central

    Smith, D G; Clement, J P; Wheeler, J R

    1995-01-01

    OBJECTIVE. This study explores the relationships among donations to not-for-profit hospitals, the returns provided by these hospitals, and fund-raising efforts. It tests a model of hospital behavior and addresses an earlier debate regarding the supply price of donations. DATA SOURCES. The main data source is the California Office of Statewide Health Planning data tapes of hospital financial disclosure reports for fiscal years 1980/1981 through 1986/1987. Complete data were available for 160 hospitals. STUDY DESIGN. Three structural equations (donations, returns, and fund-raising) are estimated as a system using a fixed-effects, pooled cross-section, time-series least squares regression. PRINCIPAL FINDINGS. Estimation results reveal the expected positive relation between donations and returns. The reverse relation between returns and donations is insignificant. The estimated effect of fund-raising on donations is insignificantly different from zero, and the effect of donations on fund-raising is negative. Fund-raising and returns are negatively associated with one another. CONCLUSION. The empirical results presented here suggest a positive donations-returns relations and are consistent with a positive supply price for donations. Hospitals appear to view a trade-off between providing returns and soliciting donations, but donors do not respond equally to these two activities. Attempts to increase free cash flow through expansion of community returns or fund-raising activity, at least in the short run, are not likely to be highly successful financing strategies for many hospitals. PMID:8537223

  11. Return stroke velocities and currents using a solid state silicon detector system

    NASA Technical Reports Server (NTRS)

    Mach, Douglas M.; Rust, W. David

    1988-01-01

    A small, portable device has been developed to measure return stroke velocities. With the device, velocities from 135 strokes that consist of 92 natural return strokes and 43 triggered return strokes have been analyzed. The average return stroke velocity for longer channels, greater than 500 meters, is 1.2 + or - 0.3 x 10 to the 8th m/s for both natural and triggered return strokes. For shorter channel lengths, less than 500 m, natural lightning has a statistically higher average return stroke velocity of 1.9 + or - 0.7 x 10 to the 8th m/s than triggered lightning with an average return stroke velocity of 1.4 + or - 0.4 x 10 to the 8th m/s. Using the transmission line model of the return stroke, natural lightning has a peak current distribution that is log-normal with a median value of 19 kA. Return stroke velocities and currents were determined for two distant single stroke natural positive cloud-to-ground flashes. The velocities were 1.0 and 1.7 x 10 to the 8th ms/s while the estimated peak current for each positive flash was over 125 kA.

  12. Antiviral treatment normalizes neurophysiological but not movement abnormalities in simian immunodeficiency virus–infected monkeys

    PubMed Central

    Fox, Howard S.; Weed, Michael R.; Huitron-Resendiz, Salvador; Baig, Jamal; Horn, Thomas F.W.; Dailey, Peter J.; Bischofberger, Norbert; Henriksen, Steven J.

    2000-01-01

    Simian immunodeficiency virus (SIV) infection of rhesus monkeys provides an excellent model of the central nervous system (CNS) consequences of HIV infection. To discern the relationship between viral load and abnormalities induced in the CNS by the virus, we infected animals with SIV and later instituted antiviral treatment to lower peripheral viral load. Measurement of sensory-evoked potentials, assessing CNS neuronal circuitry, revealed delayed latencies after infection that could be reversed by lowering viral load. Cessation of treatment led to the reappearance of these abnormalities. In contrast, the decline in general motor activity induced by SIV infection was unaffected by antiviral treatment. An acute increase in the level of the chemokine monocyte chemoattractant protein-1 (MCP-1) was found in the cerebrospinal fluid (CSF) relative to plasma in the infected animals at the peak of acute viremia, likely contributing to an early influx of immune cells into the CNS. Examination of the brains of the infected animals after return of the electrophysiological abnormalities revealed diverse viral and inflammatory findings. Although some of the physiological abnormalities resulting from SIV infection can be at least temporarily reversed by lowering viral load, the viral-host interactions initiated by infection may result in long-lasting changes in CNS-mediated functions. PMID:10880046

  13. Antiviral treatment normalizes neurophysiological but not movement abnormalities in simian immunodeficiency virus-infected monkeys.

    PubMed

    Fox, H S; Weed, M R; Huitron-Resendiz, S; Baig, J; Horn, T F; Dailey, P J; Bischofberger, N; Henriksen, S J

    2000-07-01

    Simian immunodeficiency virus (SIV) infection of rhesus monkeys provides an excellent model of the central nervous system (CNS) consequences of HIV infection. To discern the relationship between viral load and abnormalities induced in the CNS by the virus, we infected animals with SIV and later instituted antiviral treatment to lower peripheral viral load. Measurement of sensory-evoked potentials, assessing CNS neuronal circuitry, revealed delayed latencies after infection that could be reversed by lowering viral load. Cessation of treatment led to the reappearance of these abnormalities. In contrast, the decline in general motor activity induced by SIV infection was unaffected by antiviral treatment. An acute increase in the level of the chemokine monocyte chemoattractant protein-1 (MCP-1) was found in the cerebrospinal fluid (CSF) relative to plasma in the infected animals at the peak of acute viremia, likely contributing to an early influx of immune cells into the CNS. Examination of the brains of the infected animals after return of the electrophysiological abnormalities revealed diverse viral and inflammatory findings. Although some of the physiological abnormalities resulting from SIV infection can be at least temporarily reversed by lowering viral load, the viral-host interactions initiated by infection may result in long-lasting changes in CNS-mediated functions.

  14. [Features of peripheral nerve injuries in workers exposed to vibration: an analysis of 197 cases].

    PubMed

    Situ, J; Lin, C M; Qin, Z H; Zhu, D X; Lin, H; Zhang, F F; Zhang, J J

    2016-12-20

    Objective: To investigate the features of peripheral nerve injuries in workers exposed to vibration. Methods: A total of 197 male workers [median age: 34 years (21 - 50 years) ; median working years of vibration exposure: 7.3 years (1 - 20 years) ] engaged in grinding in an enterprise were enrolled. Their clinical data and electromyography results were analyzed to investigate the features of peripheral nerve impairment. Results: Of all workers, 96 (48.73%) had abnormal electromyography results. Of all workers, 88 (44.7%) had simple mild median nerve injury in the wrist, who accounted for 91.7% (88/96) of all workers with abnormal electromy-ography results. Six workers had ulnar nerve injury, superficial radial nerve injury, or/and superficial peroneal nerve injury and accounted for 6.3% of all workers with abnormal electromyography results. Of all workers, 88 had a reduced amplitude of median nerve sensory transduction, and 28 had slowed median nerve sensory transduction. A total of 46 workers were diagnosed with occupational hand-arm vibration disease and hospitalized for treatment. They were followed up for more than 4 months after leaving their jobs, and most of them showed improvements in neural electromyography results and returned to a normal state. Conclusion: Workers exposed to vibration have a high incidence rate of nerve injury in the hand, mainly sensory function impairment at the distal end of the median nerve, and all injuries are mild peripheral nerve injuries. After leaving the vibration job and being treated, most workers can achieve improvements and return to a normal state.

  15. Serum Free Light Chain Assay and κ/λ Ratio Performance in Patients Without Monoclonal Gammopathies:  High False-Positive Rate.

    PubMed

    Singh, Gurmukh

    2016-08-01

    Serum free light chain assay is a recommended screening test for monoclonal gammopathies. Anecdotal observations indicated a high rate of false-positive abnormal κ/λ ratios. This study was undertaken to ascertain the magnitude of the false-positive rate and factors contributing to the error rate. Results of serum protein electrophoresis, serum free light chains, and related tests, usually done for investigation of suspected monoclonal gammopathy, were reviewed retrospectively for 270 patients and 297 observations. Using the conventional κ/λ ratio, 36.4% of the ratios were abnormal, in the absence of monoclonal gammopathy. When the renal κ/λ ratio was used, the rate of abnormal κ/λ ratios was 30.1%. In patients with a γ-globulin concentration of 1.6 g/dL or more, the usual κ/λ ratio was abnormal in 54.8% of the patients. Urine protein electrophoresis was used in 53 (19.6%) instances, whereas bone marrow examination was done in 65 (24.1%) cases. Usual κ/λ ratio was abnormal in 36.4% of the observations in patients without evidence of monoclonal gammopathy, and an abnormal κ/λ ratio should not be used as the sole indicator for diagnosis of neoplastic proliferation of the lympho-plasmacytic system. Hypergammaglobulinemia is associated with a higher rate of false-positive abnormal κ/λ ratios. Examination of urine for monoclonal immunoglobulins may be underused, and recommendations by some to use serum free light chain assay in place of, rather than as an adjunct to, urine electrophoresis are not warranted. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. The Ideal Strategy for Cervical Cancer Screening in Japan: Result from the Fukui Cervical Cancer Screening Study.

    PubMed

    Kurokawa, T; Onuma, T; Shinagawa, A; Chino, Y; Kobayashi, M; Yoshida, Y

    2018-05-16

    The aims of the Fukui Cervical Cancer Screening (FCCS) study are to determine the frequency of women with high-risk HPV (hrHPV), whether HPV16 or HPV18 (HPV16/18), in the Japanese cancer screening population for the first time and to identify the best strategy for cervical cancer screening in Japan. This study enrolled 7,584 women ≥25 years of age who were undergoing routine screening. All women underwent liquid-based cytology and cobas HPV tests. Women with abnormal cytology, whether hrHPV positive or negative; women with hrHPV positivity with either normal or abnormal cytology; and women randomly selected from women with normal cytology and negative hrHPV negative were referred for colposcopy. The prevalences of hrHPV positivity and HPV16/18 positivity were 6.8% and 1.7%, respectively. The baseline data from the FCCS study showed that the combination of HPV tests and cytology was more sensitive than cytology with respect to the detection of intraepithelial neoplasia grade 2 or worse. However, the specificity (94.1%) of the co-testing strategy that required all women with abnormal cytology or hrHPV positivity to be referred for colposcopy was much lower than that (97.8%) of cytology. The sensitivity and specificity of the co-testing strategy that required only women with abnormal cytology or HPV16/18 positivity to undergo colposcopy were 85.5% and 97.0%, respectively. The baseline data from the FCCS study suggest that a cervical cancer screening strategy in which only women with abnormal cytology or HPV16/18 positivity undergo colposcopy offers a more balanced sensitivity and specificity than other strategies. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  17. The propagation speed of a positive lightning return stroke

    NASA Technical Reports Server (NTRS)

    Idone, Vincent P.; Orville, Richard E.; Mach, Douglas M.; Rust, W. David

    1987-01-01

    The first direct determination of the propagation speed of a lightning return stroke lowering positive charge to ground has been made. This stroke was the third of eight otherwise negative strokes in a triggered lightning flash initiated at the Kennedy Space Center, FL. Two independent optical systems, one photographic and the other photoelectric, yielded common recordings for the third and fourth strokes; the respective two-dimensional return stroke propagation speeds were 1.0 vs 0.93 x 10 to the 8th m/s for the positive (third) stroke and 1.0 vs 1.0 x 10 to the 8th m/s for the fourth stroke. Using fast electric-field data, the positive stroke peak current was estimated to be 21 kA. Photoelectric data only yielded propagation speeds of 1.4, 1.6, 1.2, 1.3, 1.0 and 0.90 x 10 to the 8th m/s for the first, second and fifth through eighth return strokes, respectively.

  18. Cytoskeletal mechanisms in positioning of the second-division spindles and meiotic restitution in tobacco (Nicotiana tabacum L.) microsporogenesis.

    PubMed

    Sidorchuk, Yuriy Vladimirovich; Deineko, Elena Victorovna

    2017-06-01

    Microsporogenesis patterns of the polyploid (2n = 4x = 96) and diploid (2n = 2x = 48) Nicotiana tabacum L. (cv. Havana Petit line SR1) plants have been analyzed and compared. Four types of abnormal positions of the second-division spindles-tripolar, parallel, proximal, and fused-have been observed. Of these abnormalities, only tripolar (2.4%) and parallel (1.4%) spindles are observable in diploid plants. As for polyploids, the increased ploidy is accompanied by an increase in the incidence of tripolar (22.8%) and parallel (8.1%) spindle orientations and emergence of two remaining abnormalities (proximal and fused spindles, 3.3%). As has been shown, the spindle position abnormalities in diploid plants have no effect on the meiotic products, whereas both dyads and triads are detectable among the tetrads in polyploid plants. Analysis of cytoskeletal remodeling has allowed for the insight into the role of interzonal radial microtubule system in spindle positioning during the second division. The reason underlying the change in spindle positioning is disturbed polymerization-depolymerization processes and interdigitation of microtubule plus ends within the interzonal cytoskeleton system in late telophase I-interkinesis and prophase II. As has been demonstrated, fused second-division spindles are formed as a result of fused cytoskeletal structures in prophase-prometaphase II in the case when the nuclei are drawn abnormally close to one another. © 2017 International Federation for Cell Biology.

  19. The demographics of unfunded pensions.

    PubMed

    Keyfitz, N

    1985-01-01

    The performance of pay-as-you-go old-age insurance under different demographic conditions can be estimated from a metric consisting of the implicit rate of return to successive cohorts. The author shows a positive return for the prospective population over the next few years, but for cohorts born after the end of the century returns will become sharply negative. A decline in returns is typical of pay-as-you-go schemes as they mature, and a change to negative returns is typical in particular as the birth rate falls under fixed economic conditions. The return can be kept positive by greatly increased fertility or immigration. Taking labor-force participation rates into account, and supposing entitlement independent of contribution, gives much larger negative rates of return, however. The main calculations considered here are for schemes with a constant pension. If the contribution rather than the pension is kept constant then the disparities between cohorts with respect to their returns are smaller, and although the negative returns for future generations then set in earlier they are smaller. The conclusions of the paper are broadly applicable to any population that showed a baby boom after World War II and replacement-level or lower fertility subsequently.

  20. Effects of Weightlessness on Vestibular Development of Quail

    NASA Technical Reports Server (NTRS)

    Fritzsch, Bernd; Bruce, Laura L.

    1999-01-01

    The data confirm previous findings that quail embryos can, under proper circumstances, develop until hatching in microgravity. There were no gross abnormalities in the few ears of the late embryos (we received 3 ears at E14.5 and 4 ears at E16.5). Due to inadequate numbers of samples returned and their fully insufficient fixation, no conclusions could be reached that warrant any publications.

  1. Effects of the Abnormal Acceleratory Environment of Flight

    DTIC Science & Technology

    1974-12-01

    vision Return of arteriolar pulsa- tion and temporary venous distension Visual failure is a continuum from loss of peripheral vision (grey- out) to...distance); intrathoracic pressure is increased by strong muscular expiratorv efforts against a partially closed glottis; and the contraction of...vigorous skeletal muscular tensing (Valsalva maneuver) can reduce +GZ tolerance and lead to an episode of unconsciousness at extremely low G levels

  2. Optical progression characteristics of an interesting natural downward bipolar lightning flash

    NASA Astrophysics Data System (ADS)

    Chen, Luwen; Lu, Weitao; Zhang, Yijun; Wang, Daohong

    2015-01-01

    high-speed cameras, Lightning Attachment Process Observation Systems, and fast and slow electrical antennas, we documented a downward bipolar lightning flash that contained one first positive stroke with a peak current of 142 kA and five subsequent negative strokes hitting on a 90 m tall structure on 29 July 2010 in Guangzhou City, China. All the six strokes propagated along the same viewed channel established by the first positive return stroke. The leader which preceded the positive return stroke propagated downward without any branches at a two-dimensional (2-D) speed of 2.5 × 106 m/s. An upward connecting leader with a length of about 80 m was observed in response to the downward positive leader. The 10-90% risetimes of the return strokes' optical pulses ranged from 2.2 µs to 3.2 µs, while the widths from the 10% wavefront to the 50% wave tail ranged from 56.5 µs to 83.1 µs, and the half peak widths ranged from 53.4 µs to 81.6 µs. All the return strokes exhibited similar speeds, ranging from 1.0 × 108 m/s to 1.3 × 108 m/s. Each of the return strokes was followed by a continuing current stage (CC). The first positive stroke CC lasted more than 150 ms, much larger than all the subsequent negative stroke CC, ranging from 13 ms to 70 ms.

  3. 5 CFR 630.504 - Reestablishment of leave account after military service.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... military service. 630.504 Section 630.504 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL... military service. (a) When an employee leaves his or her civilian position to enter the military service... returns to a civilian position following military service, the agency to which the employee returns shall...

  4. Clinical features and disease progression of L-2-hydroxyglutaric aciduria in 27 Staffordshire bull terriers.

    PubMed

    Shea, A; De Risio, L; Carruthers, H; Ekiri, A; Beltran, E

    2016-11-26

    To describe the development of clinical signs (CS) and outcome of L-2-hydroxyglutaric aciduria (L-2-HGA), owners of 119 Staffordshire bull terriers positive for the known L-2-hydroxyglutarate dehydrogenase autosomal-recessive mutations were requested to complete a questionnaire regarding their pet's CS. Questionnaires were returned for 27 dogs, all with neurological abnormalities-not all questions were answered in all cases. The mean age of CS onset was 12 months (range 2.5-60). Gait dysfunction was reported in 26/26 dogs, with stiffness of all four limbs the most common (24/26) and earliest recognised abnormality. Kyphosis (19/26), body and/or head tremors (19/26) and hypermetria (15/26) were frequent. Behavioural changes were present in 24/27 dogs; most commonly staring into space (21/24), signs of dementia (17/24) and loss of training (15/24). Eighteen dogs demonstrated paroxysmal seizure-like/dyskinetic episodes. Nineteen (70 per cent) dogs were alive at a mean survival time of 76.6 months (12-170) after onset of CS. L-2-HGA was the cause of euthanasia in six dogs. Euthanasia occurred at a mean survival time of 44 months (8.5-93) after onset of CS, with 2/8 dogs euthanased within 12 months. L-2-HGA is considered a progressive neurological disease; however, CS can be successfully managed with affected dogs potentially living a normal lifespan. British Veterinary Association.

  5. Update Direct-Strike Lightning Environment for Stockpile-to-Target Sequence (Second Revision)

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

    Uman, Martin A.; Rakov, V. A.; Elisme, J. O.

    2010-10-05

    The University of Florida has surveyed all relevant publications reporting lightning characteristics and presents here an up-to-date version of the direct-strike lightning environment specifications for nuclear weapons published in 1989 by R. J. Fisher and M. A. Uman. Further, we present functional expressions for current vs. time, current derivative vs. time, second current derivative vs. time, charge transfer vs. time, and action integral (specific energy) vs. time for positive and negative first return strokes, for negative subsequent return strokes, and for positive and negative continuing currents; and we give sets of constants for these functional expressions so that the resultantmore » waveforms exhibit approximately the median and extreme lightning parameters presented in the updated direct strike environment. Fourier transforms of the return stroke current waveforms are presented. The results of our literature survey are included in three Appendices entitled Return Stroke Current, Continuing Current, and Positive Lightning.« less

  6. Antinuclear antibodies in patients with polymorphic light eruption: a long-term follow-up study.

    PubMed

    Tzaneva, S; Volc-Platzer, B; Kittler, H; Hönigsmann, H; Tanew, A

    2008-05-01

    Previous studies have shown elevated titres of antinuclear antibodies (ANA) in 2.9-19% of patients with polymorphic light eruption (PLE). A diagnosis of lupus erythematosus (LE) was finally established in some of these ANA-positive patients. To investigate whether the presence of ANA in patients with PLE merely represents an epiphenomenon or is associated with an increased risk of eventual progression to LE. We identified 472 patients with PLE who had received prophylactic photo(chemo)therapy between 1986 and 2003 and were routinely tested for the presence of ANA. All ANA-positive (ANA titre of>or=1:80) patients were asked to attend for a follow-up examination comprising a medical history, complete skin inspection and a detailed laboratory analysis including ANA and antibodies against extractable nuclear antigens. Of all the patients, 55 (11.7%) were found to be ANA positive on one or several occasions, and three (0.6%) also had antibodies to SS-A/Ro. Thirty-nine (71%) of all ANA-positive patients including all Ro+ subjects were available for follow-up after a median follow-up period of 8 years (interquartile range 5-11.5). Twenty-five patients showed persistence of ANA positivity with a median titre of 1:160 (range 1:80-1:640), whereas in 14 patients ANA titres had returned to normal levels. None of the patients revealed additional clinical, histopathological or laboratory abnormalities suggestive of LE. After a median follow-up period of 8 years none of the ANA-positive patients developed LE. Our findings indicate that PLE is a benign disease without tendency to progress to LE.

  7. Returning HIV-1 viral load results to participant-selected health facilities in national Population-based HIV Impact Assessment (PHIA) household surveys in three sub-Saharan African Countries, 2015 to 2016.

    PubMed

    Saito, Suzue; Duong, Yen T; Metz, Melissa; Lee, Kiwon; Patel, Hetal; Sleeman, Katrina; Manjengwa, Julius; Ogollah, Francis M; Kasongo, Webster; Mitchell, Rick; Mugurungi, Owen; Chimbwandira, Frank; Moyo, Crispin; Maliwa, Vusumuzi; Mtengo, Helecks; Nkumbula, Tepa; Ndongmo, Clement B; Vere, Nora Skutayi; Chipungu, Geoffrey; Parekh, Bharat S; Justman, Jessica; Voetsch, Andrew C

    2017-11-01

    Logistical complexities of returning laboratory test results to participants have precluded most population-based HIV surveys conducted in sub-Saharan Africa from doing so. For HIV positive participants, this presents a missed opportunity for engagement into clinical care and improvement in health outcomes. The Population-based HIV Impact Assessment (PHIA) surveys, which measure HIV incidence and the prevalence of viral load (VL) suppression in selected African countries, are returning VL results to health facilities specified by each HIV positive participant within eight weeks of collection. We describe the performance of the specimen and data management systems used to return VL results to PHIA participants in Zimbabwe, Malawi and Zambia. Consenting participants underwent home-based counseling and HIV rapid testing as per national testing guidelines; all confirmed HIV positive participants had VL measured at a central laboratory on either the Roche CAP/CTM or Abbott m2000 platform. On a bi-weekly basis, a dedicated data management team produced logs linking the VL test result with the participants' contact information and preferred health facility; project staff sent test results confidentially via project drivers, national courier systems, or electronically through an adapted short message service (SMS). Participants who provided cell phone numbers received SMS or phone call alerts regarding availability of VL results. From 29,634 households across the three countries, 78,090 total participants 0 to 64 years in Zimbabwe and Malawi and 0 to 59 years in Zambia underwent blood draw and HIV testing. Of the 8391 total HIV positive participants identified, 8313 (99%) had VL tests performed and 8245 (99%) of these were returned to the selected health facilities. Of the 5979 VL results returned in Zimbabwe and Zambia, 85% were returned within the eight-week goal with a median turnaround time of 48 days (IQR: 33 to 61). In Malawi, where exact return dates were unavailable all 2266 returnable results reached the health facilities by 11 weeks. The first three PHIA surveys returned the vast majority of VL results to each HIV positive participant's preferred health facility within the eight-week target. Even in the absence of national VL monitoring systems, a system to return VL results from a population-based survey is feasible, but it requires developing laboratory and data management systems and dedicated staff. These are likely important requirements to strengthen return of results systems in routine clinical care. © 2017 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

  8. Early physiological abnormalities after simian immunodeficiency virus infection.

    PubMed

    Horn, T F; Huitron-Resendiz, S; Weed, M R; Henriksen, S J; Fox, H S

    1998-12-08

    Central nervous system (CNS) damage and dysfunction are devastating consequences of HIV infection. Although the CNS is one of the initial targets for HIV infection, little is known about early viral-induced abnormalities that can affect CNS function. Here we report the detection of early physiological abnormalities in simian immunodeficiency virus-infected monkeys. The acute infection caused a disruption of the circadian rhythm manifested by rises in body temperature, observed in all five individuals between 1 and 2 weeks postinoculation (p.i.), accompanied by a reduction in daily motor activity to 50% of control levels. Animals remained hyperthermic at 1 and 2 months p.i. and returned to preinoculation temperatures at 3 months after viral inoculation. Although motor activity recovered to baseline values at 1 month p.i., activity levels then decreased to approximately 50% of preinoculation values over the next 2 months. Analysis of sensory-evoked responses 1 month p.i. revealed distinct infection-induced changes in auditory-evoked potential peak latencies that persisted at 3 months after viral inoculation. These early physiological abnormalities may precede the development of observable cognitive or motor deficiencies and can provide an assay to evaluate agents to prevent or alleviate neuronal dysfunction.

  9. Early physiological abnormalities after simian immunodeficiency virus infection

    PubMed Central

    Horn, Thomas F. W.; Huitron-Resendiz, Salvador; Weed, Michael R.; Henriksen, Steven J.; Fox, Howard S.

    1998-01-01

    Central nervous system (CNS) damage and dysfunction are devastating consequences of HIV infection. Although the CNS is one of the initial targets for HIV infection, little is known about early viral-induced abnormalities that can affect CNS function. Here we report the detection of early physiological abnormalities in simian immunodeficiency virus-infected monkeys. The acute infection caused a disruption of the circadian rhythm manifested by rises in body temperature, observed in all five individuals between 1 and 2 weeks postinoculation (p.i.), accompanied by a reduction in daily motor activity to 50% of control levels. Animals remained hyperthermic at 1 and 2 months p.i. and returned to preinoculation temperatures at 3 months after viral inoculation. Although motor activity recovered to baseline values at 1 month p.i., activity levels then decreased to approximately 50% of preinoculation values over the next 2 months. Analysis of sensory-evoked responses 1 month p.i. revealed distinct infection-induced changes in auditory-evoked potential peak latencies that persisted at 3 months after viral inoculation. These early physiological abnormalities may precede the development of observable cognitive or motor deficiencies and can provide an assay to evaluate agents to prevent or alleviate neuronal dysfunction. PMID:9844017

  10. Radiology curriculum topics for medical students: students' perspectives.

    PubMed

    Subramaniam, Rathan M; Beckley, Vaughan; Chan, Michael; Chou, Tina; Scally, Peter

    2006-07-01

    We sought to establish medical students' perspectives of a set of curriculum topics for radiology teaching. A multicenter study was conducted in New Zealand. A modified Delphi method was adopted. Students enrolled in two New Zealand Universities received a questionnaire. Each learning topic was graded on a scale of 1 (very strongly disagree) to 6 (very strongly agree). Students could also put forward and grade suggestions that were not on the questionnaire. Of 200 questionnaires, 107 were returned. Fifty male and 57 female students participated, with an average age of 23.7 years. The five highest ranking curriculum topics in order of importance were developing a system for viewing chest radiographs (5.77, SD 0.7), developing a system for viewing abdominal radiographs (5.66, SD 0.8), developing a system for viewing bone and joint radiographs (5.56, SD 0.8), distinguishing normal structures from abnormal in chest and abdominal radiographs (5.38, SD 0.9), and identifying gross bone or joint abnormalities in skeletal radiographs (5.29, SD 0.9). Medical students want to know how to look at radiographs, how to distinguish normal from abnormal, and how to identify gross abnormalities.

  11. An Electrophysiological Investigation of Emotional Abnormalities in Groups at Risk for Schizophrenia-Spectrum Personality Disorders

    PubMed Central

    Martin, Elizabeth A.; Karcher, Nicole R.; Bartholow, Bruce D.; Siegle, Greg J.; Kerns, John G.

    2017-01-01

    Both extreme levels of social anhedonia (SocAnh) and perceptual aberration/magical ideation (PerMag) are associated with risk for schizophrenia-spectrum disorders and with emotional abnormalities. Yet, the nature of any psychophysiological-measured affective abnormality, including the role of automatic/controlled processes, is unclear. We examined the late positive potential (LPP) during passive viewing (to assess automatic processing) and during cognitive reappraisal (to assess controlled processing) in three groups: SocAnh, PerMag, and controls. The SocAnh group exhibited an increased LPP when viewing negative images. Further, SocAnh exhibited greater reductions in the LPP for negative images when told to use strategies to alter negative emotion. Similar to SocAnh, PerMag exhibited an increased LPP when viewing negative images. However, PerMag also exhibited an increased LPP when viewing positive images as well as an atypical decreased LPP when increasing positive emotion. Overall, these results suggest that at-risk groups are associated with shared and unique automatic and controlled abnormalities. PMID:28174121

  12. Clinical Outcomes after Conservative Management of Cervical Intraepithelial Neoplasia Grade 2 (CIN2) in Women Ages 21-39 Years.

    PubMed

    Silver, Michelle I; Gage, Julia C; Schiffman, Mark; Fetterman, Barbara; Poitras, Nancy E; Lorey, Thomas; Cheung, Li C; Katki, Hormuzd A; Locke, Alexander; Kinney, Walter K; Castle, Philip E

    2018-03-01

    Cervical intraepithelial neoplasia grade 2 (CIN2) frequently regresses, is typically slow-growing, and rarely progresses to cancer. Some women forgo immediate treatment, opting for conservative management (heightened surveillance with cytology and colposcopy), to minimize overtreatment and increased risk of obstetric complications; however, there are limited data examining clinical outcomes in these women. We performed a retrospective cohort analysis of younger women diagnosed with initially untreated CIN1/2, CIN2 and CIN2/3 lesions at Kaiser Permanente Northern California between 2003 and 2015. Clinical outcomes were categorized into five mutually exclusive hierarchical groups: cancer, treated, returned to routine screening, persistent high-grade lesion, or persistent low-grade lesion. Median follow-up for the 2,417 women was 48 months. Six women were diagnosed with cancer (0.2%), all with history of high-grade cytology, and none after a negative cotest. Thirty percent of women were treated, and only 20% returned to routine screening; 50% remained in continued intensive follow-up, of which 86% had either low-grade cytology/histology or high-risk human papillomavirus (HPV) positivity, but not necessarily persistence of a single HPV type. No cancers were detected after a single negative cotest in follow-up. Almost half of initially untreated women did not undergo treatment, but remained by protocol in colposcopy clinic for 2 or more years in the absence of persisting CIN2 + Their incomplete return to total negativity was possibly due to sequential new and unrelated low-grade abnormalities. The prolonged colposcopic surveillance currently required to return to routine screening in the absence of persisting CIN2 + might not be necessary after a negative cotest. Significance: Many younger women under conservative management following an initial CIN2 result remain in a clinical protocol of prolonged intensified surveillance without a subsequent diagnosis of CIN2 or more severe diagnoses. More research is needed to determine whether such prolonged management might be unnecessary following a negative cotest for those women with an initial CIN2 but otherwise only low-grade findings. Cancer Prev Res; 11(3); 165-70. ©2018 AACR . ©2018 American Association for Cancer Research.

  13. Essays on the effects of oil price shocks on the U.S. stock returns

    NASA Astrophysics Data System (ADS)

    Alsalman, Zeina N.

    This research investigates the effect of changes in oil prices and oil price volatility on the U.S. stock returns. The first essay tests whether the sign and the size of oil price shocks matter for the U.S. stock returns. The results suggest a linear model provides a good approximation to the response of real stock returns to real oil price innovations. However, this is not the case when the model is specified in terms of the nominal price of crude oil. Using a modified structural VAR to accommodate GARCH-in-Mean errors, the second essay studies the direct effects of oil price uncertainty on the U.S. stock returns at the aggregate and sectoral levels. We also simulate the response of U.S. stock returns to positive and negative oil price shocks, to examine whether the responses to positive and negative shocks are symmetric. Estimation results suggest that there is no statistically significant effect of oil price volatility on the U.S. stock returns. Moreover, the impulse responses indicate that oil price increases and decreases have symmetric effects on the U.S. stock returns. Using high frequency data, the third essay addresses the issue of uncertainty in oil prices and its effect on U.S. stock returns, taking into account the day of the week effect. The results suggest that the-day-of-the-week effect is present in both the mean and volatility equations. The results also show that the U.S. stock market is sensitive to oil price variations not only at the aggregate level but also across some industries, such as chemicals, entertainment, and retail, where uncertainty in oil prices proves to have positive and statistically significant effect.

  14. Photoelectric return-stroke velocity and peak current estimates in natural and triggered lightning

    NASA Technical Reports Server (NTRS)

    Mach, Douglas M.; Rust, W. David

    1989-01-01

    Two-dimensional photoelectric return stroke velocities from 130 strokes are presented, including 86 negative natural, 41 negative triggered, one positive triggered, and two positive natural return strokes. For strokes starting near the ground and exceeding 500 m in length, the average velocity is 1.3 + or - 0.3 X 10 to the 8th m/s for natural return strokes and 1.2 + or - 0.3 X 10 to the 8th m/s for triggered return strokes. For strokes with lengths less than 500 m, the average velocities are slightly higher. Using the transmission line model (TLM), the shortest segment one-dimensional return stroke velocity, and either the maximum or plateau electric field, it is shown that natural strokes have a peak current distribution that is lognormal with a median value of 16 kA (maximum E) or 12 kA (plateau E). Triggered lightning has a medium peak current value of 21 kA (maximum E) or 15 kA (plateau E). Correlations are found between TLM peak currents and velocities for triggered and natural subsequent return strokes, but not between TLM peak currents and natural first return stroke velocities.

  15. Does expecting mean achieving? The association between expecting to return to work and recovery in whiplash associated disorders: a population-based prospective cohort study.

    PubMed

    Ozegovic, Dejan; Carroll, Linda J; David Cassidy, J

    2009-06-01

    To determine the association between expectations to return to work and self-assessed recovery. Positive expectations predict better outcomes in many health conditions, but to date the relationship between expecting to return to work after traffic-related whiplash-associated disorders and actual recovery has not been reported. We assessed early expectations for return to work in a cohort of 2,335 individuals with traffic-related whiplash injury to the neck. Using multivariable Cox proportional hazard analysis we assessed the association between return to work expectations and self-perceived recovery during the first year following the event. After adjusting for the effects of sociodemographic characteristics, initial pain and symptoms, post-crash mood, prior health status and collision-related factors, those who expected to return to work reported global recovery 42% more quickly than those who did not have positive expectations (HRR = 1.42, 95% CI 1.26-1.60). Knowledge of return to work expectation provides an important prognostic tool to clinicians for recovery.

  16. Proximal Hypospadias

    PubMed Central

    Kraft, Kate H.; Shukla, Aseem R.; Canning, Douglas A.

    2011-01-01

    Hypospadias results from abnormal development of the penis that leaves the urethral meatus proximal to its normal glanular position. Meatal position may be located anywhere along the penile shaft, but more severe forms of hypospadias may have a urethral meatus located at the scrotum or perineum. The spectrum of abnormalities may also include ventral curvature of the penis, a dorsally redundant prepuce, and atrophic corpus spongiosum. Due to the severity of these abnormalities, proximal hypospadias often requires more extensive reconstruction in order to achieve an anatomically and functionally successful result. We review the spectrum of proximal hypospadias etiology, presentation, correction, and possible associated complications. PMID:21516286

  17. In Vivo Detection of Choroidal Abnormalities Related to NF1: Feasibility and Comparison With Standard NIH Diagnostic Criteria in Pediatric Patients.

    PubMed

    Parrozzani, Raffaele; Clementi, Maurizio; Frizziero, Luisa; Miglionico, Giacomo; Perrini, Pierdavide; Cavarzeran, Fabiano; Kotsafti, Olympia; Comacchio, Francesco; Trevisson, Eva; Convento, Enrica; Fusetti, Stefano; Midena, Edoardo

    2015-09-01

    To evaluate the feasibility of near-infrared (NIR) imaging acquisition in a large sample of consecutive pediatric patients with neurofibromatosis type 1 (NF1), to evaluate the diagnostic performance of NF1-related choroidal abnormalities as a diagnostic criterion of the disease, and to compare this criterion with other standard National Institutes of Health (NIH) diagnostic criteria. A total of 140 consecutive pediatric patients (0-16 years old) affected by NF1 (at least two diagnostic criteria), 59 suspected (a single diagnostic criterion), and 42 healthy subjects (no diagnostic criterion) were consecutively included. Each patient underwent genetic, dermatologic, and ophthalmologic examination to evaluate the presence/absence of each NIH diagnostic criterion. The presence of NF1-related choroidal abnormalities was investigated using NIR confocal ophthalmoscopy. Two masked operators assessed Lisch nodules and NF1-related choroidal abnormalities. Neurofibromatosis type 1-related choroidal abnormalities were detected in 72 affected (60.5%) and 1 suspected (2.4%) child. No healthy subject had choroidal abnormalities. Feasibility rate of this sign was 82%. Sensitivity, specificity, and positive and negative predictive values of NF1-related choroidal abnormalities were 0.60, 0.97, 0.98, and 0.46, respectively. Compared with standard NIH criteria, the presence of NF1-related choroidal abnormalities was the third parameter for positive predictive value and the fourth for sensitivity, specificity, and negative predictive value. Compared with Lisch nodules, NF1-related choroidal abnormalities were characterized by higher specificity and positive predictive value. The interoperator agreement for Lisch nodules and NF1-related choroidal abnormalities was 0.67 (substantial) and 0.97 (almost perfect), respectively. The use of this sign moved one patient from the suspected to the affected group (0.5%). Neurofibromatosis type 1-related choroidal abnormalities represent a new diagnostic sign in NF1 children. The main advantage of this sign seems the theoretical possibility to anticipate NF1 diagnosis, whereas the main obstacle is the cooperation required by very young patients.

  18. Delayed hypersensitivity and neutrophil chemotaxis: effect of trauma.

    PubMed

    Meakins, J L; McLean, A P; Kelly, R; Bubenik, O; Pietsch, J B; MacLean, L D

    1978-04-01

    To investigate alterations in host defense produced by trauma, skin testing with five standard recall antigens was done on admission and weekly on 53 patients with blunt trauma and seven with penetrating missile injuries, who then were classified as normal (N), 2 or more positive responses; relatively anergic (RA), one positive response; or anergic (A), no response. Neutrophil chemotaxis was tested 145 times in 32 patients. Degree of injury was assessed by assigning one point to pelvic fracture, long-bone fracture, head, chest, or abdominal injury, to a maximum of five. The A and RA patients had greater trauma, 3 vs. 1.6 for N, and a significantly increased rate of sepsis (p less than 0.005) and mortality (p less than 0.05). Incidence of anergy depended upon age and extent of trauma. Neutrophil chemotaxis in A and RA patients was significantly (p less than 0.001) worse at 96.7 +/- 2.4 mu and 99.8 +/- 1.7 mu compared to N, 113.2 +/- 1.7 mu, and controls 121 +/- 4 mu. With recovery, chemotaxis returned to normal. It is concluded that failure of delayed hypersensitivity responses follows trauma, is related to the severity of injury and age of patient, and is associated with an abnormality of neutrophil chemotaxis and increased rate of sepsis.

  19. Virtual 3D planning of tracheostomy placement and clinical applicability of 3D cannula design: a three-step study.

    PubMed

    de Kleijn, Bertram J; Kraeima, Joep; Wachters, Jasper E; van der Laan, Bernard F A M; Wedman, Jan; Witjes, M J H; Halmos, Gyorgy B

    2018-02-01

    We aimed to investigate the potential of 3D virtual planning of tracheostomy tube placement and 3D cannula design to prevent tracheostomy complications due to inadequate cannula position. 3D models of commercially available cannula were positioned in 3D models of the airway. In study (1), a cohort that underwent tracheostomy between 2013 and 2015 was selected (n = 26). The cannula was virtually placed in the airway in the pre-operative CT scan and its position was compared to the cannula position on post-operative CT scans. In study (2), a cohort with neuromuscular disease (n = 14) was analyzed. Virtual cannula placing was performed in CT scans and tested if problems could be anticipated. Finally (3), for a patient with Duchenne muscular dystrophy and complications of conventional tracheostomy cannula, a patient-specific cannula was 3D designed, fabricated, and placed. (1) The 3D planned and post-operative tracheostomy position differed significantly. (2) Three groups of patients were identified: (A) normal anatomy; (B) abnormal anatomy, commercially available cannula fits; and (C) abnormal anatomy, custom-made cannula, may be necessary. (3) The position of the custom-designed cannula was optimal and the trachea healed. Virtual planning of the tracheostomy did not correlate with actual cannula position. Identifying patients with abnormal airway anatomy in whom commercially available cannula cannot be optimally positioned is advantageous. Patient-specific cannula design based on 3D virtualization of the airway was beneficial in a patient with abnormal airway anatomy.

  20. Work and Rest Patterns and Psychomotor Vigilance Performance of Crewmemebers of the USS Jason Dunham: A Comparison of the 3/9 and 6/6 Watchstanding Schedules

    DTIC Science & Technology

    2014-12-31

    collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1...24 3. Posttest Questionnaires .................................................................................. 26 4. Work...abnormal behavior for humans. Many human physiological functions are controlled by the circadian clock; for example, sleep and its associated functions

  1. Return to High School and College Level Football following ACL Reconstruction: A MOON Cohort Study

    PubMed Central

    McCullough, Kirk A.; Phelps, Kevin D.; Spindler, Kurt P.; Matava, Matthew J.; Dunn, Warren R.; Parker, Richard D.; Reinke, Emily K.

    2013-01-01

    Background While published studies on return to play for various sports exist in the literature, there is a relative paucity of data regarding the effect of ACL reconstruction on the ability of American high school and collegiate football players to return to play at the same level of competition as before their injury, or to progress to play at the next level of competition. Purpose The purpose of this study was threefold: 1) to identify the percentage of high school and collegiate American football players who successfully returned to play at their previous level of competition; 2) to investigate self-reported performance for those players able to return to play or reason(s) for not returning to play; 3) to elucidate risk factors responsible for players not being able to return to play or not returning to the same level of performance. Study Design Retrospective cohort study; level of evidence, 2. Methods This study was a retrospective analysis of prospective patients taken from the Multicenter Orthopaedic Outcomes Network (MOON) cohort who identified football as their primary or secondary sport. Identified patients were then questioned in a structured interview regarding their ACL injury, participation in football prior to their injury, and factors associated with returning to play. Data was analyzed for player position, concurrent meniscal/ligamentous/chondral pathology, surgical technique and graft used for ACL reconstruction, and issues pertaining to timing and ability to return to play. Results 147 players (68 high school, 26 collegiate) met our criteria and were contacted from the 2002 and 2003 MOON cohorts. Return-to-play rates for all high school and collegiate athletes were similar (63% and 69%, respectively). Based on player perception, 43% of the players were able to return to play at the same self-described performance level. Approximately 27% felt they did not perform at a level attained prior to their ACL tear, and 30% were unable to return to play at all. Although 2/3 of players reported some “other interest” contributing to their decision not to return, at both levels of competition fear of re-injury or further damage was cited by ~50% of the players who did not return to play. Analysis of patient-reported outcome scores at a minimum of two years after surgery between patients who returned to play and those that did not demonstrated clinically and statistically significant differences in the IKDC, Marx activity, and KOOS knee related quality of life subscales in the collegiate players. Similar clinical differences were not statistically significant in the high school students. Player position did not have a statistically significant effect on the ability to return to play for high school players, and 41% of “skilled” position players and 50% of “non-skilled” position players were able to return to play at the same performance level. Conclusion Return-to-play percentages for amateur American football players following ACL reconstruction are not as high as would be expected. While technical aspects of ACL reconstruction and the ensuing rehabilitation have been studied extensively, the psychological factors (primarily a fear of re-injury) influencing the ability to return to play following ACL surgery may be underestimated as a critical factor responsible for athletes not returning to play at any level of competition. PMID:22922520

  2. Adverse reactions and other factors that impact subsequent blood donation visits.

    PubMed

    Custer, Brian; Rios, Jorge A; Schlumpf, Karen; Kakaiya, Ram M; Gottschall, Jerome L; Wright, David J

    2012-01-01

    The importance of adverse reactions in terms of donor safety recently has received significant attention, but their role in subsequent donation behavior has not been thoroughly investigated. Six REDS-II blood centers provided data for this analysis. Summary minor and major adverse reaction categories were created. The influence of adverse reactions on donation was examined in two ways: Kaplan-Meier curves were generated to determine the cumulative pattern of first return, and adjusted odds ratios (AORs) for demographic and other factors positively and negatively associated with return were estimated using multivariable logistic regression. Donors who had major reactions had longer times to return than donors with minor or no reactions. The AOR of returning for donors with major reactions was 0.32 (95% confidence interval [CI], 0.28-0.37) and with minor reactions 0.59 (95% CI, 0.56-0.62) when compared to donors who did not have reactions. Conversely, the most important factors positively associated with return were the number of donations in the previous year and increasing age. Subsequent return, whether a major, minor, or no reaction occurred, varied by blood center. Factors that are associated with the risk of having adverse reactions were not substantial influences on the return after adverse reactions. Having an adverse reaction leads to significantly lower odds of subsequent donation irrespective of previous donation history. Factors that have been associated with a greater risk of adverse reactions were not important positive or negative predictors of return after a reaction. © 2011 American Association of Blood Banks.

  3. Extraction of fault component from abnormal sound in diesel engines using acoustic signals

    NASA Astrophysics Data System (ADS)

    Dayong, Ning; Changle, Sun; Yongjun, Gong; Zengmeng, Zhang; Jiaoyi, Hou

    2016-06-01

    In this paper a method for extracting fault components from abnormal acoustic signals and automatically diagnosing diesel engine faults is presented. The method named dislocation superimposed method (DSM) is based on the improved random decrement technique (IRDT), differential function (DF) and correlation analysis (CA). The aim of DSM is to linearly superpose multiple segments of abnormal acoustic signals because of the waveform similarity of faulty components. The method uses sample points at the beginning of time when abnormal sound appears as the starting position for each segment. In this study, the abnormal sound belonged to shocking faulty type; thus, the starting position searching method based on gradient variance was adopted. The coefficient of similar degree between two same sized signals is presented. By comparing with a similar degree, the extracted fault component could be judged automatically. The results show that this method is capable of accurately extracting the fault component from abnormal acoustic signals induced by faulty shocking type and the extracted component can be used to identify the fault type.

  4. Career Length and Performance Among Professional Baseball Players Returning to Play After Hip Arthroscopy.

    PubMed

    Frangiamore, Salvatore J; Mannava, Sandeep; Briggs, Karen K; McNamara, Shannen; Philippon, Marc J

    2018-05-01

    Hip arthroscopy has been shown to be effective for management of symptomatic femoroacetabular impingement (FAI) in professional athletes; however, it is unclear how hip arthroscopy affects career length and performance when professional baseball players return to play. To determine the career length, performance, and return-to-play rates of professional baseball players after undergoing arthroscopy for symptomatic FAI. Case series; Level of evidence, 4. Forty-four professional baseball players (51 hips) underwent hip arthroscopy for FAI between 2000 and 2015 by a single surgeon. Data were retrieved for each player from MLB.com , MiLB.com , Baseballreference.com , and individual team websites. Age, surgical procedure, and intraoperative findings were also used in analysis. Return to play was defined as playing in a preseason or regular season major or minor league game after arthroscopy. Career length was measured as total years played before and after arthroscopy. Performance measures included earned run average for pitchers, batting average for position players, and games played for all players. Of the 44 players, there were 21 pitchers and 23 position players. Ninety-five percent (n = 42) were able to return to professional baseball after hip arthroscopy. The mean career length for all players was 9.5 years. The mean career length after return to play was 3.6 seasons (range, 1-14 seasons). Pitchers had a mean career length of 8.7 years (3.3 after surgery), and position players averaged a career length of 10 years (3.9 after surgery). There were no differences in performance measures between preinjury and postoperative values. Professional baseball players undergoing hip arthroscopy for FAI returned to sport and had similar performance as they did before injury. The average career length was 9.5 years. In our study cohort, more pitchers than position players underwent hip arthroscopy. Hip arthroscopy appears to be an effective surgical intervention, allowing for return to play after complete recovery.

  5. Diagnostic classification of macular ganglion cell and retinal nerve fiber layer analysis: differentiation of false-positives from glaucoma.

    PubMed

    Kim, Ko Eun; Jeoung, Jin Wook; Park, Ki Ho; Kim, Dong Myung; Kim, Seok Hwan

    2015-03-01

    To investigate the rate and associated factors of false-positive diagnostic classification of ganglion cell analysis (GCA) and retinal nerve fiber layer (RNFL) maps, and characteristic false-positive patterns on optical coherence tomography (OCT) deviation maps. Prospective, cross-sectional study. A total of 104 healthy eyes of 104 normal participants. All participants underwent peripapillary and macular spectral-domain (Cirrus-HD, Carl Zeiss Meditec Inc, Dublin, CA) OCT scans. False-positive diagnostic classification was defined as yellow or red color-coded areas for GCA and RNFL maps. Univariate and multivariate logistic regression analyses were used to determine associated factors. Eyes with abnormal OCT deviation maps were categorized on the basis of the shape and location of abnormal color-coded area. Differences in clinical characteristics among the subgroups were compared. (1) The rate and associated factors of false-positive OCT maps; (2) patterns of false-positive, color-coded areas on the GCA deviation map and associated clinical characteristics. Of the 104 healthy eyes, 42 (40.4%) and 32 (30.8%) showed abnormal diagnostic classifications on any of the GCA and RNFL maps, respectively. Multivariate analysis revealed that false-positive GCA diagnostic classification was associated with longer axial length and larger fovea-disc angle, whereas longer axial length and smaller disc area were associated with abnormal RNFL maps. Eyes with abnormal GCA deviation map were categorized as group A (donut-shaped round area around the inner annulus), group B (island-like isolated area), and group C (diffuse, circular area with an irregular inner margin in either). The axial length showed a significant increasing trend from group A to C (P=0.001), and likewise, the refractive error was more myopic in group C than in groups A (P=0.015) and B (P=0.014). Group C had thinner average ganglion cell-inner plexiform layer thickness compared with other groups (group A=B>C, P=0.004). Abnormal OCT diagnostic classification should be interpreted with caution, especially in eyes with long axial lengths, large fovea-disc angles, and small optic discs. Our findings suggest that the characteristic patterns of OCT deviation map can provide useful clues to distinguish glaucomatous changes from false-positive findings. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  6. Serology for brucellosis

    MedlinePlus

    ... are most likely to get this disease. Normal Results A normal (negative) result usually means you have ... meaning of your specific test results. What Abnormal Results Mean An abnormal (positive) result usually means you ...

  7. Twitter sentiment around the Earnings Announcement events

    PubMed Central

    Grčar, Miha

    2017-01-01

    We investigate the relationship between social media, Twitter in particular, and stock market. We provide an in-depth analysis of the Twitter volume and sentiment about the 30 companies in the Dow Jones Industrial Average index, over a period of three years. We focus on Earnings Announcements and show that there is a considerable difference with respect to when the announcements are made: before the market opens or after the market closes. The two different timings of the Earnings Announcements were already investigated in the financial literature, but not yet in the social media. We analyze the differences in terms of the Twitter volumes, cumulative abnormal returns, trade returns, and earnings surprises. We report mixed results. On the one hand, we show that the Twitter sentiment (the collective opinion of the users) on the day of the announcement very well reflects the stock moves on the same day. We demonstrate this by applying the event study methodology, where the polarity of the Earnings Announcements is computed from the Twitter sentiment. Cumulative abnormal returns are high (2–4%) and statistically significant. On the other hand, we find only weak predictive power of the Twitter sentiment one day in advance. It turns out that it is important how to account for the announcements made after the market closes. These after-hours announcements draw high Twitter activity immediately, but volume and price changes in trading are observed only on the next day. On the day before the announcements, the Twitter volume is low, and the sentiment has very weak predictive power. A useful lesson learned is the importance of the proper alignment between the announcements, trading and Twitter data. PMID:28235103

  8. Twitter sentiment around the Earnings Announcement events.

    PubMed

    Gabrovšek, Peter; Aleksovski, Darko; Mozetič, Igor; Grčar, Miha

    2017-01-01

    We investigate the relationship between social media, Twitter in particular, and stock market. We provide an in-depth analysis of the Twitter volume and sentiment about the 30 companies in the Dow Jones Industrial Average index, over a period of three years. We focus on Earnings Announcements and show that there is a considerable difference with respect to when the announcements are made: before the market opens or after the market closes. The two different timings of the Earnings Announcements were already investigated in the financial literature, but not yet in the social media. We analyze the differences in terms of the Twitter volumes, cumulative abnormal returns, trade returns, and earnings surprises. We report mixed results. On the one hand, we show that the Twitter sentiment (the collective opinion of the users) on the day of the announcement very well reflects the stock moves on the same day. We demonstrate this by applying the event study methodology, where the polarity of the Earnings Announcements is computed from the Twitter sentiment. Cumulative abnormal returns are high (2-4%) and statistically significant. On the other hand, we find only weak predictive power of the Twitter sentiment one day in advance. It turns out that it is important how to account for the announcements made after the market closes. These after-hours announcements draw high Twitter activity immediately, but volume and price changes in trading are observed only on the next day. On the day before the announcements, the Twitter volume is low, and the sentiment has very weak predictive power. A useful lesson learned is the importance of the proper alignment between the announcements, trading and Twitter data.

  9. Transient elastography as a noninvasive assessment tool for hepatopathies of different etiology in pediatric type 1 diabetes mellitus.

    PubMed

    Elkabbany, Zeinab A; Elbarbary, Nancy S; Ismail, Eman A; Mohamed, Nesrine A; Ragab, Dina; Abdel Alem, Shereen; Ezzat, Yasmine M; Maurice, Sarah S; Hashem, Noha U

    2017-01-01

    To identify the prevalence and effect of hepatopathies of different etiologies among pediatric patients with type 1 diabetes mellitus (T1DM) using transient elastography (TE) and its relation to glycemic control. One hundred T1DM patients were studied focusing on liver functions, fasting lipid profile, hemoglobin A1c (HbA1c), hepatitis C virus (HCV), serum immunoglobulins, autoimmune antibodies; anti-nuclear antibody (ANA), anti-smooth muscle antibody (ASMA), and anti-liver kidney microsomal antibody (anti-LKM). Abdominal ultrasound was performed and TE was done for patients with HCV, positive autoimmune antibody and/or abnormal ultrasound findings. Thirty-one patients were found to have one or more hepatic abnormalities; clinical hepatomegaly in 8%, elevated alanine aminotransferase (ALT) in 10%, HCV in 6%, autoimmune hepatitis (AIH) in 11% (10 were positive for ASMA and 2 were positive for ANA while anti-LKM antibodies were negative) and abnormal hepatic ultrasound in 20% (12 non-alcoholic fatty liver disease, 5 AIH, 2 HCV, 1 Mauriac syndrome). Mean liver stiffness in those 31 patients was 7.0±2.1kPa (range, 3.1-11.8kPa); 24 were Metavir F0-F1, 7 were F2-F3 while none was F4. Type 1 diabetic patients with abnormal hepatic ultrasound had higher fasting blood glucose, HbA1c and total cholesterol than those with normal findings. Liver stiffness was significantly higher in patients with abnormal liver ultrasound compared with normal sonography. Liver stiffness was positively correlated to HbA1c and ALT. Hepatic abnormalities are prevalent in T1DM and related to poor metabolic control. TE provides a non-invasive method for detection of hepatopathy-induced fibrosis. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Audit of paired anal cytology and histopathology outcomes in patients referred to a public sexual health clinic.

    PubMed

    Williams, Vincent M; Metcalf, Cecily; French, Martyn A; McCloskey, Jenny C

    2010-09-01

    The level of agreement between anal cytology and histopathology is not clear with only a few studies evaluating the reliability of anal specimen reporting. Australian data in relation to this are limited. The results of paired anal cytology and histopathology specimens received between 2002 and 2008 from patients who were referred within the sexual health clinic were retrieved from the anatomical pathology database. A total of 248 paired samples from 154 (21 females, 133 males) participants were extracted. Concurrent high risk human papilloma virus (hrHPV) DNA assay and HIV status for the study group were also collected. Data were tabulated according to reported grade of squamous abnormality based on the Bethesda system. Using the biopsy result as the gold standard the specificity, sensitivity, positive predictive value (PPV) and negative predictive value (NPV) for cytology were calculated and the association between grade of abnormality, HIV status and hrHPV infection estimated. Concordance between cytology and histology showed that in 204 (85%) paired samples both tests were categorised as abnormal (Kappa statistic 0.73, P = 0.013). The cytology result showed a sensitivity of 96%, specificity 14%, PPV 89% and NPV 31% when compared with histopathology. HrHPV assay was positive in 192 (80%) samples. High-grade squamous abnormalities were reported in biopsy specimens from 60% (n = 42/67) of HIV-positive subjects and 25% (n = 22/87) of HIV-negative subjects. HIV-positive individuals were more likely to be hrHPV positive, odds ratio (OR) 6.21 [95% confidence interval (CI) 2.69 to 14.34], when compared with HIV-negative subjects. Anal cytology is highly sensitive for the detection of abnormal squamous cells. While cytology has low specificity for predicting the grade of abnormality compared with biopsy outcome, its application as a screening method in asymptomatic at risk populations warrants further study.

  11. Prevalence of human papillomavirus infection & cervical abnormalities in HIV-positive women in eastern India.

    PubMed

    Chakravarty, Jaya; Chourasia, Ankita; Thakur, Minaxi; Singh, Abhishek Kumar; Sundar, Shyam; Agrawal, Nisha Rani

    2016-01-01

    India has the third highest burden of HIV and highest number of cervical cancer in the world. A cross-sectional study was performed to determine the prevalence and types of human papillomavirus (HPV) infection, and the factors associated with HPV infection and abnormal cervical cytology in HIV-positive women attending the Antiretroviral Therapy (ART) Centre in a tertiary care hospital in eastern India. We screened 216 HIV- positive women with Papanicolau smear cytology and HPV testing. HPV DNA was detected by using consensus primers followed by sequencing. Of the 216 HIV-positive women screened, 58 (26.85%) were HPV-positive; 56 (25.9%) were of high-risk (HR) HPV type. The most prevalent HPV type was HPV-16 (7.9%); non 16 and 18 HPV types were present in 17.6 per cent patients. Age ≤ 35 yr [(OR), 2.56 (1.26-5.19)], illiteracy [OR, 2.30 (1.19-4.46)], rural residence [OR, 3.99 (1.27-12.56)] and CD4 ≤ 350/µl [OR, 2.46 (1.26-4.83)] were associated with increased risk of acquisition of HPV. One hundred thirty nine (74.33%) patients had normal/ negative for intraepithelial lesions (NILM) cytology, three (1.60%) had atypical squamous cells of undetermined significance (ASCUS), 32 (17.11%) had low-grade squamous intraepithelial lesions (LSIL), 10 (5.35%) had high-grade squamous intraepithelial lesions (HSIL) and three (1.60%) had carcinoma cervix. WHO clinical Stage III and IV [OR, 2.83 (1.07-7.49)] and CD4 ≤ 350/µl [OR, 2.84 (1.30-6.20)] were risk factors for abnormal cytology. Our study showed 26.85 per cent HPV positivity in HIV infected women in this region, with HPV-16 as the commonest genotype. Abnormal cervical cytology was seen in about 25 per cent women. Regular Pap smear screening as recommended by the National AIDS Control Organization will help in early detection of cervical abnormalities in HIV- positive women.

  12. Noncystic Fibrosis Bronchiectasis: Regional Abnormalities and Response to Airway Clearance Therapy Using Pulmonary Functional Magnetic Resonance Imaging.

    PubMed

    Svenningsen, Sarah; Guo, Fumin; McCormack, David G; Parraga, Grace

    2017-01-01

    Evidence-based treatment and management for patients with bronchiectasis remain challenging. There is a need for regional disease measurements as focal distribution of disease is common. Our objective was to evaluate the ability of magnetic resonance imaging (MRI) to detect regional ventilation impairment and response to airway clearance therapy (ACT) in patients with noncystic fibrosis (CF) bronchiectasis, providing a new way to objectively and regionally evaluate response to therapy. Fifteen participants with non-CF bronchiectasis and 15 age-matched healthy volunteers provided written informed consent to an ethics board-approved Health Insurance Portability and Accountability Act-compliant protocol and underwent spirometry, plethysmography, computed tomography (CT), and hyperpolarized 3 He MRI. Bronchiectasis patients also completed a Six-Minute Walk Test, the St. George's Respiratory questionnaire, and Patient Evaluation Questionnaire (PEQ), and returned for a follow-up visit after 3 weeks of daily oscillatory positive expiratory pressure use. CT evidence of bronchiectasis was qualitatively reported by lobe, and MRI ventilation defect percent (VDP) was measured for the entire lung and individual lobes. CT evidence of bronchiectasis and abnormal VDP (14 ± 7%) was observed for all bronchiectasis patients and no healthy volunteers. There was CT evidence of bronchiectasis in all lobes for 3 patients and in 3 ± 1 lobes (range = 1-4) for 12 patients. VDP in lobes with CT evidence of bronchiectasis (19 ± 12%) was significantly higher than in lobes without CT evidence of bronchiectasis (8 ± 5%, P = .001). For patients, VDP in lung lobes with (P < .0001) and without CT evidence of bronchiectasis (P = .006) was higher than in healthy volunteers (3 ± 1%). For all patients, mean PEQ-ease-bringing-up-sputum (P = .048) and PEQ-patient-global-assessment (P = .01) were significantly improved post-oscillatory positive expiratory pressure. An improvement in regional VDP greater than the minimum clinical important difference was observed for 8 of the 14 patients evaluated. There was CT and MRI evidence of structure-function abnormalities in patients with bronchiectasis; in approximately half, there was evidence of ventilation improvements after airway clearance therapy. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  13. RETURN TO PLAY PROGRESSION FOR RUGBY FOLLOWING INJURY TO THE LOWER EXTREMITY: A CLINICAL COMMENTARY AND REVIEW OF THE LITERATURE

    PubMed Central

    Davis, Chelseana C.

    2016-01-01

    Background & Purpose Rugby requires unique demands from its players. Those involved in rehabilitation and care of these athletes must possess an understanding of both the game and various positions. There have been numerous reports focusing on the physiological demands and biomechanical analyses of various components of gameplay, but no specific progression has been developed to assist clinicians assessing the readiness to return of a player after injury. The purpose of this clinical commentary is to outline testing components, general gameplay guidelines, movement progressions, and sport and position-specific progressions related to rugby gameplay following a lower extremity injury. Description of Topic This commentary provides a recommended progression for clinical use for use in a return to rugby program. It includes metabolic considerations, advanced strengthening exercises, agility exercises, and incorporation of drills specific to the sport of rugby that may be performed with the clinician or with assistance from team members. This progression also includes testing parameters for each phase and guidance for clinicians regarding the ability to gauge readiness to return to sport. Discussion It is essential that an athlete returning to the sport of rugby undertake a guided, graduated return to sport progression to ensure safety and to decrease the risk of re-injury. This proposed return to sport progression outlines key parameters for both the sport as a whole and for various specific positions. Level of Evidence Level 5 – Clinical Commentary, Review of Literature PMID:27104062

  14. Neonatal cystic fibrosis screening

    MedlinePlus

    ... also be used to screen for CF. Normal Results If the test result is negative, the child ... further testing will likely be done. What Abnormal Results Mean An abnormal (positive) result suggests that your ...

  15. Transjugular Intrahepatic Portosystemic Shunt Dysfunction: Concordance of Clinical Findings, Doppler Ultrasound Examination, and Shunt Venography.

    PubMed

    Owen, Joshua M; Gaba, Ron Charles

    2016-01-01

    The objective of this study was to evaluate the concordance between clinical symptoms, Doppler ultrasound (US), and shunt venography for the detection of stent-graft transjugular intrahepatic portosystemic shunt (TIPS) dysfunction. Forty-one patients (M:F 30:11, median age 55 years) who underwent contemporaneous clinical exam, Doppler US, and TIPS venography between 2003 and 2014 were retrospectively studied. Clinical symptoms (recurrent ascites or variceal bleeding) were dichotomously classified as present/absent, and US and TIPS venograms were categorized in a binary fashion as normal/abnormal. US abnormalities included high/low (>190 or <90 cm/s) TIPS velocity, significant velocity rise/fall (>50 cm/s), absent flow, and return of antegrade intra-hepatic portal flow. Venographic abnormalities included shunt stenosis/occlusion and/or pressure gradient elevation. Clinical and imaging concordance rates were calculated. Fifty-two corresponding US examinations and venograms were assessed. The median time between studies was 3 days. Forty of 52 (77%) patients were symptomatic, 33/52 (64%) US examinations were abnormal, and 20/52 (38%) TIPS venograms were abnormal. Concordance between clinical symptoms and TIPS venography was 48% (25/52), while the agreement between US and shunt venography was 65% (34/52). Clinical symptoms and the US concurred in 60% (31/52) of the patients. The sensitivity of clinical symptoms and US for the detection of venographically abnormal shunts was 80% (16/20) and 85% (17/20), respectively. Both clinical symptoms and the US had low specificity (25%, 8/32 and 50%, 16/32) for venographically abnormal shunts. Clinical findings and the US had low concordance rates with TIPS venography, with acceptable sensitivity but poor specificity. These findings suggest the need for improved noninvasive imaging methods for stent-graft TIPS surveillance.

  16. Transjugular Intrahepatic Portosystemic Shunt Dysfunction: Concordance of Clinical Findings, Doppler Ultrasound Examination, and Shunt Venography

    PubMed Central

    Owen, Joshua M; Gaba, Ron Charles

    2016-01-01

    Objectives: The objective of this study was to evaluate the concordance between clinical symptoms, Doppler ultrasound (US), and shunt venography for the detection of stent-graft transjugular intrahepatic portosystemic shunt (TIPS) dysfunction. Materials and Methods: Forty-one patients (M:F 30:11, median age 55 years) who underwent contemporaneous clinical exam, Doppler US, and TIPS venography between 2003 and 2014 were retrospectively studied. Clinical symptoms (recurrent ascites or variceal bleeding) were dichotomously classified as present/absent, and US and TIPS venograms were categorized in a binary fashion as normal/abnormal. US abnormalities included high/low (>190 or <90 cm/s) TIPS velocity, significant velocity rise/fall (>50 cm/s), absent flow, and return of antegrade intra-hepatic portal flow. Venographic abnormalities included shunt stenosis/occlusion and/or pressure gradient elevation. Clinical and imaging concordance rates were calculated. Results: Fifty-two corresponding US examinations and venograms were assessed. The median time between studies was 3 days. Forty of 52 (77%) patients were symptomatic, 33/52 (64%) US examinations were abnormal, and 20/52 (38%) TIPS venograms were abnormal. Concordance between clinical symptoms and TIPS venography was 48% (25/52), while the agreement between US and shunt venography was 65% (34/52). Clinical symptoms and the US concurred in 60% (31/52) of the patients. The sensitivity of clinical symptoms and US for the detection of venographically abnormal shunts was 80% (16/20) and 85% (17/20), respectively. Both clinical symptoms and the US had low specificity (25%, 8/32 and 50%, 16/32) for venographically abnormal shunts. Conclusion: Clinical findings and the US had low concordance rates with TIPS venography, with acceptable sensitivity but poor specificity. These findings suggest the need for improved noninvasive imaging methods for stent-graft TIPS surveillance. PMID:27563495

  17. Critical congenital heart disease--utility of routine screening for chromosomal and other extracardiac malformations.

    PubMed

    Baker, Kimberly; Sanchez-de-Toledo, Joan; Munoz, Ricardo; Orr, Richard; Kiray, Shareen; Shiderly, Dana; Clemens, Michele; Wearden, Peter; Morell, Victor O; Chrysostomou, Constantinos

    2012-01-01

    Objective.  Infants with critical congenital heart disease (CHD) can have genetic and other extracardiac malformations, which add to the short- and long-term risk of morbidity and perhaps mortality. We sought to examine our center's practice of screening for extracardiac anomalies and to determine the yield of these tests among specific cardiac diagnostic categories. Design.  Retrospective review of infants admitted to the cardiac intensive care unit with a new diagnosis of CHD. Subjects were categorized into six groups: septal defects (SD), conotruncal defects (CTD), single-ventricle physiology (SV), left-sided obstructive lesions (LSO), right-sided obstructive lesions (RSO), and "other" (anomalous pulmonary venous return, Ebstein's anomaly). Screening modalities included genetic testing (karyotype and fluorescent in situ hybridization for 22q11.2 deletion), renal ultrasound (RUS), and head ultrasound (HUS). Results.  One hundred forty-one patients were identified. The incidence of cardiac anomalies was: CTD (36%), SD (18%), SV (18%), LSO (14%), RSO (3%), and "other" (8%). Overall 14% had an abnormal karyotype, 5% had a deletion for 22q11.2, 28% had an abnormal RUS and 22% had abnormal HUS. Patients in SD and SV had the highest incidence of abnormal karyotype (36% and 17%); 22q11.2 deletion was present only in CTD and LSO groups (9% and 7%, respectively); abnormal RUS and HUS were seen relatively uniformly in all categories. Premature infants had significantly higher incidence of renal 43% vs. 24%, and intracranial abnormalities 46% vs. 16%. Conclusion.  Infants with critical CHD and particularly premature infants have high incidence of genetic and other extracardiac anomalies. Universal screening for these abnormalities with ultrasonographic and genetic testing maybe warranted because early detection could impact short and long-term outcomes. © 2011 Wiley Periodicals, Inc.

  18. Do Returns to Education Matter to Schooling Participation? Evidence from India

    ERIC Educational Resources Information Center

    Kingdon, Geeta Gandhi; Theopold, Nicolas

    2008-01-01

    While it might be expected that demand for schooling will depend positively on the economic returns to education (ER) in the local labor market, in fact there is theoretical ambiguity about the sign of the schooling-ER relationship when households are liquidity-constrained. Whether the relationship is positive or negative depends on which effect…

  19. Return behavior of occasional and multigallon blood donors: the role of theory of planned behavior, self-identity, and organizational variables.

    PubMed

    Wevers, Anne; Wigboldus, Daniël H J; van Baaren, Rick; Veldhuizen, Ingrid J T

    2014-03-01

    For blood establishments it is important that blood donors return for a donation. Past research has stressed the importance of theory of planned behavior (TPB) on return behavior, but self-identity (SI) and organizational variables (OVs) might play a role as well. This study added SI and OVs to the TPB to identify the determinants for return behavior. Whole blood donors (n = 2005) completed a questionnaire assessing TPB, SI, and OVs. OVs contained "perceived satisfaction with the blood bank" and "feeling pressure from the blood bank to donate blood." Return behavior over the past 2 years was dichotomized as low return (0%-50%) versus high return (51%-100%). Logistic regression analyses assessed the effects of TPB, SI, and OVs on high return, separately for occasional donors (two to 10 lifetime donations) and multigallon donors (>10 lifetime donations). Results showed that, for all donors, affective attitude was positively associated with return behavior, whereas pressure to donate blood was negatively associated with return behavior. The point estimates of self-efficacy, SI, and perceived satisfaction are high for multigallon donors, but do not reach significance. For all donors, positive feelings about donating blood stimulate return behavior, while experiencing a pressure to donate blood emanating from the blood bank was not beneficial. Results suggest that multigallon donors are more stimulated to return when they score higher on self-efficacy, SI, and perceived satisfaction. Interventions aiming at donor retention need to be carefully formulated to avoid negative effects of feeling pressure to donate blood. © 2013 American Association of Blood Banks.

  20. Clinostat exposure and symmetrization of frog eggs

    NASA Technical Reports Server (NTRS)

    Nace, G. W.; Tremor, J. W.

    1982-01-01

    Since the orientation of unfertilized eggs and the righting of eggs after grey crescent formation do not affect the axes, attention here is directed toward a comparative study of the initial rotation of the fertilized egg, the so-called rotation of orientation (R-of-O). The goal of the investigation is to determine the timing and dynamics of the R-of-O (as distinct from inversion rotations), to confirm prior observations, and to examine the influence of gravity compensation at periods that might be crucial. Gravity compensation for 1 hr during the R-of-O is found to yield fewer abnormalities. It is hypothesized that it changes the axes and that return to normal conditions permits regulation. Longer exposure is found to yield more abnormalities, perhaps by perturbing both the action of the aster and regulation.

  1. Clozapine-induced EEG abnormalities and clinical response to clozapine.

    PubMed

    Risby, E D; Epstein, C M; Jewart, R D; Nguyen, B V; Morgan, W N; Risch, S C; Thrivikraman, K V; Lewine, R L

    1995-01-01

    The authors hypothesized that patients who develop gross EEG abnormalities during clozapine treatment would have a less favorable outcome than patients who did not develop abnormal EEGs. The clinical EEGs and the Brief Psychiatric Rating Scale (BPRS) scores of 12 patients with schizophrenia and 4 patients with schizoaffective disorder were compared before and during treatment with clozapine. Eight patients developed significant EEG abnormalities on clozapine; 1 showed worsening of an abnormal pre-clozapine EEG; none of these subjects had clinical seizures. BPRS scores improved significantly in the group of patients who developed abnormal EEGs but not in the group who did not. Findings are consistent with previous reports of a high incidence of clozapine-induced EEG abnormalities and a positive association between these abnormalities and clinical improvement.

  2. Video Taping and Abnormal Psychology: Dramatized Clinical Interviews.

    ERIC Educational Resources Information Center

    Lyons, Michael J.; And Others

    1984-01-01

    Students in an abnormal psychology course worked in teams to produce dramatizations of diagnostic interviews and then presented them in class. Positive and negative aspects of the activity are discussed. (RM)

  3. Optical and electrical observations of an abnormal triggered lightning event with two upward propagations

    NASA Astrophysics Data System (ADS)

    Zheng, Dong; Zhang, Yijun; Lu, Weitao; Zhang, Yang; Dong, Wansheng; Chen, Shaodong; Dan, Jianru

    2012-08-01

    This study investigates an abnormal artificially triggered lightning event that produced two positive upward propagations: one during the initial stage (i.e., the upward leader (UL)) and the other after a negative downward aborted leader (DAL). The triggered lightning was induced in a weak thunderstorm over the experiment site and did not produce a return stroke. All of the intra-cloud lightning around the experiment site produced positive changes in the electric field. The initial stage was a weak discharge process. A downward dart leader propagated along the channel produced by the first UL, ending at a height of approximately 453 m and forming a DAL. Under the influence of the DAL, the electric field at a point located 78 m from the rod experienced a steady reduction of about 6.8 kV m-1 over 5.24 ms prior to the initiation of a new upward channel (i.e., the second upward propagation (UP)). The second UP, which started approximately 4.1 ms after the termination of the DAL and propagated along the original channel, was triggered by the DAL and sustained for approximately 2.95 ms. Two distinct current pulses were superimposed on the current of the second UP. The first pulse, which was related to the sudden initiation of the second UP, was characterized by a more rapid increase and decrease and a larger peak value than the second pulse, which was related to the development of the second UP into the area affected by the DAL. The second UP contained both a similar-to-leader process and a following neutralization process. This study introduces a new type of triggering leader, in which a new upward discharge is triggered in an established channel by an aborted leader propagating along the same channel with opposite polarity and propagation direction.

  4. Ongoing Recovery Basic Information Tool (ORBIT)

    NASA Technical Reports Server (NTRS)

    Oberg, Donald

    1993-01-01

    The Federal Drug Free Work Place Program (DFWP) has now matured to the point of being able to return employees to sensitive testing designated positions (TDP) after completion of treatment of their addiction. The known tendency of addicted individuals to suffer multiple relapses prior to their final recovery has resulted in several positive urine tests (relapses) occurring among those Federal employees who have already completed treatment and who have been returned to TDP's. The very real potential for further relapses occurring after additional employees return to TDP's will be a critical factor in the ultimate success of the DFWP and in the public's impression of the program's effectiveness. In response to this concern, NASA has begun development of its Ongoing Recovery Basic Information Tool (ORBIT) instrument. The aim of the NASA ORBIT is to provide Employee Assistance Program (EAP) professionals with an advanced clinical tool which will be helpful in supporting recovery from substance abuse and which will allow more accurate determinations of when clients may be successfully returned to sensitive positions.

  5. Infectious mononucleosis and the spleen.

    PubMed

    Kinderknecht, James J

    2002-04-01

    Infectious mononucleosis is an extremely common problem in the athletic population. "Mono" occurs in 3% of college students. Diagnosing infectious mononucleosis requires an understanding of the clinical features such as fever, lymphadenopathy, pharyngitis, and splenomegaly, as well as laboratory findings. The time at which these clinical features and laboratory abnormalities develop is also important to understand. Splenomegaly is common, but splenic rupture is very rare. Whether an athlete may return to activity usually relates to the presence of splenomegaly and the duration of the illness. Splenic rupture has not been reported after an individual has been ill for more than 3 weeks. This article provides an overview of infectious mononucleosis. The most common complications are reviewed and the management of these problems discussed. A practical approach to determining when an athlete may return to activity is presented.

  6. An electrophysiological investigation of emotional abnormalities in groups at risk for schizophrenia-spectrum personality disorders.

    PubMed

    Martin, Elizabeth A; Karcher, Nicole R; Bartholow, Bruce D; Siegle, Greg J; Kerns, John G

    2017-03-01

    Both extreme levels of social anhedonia (SocAnh) and perceptual aberration/magical ideation (PerMag) are associated with risk for schizophrenia-spectrum disorders and with emotional abnormalities. Yet, the nature of any psychophysiological-measured affective abnormality, including the role of automatic/controlled processes, is unclear. We examined the late positive potential (LPP) during passive viewing (to assess automatic processing) and during cognitive reappraisal (to assess controlled processing) in three groups: SocAnh, PerMag, and controls. The SocAnh group exhibited an increased LPP when viewing negative images. Further, SocAnh exhibited greater reductions in the LPP for negative images when told to use strategies to alter negative emotion. Similar to SocAnh, PerMag exhibited an increased LPP when viewing negative images. However, PerMag also exhibited an increased LPP when viewing positive images as well as an atypical decreased LPP when increasing positive emotion. Overall, these results suggest that at-risk groups are associated with shared and unique automatic and controlled abnormalities. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Clinical experience of laboratory follow-up with noninvasive prenatal testing using cell-free DNA and positive microdeletion results in 349 cases.

    PubMed

    Schwartz, S; Kohan, M; Pasion, R; Papenhausen, P R; Platt, L D

    2018-02-01

    Screening via noninvasive prenatal testing (NIPT) involving the analysis of cell-free DNA (cfDNA) from plasma has become readily available to screen for chromosomal and DNA aberrations through maternal blood. This report reviews a laboratory's experience with follow-up of positive NIPT screens for microdeletions. Patients that were screened positive by NIPT for a microdeletion involving 1p, 4p, 5p, 15q, or 22q who underwent diagnostic studies by either chorionic villus sampling or amniocentesis were evaluated. The overall positive predictive value for 349 patients was 9.2%. When a microdeletion was confirmed, 39.3% of the cases had additional abnormal microarray findings. Unrelated abnormal microarray findings were detected in 11.8% of the patients in whom the screen positive microdeletion was not confirmed. Stretches of homozygosity in the microdeletion were frequently associated with a false positive cfDNA microdeletion result. Overall, this report reveals that while cfDNA analysis will screen for microdeletions, the positive predictive value is low; in our series it is 9.2%. Therefore, the patient should be counseled accordingly. Confirmatory diagnostic microarray studies are imperative because of the high percentage of false positives and the frequent additional abnormalities not delineated by cfDNA analysis. © 2018 John Wiley & Sons, Ltd.

  8. Leukocyte esterase urine test

    MedlinePlus

    ... the urine. This may mean you have a urinary tract infection . If this test is positive, the urine should ... Results Mean An abnormal result indicates a possible urinary tract infection. The following may turn the test abnormal even ...

  9. The returns and risks of investment portfolio in stock market crashes

    NASA Astrophysics Data System (ADS)

    Li, Jiang-Cheng; Long, Chao; Chen, Xiao-Dan

    2015-06-01

    The returns and risks of investment portfolio in stock market crashes are investigated by considering a theoretical model, based on a modified Heston model with a cubic nonlinearity, proposed by Spagnolo and Valenti. Through numerically simulating probability density function of returns and the mean escape time of the model, the results indicate that: (i) the maximum stability of returns is associated with the maximum dispersion of investment portfolio and an optimal stop-loss position; (ii) the maximum risks are related with a worst dispersion of investment portfolio and the risks of investment portfolio are enhanced by increasing stop-loss position. In addition, the good agreements between the theoretical result and real market data are found in the behaviors of the probability density function and the mean escape time.

  10. [X-ray computed tomographic abnormalities in schizophrenia. Trial of relationship with clinical data].

    PubMed

    D'Amato, T; Rochet, T; Dalery, J; Chauchat, J H; Terra, J L; Arteaga, C; Marie-Cardine, M

    1992-01-01

    Computerized tomography (CT-scan) studies in schizophrenia revealed that some patients have neuromorphological abnormalities. The structural changes consist mainly in lateral and third ventricle enlargement, and in cortical atrophy. The present study evaluates these three changes in 42 schizophrenics aged 18 to 50, compared to 24 healthy controls. Diagnosis were established from information gathered by personal interview with the SADS-LA. Clinical sub-types were evaluated according to the DSM III-R criteria. Moreover, detailed symptoms were rated according to the Positive And Negative Syndrome Scale (PANSS). CT scans were recorded in floppy disks and blindly analyzed. Schizophrenics shown significant higher mean size of lateral and third ventricles, and higher mean anterior cortical atrophy than healthy subjects. Significant differences were also found between subtypes, with more marked abnormalities in the disorganized group. The relationship between brain abnormalities and clinical symptoms recorded with the PANSS, were analysed using Pearson correlates. Positive correlations concerned mainly negative symptoms like blunted affect, emotional withdrawal, difficulties in abstract thinking, passive apathetic social withdrawal and lack of spontaneity of conversation. Positive correlations are also observed with some symptoms classified with the PANSS in the General Psychopathology scale such as mannerism and disorientation. Negative correlation concerned most of PANSS positive symptoms.

  11. Acute respiratory infections among returning Hajj pilgrims-Jordan, 2014.

    PubMed

    Al-Abdallat, Mohammad Mousa; Rha, Brian; Alqasrawi, Sultan; Payne, Daniel C; Iblan, Ibrahim; Binder, Alison M; Haddadin, Aktham; Nsour, Mohannad Al; Alsanouri, Tarek; Mofleh, Jawad; Whitaker, Brett; Lindstrom, Stephen L; Tong, Suxiang; Ali, Sami Sheikh; Dahl, Rebecca Moritz; Berman, LaShondra; Zhang, Jing; Erdman, Dean D; Gerber, Susan I

    2017-04-01

    The emergence of Middle East Respiratory Syndrome coronavirus (MERS-CoV) has prompted enhanced surveillance for respiratory infections among pilgrims returning from the Hajj, one of the largest annual mass gatherings in the world. To describe the epidemiology and etiologies of respiratory illnesses among pilgrims returning to Jordan after the 2014 Hajj. Surveillance for respiratory illness among pilgrims returning to Jordan after the 2014 Hajj was conducted at sentinel health care facilities using epidemiologic surveys and molecular diagnostic testing of upper respiratory specimens for multiple respiratory pathogens, including MERS-CoV. Among the 125 subjects, 58% tested positive for at least one virus; 47% tested positive for rhino/enterovirus. No cases of MERS-CoV were detected. The majority of pilgrims returning to Jordan from the 2014 Hajj with respiratory illness were determined to have a viral etiology, but none were due to MERS-CoV. A greater understanding of the epidemiology of acute respiratory infections among returning travelers to other countries after Hajj should help optimize surveillance systems and inform public health response practices. Published by Elsevier B.V.

  12. Partial abnormal drainage of superior and inferior caval veins into the left atrium: two case reports.

    PubMed

    Chessa, Massimo; Carminati, Mario; Cinteză, Eliza Elena; Butera, Gianfranco; Giugno, Luca; Arcidiacono, Carmelo; Piazza, Luciane; Bulescu, Nicolae Cristian; Pome, Giuseppe; Frigiola, Alessandro; Giamberti, Alessandro

    2016-01-01

    Abnormal connection of the right superior caval vein to the left atrium is an uncommon systemic vein drainage anomaly, with only a few cases reported among congenital heart disease (CHD), around 20 cases published in the medical literature. The inferior vena cava connection with the left atrium, also very rare, can appear directly or in heterotaxy. Clinical suspicion arises due to the presence of cyanosis in the absence of other specific clinical signs (without other associated CHD). We present the cases of two children with abnormal superior and inferior systemic venous return. The first case is an abnormal connection of right superior vena cava to the left atrium associated with persistent left superior vena cava draining into the right atrium through the coronary sinus. The second case is an interruption of the inferior vena cava with hemiazygos continuation, drained into the left superior vena cava, which drained into the left atrium. The diagnosis was imagistic - echocardiography and angiography. Surgical treatment solutions vary from one case to another, usually following anatomic correction. Hypoxia accompanied by cyanosis must bring into question the pathology of systemic venous drainage anomaly, after other common causes have been excluded. Surgery is indicated in all cases due to the risk associated with the presence of right-to-left shunt.

  13. [Arterial sequelae of pregnancy hypertension. Detection by carotid piezogram].

    PubMed

    Meyer-Heine, A; Asquer, J C; Lagrue, G

    1989-01-01

    High blood pressure (HTA) is characterized by elevation of pression, but also by modifications of arterial pulse wave. Carotid piezograms were used to evaluate arterial pulse wave. Diastolic blood pressure is significantly correlated with dicrotic notch pressure. The duration of dicrotic notch is negatively correlated with arterial wall elasticity. Thus by carotid piezogram analysis one can determine the respective participation of arterial wall elasticity, peripheral resistance and cardiac factors in blood pressure elevation. Carotid piezograms were measured in 97 women (mean age 27, 8 y), with previous hypertensive pregnancy and apparently cured (mean blood pressure 122-74 mmHg at time of examination). 25 women only had normal piezogram drawing. Abnormalities similar to that of permanent hypertensive disease were observed in most cases. Dicrotic notch duration was significantly reduced and dicrotic notch pressure enhanced; in 34 women both of these abnormalities were present. In conclusion, among women previously hypertensive during pregnancy, even when blood pressure is returned to normal, abnormalities of arterial pulse wave may be present, suggesting that these women are prone to subsequent permanent hypertension.

  14. Follow-Up of Abnormal Breast and Colorectal Cancer Screening by Race/Ethnicity.

    PubMed

    McCarthy, Anne Marie; Kim, Jane J; Beaber, Elisabeth F; Zheng, Yingye; Burnett-Hartman, Andrea; Chubak, Jessica; Ghai, Nirupa R; McLerran, Dale; Breen, Nancy; Conant, Emily F; Geller, Berta M; Green, Beverly B; Klabunde, Carrie N; Inrig, Stephen; Skinner, Celette Sugg; Quinn, Virginia P; Haas, Jennifer S; Schnall, Mitchell; Rutter, Carolyn M; Barlow, William E; Corley, Douglas A; Armstrong, Katrina; Doubeni, Chyke A

    2016-10-01

    Timely follow-up of abnormal tests is critical to the effectiveness of cancer screening, but may vary by screening test, healthcare system, and sociodemographic group. Timely follow-up of abnormal mammogram and fecal occult blood testing or fecal immunochemical tests (FOBT/FIT) were compared by race/ethnicity using Population-Based Research Optimizing Screening through Personalized Regimens consortium data. Participants were women with an abnormal mammogram (aged 40-75 years) or FOBT/FIT (aged 50-75 years) in 2010-2012. Analyses were performed in 2015. Timely follow-up was defined as colonoscopy ≤3 months following positive FOBT/FIT; additional imaging or biopsy ≤3 months following Breast Imaging Reporting and Data System Category 0, 4, or 5 mammograms; or ≤9 months following Category 3 mammograms. Logistic regression was used to model receipt of timely follow-up adjusting for study site, age, year, insurance, and income. Among 166,602 mammograms, 10.7% were abnormal; among 566,781 FOBT/FITs, 4.3% were abnormal. Nearly 96% of patients with abnormal mammograms received timely follow-up versus 68% with abnormal FOBT/FIT. There was greater variability in receipt of follow-up across healthcare systems for positive FOBT/FIT than for abnormal mammograms. For mammography, black women were less likely than whites to receive timely follow-up (91.8% vs 96.0%, OR=0.71, 95% CI=0.51, 0.97). For FOBT/FIT, Hispanics were more likely than whites to receive timely follow-up than whites (70.0% vs 67.6%, OR=1.12, 95% CI=1.04, 1.21). Timely follow-up among women was more likely for abnormal mammograms than FOBT/FITs, with small variations in follow-up rates by race/ethnicity and larger variation across healthcare systems. Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.

  15. Cloud-to-ground lightning flash characteristics from June 1984 through May 1985

    NASA Technical Reports Server (NTRS)

    Orville, Richard E.; Weisman, Robert A.; Pyle, Richard B.; Henderson, Ronald W.; Orville, Richard E., Jr.

    1987-01-01

    A magnetic direction-finding network for the detection of lightning cloud-to-ground strikes has been installed along the east coast of the United States. Time, location, flash polarity, stroke count, and peak signal amplitude are recorded in real time. The data were recorded from Maine to North Carolina and as far west as Ohio; analyses were restricted to flashes within 300 km of a direction finder. Measurements of peak signal strength have been obtained from 720,284 first return strokes lowering negative charge. The resulting distribution indicates that few negative strokes have peak currents exceeding 100 kA. Measurements have also been obtained of peak signal strength from 17,694 first return strokes lowering positive charge. These strokes have a median peak current of 45 kA, with some peak currents reaching 300-400 kA. The median peak signal strength and the peak current, double from summer to winter for both negative and positive first return strokes. The polarity of ground flashes is observed to be less than 5 percent positive throughout the summer and early fall, then increases to over 50 percent during the winter, and returns to less than 10 percent in early spring. The percent of positive flashes with one stroke is observed to be approximately 90 percent throughout the year. The percent of negative flashes with one stroke is observed to increase from 40 percent in the summer to approximately 80 percent in January, returning to less than 50 percent in the spring.

  16. 49 CFR 655.46 - Return to duty following refusal to submit to a test, verified positive drug test result and/or...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Return to duty following refusal to submit to a test, verified positive drug test result and/or breath alcohol test result of 0.04 or greater. 655.46 Section 655.46 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION...

  17. 49 CFR 655.46 - Return to duty following refusal to submit to a test, verified positive drug test result and/or...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Return to duty following refusal to submit to a test, verified positive drug test result and/or breath alcohol test result of 0.04 or greater. 655.46 Section 655.46 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION...

  18. 49 CFR 655.46 - Return to duty following refusal to submit to a test, verified positive drug test result and/or...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Return to duty following refusal to submit to a test, verified positive drug test result and/or breath alcohol test result of 0.04 or greater. 655.46 Section 655.46 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION...

  19. 49 CFR 655.46 - Return to duty following refusal to submit to a test, verified positive drug test result and/or...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Return to duty following refusal to submit to a test, verified positive drug test result and/or breath alcohol test result of 0.04 or greater. 655.46 Section 655.46 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION...

  20. 49 CFR 655.46 - Return to duty following refusal to submit to a test, verified positive drug test result and/or...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Return to duty following refusal to submit to a test, verified positive drug test result and/or breath alcohol test result of 0.04 or greater. 655.46 Section 655.46 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION...

  1. Transendoscopic, laser-assisted ventriculocordectomy for treatment of left laryngeal hemiplegia in horses: 22 cases (1999-2005).

    PubMed

    Henderson, Cortney E; Sullins, Kenneth E; Brown, Jennifer A

    2007-12-15

    To determine long-term effects of transendoscopic, laser-assisted ventriculocordectomy (LAVC) on airway noise and performance in horses with naturally occurring left laryngeal hemiplegia. Retrospective case series. 22 horses with left laryngeal hemiplegia treated by means of LAVC. Medical records were reviewed and initial complaint, intended use of the horse, duration of abnormal airway noise, preoperative performance level, endoscopic findings, surgical procedure, postoperative treatment, and complications were recorded. Follow-up telephone interviews with owners and trainers were conducted to determine time for return to intended use, level of postoperative performance, and percentage reduction in airway noise. All horses were examined because of excessive airway noise; 10 (45%) had concurrent exercise intolerance. Left ventriculocordectomy was performed in all 22 horses; bilateral ventriculocordectomy (right ventriculocordectomy was done 1 year later) was performed in 1 horse (5%). Complications occurred in 3 (14%) horses. Twenty (91%) horses returned to their intended use. Excessive airway noise was eliminated after surgery in 18 (82%) horses; exercise intolerance improved postoperatively in 8 of 10 horses. Three racing Thoroughbreds returned to racing; 1 additional racehorse returned to racing but required a laryngoplasty 1 year later to continue racing. Results suggested that LAVC was an effective procedure for elimination of excessive airway noise and improvement of performance in horses with left laryngeal hemiplegia.

  2. Some Further Evidence on the Rate of Return to Schooling and the Business Cycle.

    ERIC Educational Resources Information Center

    King, Randall H.

    1980-01-01

    The business cycle has a strong impact on calculated rates of return to schooling. Cross-sectional rates of return are positively related to the unemployment rate in the year the cross-section is taken. The sensitivity of the relationship was not found to be substantially different among the races. (CT)

  3. Domestic Aerial Surveillance and Homeland Security: Should Americans Fear the Eye in the Sky?

    DTIC Science & Technology

    2014-03-01

    In this case, an individual in North Dakota barricaded himself inside his property after officials ordered him to return six cows that wondered onto...www.hsdl.org/?view&did=737816. 24 Donald F. Kettl, System under Stress : Homeland Security and American Politics (Washington, DC: CQ, 2007), 113-115...police used a thermal imaging device to detect abnormal levels of heat radiating from the home of Danny Kyllo. Officials entered his home without a

  4. Women and men who have served in Afghanistan/Iraq: coming home.

    PubMed

    Beder, Joan; Coe, Ray; Sommer, Darren

    2011-01-01

    The experience of war changes people - some will acknowledge that the changes are positive and some will feel the opposite or a combination, but that it changes a person cannot be disputed. For those who return, the experience of reintegration to civilian life or as a respite before redeployment can present numerous challenges. The research presented in this article reports the findings on interviews with over 800 service members who had returned from either Afghanistan or Iraq. The Post Deployment Reintegration Scale was used to refine the areas that respondents identified as positive or negative in their reintegration experience. Implications for practice with returning service members are noted.

  5. Strategies to support nurse work reintegration after deployment constructed from analysis of army nurses' redeployment experiences.

    PubMed

    Hopkins-Chadwick, Denise L

    2012-01-01

    Many military nurses find a period of transition is necessary in order to fully return to work after deployment. Coworkers and supervisors can be a positive or negative force in that transition. Using data from a larger study, evidence-based strategies to support nurses who return to nursing work after deployment were developed. Having an understanding of what returning nurses say about their "coming home" phase can help coworkers and supervisors be a positive force in work transition. A table of tasks with explanations is provided to assist coworkers and supervisors in facilitating the transition back to noncombat nurse work.

  6. Correlation between pesticide use in agriculture and adverse birth outcomes in Brazil: an ecological study.

    PubMed

    de Siqueira, Marília Teixeira; Braga, Cynthia; Cabral-Filho, José Eulálio; Augusto, Lia Giraldo da Silva; Figueiroa, José Natal; Souza, Ariani Impieri

    2010-06-01

    This ecological study analyzed the association between pesticide use and prematurity, low weight and congenital abnormality at birth, infant death by congenital abnormality, and fetal death in Brazil in 2001. Simple linear regression analysis has determined a positive association between pesticide use and prematurity, low birth weight, and congenital abnormality. The association between pesticide use and low birth weight (p = 0.045) and, congenital abnormality (p = 0.004) and infant death rate by congenital abnormality (p = 0.039) remained after the adjustment made by the proportion of pregnant women with a low number of prenatal care visits.

  7. KENNEDY SPACE CENTER, FLA. - Workers in NASA Spacecraft Hangar AE position the Space Infrared Telescope Facility (SIRTF), which has been returned to the hangar from the launch pad, for further processing. SIRTF will remain in the clean room until it returns to the pad in early August. One of NASA's largest infrared telescopes to be launched, SIRTF will obtain images and spectra by detecting the infrared energy, or heat, radiated by objects in space.

    NASA Image and Video Library

    2003-05-02

    KENNEDY SPACE CENTER, FLA. - Workers in NASA Spacecraft Hangar AE position the Space Infrared Telescope Facility (SIRTF), which has been returned to the hangar from the launch pad, for further processing. SIRTF will remain in the clean room until it returns to the pad in early August. One of NASA's largest infrared telescopes to be launched, SIRTF will obtain images and spectra by detecting the infrared energy, or heat, radiated by objects in space.

  8. Non-invasive prenatal testing for fetal chromosomal abnormalities by low-coverage whole-genome sequencing of maternal plasma DNA: review of 1982 consecutive cases in a single center.

    PubMed

    Lau, T K; Cheung, S W; Lo, P S S; Pursley, A N; Chan, M K; Jiang, F; Zhang, H; Wang, W; Jong, L F J; Yuen, O K C; Chan, H Y C; Chan, W S K; Choy, K W

    2014-03-01

    To review the performance of non-invasive prenatal testing (NIPT) by low-coverage whole-genome sequencing of maternal plasma DNA at a single center. The NIPT result and pregnancy outcome of 1982 consecutive cases were reviewed. NIPT was based on low coverage (0.1×) whole-genome sequencing of maternal plasma DNA. All subjects were contacted for pregnancy and fetal outcome. Of the 1982 NIPT tests, a repeat blood sample was required in 23 (1.16%). In one case, a conclusive report could not be issued, probably because of an abnormal vanished twin fetus. NIPT was positive for common trisomies in 29 cases (23 were trisomy 21, four were trisomy 18 and two were trisomy 13); all were confirmed by prenatal karyotyping (specificity=100%). In addition, 11 cases were positive for sex-chromosomal abnormalities (SCA), and nine cases were positive for other aneuploidies or deletion/duplication. Fourteen of these 20 subjects agreed to undergo further investigations, and the abnormality was found to be of fetal origin in seven, confined placental mosaicism (CPM) in four, of maternal origin in two and not confirmed in one. Overall, 85.7% of the NIPT-suspected SCA were of fetal origin, and 66.7% of the other abnormalities were caused by CPM. Two of the six cases suspected or confirmed to have CPM were complicated by early-onset growth restriction requiring delivery before 34 weeks. Fetal outcome of the NIPT-negative cases was ascertained in 1645 (85.15%). Three chromosomal abnormalities were not detected by NIPT, including one case each of a balanced translocation, unbalanced translocation and triploidy. There were no known false negatives involving the common trisomies (sensitivity=100%). Low-coverage whole-genome sequencing of maternal plasma DNA was highly accurate in detecting common trisomies. It also enabled the detection of other aneuploidies and structural chromosomal abnormalities with high positive predictive value. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.

  9. Prevalence of human papillomavirus infection & cervical abnormalities in HIV-positive women in eastern India

    PubMed Central

    Chakravarty, Jaya; Chourasia, Ankita; Thakur, Minaxi; Singh, Abhishek Kumar; Sundar, Shyam; Agrawal, Nisha Rani

    2016-01-01

    Background & objectives: India has the third highest burden of HIV and highest number of cervical cancer in the world. A cross-sectional study was performed to determine the prevalence and types of human papillomavirus (HPV) infection, and the factors associated with HPV infection and abnormal cervical cytology in HIV-positive women attending the Antiretroviral Therapy (ART) Centre in a tertiary care hospital in eastern India. Methods: We screened 216 HIV- positive women with Papanicolau smear cytology and HPV testing. HPV DNA was detected by using consensus primers followed by sequencing. Results: Of the 216 HIV-positive women screened, 58 (26.85%) were HPV-positive; 56 (25.9%) were of high-risk (HR) HPV type. The most prevalent HPV type was HPV-16 (7.9%); non 16 and 18 HPV types were present in 17.6 per cent patients. Age ≤ 35 yr [(OR), 2.56 (1.26-5.19)], illiteracy [OR, 2.30 (1.19-4.46)], rural residence [OR, 3.99 (1.27-12.56)] and CD4 ≤350/μl [OR, 2.46 (1.26-4.83)] were associated with increased risk of acquisition of HPV. One hundred thirty nine (74.33%) patients had normal/ negative for intraepithelial lesions (NILM) cytology, three (1.60%) had atypical squamous cells of undetermined significance (ASCUS), 32 (17.11%) had low-grade squamous intraepithelial lesions (LSIL), 10 (5.35%) had high-grade squamous intraepithelial lesions (HSIL) and three (1.60%) had carcinoma cervix. WHO clinical Stage III and IV [OR, 2.83 (1.07-7.49)] and CD4 ≤350/μl [OR, 2.84 (1.30-6.20)] were risk factors for abnormal cytology. Interpretation &conclusions: Our study showed 26.85 per cent HPV positivity in HIV infected women in this region, with HPV-16 as the commonest genotype. Abnormal cervical cytology was seen in about 25 per cent women. Regular Pap smear screening as recommended by the National AIDS Control Organization will help in early detection of cervical abnormalities in HIV- positive women. PMID:26997018

  10. Maternal perspectives on postpartum return to the workplace.

    PubMed

    Nichols, Mary R; Roux, Gayle M

    2004-01-01

    To describe maternal perceptions about postpartum return to the workplace. The research framework was McCubbin and McCubbin's Resiliency Model of Family Stress, Adjustment, and Adaptation. Employed, postpartum women, who resided in six different states, were recruited from day care and primary care settings to participate in this descriptive study. Seventy-four employed, married women, who returned to the workplace within one year after childbirth. As part of a larger study, perceptions about combining multiple roles after return to the workplace are the focus for this report. Participants responded to open-ended questions about their return to the workplace during the first months after giving birth. Content analysis of those responses resulted in two major categories, Resiliency Challenges: Negative Aspects (role conflict/overload, family stress, family/child issues, finances, psychosocial issues) and Resiliency Building: Positive Aspects (social support, maternal role satisfaction, positive adaptation, career role satisfaction). The data support the premise that employed women view returning to the workforce as having more challenges than they expected because the experience was viewed as being mostly negative. Preparing for return to the workplace is an important, but neglected, topic that needs to be addressed and defined more clearly in the literature. Therefore, future research is needed to identify resources and interventions that will help women experience fewer challenges associated with postpartum employment.

  11. Occult Blood Testing for Early Detection of Colorectal Cancer: Diagnostic Outcomes

    PubMed Central

    Hislop, T. Gregory; Morrison, Brenda J.; Hoogewerf, Peter E.; Burns, Sheilagh D.; Sizto, Ronald

    1987-01-01

    Three thousand five hundred and fifty-four asymptomatic persons from 32 family practices returned hemoccult II tests for colorectal cancer; 2.2% of these returned tests were positive. The diagnoses for the 47 persons with positive tests which were done while on meat restriction included six cancers (1.7/1000) and five polyps (1.4/1000); 18 were diagnosed with other known sources, and 18 were undiagnosed. All polyps and four of six cancers were diagnosed by combined barium enema with sigmoidoscopy or by colonoscopy. Five of six cancers were diagnosed at early stages. Meat restriction, the method of returning the test for analysis, the number of holes completed in the test, and the delay time from completing the test to analysis did not influence the likelihood of a positive test. PMID:20469468

  12. A STUDY OF THE EFFECT OF SUBSTITUENTS AND OF SOLVENT ON THE REACTIVITY OF THE NORMAL AND ABNORMAL POSITIONS OF UNSYMMETRICAL ORGANIC EPOXIDES

    DTIC Science & Technology

    determined by a kinetic study of the reactions of m-chloro- and 3,4-dimethylbenzylamine with styrene oxide in ethanol at 3 temperatures. The results...and o-methyl-styrene oxide with benzylamine in ethanol showed that the beta-methyl group reduces the rate of attack at both positions very...considerably, while the alpha-methyl group reduces the rate of normal attack slightly and that of abnormal attack considerably, and the o-methyl group has surprisingly little effect of the rate of attack at either position. (Author)

  13. Diagnostic yield and accuracy of coronary CT angiography after abnormal nuclear myocardial perfusion imaging.

    PubMed

    Meinel, Felix G; Schoepf, U Joseph; Townsend, Jacob C; Flowers, Brian A; Geyer, Lucas L; Ebersberger, Ullrich; Krazinski, Aleksander W; Kunz, Wolfgang G; Thierfelder, Kolja M; Baker, Deborah W; Khan, Ashan M; Fernandes, Valerian L; O'Brien, Terrence X

    2018-06-15

    We aimed to determine the diagnostic yield and accuracy of coronary CT angiography (CCTA) in patients referred for invasive coronary angiography (ICA) based on clinical concern for coronary artery disease (CAD) and an abnormal nuclear stress myocardial perfusion imaging (MPI) study. We enrolled 100 patients (84 male, mean age 59.6 ± 8.9 years) with an abnormal MPI study and subsequent referral for ICA. Each patient underwent CCTA prior to ICA. We analyzed the prevalence of potentially obstructive CAD (≥50% stenosis) on CCTA and calculated the diagnostic accuracy of ≥50% stenosis on CCTA for the detection of clinically significant CAD on ICA (defined as any ≥70% stenosis or ≥50% left main stenosis). On CCTA, 54 patients had at least one ≥50% stenosis. With ICA, 45 patients demonstrated clinically significant CAD. A positive CCTA had 100% sensitivity and 84% specificity with a 100% negative predictive value and 83% positive predictive value for clinically significant CAD on a per patient basis in MPI positive symptomatic patients. In conclusion, almost half (48%) of patients with suspected CAD and an abnormal MPI study demonstrate no obstructive CAD on CCTA.

  14. Planning for positive clinical & financial returns with telemonitoring.

    PubMed

    Wright, Kristy

    2003-10-01

    Telemonitoring is a burgeoning market in the home care industry. Making the decision to invest in telemonitoring technology can be difficult in the best situations. The financial investment is significant, the risks can be high, and the need to achieve a positive return is critical to future success. In spite of the risks, this relatively new technology in home care holds the promise for the redefinition of the industry.

  15. Effects of β-adrenergic receptor blockade on drug-related memory reconsolidation in abstinent heroin addicts.

    PubMed

    Zhao, Li-Yan; Sun, Li-Li; Shi, Jie; Li, Peng; Zhang, Yan; Lu, Lin

    2011-11-01

    The reactivation of a consolidated memory can return it to a labile state, a process referred to as reconsolidation. A previous study showed that oral administration of the β-adrenergic receptor antagonist propranolol before memory reactivation in humans erased the behavioral expression of the fear memory 24h later. In this study, we investigated whether propranolol impairs the drug-related memory by disrupting the reconsolidation process in heroin addicts. Seventy abstinent heroin addicts learned a word list (including 10 heroin-related positive words, 10 heroin-related negative words, and 10 neutral words) on day 1. Participants orally administered the β-adrenergic receptor antagonist propranolol or placebo before retrieval of the word list on day 2. Free recall of the word list and other psychological and physical responses were assessed on day 3. Oral administration of propranolol before reactivation of the word list impaired reconsolidation of drug-related positive and negative but not neutral words in abstinent heroin addicts, and these impairments critically depended on reactivation of the word list. This study extends earlier reports that a β-adrenergic receptor antagonist affects the drug-related memory reconsolidation process. Our findings may have important implications for the understanding and treatment of persistent and abnormal drug-related memories in abstinent heroin addicts. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  16. Neurophysiological Outcomes of mTBI

    DTIC Science & Technology

    2017-03-28

    position : an experimental approach to timing and working memory deficits in schizophrenia. Journal of abnormal psychology . 2004 Nov; 113(4 ):509 . Gilaie...clinical boys with hyperactive behavior: the effect of methylphenidate on motor timing. Journal of abnormal child psychology . 2003 Jun 1 ;31 (3) :301-13...disorder (ADHD). Journal of abnormal child psychology . 2005 Oct 1 ;33(5):639-54. Toplak ME, Ruckl idge JJ , Hetherington R, John SC, Tannock R. Time

  17. Comparison of renal ultrasonography and dimercaptosuccinic acid renal scintigraphy in febrile urinary tract infection.

    PubMed

    Ayazi, Parviz; Mahyar, Abolfazl; Noroozian, Elham; Esmailzadehha, Neda; Barikani, Ameneh

    2015-12-01

    Accurate and early diagnosis and appropriate treatment of patient with urinary tract infection (UTI) are essential for the prevention or restriction of permanent damage to the kidneys in children. The aim of this study was to compare renal ultrasonography (US) and dimercaptosuccinic acid (DMSA) renal scan in the diagnosis of patients with febrile urinary tract infection. This study involved the medical records of children with febrile urinary tract infection who were admitted to the children's hospital in Qazvin, Iran. Pyelonephritis was diagnosed on the basis of clinical symptoms, laboratory tests and abnormal DMSA renal scans. The criteria for abnormality of renal US were an increase or a decrease in diffuse or focal parenchymal echogenicity, loss of corticomedullary differentiation, kidney position irregularities, parenchymal reduction and increased kidney size. Of the 100 study patients, 23% had an abnormal US and 46% had an abnormal DMSA renal scan. Of the latter patients, 15 had concurrent abnormal US (P value ≤ 0.03, concordance rate: 18%). Renal US had a sensitivity of 32%, specificity of 85%, positive predictive value of 65% and negative predictive value of 60%. Of the 77 patients with normal US, 31 (40.2%) had an abnormal DMSA renal scan. Despite the benefits and accessibility of renal US, its value in the diagnosis of pyelonephritis is limited.

  18. Abnormal Magnetic Field Effects on Electrogenerated Chemiluminescence

    NASA Astrophysics Data System (ADS)

    Pan, Haiping; Shen, Yan; Wang, Hongfeng; He, Lei; Hu, Bin

    2015-03-01

    We report abnormal magnetic field effects on electrogenerated chemiluminescence (MFEECL) based on triplet emission from the Ru(bpy)3Cl2-TPrA electrochemical system: the appearance of MFEECL after magnetic field ceases. In early studies the normal MFEECL have been observed from electrochemical systems during the application of magnetic field. Here, the abnormal MFEECL suggest that the activated charge-transfer [Ru(bpy)33+ … TPrA•] complexes may become magnetized in magnetic field and experience a long magnetic relaxation after removing magnetic field. Our analysis indicates that the magnetic relaxation can gradually increase the density of charge-transfer complexes within reaction region due to decayed magnetic interactions, leading to a positive component in the abnormal MFEECL. On the other hand, the magnetic relaxation facilitates an inverse conversion from triplets to singlets within charge-transfer complexes. The inverse triplet --> singlet conversion reduces the density of triplet light-emitting states through charge-transfer complexes and gives rise to a negative component in the abnormal MFEECL. The combination of positive and negative components can essentially lead to a non-monotonic profile in the abnormal MFEECL after ceasing magnetic field. Nevertheless, our experimental studies may reveal un-usual magnetic behaviors with long magnetic relaxation from the activated charge-transfer [Ru(bpy)33+ … TPrA•] complexes in solution at room temperature.

  19. The Labor Market Returns to a Community College Education for Non-Competing Students. A CAPSEE Working Paper

    ERIC Educational Resources Information Center

    Bahr, Peter Riley

    2016-01-01

    In this study, I use data from California to estimate the returns to a community college education for students who do not complete postsecondary credentials. I find strong, positive returns to completed credits in career and technical education (CTE) fields that are closely linked to employment sectors that are not credential-intensive, such as…

  20. 77 FR 58881 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing of Proposed Rule Change Relating...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-24

    ... return (before fees and expenses) of its target benchmark commodity or currency on a given day. The...% of the return (before fees and expenses) of its target benchmark commodity on a given day. The Bear... correlate positively to three times (300%) the daily return of a target benchmark, meaning a Leveraged Bull...

  1. Nonpecuniary Returns to Postsecondary Education: Examining Early Non-Wage Labor Market Outcomes among College-Goers in the United States. A CAPSEE Working Paper

    ERIC Educational Resources Information Center

    Schudde, Lauren

    2017-01-01

    While research consistently finds positive earnings returns to educational attainment, there is little evidence on postsecondary education's impact on other employment-related outcomes. Yet nonpecuniary returns to schooling are particularly important in the United States, where fringe benefits are typically tied to employment and there is a great…

  2. The evolution of discharge current and channel radius in cloud-to-ground lightning return stroke process

    NASA Astrophysics Data System (ADS)

    Fan, Tingting; Yuan, Ping; Wang, Xuejuan; Cen, Jianyong; Chang, Xuan; Zhao, Yanyan

    2017-09-01

    The spectra of two negative cloud-to-ground lightning discharge processes with multi-return strokes are obtained by a slit-less high-speed spectrograph, which the temporal resolution is 110 μs. Combined with the synchronous electrical observation data and theoretical calculation, the physical characteristics during return strokes process are analysed. A positive correlation between discharge current and intensity of ionic lines in the spectra is verified, and based on this feature, the current evolution characteristics during four return strokes are investigated. The results show that the time from peak current to the half-peak value estimated by multi point-fitting is about 101 μs-139 μs. The Joule heat in per unit length of four return strokes channel is in the order of 105J/m-106 J/m. The radius of arc discharge channel is positively related to the discharge current, and the more intense the current is, the greater the radius of channel is. Furthermore, the evolution for radius of arc core channel in the process of return stroke is consistent with the change trend of discharge current after the peak value. Compared with the decay of the current, the temperature decreases more slowly.

  3. Return to Play After Partial Lateral Meniscectomy in National Football League Athletes.

    PubMed

    Aune, Kyle T; Andrews, James R; Dugas, Jeffrey R; Cain, E Lyle

    2014-08-01

    Lateral meniscal injury is a common and possibly career-threatening injury among players in the National Football League (NFL). The rate of return to play (RTP) and factors that affect RTP after lateral meniscal injury in NFL players are currently not defined. The aims of this study were to determine the rate of RTP to regular-season NFL game play of NFL players after arthroscopic partial lateral meniscectomy and to identify factors that can predict the ability to return to play. Case series; Level of evidence, 4. Seventy-two patients undergoing 77 arthroscopic lateral partial meniscectomies were followed to determine the rate of RTP (defined as successful RTP in at least 1 regular-season NFL game after meniscectomy) and factors predicting players' ability to return to play. Perioperative variables were recorded using retrospective chart review. Players' heights and weights, dates of return, draft rounds, and counts of games, starts, and seasons both before and after meniscectomy were all collected from statistical databases maintained by the NFL. Chi-square and Student t tests were performed to assess differences among covariates with respect to an athlete's ability to return to play, and odds ratios were calculated as appropriate. All percentages were calculated as percent of total procedures performed (n = 77). Of the 77 partial lateral meniscectomies performed, 61% (n = 47) resulted in the athlete returning to play at his previous level of competition with an average length of time to RTP of 8.5 months; 19 (40%) of those who returned were still active in the NFL at the time of follow-up. Age at time of surgery, games and seasons played before surgery, and individual position were not significantly different between those who did and did not return to play. Undergoing a concomitant procedure did not affect an athlete's ability to return to play, nor did concurrent arthroscopic anterior cruciate ligament reconstruction affect a player's likelihood to return to play. Players drafted in the first 4 rounds of the NFL draft were 3.7 times more likely to return to play than players drafted after the fourth round, and players who started more than 46.2% of their games played (the mean value for this population) were 2.8 times more likely to return to play. Speed-position players (running backs, receivers, linebackers, and defensive backs) were 4.0 times less likely to return to play than non-speed position players (linemen and tight ends). The majority of NFL players undergoing arthroscopic lateral meniscectomy are able to return to play. Players selected earlier in the NFL draft and who are listed as starters in more of their games are more likely to return to play, as are linemen and tight ends. It is significantly more difficult for running backs, receivers, linebackers, and defensive backs to return to play. © 2014 The Author(s).

  4. Leishmania infections in Austrian soldiers returning from military missions abroad: a cross-sectional study.

    PubMed

    Obwaller, A G; Köhsler, M; Poeppl, W; Herkner, H; Mooseder, G; Aspöck, H; Walochnik, J

    2018-01-12

    The incidence of leishmaniasis is known to increase in conflict areas. The aims of this study were to determine the exposure to Leishmania species in Austrian soldiers returning from missions abroad and to assess possible risk factors. A retrospective explorative cross-sectional serologic study was conducted in 225 healthy Austrian soldiers returning from UN or EU peacekeeping missions in Syria, Lebanon and Bosnia and Herzegovina (BIH). Sera were tested for anti-Leishmania antibodies using a commercial enzyme-linked immunosorbent assay. All positive individuals were screened for Leishmania DNA by PCR targeting the ITS1 region using EDTA blood samples. In total, 13.3% (30/225) of the individuals tested were either positive (8%, 18/225) or borderline (5.3%, 12/225) in the enzyme-linked immunosorbent assay, with the highest seroprevalence in soldiers returning from Syria (17.8%, 18/101; 12 positive, six borderline), second from Lebanon (11.1%, 7/63; four positive, three borderline) and lowest from BIH (8.2%, 5/61; two positive, three borderline). Ten soldiers returning from Syria and one from BIH were also positive for Leishmania DNA. Six of these were identified as Leishmania donovani/infantum complex, two as L. tropica and another three as mixed infections by DNA sequencing. Epidemiologic data were collected via a questionnaire, and seropositivity was correlated with a history of insect bites that took a long time to heal (odds ratio, 5.33; 95% confidence interval, 1.23-23.04; p 0.025). Although pretravel serologic data were not available in this study, the exposure of soldiers to Leishmania spp. during their missions can be assumed to be considerable. Because even asymptomatic infections may resurge in case of emerging immunodeficiencies, adequate prevention measures seem important. Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  5. Tuberculin Skin Tests versus Interferon-Gamma Release Assays in Tuberculosis Screening among Immigrant Visa Applicants.

    PubMed

    Chuke, Stella O; Yen, Nguyen Thi Ngoc; Laserson, Kayla F; Phuoc, Nguyen Huu; Trinh, Nguyen An; Nhung, Duong Thi Cam; Mai, Vo Thi Chi; Qui, An Dang; Hai, Hoang Hoa; Loan, Le Thien Huong; Jones, Warren G; Whitworth, William C; Shah, J Jina; Painter, John A; Mazurek, Gerald H; Maloney, Susan A

    2014-01-01

    Objective. Use of tuberculin skin tests (TSTs) and interferon gamma release assays (IGRAs) as part of tuberculosis (TB) screening among immigrants from high TB-burden countries has not been fully evaluated. Methods. Prevalence of Mycobacterium tuberculosis infection (MTBI) based on TST, or the QuantiFERON-TB Gold test (QFT-G), was determined among immigrant applicants in Vietnam bound for the United States (US); factors associated with test results and discordance were assessed; predictive values of TST and QFT-G for identifying chest radiographs (CXRs) consistent with TB were calculated. Results. Of 1,246 immigrant visa applicants studied, 57.9% were TST positive, 28.3% were QFT-G positive, and test agreement was 59.4%. Increasing age was associated with positive TST results, positive QFT-G results, TST-positive but QFT-G-negative discordance, and abnormal CXRs consistent with TB. Positive predictive values of TST and QFT-G for an abnormal CXR were 25.9% and 25.6%, respectively. Conclusion. The estimated prevalence of MTBI among US-bound visa applicants in Vietnam based on TST was twice that based on QFT-G, and 14 times higher than a TST-based estimate of MTBI prevalence reported for the general US population in 2000. QFT-G was not better than TST at predicting abnormal CXRs consistent with TB.

  6. Does feeling respected influence return to work? Cross-sectional study on sick-listed patients' experiences of encounters with social insurance office staff.

    PubMed

    Lynöe, Niels; Wessel, Maja; Olsson, Daniel; Alexanderson, Kristina; Helgesson, Gert

    2013-03-23

    Previous research shows that how patients perceive encounters with healthcare staff may affect their health and self-estimated ability to return to work. The aim of the present study was to explore long-term sick-listed patients' encounters with social insurance office staff and the impact of these encounters on self-estimated ability to return to work. A random sample of long-term sick-listed patients (n = 10,042) received a questionnaire containing questions about their experiences of positive and negative encounters and item lists specifying such experiences. Respondents were also asked whether the encounters made them feel respected or wronged and how they estimated the effect of these encounters on their ability to return to work. Statistical analysis was conducted using 95% confidence intervals (CI) for proportions, and attributable risk (AR) with 95% CI. The response rate was 58%. Encounter items strongly associated with feeling respected were, among others: listened to me, believed me, and answered my questions. Encounter items strongly associated with feeling wronged were, among others: did not believe me, doubted my condition, and questioned my motivation to work. Positive encounters facilitated patients' self-estimated ability to return to work [26.9% (CI: 22.1-31.7)]. This effect was significantly increased if the patients also felt respected [49.3% (CI: 47.5-51.1)]. Negative encounters impeded self-estimated ability to return to work [29.1% (CI: 24.6-33.6)]; when also feeling wronged return to work was significantly further impeded [51.3% (CI: 47.1-55.5)]. Long-term sick-listed patients find that their self-reported ability to return to work is affected by positive and negative encounters with social insurance office staff. This effect is further enhanced by feeling respected or wronged, respectively.

  7. Postural abnormalities and contraversive pushing following right hemisphere brain damage.

    PubMed

    Lafosse, C; Kerckhofs, E; Vereeck, L; Troch, M; Van Hoydonck, G; Moeremans, M; Sneyers, C; Broeckx, J; Dereymaeker, L

    2007-06-01

    We investigated the presence of postural abnormalities in a consecutive sample of stroke patients, with either left or right brain damage, in relation to their perceived body position in space. The presence or absence of posture-related symptoms was judged by two trained therapists and subsequently analysed by hierarchical classes analysis (HICLAS). The subject classes resulting from the HICLAS model were further validated with respect to posture-related measurements, such as centre of gravity position and head position, as well as measurements related to the postural body scheme, such as the perception of postural and visual verticality. The results of the classification analysis clearly demonstrated a relation between the presence of right brain damage and abnormalities in body geometry. The HICLAS model revealed three classes of subjects: The first class contained almost all the patients without neglect and without any signs of contraversive pushing. They were mainly characterised by a normal body axis in any position. The second class were all neglect patients but predominantly without any contraversive pushing. The third class contained right brain damaged patients, all showing neglect and mostly exhibiting contraversive pushing. The patients in the third class showed a clear resistance to bringing the weight over to the ipsilesional side when the therapist attempted to make the subject achieve a vertical posture across the midline. The clear correspondence between abnormalities of the observed body geometry and the tilt of the subjective postural and visual vertical suggests that a patient's postural body geometry is characterised by leaning towards the side of space where he/she feels aligned with an altered postural body scheme. The presence of contraversive pushing after right brain damage points in to a spatial higher-order processing deficit underlying the higher frequency and severity of the axial postural abnormalities found after right brain lesions.

  8. Cardiovascular screening in adolescents and young adults: a prospective study comparing the Pre-participation Physical Evaluation Monograph 4th Edition and ECG

    PubMed Central

    Fudge, Jessie; Harmon, Kimberly G; Owens, David S; Prutkin, Jordan M; Salerno, Jack C; Asif, Irfan M; Haruta, Alison; Pelto, Hank; Rao, Ashwin L; Toresdahl, Brett G; Drezner, Jonathan A

    2015-01-01

    Background This study compares the accuracy of cardiovascular screening in active adolescents and young adults using a standardised history, physical examination and resting 12-lead ECG. Methods Participants were prospectively screened using a standardised questionnaire based on the Pre-participation Physical Evaluation Monograph 4th Edition (PPE-4), physical examination and ECG interpreted using modern standards. Participants with abnormal findings had focused echocardiography and further evaluation. Primary outcomes included disorders associated with sudden cardiac arrest (SCA). Results From September 2010 to July 2011, 1339 participants underwent screening: age 13–24 (mean 16) years, 49% male, 68% Caucasian, 17% African-American and 1071 (80%) participating in organised sports. Abnormal history responses were reported on 916 (68%) questionnaires. After physician review, 495/ 916 (54%) participants with positive questionnaires were thought to have non-cardiac symptoms and/or a benign family history and did not warrant additional evaluation. Physical examination was abnormal in 124 (9.3%) participants, and 72 (5.4%) had ECG abnormalities. Echocardiograms were performed in 586 (44%) participants for abnormal history (31%), physical examination (8%) or ECG (5%). Five participants (0.4%) were identified with a disorder associated with SCA, all with ECG-detected Wolff-Parkinson-White. The false-positive rates for history, physical examination and ECG were 31.3%, 9.3% and 5%, respectively. Conclusions A standardised history and physical examination using the PPE-4 yields a high false-positive rate in a young active population with limited sensitivity to identify those at risk for SCA. ECG screening has a low false-positive rate using modern interpretation standards and improves detection of primary electrical disease at risk of SCA. PMID:24948082

  9. Comparison of neuromuscular abnormalities between upper and lower extremities in hemiparetic stroke.

    PubMed

    Mirbagheri, M M; AliBiglou, L; Thajchayapong, M; Lilaonitkul, T; Rymer, W Z

    2006-01-01

    We studied the neuromuscular mechanical properties of the elbow and ankle joints in chronic, hemiparetic stroke patients and healthy subjects. System identification techniques were used to characterize the mechanical abnormalities of these joints and to identify the contribution of intrinsic and reflex stiffness to these abnormalities. Modulation of intrinsic and reflex stiffness with the joint angle was studied by applying PRBS perturbations to the joint at different joint angles. The experiments were performed for both spastic (stroke) and contralateral (control) sides of stroke patients and one side of healthy (normal) subjects. We found reflex stiffness gain (GR) was significantly larger in the stroke than the control side for both elbow and ankle joints. GR was also strongly position dependent in both joints. However, the modulation of GR with position was slightly different in two joints. GR was also larger in the control than the normal joints but the differences were significant only for the ankle joint. Intrinsic stiffness gain (K) was also significantly larger in the stroke than the control joint at elbow extended positions and at ankle dorsiflexed positions. Modulation of K with the ankle angle was similar for stroke, control and normal groups. In contrast, the position dependency of the elbow was different. K was larger in the control than normal ankle whereas it was lower in the control than normal elbow. However, the differences were not significant for any joint. The findings demonstrate that both reflex and intrinsic stiffness gain increase abnormally in both upper and lower extremities. However, the major contribution of intrinsic and reflex stiffness to the abnormalities is at the end of ROM and at the middle ROM, respectively. The results also demonstrate that the neuromuscular properties of the contralateral limb are not normal suggesting that it may not be used as a suitable control at least for the ankle study.

  10. A System Approach to Navy Medical Education and Training. Appendix 16. Aviation Technician.

    DTIC Science & Technology

    1974-08-31

    PHYSICAL/EMCTICNAL RESPONSE Tn ITREATMENT/DIAGNOSTIC PROCEDURES 5 Ir𔃽SERVE/REPOPT SYMPTO4S OF SIDE EFFECTS TO TREATENT/MEOICATION 6 ICHECK TEXTURE OF...SKIN, E.G. DRY, OILY, SCALY 7 ICHECK COLOR OF SKIN, E.G. CYANOSIS, BLANCHING, JAUNPICE, MOTTLING 8 ICHECK TEMPERATURE OF SKIN j 9 IPERFORM...CIRCULATION CHECK, E.G. COLOR, PULSE, TEmPERATUrE OF ISKIN, CAPILLARY RETURN 10 ICHECK SKIN FOR ABNORMAL CONDITIONS, E.G. PPESSURE SORES, IBRUISES, NEEDLE MARKS

  11. Positive attitudes and preserved high level of motor performance are important factors for return to work in younger persons after stroke: a national survey.

    PubMed

    Lindström, Britta; Röding, Jenny; Sundelin, Gunnevi

    2009-09-01

    Significant numbers of younger persons with stroke should be given the opportunity to return to work. The aim of this study was to investigate factors of importance for return to work among persons after first ever stroke, in the age range 18-55 years. A questionnaire was sent to all persons who had experienced a first ever stroke, 18-55 years of age, registered in the Swedish national quality register for stroke care, Riks-Stroke. Of the 1068 who answered the questionnaire, 855 (539 men and 316 women) were in paid employment before their stroke, and were included in this study. Sixty-five percent returned to work and, of these, an equal proportion were men and women. Significant factors associated with return to work were the perceived importance of work (odds ratio (OR) 5.10), not perceiving themselves as a burden on others (OR 3.33), support from others for return to work (OR 3.66), retaining the ability to run a short distance (OR 2.77), and higher socioeconomic codes (OR 2.12). A negative association was found between those rehabilitated in wards intended for younger persons and return to work (OR 0.37). External support from others, and positive attitudes towards return to work, were factors associated with successful return to work after stroke. Contrary to what was expected, independence in personal activities of daily living and cognitive factors were not associated with return to work to the same extent as persistent higher level of physical functions, such as ability to run a short distance.

  12. Statistical analysis on multifractal detrended cross-correlation coefficient for return interval by oriented percolation

    NASA Astrophysics Data System (ADS)

    Deng, Wei; Wang, Jun

    2015-06-01

    We investigate and quantify the multifractal detrended cross-correlation of return interval series for Chinese stock markets and a proposed price model, the price model is established by oriented percolation. The return interval describes the waiting time between two successive price volatilities which are above some threshold, the present work is an attempt to quantify the level of multifractal detrended cross-correlation for the return intervals. Further, the concept of MF-DCCA coefficient of return intervals is introduced, and the corresponding empirical research is performed. The empirical results show that the return intervals of SSE and SZSE are weakly positive multifractal power-law cross-correlated, and exhibit the fluctuation patterns of MF-DCCA coefficients. The similar behaviors of return intervals for the price model is also demonstrated.

  13. Sign realized jump risk and the cross-section of stock returns: Evidence from China's stock market.

    PubMed

    Chao, Youcong; Liu, Xiaoqun; Guo, Shijun

    2017-01-01

    Using 5-minute high frequency data from the Chinese stock market, we employ a non-parametric method to estimate Fama-French portfolio realized jumps and investigate whether the estimated positive, negative and sign realized jumps could forecast or explain the cross-sectional stock returns. The Fama-MacBeth regression results show that not only have the realized jump components and the continuous volatility been compensated with risk premium, but also that the negative jump risk, the positive jump risk and the sign jump risk, to some extent, could explain the return of the stock portfolios. Therefore, we should pay high attention to the downside tail risk and the upside tail risk.

  14. Ultrasound assessment of endometrial cavity in perimenopausal women on oral progesterone for abnormal uterine bleeding: comparison of diagnostic accuracy of imaging with hysteroscopy-guided biopsy.

    PubMed

    Dasgupta, Subhankar; Dasgupta, Shyamal; Sharma, Partha Pratim; Mukherjee, Amitabha; Ghosh, Tarun Kumar

    2011-11-01

    To investigate the effect of oral progesterone on the accuracy of imaging studies performed to detect endometrial pathology in comparison to hysteroscopy-guided biopsy in perimenopausal women on progesterone treatment for abnormal uterine bleeding. The study population comprised of women aged 40-55 years with complaints of abnormal uterine bleeding who were also undergoing oral progesterone therapy. Women with a uterus ≥ 12 weeks' gestation size, previous abnormal endometrial biopsy, cervical lesion on speculum examination, abnormal Pap smear, active pelvic infection, adnexal mass on clinical examination or during ultrasound scan and a positive pregnancy test were excluded. A transvaginal ultrasound followed by saline infusion sonography were done. On the following day, a hysteroscopy followed by a guided biopsy of the endometrium or any endometrial lesion was performed. Comparison between the results of the imaging study with the hysteroscopy and guided biopsy was done. The final analysis included 83 patients. For detection of overall pathology, polyp and fibroid transvaginal ultrasound had a positive likelihood ratio of 1.65, 5.45 and 5.4, respectively, and a negative likelihood ratio of 0.47, 0.6 and 0.43, respectively. For detection of overall pathology, polyp and fibroid saline infusion sonography had a positive likelihood ratio of 4.4, 5.35 and 11.8, respectively, and a negative likelihood ratio of 0.3, 0.2 and 0.15, respectively. In perimenopausal women on oral progesterone therapy for abnormal uterine bleeding, imaging studies cannot be considered as an accurate method for diagnosing endometrial pathology when compared to hysteroscopy and guided biopsy. © 2011 The Authors. Journal of Obstetrics and Gynaecology Research © 2011 Japan Society of Obstetrics and Gynecology.

  15. Anterior cruciate ligament- specialized post-operative return-to-sports (ACL-SPORTS) training: a randomized control trial

    PubMed Central

    2013-01-01

    Background Anterior cruciate ligament reconstruction (ACLR) is standard practice for athletes that wish to return to high-level activities; however functional outcomes after ACLR are poor. Quadriceps strength weakness, abnormal movement patterns and below normal knee function is reported in the months and years after ACLR. Second ACL injuries are common with even worse outcomes than primary ACLR. Modifiable limb-to-limb asymmetries have been identified in individuals who re-injure after primary ACLR, suggesting a neuromuscular training program is needed to improve post-operative outcomes. Pre-operative perturbation training, a neuromuscular training program, has been successful at improving limb symmetry prior to surgery, though benefits are not lasting after surgery. Implementing perturbation training after surgery may be successful in addressing post-operative deficits that contribute to poor functional outcomes and second ACL injury risk. Methods/Design 80 athletes that have undergone a unilateral ACLR and wish to return to level 1 or 2 activities will be recruited for this study and randomized to one of two treatment groups. A standard care group will receive prevention exercises, quadriceps strengthening and agility exercises, while the perturbation group will receive the same exercise program with the addition of perturbation training. The primary outcomes measures will include gait biomechanics, clinical and functional measures, and knee joint loading. Return to sport rates, return to pre-injury level of activity rates, and second injury rates will be secondary measures. Discussion The results of this ACL-Specialized Post-Operative Return To Sports (ACL-SPORTS) Training program will help clinicians to better determine an effective post-operative treatment program that will improve modifiable impairments that influence outcomes after ACLR. Trial registration Randomized Control Trial NIH 5R01AR048212-07. ClinicalTrials.gov: NCT01773317 PMID:23522373

  16. Risk-Return Relationship in a Complex Adaptive System

    PubMed Central

    Song, Kunyu; An, Kenan; Yang, Guang; Huang, Jiping

    2012-01-01

    For survival and development, autonomous agents in complex adaptive systems involving the human society must compete against or collaborate with others for sharing limited resources or wealth, by using different methods. One method is to invest, in order to obtain payoffs with risk. It is a common belief that investments with a positive risk-return relationship (namely, high risk high return and vice versa) are dominant over those with a negative risk-return relationship (i.e., high risk low return and vice versa) in the human society; the belief has a notable impact on daily investing activities of investors. Here we investigate the risk-return relationship in a model complex adaptive system, in order to study the effect of both market efficiency and closeness that exist in the human society and play an important role in helping to establish traditional finance/economics theories. We conduct a series of computer-aided human experiments, and also perform agent-based simulations and theoretical analysis to confirm the experimental observations and reveal the underlying mechanism. We report that investments with a negative risk-return relationship have dominance over those with a positive risk-return relationship instead in such a complex adaptive systems. We formulate the dynamical process for the system's evolution, which helps to discover the different role of identical and heterogeneous preferences. This work might be valuable not only to complexity science, but also to finance and economics, to management and social science, and to physics. PMID:22479416

  17. Risk-return relationship in a complex adaptive system.

    PubMed

    Song, Kunyu; An, Kenan; Yang, Guang; Huang, Jiping

    2012-01-01

    For survival and development, autonomous agents in complex adaptive systems involving the human society must compete against or collaborate with others for sharing limited resources or wealth, by using different methods. One method is to invest, in order to obtain payoffs with risk. It is a common belief that investments with a positive risk-return relationship (namely, high risk high return and vice versa) are dominant over those with a negative risk-return relationship (i.e., high risk low return and vice versa) in the human society; the belief has a notable impact on daily investing activities of investors. Here we investigate the risk-return relationship in a model complex adaptive system, in order to study the effect of both market efficiency and closeness that exist in the human society and play an important role in helping to establish traditional finance/economics theories. We conduct a series of computer-aided human experiments, and also perform agent-based simulations and theoretical analysis to confirm the experimental observations and reveal the underlying mechanism. We report that investments with a negative risk-return relationship have dominance over those with a positive risk-return relationship instead in such a complex adaptive systems. We formulate the dynamical process for the system's evolution, which helps to discover the different role of identical and heterogeneous preferences. This work might be valuable not only to complexity science, but also to finance and economics, to management and social science, and to physics.

  18. Longitudinal Analysis of Carcinogenic Human Papillomavirus Infection and Associated Cytologic Abnormalities in the Guanacaste Natural History Study: Looking Ahead to Cotesting

    PubMed Central

    Rodriguez, Ana C.; Burk, Robert D.; Hildesheim, Allan; Herrero, Rolando; Wacholder, Sholom; Hutchinson, Martha; Schiffman, Mark

    2012-01-01

    Background. Few studies have addressed the timing of cervical cytologic abnormalities and human papillomavirus (HPV) positivity during the course of an infection. It remains largely unknown how infections detected by HPV and cytology wax and wane relative to each other. The aim of this analysis was to assess the longitudinal relationship of abnormal cytology and HPV positivity in a 7-year prospective study of 2500 women in Guanacaste, Costa Rica. Methods. At each semiannual or annual visit, cervical specimens were screened using liquid-based cytology and tested for >40 HPV types with use of MY09/MY11 L1 degenerate primer polymerase chain reaction–based methods. On the basis of previous work, we separated prevalent and newly detected infections in younger and older women. Results. Among newly detected HPV- and/or cytology-positive events, HPV and cytology appeared together ∼60% of the time; when discordant, HPV tended to appear before cytology in younger and older women. Combining newly and prevalently detected events, HPV and cytology disappeared at the same time >70% of the time. When discordant, HPV tended to disappear after cytology in younger and older women. Conclusions. Detection of HPV DNA and associated cytological abnormalities tend to come and leave together; however, when discordant, detection of HPV DNA tends to precede and/or last longer than associated cytologic abnormalities. PMID:22147792

  19. Stress injuries of the pars interarticularis: Radiologic classification and indications for radionuclide imaging

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

    Pennell, R.; Maurer, A.R.; Bonakdarpour, A.

    Lumbar spine radiographs and radionuclide images were compared and correlated with clinical histories of 20 athletes with low back pain. Radiographs were classified as: Normal (Type 0); showing a healing stress fracture (an irregular lucent line) with sclerosis (Type I); as an evolving or healed stress injury with either sclerosis, narrowing, or demineralization (Type II); and as a chronic fracture showing a large lucency with well-defined margins classically referred to as spondylolysis (Type III). Patients were grouped clinically on the basis of their pain: acute onset (Group A, n = 7), acute superimposed on chronic (Group B, n = 9),more » and chronic pain without an acute event (Group C, n = 4). Radiographic abnormalities were present in 95% (19/20) of the patients and radionuclide studies were positive in 60% (12/20). Scintigraphy was positive most often with Type I pars abnormalities (77%, 10/13) and negative most often with Type III abnormalities (91%, 11/12). Of all positive scintigraphy 12/14 (86%) were in pts in Groups A and B (acute symptoms). The authors' findings support theories that radiographic pars abnormalities exist which correspond to stages in the healing of stress induced fractures. With acute symptoms radionuclide imaging need not be obtained if a Type I radiographic abnormality is seen. Radionuclide imaging is indicated with either Type 0, II or III radiographs to confirm or rule out recent stress injury.« less

  20. Comparative sensitivity of commercially available aPTT reagents to mulga snake (Pseudechis australis) venom.

    PubMed

    Lincz, Lisa F; Scorgie, Fiona E; Johnston, Christopher I; O'Leary, Margaret; Prasad, Ritam; Seldon, Michael; Favaloro, Emmanuel; Isbister, Geoffrey K

    2014-08-01

    This study aimed to determine the relative sensitivity of activated partial thromboplastin time (aPTT) reagents to the anticoagulant effects of phospholipases in mulga snake (Pseudechis australis) venom.Twenty-one haematology laboratories participating in the Royal College of Pathologists of Australasia Quality Assurance Programs were sent human plasma samples spiked with mulga venom (n=25 total results). Results for 17 patients with mulga snake envenoming were available through the Australian Snakebite Project.Only 12 of 25 venom spiked samples returned an abnormally prolonged aPTT. Tests performed with Dade Actin FS (n=7) did not identify any of the spiked samples as abnormal. Although clotting times were significantly prolonged using the lupus anticoagulant sensitive Actin FSL (n=5, p=0.043), only one was reported as abnormal. Only laboratories using TriniCLOT aPTT S (n=6), HemosIL APTT SP (n=2) and Stago PTT-A (n=1) consistently recorded the spiked sample as being above the upper normal reference interval. Abnormally prolonged aPTTs were recorded for four of eight patients whose tests were performed with Actin FSL, five of eight patients with TriniCLOT aPTT HS, and three of three patients using TriniCLOT aPTT S.We conclude that some reagents used for routine aPTT testing are relatively insensitive to the anticoagulant effects of mulga snake venom. Tests performed with these reagents should be interpreted with caution.

  1. Detection and clearance of prostate cells subsequent to ultrasound-guided needle biopsy as determined by multiplex nested reverse transcription polymerase chain reaction assay.

    PubMed

    Price, D K; Clontz, D R; Woodard, W L; Kaufman, J S; Daniels, J M; Stolzenberg, S J; Teigland, C M

    1998-08-01

    To determine if circulating prostate cells are detectable subsequent to transrectal ultrasound (TRUS)-guided biopsy, and if so, whether cells remain in circulation for up to 4 weeks. Blood samples were drawn from 90 patients with elevated serum prostate-specific antigen (PSA) levels and/or abnormal digital rectal examination. Two samples were drawn from all patients immediately prior to TRUS and 30 minutes postbiopsy. Blood samples were also obtained 1 week postbiopsy from 83 patients, and 1 month postbiopsy from 61 patients. Multiplex nested reverse transcription polymerase chain reaction assay (RT-PCR) for PSA and prostate-specific membrane antigen (PSM) was performed on total ribonucleic acid (RNA) from each sample. Results were reported as positive if at least one of the targets was detected. Of 45 patients with biopsy-proven adenocarcinoma, 22 were RT-PCR positive prebiopsy and all remained positive 30 minutes postbiopsy. Of 23 patients with adenocarcinoma who were RT-PCR negative prebiopsy, 5 (22%) converted to positive 30 minutes postbiopsy (P < 0.001). Four of these 5 patients returned to negative after 1 week or 1 month. Of 45 patients without cancer at biopsy, 32 were RT-PCR negative prebiopsy and 6 (19%) converted to positive 30 minutes postbiopsy (P < 0.001). Although four of six available samples were still positive at 1 week, all four samples available 1 month postbiopsy were negative. Detection of circulating prostate cells subsequent to biopsy occurred in 11 of 55 (20%) previously RT-PCR negative patients, a proportion twice that reported in the literature. We attribute this higher proportion to the simultaneous detection of PSA and PSM mRNA in our multiplex assay. Conversion rates were similar in patients regardless of biopsy result. Testing of serial postbiopsy blood demonstrates clearing of these cells by 4 weeks in most patients.

  2. Prenatal diagnosis of 47,XXX.

    PubMed

    Khoury-Collado, Fady; Wehbeh, Ammar N; Fisher, Allan J; Bombard, Allan T; Weiner, Zeev

    2005-05-01

    We report 2 cases of 47,XXX that were diagnosed prenatally and were screened positive for trisomy 21 by biochemical and ultrasound markers. These cases underline the importance of discussing the sex chromosome abnormalities during the genetic counseling after an abnormal triple screen test or ultrasound examination.

  3. Fruit Consumption Reduces the Risk of Esophageal Cancer in Yanting, People's Republic of China.

    PubMed

    Song, Qingkun; Zhao, Lin; Li, Jun; Ren, Jun

    2015-05-01

    This study aimed to investigate the contribution of fruit and family history to esophageal cancer, among residents with abnormal esophagus discovered in screening. The study was a frequency-matched case-control design in groups of normal esophagus, abnormal esophagus but not carcinoma, and esophageal squamous cell carcinoma. Odds ratio (OR) was estimated by unconditional logistic regression. Fruit intake (OR = 0.19, 95% CI = 0.06-0.56) and positive family history of esophageal cancer (OR = 3.87, 95% CI = 1.41-10.63) were associated with esophageal cancer compared to individuals with abnormal conditions of the esophagus. In individuals who consumed fruits at least once per week, the OR for family cancer history is reduced to a nonsignificant level (OR = 1.06, 95% CI = 0.07-15.91). In the individuals with abnormal esophagus at screening, fruit intake was possibly protective against esophageal cancer, even in the ones with positive family history. Local public health strategies should focus on the improvement in fruit intake. © 2014 APJPH.

  4. Myocardial perfusion abnormalities in asymptomatic patients with systemic lupus erythematosus

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

    Hosenpud, J.D.; Montanaro, A.; Hart, M.V.

    1984-08-01

    Accelerated coronary artery disease and myocardial infarction in young patients with systemic lupus erythematosus is well documented; however, the prevalence of coronary involvement is unknown. Accordingly, 26 patients with systemic lupus were selected irrespective of previous cardiac history to undergo exercise thallium-201 cardiac scintigraphy. Segmental perfusion abnormalities were present in 10 of the 26 studies (38.5 percent). Five patients had reversible defects suggesting ischemia, four patients had persistent defects consistent with scar, and one patient had both reversible and persistent defects in two areas. There was no correlation between positive thallium results and duration of disease, amount of corticosteroid treatment,more » major organ system involvement or age. Only a history of pericarditis appeared to be associated with positive thallium-201 results (p less than 0.05). It is concluded that segmental myocardial perfusion abnormalities are common in patients with systemic lupus erythematosus. Whether this reflects large-vessel coronary disease or small-vessel abnormalities remains to be determined.« less

  5. The sensitivity of clinical diagnostic methods in the diagnosis of diabetic neuropathy.

    PubMed

    Onde, M E; Ozge, A; Senol, M G; Togrol, E; Ozdag, F; Saracoglu, M; Misirli, H

    2008-01-01

    This study assessed the sensitivity of various methods for the clinical diagnosis of diabetic peripheral neuropathy. A total of 147 randomly selected patients with diabetes mellitus and 65 age- and sex-matched healthy controls were evaluated by various clinical (the neuropathy symptom score [NSS], the neuropathy disability score [NDS], vibration perception thresholds [VPTs], Tinel's sign and Phalen's sign), laboratory (fasting plasma glucose and glycosylated haemoglobin levels) and electro-physiological (nerve conduction studies, H-reflex and F-wave measurements) methods. In the patient group, 8.2% had an abnormal NSS, 28.5% had a positive Phalen's sign, 32.6% had a positive Tinel's sign, 42.8% had an abnormal VPT and 57.1% had an abnormal NDS. Significant correlations were found between electro-physiologically confirmed neuropathy and the two provocation tests and abnormal VPTs. In conclusion, assessment with a complete neurological examination and standard electrophysiological tests is very important for the diagnosis of diabetic peripheral neuropathy and the prevention of morbidity in patients with or without symptoms.

  6. Cervical Screening within HIV Care: Findings from an HIV-Positive Cohort in Ukraine

    PubMed Central

    Bailey, Heather; Thorne, Claire; Semenenko, Igor; Malyuta, Ruslan; Tereschenko, Rostislav; Adeyanova, Irina; Kulakovskaya, Elena; Ostrovskaya, Lyudmila; Kvasha, Liliana; Cortina-Borja, Mario; Townsend, Claire L.

    2012-01-01

    Introduction HIV-positive women have an increased risk of invasive cervical cancer but cytologic screening is effective in reducing incidence. Little is known about cervical screening coverage or the prevalence of abnormal cytology among HIV-positive women in Ukraine, which has the most severe HIV epidemic in Europe. Methods Poisson regression models were fitted to data from 1120 women enrolled at three sites of the Ukraine Cohort Study of HIV-infected Childbearing Women to investigate factors associated with receiving cervical screening as part of HIV care. All women had been diagnosed as HIV-positive before or during their most recent pregnancy. Prevalence of cervical abnormalities (high/low grade squamous intraepithelial lesions) among women who had been screened was estimated, and associated factors explored. Results Overall, 30% (337/1120) of women had received a cervical screening test as part of HIV care at study enrolment (median 10 months postpartum), a third (115/334) of whom had been tested >12 months previously. In adjusted analyses, women diagnosed as HIV-positive during (vs before) their most recent pregnancy were significantly less likely to have a screening test reported, on adjusting for other potential risk factors (adjusted prevalence ratio (APR) 0.62, 95% CI 0.51–0.75 p<0.01 for 1st/2nd trimester diagnosis and APR 0.42, 95% CI 0.28–0.63 p<0.01 for 3rd trimester/intrapartum diagnosis). Among those with a cervical screening result reported at any time (including follow-up), 21% (68/325) had a finding of cervical abnormality. In adjusted analyses, Herpes simplex virus 2 seropositivity and a recent diagnosis of bacterial vaginosis were associated with an increased risk of abnormal cervical cytology (APR 1.83 95% CI 1.07–3.11 and APR 3.49 95% CI 2.11–5.76 respectively). Conclusions In this high risk population, cervical screening coverage as part of HIV care was low and could be improved by an organised cervical screening programme for HIV-positive women. Bacterial vaginosis testing and treatment may reduce vulnerability to cervical abnormalities. PMID:22545087

  7. Unexpected death in elephantiasis due to an abnormal life-style.

    PubMed

    Sato, Hiroaki; Tanaka, Toshiko; Kasai, Kentaro; Kita, Toshiro; Tanaka, Noriyuki

    2009-11-01

    A 22-year-old man was found dead after he had continued to sit on a reclining chair for 2 years. He had consumed an unbalanced diet, kept wearing the same pair of socks and never washed himself for the term. His skin of bilateral crura developed into elephantiasis with severely festered ulcers on its surface. At autopsy, subcutaneous edema was significant in his lower limbs, and chronic circulatory disturbance of lymphoducts and veins was observed histologically. There were no crucial findings to account for chronic edema in the lower limbs. It has been reported that maintaining a seated posture obstructs both lymphoducts and veins because of bending the groin, decreases their return flow by inducing muscular atrophy, and causes subcutaneous edema in the lower limbs. Oligotrophia and dirt on his limbs might have exacerbated the chronic edema in elephantiasis. We concluded that a long-term abnormal life-style had caused fatal elephantiasis.

  8. Respiratory tract disease from thermosetting resins. Study of an outbreak in rubber tire workers.

    PubMed

    doPico, G A; Rankin, J; Chosy, L W; Reddan, W G; Barbee, R A; Gee, B; Dickie, H A

    1975-08-01

    An outbreak of upper and lower respiratory tract inflammatory disease and conjunctivitis among synthetic rubber tire workers occurred. The outbreak began after the introduction of a new thermosetting resin, containing resorcinol and a trimere of methylene aminoacetronitrile, into the rubber tire carcass stock formulation. Two hundred ten workers were affected. Characteristically, symptoms improved during periods of sick leave or vacation, recurring upon the workers' return to the plant. Chest radiograms disclosed pneumonic infiltrates in about one fourth of the cases. Pulmonary function studies detected abnormal airways dynamics as well as abnormal diffusing capacity in more than one third of the workers tested. Lung biopsy showed evidence of focal interstitial fibrosis and peribronchiolar and perivascular chronic inflammatory reaction. The illness was ascribed to volatile products released during the manufacture of synthetic rubber tires. The exact chemical nature of these products is unknown.

  9. Returns on equity for not-for-profit hospitals.

    PubMed

    Pauly, M V

    1986-04-01

    This study examines the circumstances in which a large third-party payer or regulator might want to set hospital prices to yield a positive rate of return on equity capital. The level of return is shown to depend on the willingness of donors to make funds available in the community relative to the (derived) demand for capital to produce output. It is shown that the appropriate price might well be set to yield a zero or below-market return, and that the return to not-for-profit firms should generally be less than that to for-profit firms, if for-profit firms are to be active in the market.

  10. Returns on equity for not-for-profit hospitals.

    PubMed Central

    Pauly, M V

    1986-01-01

    This study examines the circumstances in which a large third-party payer or regulator might want to set hospital prices to yield a positive rate of return on equity capital. The level of return is shown to depend on the willingness of donors to make funds available in the community relative to the (derived) demand for capital to produce output. It is shown that the appropriate price might well be set to yield a zero or below-market return, and that the return to not-for-profit firms should generally be less than that to for-profit firms, if for-profit firms are to be active in the market. PMID:3086256

  11. Clinical Utility of Circulating Tumor Cells in ALK-Positive Non-Small-Cell Lung Cancer.

    PubMed

    Faugeroux, Vincent; Pailler, Emma; Auger, Nathalie; Taylor, Melissa; Farace, Françoise

    2014-01-01

    The advent of rationally targeted therapies such as small-molecule tyrosine kinase inhibitors (TKIs) has considerably transformed the therapeutic management of a subset of patients with non-small-cell lung cancer (NSCLC) harboring defined molecular abnormalities. When such genetic molecular alterations are detected the use of specific TKI has demonstrated better results (overall response rate, progression free survival) compared to systemic therapy. However, the detection of such molecular abnormalities is complicated by the difficulty in obtaining sufficient tumor material, in terms of quantity and quality, from a biopsy. Here, we described how circulating tumor cells (CTCs) can have a clinical utility in anaplastic lymphoma kinase (ALK) positive NSCLC patients to diagnose ALK-EML4 gene rearrangement and to guide therapeutic management of these patients. The ability to detect genetic abnormalities such ALK rearrangement in CTCs shows that these cells could offer new perspectives both for the diagnosis and the monitoring of ALK-positive patients eligible for treatment with ALK inhibitors.

  12. Clinical Utility of Circulating Tumor Cells in ALK-Positive Non-Small-Cell Lung Cancer

    PubMed Central

    Faugeroux, Vincent; Pailler, Emma; Auger, Nathalie; Taylor, Melissa; Farace, Françoise

    2014-01-01

    The advent of rationally targeted therapies such as small-molecule tyrosine kinase inhibitors (TKIs) has considerably transformed the therapeutic management of a subset of patients with non-small-cell lung cancer (NSCLC) harboring defined molecular abnormalities. When such genetic molecular alterations are detected the use of specific TKI has demonstrated better results (overall response rate, progression free survival) compared to systemic therapy. However, the detection of such molecular abnormalities is complicated by the difficulty in obtaining sufficient tumor material, in terms of quantity and quality, from a biopsy. Here, we described how circulating tumor cells (CTCs) can have a clinical utility in anaplastic lymphoma kinase (ALK) positive NSCLC patients to diagnose ALK-EML4 gene rearrangement and to guide therapeutic management of these patients. The ability to detect genetic abnormalities such ALK rearrangement in CTCs shows that these cells could offer new perspectives both for the diagnosis and the monitoring of ALK-positive patients eligible for treatment with ALK inhibitors. PMID:25414829

  13. Deviations of the visual upright in three dimensions in disorders of the brainstem: a clinical exploration.

    PubMed

    Frisén, Lars

    2010-12-01

    Deviations of the subjective visual vertical in the roll or fronto-parallel plane occur commonly in disorders of the brainstem and have been extensively explored. In contrast, little is known about deviations in other directions. The present retrospective study focused on deviations in the pitch (sagittal) direction in 176 patients with a wide variety of disorders. The test task was to set a self-illuminated rod in the apparent upright position, in total darkness. Abnormal results (outside ± 4°) were recorded in 58% of the subjects. Negative (top backward) deviations were the most common, particularly with mass lesions in the pineal region, obstructive hydrocephalus, cerebellar lesions and crowding at the craniocervical junction. Positive and negative deviations were about equally common with focal intra-axial lesions. Negative deviations appeared related to dorsal locations of lesions and vice versa. Normal pressure hydrocephalus, Parkinson's disease and progressive supranuclear palsy were associated with smaller deviations, without a clear directional preponderance, and a larger individual variability. Most subjects lacked overt clinical corollaries. The most common ocular signs were aqueduct syndromes (n = 17) and ocular tilt reactions (n = 12), which were associated with deviations in 47 and 92% of instances, respectively. Subjective corollaries of deviation were never reported, not even by those subjects who showed a dramatic improvement upon resolution of the underlying condition. Deviations were also assessed in roll in a subgroup of 40 patients with focal lesions. Thirty subjects returned abnormal results: 13% in roll, 47% in pitch and 40% in pitch and roll. The direction of roll deviation appeared primarily related to laterality, with clockwise deviations with right-sided lesions and vice versa. All subjects with ocular tilt reactions had combined pitch and roll deviations, implying a common neural substrate. Correlation analyses, geometrical modelling and experimental self-observations indicated that deviations in pitch were attributable to cyclotorsional asymmetries between the eyes. The frequent co-existence of abnormal pitch and roll results implies that the true axis of deviation in focal brainstem disorders commonly falls outside traditional reference planes. The term 'visual upright in three dimensions' is suggested to identify unrestricted measurements, preserving the established term 'visual vertical' for measurements confined to the roll plane. Assessment of the visual upright in three dimensions provides a new, quantitative angle on brainstem disorders. The test appears useful for identifying a ubiquitous yet clinically silent feature of brainstem disease and also for monitoring the evolution of underlying conditions. More detailed explorations appear well motivated.

  14. The sympathetic nervous system and the physiologic consequences of spaceflight: a hypothesis

    NASA Technical Reports Server (NTRS)

    Robertson, D.; Convertino, V. A.; Vernikos, J.

    1994-01-01

    Many of the physiologic consequences of weightlessness and the cardiovascular abnormalities on return from space could be due, at least in part, to alterations in the regulation of the autonomic nervous system. In this article, the authors review the rationale and evidence for an autonomic mediation of diverse changes that occur with spaceflight, including the anemia and hypovolemia of weightlessness and the tachycardia and orthostatic intolerance on return from space. This hypothesis is supported by studies of two groups of persons known to have low catecholamine levels: persons subjected to prolonged bedrest and persons with syndromes characterized by low circulating catecholamines (Bradbury-Eggleston syndrome and dopamine beta-hydroxylase deficiency). Both groups exhibit the symptoms mentioned. The increasing evidence that autonomic mechanisms underlie many of the physiologic consequences of weightlessness suggests that new pharmacologic approaches (such as administration of beta-blockers and/or sympathomimetic amines) based on these findings may attenuate these unwanted effects.

  15. Analyzing the financial crisis using the entropy density function

    NASA Astrophysics Data System (ADS)

    Oh, Gabjin; Kim, Ho-yong; Ahn, Seok-Won; Kwak, Wooseop

    2015-02-01

    The risk that is created by nonlinear interactions among subjects in economic systems is assumed to increase during an abnormal state of a financial market. Nevertheless, investigating the systemic risk in financial markets following the global financial crisis is not sufficient. In this paper, we analyze the entropy density function in the return time series for several financial markets, such as the S&P500, KOSPI, and DAX indices, from October 2002 to December 2011 and analyze the variability in the entropy value over time. We find that the entropy density function of the S&P500 index during the subprime crisis exhibits a significant decrease compared to that in other periods, whereas the other markets, such as those in Germany and Korea, exhibit no significant decrease during the market crisis. These findings demonstrate that the S&P500 index generated a regular pattern in the return time series during the financial crisis.

  16. An electrophysiological follow up of patients with n-hexane polyneuropathy.

    PubMed Central

    Chang, Y C

    1991-01-01

    Electroneurographic (ENeG) and evoked potential (EP) studies were regularly performed on 11 printing workers with n-hexane polyneuropathy after cessation of exposure. At the initial examination, the ENeG studies simulated a demyelinative process. Further slowing of nerve conduction velocity, or further decreasing of action potential amplitude, or both in the follow up ENeG study were found in about half the patients. The motor distal latency did not worsen. Nerve conduction returned to normal earlier in the sensory than in the motor nerves. After the patients had regained full motor capability, conduction velocities in motor nerves were still significantly slowed. These ENeG characteristics correlate with the pathological and pathophysiological changes in experimental hexa-carbon neuropathies. The initial findings from the EP studies indicated a conduction abnormality in the central nervous system (CNS). Delayed worsening occurred in the amplitude of visual EPs in three patients. On serial follow up, the interpeak latency and interpeak amplitude of visual EPs improved little. Residual abnormalities were also found in the interpeak latency of auditory EPs in the brainstem and in the absolute latency of scalp somatosensory EPs from the peroneal nerve. Astroglial proliferation in the CNS probably impedes recovery of the abnormalities in EP. PMID:1993154

  17. New treatment of vertigo caused by jugular bulb abnormalities.

    PubMed

    Hitier, Martin; Barbier, Charlotte; Marie-Aude, Thenint; Moreau, Sylvain; Courtheoux, Patrick; Patron, Vincent

    2014-08-01

    Jugular bulb abnormalities can induce tinnitus, hearing loss, or vertigo. Vertigo can be very disabling and may need surgical treatments with risk of hearing loss, major bleeding or facial palsy. Hence, we have developed a new treatment for vertigo caused by jugular bulb anomalies, using an endovascular technique. Three patients presented with severe vertigos mostly induced by high venous pressure. One patient showed downbeat vertical nystagmus during the Valsalva maneuver. The temporal-bone computed tomography scan showed a high rising jugular bulb or a jugular bulb diverticulum with dehiscence and compression of the vestibular aqueduct in all cases. We plugged the upper part of the bulb with coils, and we used a stent to maintain the coils and preserving the venous permeability. After 12- to 24-month follow-up, those patients experienced no more vertigo, allowing return to work. The 3-month arteriographs showed good permeability of the sigmoid sinus and jugular bulb through the stent, with complete obstruction of the upper part of the bulb in all cases. Disabling vertigo induced by jugular bulb abnormalities can be effectively treated by an endovascular technique. This technique is minimally invasive with a probable greater benefit/risk ratio compare with surgery. © The Author(s) 2013.

  18. Brain white matter changes associated with urological chronic pelvic pain syndrome: multisite neuroimaging from a MAPP case-control study.

    PubMed

    Huang, Lejian; Kutch, Jason J; Ellingson, Benjamin M; Martucci, Katherine T; Harris, Richard E; Clauw, Daniel J; Mackey, Sean; Mayer, Emeran A; Schaeffer, Anthony J; Apkarian, A Vania; Farmer, Melissa A

    2016-12-01

    Clinical phenotyping of urological chronic pelvic pain syndromes (UCPPSs) in men and women have focused on end organ abnormalities to identify putative clinical subtypes. Initial evidence of abnormal brain function and structure in male pelvic pain has necessitated large-scale, multisite investigations into potential UCPPS brain biomarkers. We present the first evidence of regional white matter (axonal) abnormalities in men and women with UCPPS, compared with positive (irritable bowel syndrome, IBS) and healthy controls. Epidemiological and neuroimaging data were collected from participants with UCPPS (n = 52), IBS (n = 39), and healthy sex- and age-matched controls (n = 61). White matter microstructure, measured as fractional anisotropy (FA), was examined by diffusion tensor imaging. Group differences in regional FA positively correlated with pain severity, including segments of the right corticospinal tract and right anterior thalamic radiation. Increased corticospinal FA was specific and sensitive to UCPPS, positively correlated with pain severity, and reflected sensory (not affective) features of pain. Reduced anterior thalamic radiation FA distinguished patients with IBS from those with UCPPS and controls, suggesting greater microstructural divergence from normal tract organization. Findings confirm that regional white matter abnormalities characterize UCPPS and can distinguish between visceral diagnoses, suggesting that regional axonal microstructure is either altered with ongoing pain or predisposes its development.

  19. Brain white matter changes associated with urological chronic pelvic pain syndrome: Multi-site neuroimaging from a MAPP case-control study

    PubMed Central

    Huang, Lejian; Kutch, Jason J.; Ellingson, Benjamin M.; Martucci, Katherine T.; Harris, Richard E.; Clauw, Daniel J.; Mackey, Sean; Mayer, Emeran A.; Schaeffer, Anthony J.; Apkarian, A. Vania; Farmer, Melissa A.

    2016-01-01

    Clinical phenotyping of urological chronic pelvic pain syndromes (UCPPS) in men and women has focused on end-organ abnormalities to identify putative clinical subtypes. Initial evidence of abnormal brain function and structure in male pelvic pain has necessitated large-scale, multi-site investigations into potential UCPPS brain biomarkers. We present the first evidence of regional white matter (axonal) abnormalities in men and women with UCPPS, compared to positive (irritable bowel syndrome, IBS) and healthy controls. Epidemiological and neuroimaging data was collected from participants with UCPPS (n=52), IBS (n=39), and healthy, sex- and age-matched controls (n=61). White matter microstructure, measured as fractional anisotropy (FA), was examined with diffusion tensor imaging (DTI). Group differences in regional FA positively correlated with pain severity, including segments of the right corticospinal tract and right anterior thalamic radiation. Increased corticospinal FA was specific and sensitive to UCPPS, positively correlated with pain severity, and reflected sensory (not affective) features of pain. Reduced anterior thalamic radiation FA distinguished IBS from UCPPS patients and controls, suggesting greater microstructural divergence from normal tract organization. Findings confirm that regional white matter abnormalities characterize UCPPS and can distinguish between visceral diagnoses, suggesting that regional axonal microstructure is either altered with ongoing pain or predisposes its development. PMID:27842046

  20. Effect of Patient Navigation on Time to Diagnostic Resolution among Patients with Colorectal Cancer Related Abnormalities

    PubMed Central

    Lee, Ji-Hyun; Fulp, William; Wells, Kristen J.; Meade, Cathy D.; Calcano, Ercilia; Roetzheim, Richard

    2013-01-01

    Objectives The objective of this study is to evaluate whether a patient navigation (PN) program is effective in reducing delay in diagnostic resolution among medically underserved patients with colorectal cancer (CRC) related abnormalities in Tampa Bay, Florida. Methods This study involved 10 primary care clinics randomized either to receive navigation or serve as controls (5 clinics per arm). Each clinic identified all subjects with colorectal-related abnormalities in the year prior to the clinic beginning participation in the Moffitt Patient Navigation Research Program. Patients with CRC related abnormalities were navigated from time of a colorectal abnormality to diagnostic resolution. Control patients received usual care, and outcome information was obtained from medical record abstraction. Using a frailty Cox proportional hazard model, we examined the length of time between colorectal abnormality and definitive diagnosis. Results 193 patients were eligible for the study because of a colorectal cancer related abnormality (75 navigated; 118 control). Analysis of PN effect by two time periods of resolution (0-4 months and > 4 months) showed a lagged effect of PN. The adjusted time-varying PN effect on diagnostic resolution compared to control was marginally significant (adjusted Hazard Ratio, aHR=1.15, 95% CI: 1.02-1.29) after controlling for insurance status. The predicted aHR at 4 months was 1.2, but showed no significant effect until 12 months. Conclusions For patients having an abnormal symptom of CRC, PN appeared to have a positive effect over time and sped diagnostic resolution after 4 months. However, the small sample size limits drawing a definitive conclusion regarding the positive PN effect. PMID:24113902

  1. Lysosomal abnormalities in hereditary spastic paraplegia types SPG15 and SPG11

    PubMed Central

    Renvoisé, Benoît; Chang, Jaerak; Singh, Rajat; Yonekawa, Sayuri; FitzGibbon, Edmond J; Mankodi, Ami; Vanderver, Adeline; Schindler, Alice B; Toro, Camilo; Gahl, William A; Mahuran, Don J; Blackstone, Craig; Pierson, Tyler Mark

    2014-01-01

    Objective Hereditary spastic paraplegias (HSPs) are among the most genetically diverse inherited neurological disorders, with over 70 disease loci identified (SPG1-71) to date. SPG15 and SPG11 are clinically similar, autosomal recessive disorders characterized by progressive spastic paraplegia along with thin corpus callosum, white matter abnormalities, cognitive impairment, and ophthalmologic abnormalities. Furthermore, both have been linked to early-onset parkinsonism. Methods We describe two new cases of SPG15 and investigate cellular changes in SPG15 and SPG11 patient-derived fibroblasts, seeking to identify shared pathogenic themes. Cells were evaluated for any abnormalities in cell division, DNA repair, endoplasmic reticulum, endosomes, and lysosomes. Results Fibroblasts prepared from patients with SPG15 have selective enlargement of LAMP1-positive structures, and they consistently exhibited abnormal lysosomal storage by electron microscopy. A similar enlargement of LAMP1-positive structures was also observed in cells from multiple SPG11 patients, though prominent abnormal lysosomal storage was not evident. The stabilities of the SPG15 protein spastizin/ZFYVE26 and the SPG11 protein spatacsin were interdependent. Interpretation Emerging studies implicating these two proteins in interactions with the late endosomal/lysosomal adaptor protein complex AP-5 are consistent with shared abnormalities in lysosomes, supporting a converging mechanism for these two disorders. Recent work with Zfyve26−/− mice revealed a similar phenotype to human SPG15, and cells in these mice had endolysosomal abnormalities. SPG15 and SPG11 are particularly notable among HSPs because they can also present with juvenile parkinsonism, and this lysosomal trafficking or storage defect may be relevant for other forms of parkinsonism associated with lysosomal dysfunction. PMID:24999486

  2. Serum response factor: positive and negative regulation of an epithelial gene expression network in the destrin mutant cornea

    PubMed Central

    Kawakami-Schulz, Sharolyn V.; Verdoni, Angela M.; Sattler, Shannon G.; Jessen, Erik; Kao, Winston W.-Y.; Ikeda, Akihiro

    2014-01-01

    Increased angiogenesis, inflammation, and proliferation are hallmarks of diseased tissues, and in vivo models of these disease phenotypes can provide insight into disease pathology. Dstncorn1 mice, deficient for the actin depolymerizing factor destrin (DSTN), display an increase of serum response factor (SRF) that results in epithelial hyperproliferation, inflammation, and neovascularization in the cornea. Previous work demonstrated that conditional ablation of Srf from the corneal epithelium of Dstncorn1 mice returns the cornea to a wild-type (WT) like state. This result implicated SRF as a major regulator of genes that contributes to abnormal phenotypes in Dstncorn1 cornea. The purpose of this study is to identify gene networks that are affected by increased expression of Srf in the Dstncorn1 cornea. Microarray analysis led to characterization of gene expression changes that occur when conditional knockout of Srf rescues mutant phenotypes in the cornea of Dstncorn1 mice. Comparison of gene expression values from WT, Dstncorn1 mutant, and Dstncorn1 rescued cornea identified >400 differentially expressed genes that are downstream from SRF. Srf ablation had a significant effect on genes associated with epithelial cell-cell junctions and regulation of actin dynamics. The majority of genes affected by SRF are downregulated in the Dstncorn1 mutant cornea, suggesting that increased SRF negatively affects transcription of SRF gene targets. ChIP-seq analysis on Dstncorn1 mutant and WT tissue revealed that, despite being present in higher abundance, SRF binding is significantly decreased in the Dstncorn1 mutant cornea. This study uses a unique model combining genetic and genomic approaches to identify genes that are regulated by SRF. These findings expand current understanding of the role of SRF in both normal and abnormal tissue homeostasis. PMID:24550211

  3. Harmonic uniflow engine

    DOEpatents

    Bennett, Charles L.

    2016-03-22

    A reciprocating-piston uniflow engine includes a harmonic oscillator inlet valve capable of oscillating at a resonant frequency for controlling the flow of working fluid into the engine. In particular, the inlet valve includes an inlet valve head and a spring arranged together as a harmonic oscillator so that the inlet valve head is moveable from an unbiased equilibrium position to a biased closed position occluding an inlet. When released, the inlet valve head undergoes a single oscillation past the equilibrium position to a maximum open position and returns to a biased return position close to the closed position to choke the flow and produce a pressure drop across the inlet valve causing the inlet valve to close. In other embodiments, the harmonic oscillator arrangement of the inlet valve enables the uniflow engine to be reversibly operated as a uniflow compressor.

  4. Diagnosis and management of cranial and caudal nuchal bursitis in four horses.

    PubMed

    García-López, José M; Jenei, Thomas; Chope, Kate; Bubeck, Kirstin A

    2010-10-01

    4 horses with a history of neck pain, abnormal head carriage, and related inability to perform were examined. Cranial nuchal bursitis was diagnosed in 2 horses, and caudal nuchal bursitis was diagnosed in the other 2. All 4 horses had prominent swelling in the region between the frontal bone and temporal fossa (ie, the poll) and abnormal head carriage. Ultrasonographic examination revealed fluid distention and synovial thickening of the cranial or caudal nuchal bursa in all 4 horses. Ultrasonography-guided aspiration of the affected region was performed successfully in 3 horses. Radiography revealed bony remodeling and mineralization over the dorsal aspect of the atlas in 1 horse and a radiolucency at the axis in another. Nuclear scintigraphy revealed an increase in radioisotope uptake at the level of C2 in 1 horse. Although a septic process was considered among the differential diagnoses in all horses, a septic process could only be confirmed in 1 horse. All horses were refractory to conservative management consisting of intrabursal injection of anti-inflammatory medications. Bursoscopic debridement and lavage of the affected bursae resulted in resolution of the clinical signs in all horses, and they all returned to their intended use. Cranial and caudal nuchal bursitis, of nonseptic or septic origin, should be considered as a differential diagnosis in horses with head and neck pain. Horses undergoing surgical intervention consisting of nuchal bursoscopy have the opportunity to return to their original degree of exercise.

  5. Wealth in Middle and Old Age in Mexico: The Role of International Migration1

    PubMed Central

    Wong, Rebeca; Palloni, Alberto; Soldo, Beth J.

    2017-01-01

    This article examines the impact that past migration to the U.S. has on the current economic well-being of individuals in middle or old age who have returned to Mexico. A priori, the net effect of U.S. migration on wealth among return migrants is difficult to predict; there are counteracting factors that can affect wealth positively or negatively. Using data from the Mexican Health and Aging Study 2001 and correcting for selection factors, the long-term effect of U.S. migration for return migrants was found consistently positive in terms of their accumulated personal wealth at middle and old age. This article speculates about the possible mechanisms that can explain this apparent advantage. PMID:29375172

  6. Sign realized jump risk and the cross-section of stock returns: Evidence from China's stock market

    PubMed Central

    Chao, Youcong; Liu, Xiaoqun; Guo, Shijun

    2017-01-01

    Using 5-minute high frequency data from the Chinese stock market, we employ a non-parametric method to estimate Fama-French portfolio realized jumps and investigate whether the estimated positive, negative and sign realized jumps could forecast or explain the cross-sectional stock returns. The Fama-MacBeth regression results show that not only have the realized jump components and the continuous volatility been compensated with risk premium, but also that the negative jump risk, the positive jump risk and the sign jump risk, to some extent, could explain the return of the stock portfolios. Therefore, we should pay high attention to the downside tail risk and the upside tail risk. PMID:28771514

  7. Tuberculin Skin Tests versus Interferon-Gamma Release Assays in Tuberculosis Screening among Immigrant Visa Applicants

    PubMed Central

    Chuke, Stella O.; Yen, Nguyen Thi Ngoc; Laserson, Kayla F.; Phuoc, Nguyen Huu; Trinh, Nguyen An; Nhung, Duong Thi Cam; Mai, Vo Thi Chi; Qui, An Dang; Hai, Hoang Hoa; Loan, Le Thien Huong; Jones, Warren G.; Whitworth, William C.; Shah, J. Jina; Painter, John A.; Mazurek, Gerald H.; Maloney, Susan A.

    2014-01-01

    Objective. Use of tuberculin skin tests (TSTs) and interferon gamma release assays (IGRAs) as part of tuberculosis (TB) screening among immigrants from high TB-burden countries has not been fully evaluated. Methods. Prevalence of Mycobacterium tuberculosis infection (MTBI) based on TST, or the QuantiFERON-TB Gold test (QFT-G), was determined among immigrant applicants in Vietnam bound for the United States (US); factors associated with test results and discordance were assessed; predictive values of TST and QFT-G for identifying chest radiographs (CXRs) consistent with TB were calculated. Results. Of 1,246 immigrant visa applicants studied, 57.9% were TST positive, 28.3% were QFT-G positive, and test agreement was 59.4%. Increasing age was associated with positive TST results, positive QFT-G results, TST-positive but QFT-G-negative discordance, and abnormal CXRs consistent with TB. Positive predictive values of TST and QFT-G for an abnormal CXR were 25.9% and 25.6%, respectively. Conclusion. The estimated prevalence of MTBI among US-bound visa applicants in Vietnam based on TST was twice that based on QFT-G, and 14 times higher than a TST-based estimate of MTBI prevalence reported for the general US population in 2000. QFT-G was not better than TST at predicting abnormal CXRs consistent with TB. PMID:24738031

  8. Rates and Determinants of Return to Play After Anterior Cruciate Ligament Reconstruction in National Collegiate Athletic Association Division I Soccer Athletes: A Study of the Southeastern Conference.

    PubMed

    Howard, Jennifer S; Lembach, Mark L; Metzler, Adam V; Johnson, Darren L

    2016-02-01

    Factors and details regarding return to play in elite, collegiate female soccer athletes after an anterior cruciate ligament (ACL) injury and reconstruction have not been well studied. To evaluate return to play among collegiate female soccer players, specifically examining the effect of surgical and individual athlete characteristics on the return-to-play rate. Descriptive epidemiology study. Sports medicine and athletic training staff at institutions from the National Collegiate Athletic Association Southeastern Conference (SEC) were contacted to request participation in the study. All institutions were sent a standardized spreadsheet with response choices and instructions regarding athlete inclusion criteria. Athlete, injury, surgical technique, and return-to-play data were requested for ACL reconstructions performed on female soccer athletes at the participating institutions over the previous 8 years. χ(2) analyses were used to compare the return-to-play rate by year in school, scholarship status, position, depth chart status, procedure, graft type, graft fixation, concomitant procedures, and previous ACL injuries. All 14 of the SEC institutions chose to participate and provided data. A total of 80 ACL injuries were reported, with 79 surgical reconstructions and return-to-play data for 78 collegiate soccer athletes. The overall return-to-play rate was 85%. There was a statistical significance in return-to-play rates favoring athletes in earlier years of eligibility versus later years (P < .001). Athletes in eligibility years 4 and 5 combined had a return-to-play rate of only 40%. Scholarship status likewise showed significance (P < .001), demonstrating a higher return-to-play rate for scholarship athletes (91%) versus nonscholarship athletes (46%). No significant differences in return-to-play rates were observed based on surgical factors, including concomitant knee procedures, graft type, and graft fixation method. Collegiate female soccer athletes have a high initial return-to-play rate. Undergoing ACL reconstruction earlier in the college career as well as the presence of a scholarship had a positive effect on return to play. Surgical factors including graft type, fixation method, tunnel placement technique, concomitant knee surgeries, and revision status demonstrated no significant effect on the return-to-play rate. © 2015 The Author(s).

  9. Sensitivity and specificity of western blot testing of cerebrospinal fluid and serum for diagnosis of equine protozoal myeloencephalitis in horses with and without neurologic abnormalities.

    PubMed

    Daft, Barbara M; Barr, Bradd C; Gardner, Ian A; Read, Deryck; Bell, William; Peyser, Karen G; Ardans, Alex; Kinde, Hailu; Morrow, Jennifer K

    2002-10-01

    To determine sensitivity and specificity of western blot testing (WBT) of CSF and serum for diagnosis of equine protozoal myeloencephalitis (EPM) in horses with and without neurologic abnormalities. Prospective investigation. 65 horses with and 169 horses without neurologic abnormalities. CSF and serum from horses submitted for necropsy were tested for Sarcocystis neurona-specific antibody with a WBT. Results of postmortem examination were used as the gold standard against which results of the WBT were compared. Sensitivity of WBT of CSF was 87% for horses with and 88% for horses without neurologic abnormalities. Specificity of WBT of CSF was 44% for horses with and 60% for horses without neurologic abnormalities. Regardless of whether horses did or did not have neurologic abnormalities, sensitivity and specificity of WBT of serum were not significantly different from values for WBT of CSF. Ninety-four horses without EPM had histologic evidence of slight CNS inflammation. The low specificity of WBT of CSF indicated that it is inappropriate to diagnose EPM on the basis of a positive test result alone because of the possibility of false-positive test results. The high sensitivity, however, means that a negative result is useful in ruling out EPM. There was no advantage in testing CSF versus serum in horses without neurologic abnormalities. Slight CNS inflammation was common in horses with and without S neurona-specific antibodies in the CSF and should not be considered an indication of CNS infection with S neurona.

  10. The importance of exercise gated blood pool imaging in Chagas Disease

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

    Meneguetti, J.C.; Neto, J.E.; Hironaka, F.H.

    1984-01-01

    Myocardial involvement in Chagas Disease (CD) often leads to cardiomyopathy and heart failure. Patients (pts) with the indeterminate form (IF) have positive complement fixation test as the only abnormality. Cardiac form (CF) pts have positive serology, abnormal ECG with or without clinical symptoms. To investigate the degree of cardiac involvement in IF pts, exercise (handgrip) gated blood pool (EGBP) was performed on 77 CD male workers (46 IF, 17-50 yrs; 31 CF, 24-61 yrs) and 28 male (22-46 yrs) normal volunteers (NV). Regional wall motion (RWM), ventricular volumes (VV) and percent EF variation (..delta..%) were analysed. NV group shoed ..delta..%more » - 3.51 +- 4.86 with normal RWM and VV. IF pts showed ..delta..% - 4.27 +- 7.46 with >-10% drop in 22% of pts; RWM and VV were abnormal in 43% and 30%, respectively; at least one parameter was abnormal in 59% of pts. CF pts showed ..delta..%-10.52 +- 7.37 with >-10% drop in 59%; RWM and VV were abnormal in 79% and 83%, respectively; at least one parameter was abnormal in 86% of pts. No ..delta..% difference was found between NV and IF groups, but there was a significant difference between these two groups and CF pts. When EGBP is considered, only 41% of IF pts are normal. Also, 14% CF pts with ECG and serologic abnormalities have no cardiac dysfunction. This suggests that EGBP study should be included as a routine procedure in CD pts and used as a basis for a new classification of the disease.« less

  11. Prevalence of anal cytological abnormalities in women with positive cervical cytology.

    PubMed

    Calore, Edenilson E; Giaccio, Claudia Maria Serafim; Nadal, Sidney R

    2011-05-01

    The objective of this study was to estimate the prevalence of cytological abnormalities of the anal mucosa in women with positive cervical cytology, but without macroscopic anal lesion. Ultimately we postulated if the anal mucosa may be a reservoir of HPV, which would allow the reinfection of cervix. Forty-nine patients with abnormal cervical cytology were selected for this work. In a period not exceeding one week of collecting cervix cytology, two swab specimens of the anal canal were also collected. Women diagnosed with cervical HSIL by Pap smear were referred for colposcopy with biopsy of the lesions, to confirm the cytologic diagnosis and ablation of the lesion. We demonstrated a high prevalence of anal squamous intraepithelial lesions in patients with cervical squamous intraepithelial lesions (29 of the total of 49 patients = 59.2%). Of the 20 cases of cervical LSIL, 11 (55%) had abnormal anal cytology. Of the 26 cases with cervical HSIL, 16 (61.5%) had abnormal anal cytology. So, there was a discrete higher prevalence of abnormal anal cytology in cases of high-grade cervical squamous lesions (cervical HSIL). These results help to support the hypothesis that the anal mucosa is a reservoir of HPV, which can be a source of re-infection for the cervix. However, there was no significant association between the practice of anal sex and the prevalence of anal cytological abnormalities. These facts are epidemiologically important for future programs for population eradication of cervical lesions related to HPV. Diagn. Cytopathol. 2011;39:323-327. © 2010 Wiley-Liss, Inc. Copyright © 2010 Wiley-Liss, Inc.

  12. Positive and negative mood following imaging-guided core needle breast biopsy and receipt of biopsy results.

    PubMed

    Perlman, Katherine L; Shelby, Rebecca A; Wren, Anava A; Kelleher, Sarah A; Dorfman, Caroline S; O'Connor, Erin; Kim, Connie; Johnson, Karen S; Soo, Mary Scott

    2017-12-01

    Positive and negative mood are independent psychological responses to stressful events. Negative mood negatively impacts well-being and co-occurring positive mood leads to improved adjustment. Women undergoing core needle breast biopsies (CNB) experience distress during CNB and awaiting results; however, influences of mood are not well known. This longitudinal study examines psychosocial and biopsy- and spirituality-related factors associated with mood in patients day of CNB and one week after receiving results. Ninety women undergoing CNB completed questionnaires on psychosocial factors (chronic stress, social support), biopsy experiences (pain, radiologist communication), and spirituality (peace, meaning, faith) day of CNB. Measures of positive and negative mood were completed day of CNB and one week after receiving results (benign n = 50; abnormal n = 25). Multiple linear regression analyses were conducted. Greater positive mood correlated with greater peace (β = .25, p = .02) day of CNB. Lower negative mood correlated with greater peace (β = -.29, p = .004) and there was a trend for a relationship with less pain during CNB (β = .19, p = .07). For patients with benign results, day of CNB positive mood predicted positive mood post-results (β = .31, p = .03) and only chronic stress predicted negative mood (β = .33, p = .03). For women with abnormal results, greater meaning day of CNB predicted lower negative mood post-results (β = -.45, p = .03). Meaning and peace may be important for women undergoing CNB and receiving abnormal results.

  13. Expert consensus on facilitators and barriers to return-to-work following surgery for non-traumatic upper extremity conditions: a Delphi study.

    PubMed

    Peters, S E; Johnston, V; Ross, M; Coppieters, M W

    2017-02-01

    This Delphi study aimed to reach consensus on important facilitators and barriers for return-to-work following surgery for non-traumatic upper extremity conditions. In Round 1, experts ( n = 42) listed 134 factors, which were appraised in Rounds 2 and 3. Consensus (⩾85% agreement) was achieved for 13 facilitators (high motivation to return-to-work; high self-efficacy for return-to-work and recovery; availability of modified/alternative duties; flexible return-to-work arrangements; positive coping skills; limited heavy work exertion; supportive return-to-work policies; supportive supervisor/management; no catastrophic thinking; no fear avoidance to return-to-work; no fear avoidance to pain/activity; return to meaningful work duties; high job satisfaction) and six barriers (mood disorder diagnosis; pain/symptoms at more than one musculoskeletal site; heavy upper extremity exertions at work; lack of flexible return-to-work arrangements; lack of support from supervisor/management; high level of pain catastrophizing). Future prognostic studies are required to validate these biopsychosocial factors to further improve return-to-work outcomes. V.

  14. Revisiting the investor sentiment-stock returns relationship: A multi-scale perspective using wavelets

    NASA Astrophysics Data System (ADS)

    Lao, Jiashun; Nie, He; Jiang, Yonghong

    2018-06-01

    This paper employs SBW proposed by Baker and Wurgler (2006) to investigate the nonlinear asymmetric Granger causality between investor sentiment and stock returns for US economy while considering different time-scales. The wavelet method is utilized to decompose time series of investor sentiment and stock returns at different time-scales to focus on the local analysis of different time horizons of investors. The linear and nonlinear asymmetric Granger methods are employed to examine the Granger causal relationship on similar time-scales. We find evidence of strong bilateral linear and nonlinear asymmetric Granger causality between longer-term investor sentiment and stock returns. Furthermore, we observe the positive nonlinear causal relationship from stock returns to investor sentiment and the negative nonlinear causal relationship from investor sentiment to stock returns.

  15. Persistence of chromosomal abnormalities additional to the Philadelphia chromosome after Philadelphia chromosome disappearance during imatinib therapy for chronic myeloid leukemia.

    PubMed

    Zaccaria, Alfonso; Valenti, Anna Maria; Donti, Emilio; Gozzetti, Alessandro; Ronconi, Sonia; Spedicato, Francesco

    2007-04-01

    Five Philadelphia chromosome positive (Ph+) chronic myeloid leukemia (CML) patients with additional chromosome abnormalities at diagnosis have been followed during Imatinib therapy. In all, the Ph chromosome disappeared, while the 5 cases, additional abnormalities [dup(1); del(5), +8 (2 patients) and +14] persisted in the subsequent studies, performed over a period of 11 to 49 months, either alone or together with a karyotypically normal cell population. This finding is consistent with a secondary origin of the Ph chromosome in these patients. It is still to early to evaluate the possible prognostic value of these additional abnormalities.

  16. Factors influencing donor return.

    PubMed

    Schlumpf, Karen S; Glynn, Simone A; Schreiber, George B; Wright, David J; Randolph Steele, Whitney; Tu, Yongling; Hermansen, Sigurd; Higgins, Martha J; Garratty, George; Murphy, Edward L

    2008-02-01

    To predict future blood donation behavior and improve donor retention, it is important to understand the determinants of donor return. A self-administered questionnaire was completed in 2003 by 7905 current donors. With data mining methods, all factors measured by the survey were ranked as possible predictors of actual return within 12 months. Significant factors were analyzed with logistic regression to determine predictors of intention and of actual return. Younger and minority donors were less likely to return in 12 months. Predictors of donor return were higher prior donation frequency, higher intention to return, a convenient place to donate, and having a good donation experience. Most factors associated with actual donor return were also associated with a high intention to return. Although not significant for actual return, feeling a responsibility to help others, higher empathetic concern, and a feeling that being a blood donor means more than just donating blood were related to high intention to return. Prior donation frequency, intention to return, donation experience, and having a convenient location appear to significantly predict donor return. Clearly, donor behavior is dependent on more than one factor alone. Altruistic behavior, empathy, and social responsibility items did not enter our model to predict actual return. A donor's stated intention to give again is positively related to actual return and, while not a perfect measure, might be a useful proxy when donor return cannot be determined.

  17. FDG-PET/CT in the evaluation of anal carcinoma

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

    Cotter, Shane E.; Medical Scientist Training Program, Washington University School of Medicine, St. Louis, MO; Grigsby, Perry W.

    2006-07-01

    Purpose: Surgical staging and treatment of anal carcinoma has been replaced by noninvasive staging studies and combined modality therapy. In this study, we compare computed tomography (CT) and physical examination to [{sup 18}F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography (FDG-PET/CT) in the staging of carcinoma of the anal canal, with special emphasis on determination of spread to inguinal lymph nodes. Methods and Materials: Between July 2003 and July 2005, 41 consecutive patients with biopsy-proved anal carcinoma underwent a complete staging evaluation including physical examination, CT, and 2-FDG-PET/CT. Patients ranged in age from 30 to 89 years. Nine men were HIV-positive. Treatment was withmore » standard Nigro regimen. Results: [{sup 18}F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography (FDG-PET/CT) detected 91% of nonexcised primary tumors, whereas CT visualized 59%. FDG-PET/CT detected abnormal uptake in pelvic nodes of 5 patients with normal pelvic CT scans. FDG-PET/CT detected abnormal nodes in 20% of groins that were normal by CT, and in 23% without abnormality on physical examination. Furthermore, 17% of groins negative by both CT and physical examination showed abnormal uptake on FDG-PET/CT. HIV-positive patients had an increased frequency of PET-positive lymph nodes. Conclusion: [{sup 18}F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography detects the primary tumor more often than CT. FDG-PET/CT detects substantially more abnormal inguinal lymph nodes than are identified by standard clinical staging with CT and physical examination.« less

  18. Breast Cancer Survivors Report Similar Concerns Related to Return to Work in Developed and Developing Nations.

    PubMed

    Luo, Shi-Xiang; Liu, Jun-E; Cheng, Andy S K; Xiao, Shu-Qin; Su, Ya-Li; Feuerstein, Michael

    2018-02-14

    Aim To determine whether breast cancer survivors (BCS) at work following the diagnosis and/or treatment of breast cancer, in a rapidly developing country such as China experience similar to return to work challenges as reported in nations with established return to work (RTW) policy and procedures for employees with cancer. Methods Semi-structured interviews were conducted with 16 BCS who returned to work following diagnosis and/or primary cancer treatment. An Interpretative Phenomenological Analysis was used to investigate responses. Results Three recurring themes emerged: (1) challenges at work related to residual effects of diagnosis and/or primary treatment; (2) positive and negative responses from employers and/or supervisors; and (3) positive and negative responses from co-workers/colleagues. Although several participants experienced a high level of workplace support, there was a subgroup that did report challenges related to symptom burden, cognitive limitations, and both positive and negative responses by employers and co-workers were reported. Conclusions Findings indicate similar challenges in BCS who RTW during and/or following cancer treatment in both rapidly developing and developed nations. Results suggest that regardless of the existence of workplace policies and practices related to RTW for workers with a history of cancer, a subgroup of BCS experience similar challenges when returning to work. These findings highlight the international nature of RTW challenges and suggest the need for more global efforts to develop and evaluate workplace interventions to assist with these similarities.

  19. Particulate matter in animal rooms housing mice in microisolation caging.

    PubMed

    Langham, Gregory L; Hoyt, Robert F; Johnson, Thomas E

    2006-11-01

    Reactions to allergens created by laboratory animals are among the most frequently encountered occupational illnesses associated with research animals. Personnel are exposed to these allergens through airborne particulate matter. Although the use of microisolation caging systems can reduce particulate matter concentrations in rooms housing mice, the operating parameters of ventilated caging systems vary extensively. We compared room air in mouse rooms containing 5 different types of caging: 1) individually ventilated caging under positive pressure with filtered intake air and exhaust air returned to the room (VCR+), 2) individually ventilated caging under negative pressure with exhaust air returned to the room (VCR-), 3) individually ventilated caging under positive pressure with exhaust air returned to the heating, ventilation, and air-conditioning (HVAC) system, 4) individually ventilated caging under negative pressure with exhaust air returned to the HVAC system, and 5) static microisolation cages. We found that rooms under VCR conditions had fewer large particles than did those under other conditions, but the numbers of 0.3 microm particles did not differ significantly among systems. Static, positive or negative pressure applied to caging units as well as route of air exhaust were found to have little influence on the total number of particles in the atmosphere. Therefore, considering the heat load, odor, and overall particulate concentration in the room, placing individually ventilated caging under negative pressure with exhaust air returned to the HVAC system appears to be the optimal overall choice when using microisolation housing for rodents.

  20. Our Strength in Families (OSIDF): A Web-Based Interactive Coping Skills and Resiliency Program for Military Families

    DTIC Science & Technology

    2006-03-01

    away) o Can learn to value partner more, rekindle relationship Page 19 o May return refreshed for parenting role after leaving and returning - can...emotional, and behavioral changes in partner b. Both positive (e.g., strengthen relationships, return from separation/deployment refreshed for parenting ... role , learn better communication and new helpful family rituals, learn to value partner more) and negative changes (e.g., intimacy reduced, numbing

  1. Coordination of a supply chain with consumer return under vendor-managed consignment inventory and stochastic demand

    NASA Astrophysics Data System (ADS)

    Wu, Zhihui; Chen, Dongyan; Yu, Hui

    2016-07-01

    In this paper, the problem of the coordination policy is investigated for vendor-managed consignment inventory supply chain subject to consumer return. Here, the market demand is assumed to be affected by promotional effort and consumer return policy. The optimal consignment inventory and the optimal promotional effort level are proposed under the decentralized and centralized decisions. Based on the optimal decision conditions, the markdown allowance-promotional cost-sharing contract is investigated to coordinate the supply chain. Subsequently, the comparison between the two extreme policies shows that full-refund policy dominates the no-return policy when the returning cost and the positive effect of return policy are satisfied certain conditions. Finally, a numerical example is provided to illustrate the impacts of consumer return policy on the coordination contract and optimal profit as well as the effectiveness of the proposed supply chain decision.

  2. Apparatus for sequentially transporting containers

    NASA Technical Reports Server (NTRS)

    Hudgins, J. L. (Inventor)

    1982-01-01

    Apparatus for transferring and manipulating a plurality of containers in a sequence is disclosed including a mechanical manipulator arm having a gripping device which automatically picks up a container at a fixed pickup position P and transfers it to a processing station. At a processing station X, the container is loaded with silicon wafers and thereafter returned by the arm to the fixed position P at the pickup and return station Y. A plurality of the containers may be processed in sequence from the fixed pickup position by providing a movable carriage upon which container pedestal platforms are supported, at least one of which is an elevator platform. The platforms include abutments for properly positioning the containers for accurate pickup by the manipulator arm.

  3. Using impedance cardiography with postural change to stratify patients with hypertension.

    PubMed

    DeMarzo, Arthur P

    2011-06-01

    Early detection of cardiovascular disease in patients with hypertension could initiate appropriate treatment to control blood pressure and prevent the progression of cardiovascular disease. The goal of this study was to show how impedance cardiography waveform analysis with postural change can be used to detect subclinical cardiovascular disease in patients with high blood pressure. Patients with high blood pressure had impedance cardiography data obtained in two positions, standing upright and supine. In 50 adults, impedance cardiography indicated that all patients had abnormal data, with 44 (88%) having multiple abnormalities. Impedance cardiography showed 32 (64%) had ventricular dysfunction, 48 (96%) had vascular load abnormalities, 34 (68%) had hemodynamic abnormalities, 2 (4%) had hypovolemia, and 3 (6%) had hypervolemia. Hypertensive patients have diverse cardiovascular abnormalities that can be quantified by impedance cardiography. By stratifying patients with ventricular, vascular, and hemodynamic abnormalities, treatment could be customized based on the abnormal underlying mechanisms with the potential to rapidly control blood pressure, prevent progression of cardiovascular disease, and possibly reverse remodeling.

  4. Mobile health is worth it! Economic benefit and impact on health of a population-based mobile screening program in new Mexico.

    PubMed

    Brown-Connolly, Nancy E; Concha, Jeannie B; English, Jennifer

    2014-01-01

    HABITS for Life was a 3-year initiative to broadly deliver a statewide biometric and retinal screening program via a mobile unit throughout New Mexico at no charge to participants. The program goal-to identify health risk and improve population health status-was tested over a 3-year period. Value to participants and impact to the healthcare system were measured to quantify impact and value of investing in prevention at the community level. We used the Mobile Health Map Return-on-Investment Calculator, a mobile screening unit, biometric screening, retinography, and community coordination. Our systems included satellite, DSL, and 3G connectivity, a Tanita® (Arlington Heights, IL) automated body mass index-measuring scale, the Cholestec® (Alere™, Waltham, MA) system for biomarkers and glycosylated hemoglobin, a Canon (Melville, NY) CR-1 Mark II camera, and the Picture Archiving Communication System. In this report for the fiscal year 2011 time frame, 6,426 individuals received biometric screening, and 5,219 received retinal screening. A 15:1 return on investment was calculated; this excluded retinal screening for the under-65 year olds, estimated at $10 million in quality-adjusted life years saved. Statistically significant improvement in health status evidenced by sequential screening included a decrease in total cholesterol level (p=0.002) (n=308) and an increase in high-density lipoprotein level after the first and second screening (p=0.02 and p=0.01, respectively), but a decrease in mean random glucose level was not statistically significant (p=0.62). Retinal results indicate 28.4% (n=1,482) with a positive/abnormal finding, of which 1.79% (n=93) required immediate referral for sight-threatening retinopathy and 27% (n=1,389) required follow-up of from 3 months to 1 year. Screening programs are cost-effective and provide value in preventive health efforts. Broad use of screening programs should be considered in healthcare redesign efforts. Community-based screening is an effective strategy to identify health risk, improve access, provide motivation to change health habits, and improve physical status while returning significant value.

  5. Bone stress: a radionuclide imaging perspective. [/sup 99m/Tc-pyrophosphate

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

    Roub, L.W.; Gumerman, L.W.; Hanley, E.N. Jr.

    Thirty-five college athletes with lower leg pain underwent radiography and radionuclide studies to rule out a stress fracture. Their asymptomatic extremities and 13 pain-free athletes served as controls. Four main patterns were observed: (a) sharply marginated scintigraphic abnormalities and positive radiographs; (b) sharply marginated scintigraphic abnormalities and negatives radiographs; (c) ill-defined scintigraphic abnormalities and negative radiographs; and (d) negative radionuclide images and negative radiographs. Since the patients with the first two patterns were otherwise identical medically, the authors feel that this scintigraphic appearance is characterisic of bone stress in the appropriate clinical setting, regardless of the radiographic findings. A schemamore » is proposed to explain the occurrence of positive radionuclide images and negative radiographs in the same patient, using a broad conceptual approach to the problem of bone stress.« less

  6. Bipolar cloud-to-ground lightning flash observations

    NASA Astrophysics Data System (ADS)

    Saba, Marcelo M. F.; Schumann, Carina; Warner, Tom A.; Helsdon, John H.; Schulz, Wolfgang; Orville, Richard E.

    2013-10-01

    lightning is usually defined as a lightning flash where the current waveform exhibits a polarity reversal. There are very few reported cases of cloud-to-ground (CG) bipolar flashes using only one channel in the literature. Reports on this type of bipolar flashes are not common due to the fact that in order to confirm that currents of both polarities follow the same channel to the ground, one necessarily needs video records. This study presents five clear observations of single-channel bipolar CG flashes. High-speed video and electric field measurement observations are used and analyzed. Based on the video images obtained and based on previous observations of positive CG flashes with high-speed cameras, we suggest that positive leader branches which do not participate in the initial return stroke of a positive cloud-to-ground flash later generate recoil leaders whose negative ends, upon reaching the branch point, traverse the return stroke channel path to the ground resulting in a subsequent return stroke of opposite polarity.

  7. Finding the Return Path: Landmark Position Effects and the Influence of Perspective

    PubMed Central

    Karimpur, Harun; Röser, Florian; Hamburger, Kai

    2016-01-01

    Much research has been done on how people find their way from one place to another. Compared to that, there is less research available on how people find back from the destination to their origin. We first present theoretical approaches to perceptual and cognitive processes involved in finding a return path, including concepts, such as visibility, structural salience, and allocentric versus egocentric perspective, followed by a series of three experiments. In these experiments, we presented subjects intersections that contained landmark information on different positions. In order to investigate the processes involved, we used different measures, such as route-continuation (in learning direction and in opposite direction) and free-recall of route information. In summary, the results demonstrate the importance of landmark positions at intersections (structural salience in combination with perspective) and that finding the return path is more difficult than reproducing the same route from the learning condition. All findings will be discussed with respect to the current research literature on landmark-based wayfinding. PMID:28066283

  8. In vivo Diagnosis of Cervical Intraepithelial Neoplasia Using 337-nm- Excited Laser-Induced Fluorescence

    NASA Astrophysics Data System (ADS)

    Ramanujam, N.; Mitchell, M. F.; Mahadevan, A.; Warren, S.; Thomsen, S.; Silva, E.; Richards-Kortum, R.

    1994-10-01

    Laser-induced fluorescence at 337-nm excitation was used in vivo to differentiate neoplastic [cervical intraepithelial neoplasia (CIN)], nonneoplastic abnormal (inflammation and human papilloma viral infection), and normal cervical tissues. A colposcope (low-magnification microscope used to view the cervix with reflected light) was used to identify 66 normal and 49 abnormal (5 inflammation, 21 human papilloma virus infection, and 23 CIN) sites on the cervix in 28 patients. These sites were then interrogated spectroscopically. A two-stage algorithm was developed to diagnose CIN. The first stage differentiated histologically abnormal tissues from colposcopically normal tissues with a sensitivity, specificity, and positive predictive value of 92%, 90%, and 88%, respectively. The second stage differentiated preneoplastic and neoplastic tissues from nonneoplastic abnormal tissues with a sensitivity, specificity, and positive predictive value of 87%, 73%, and 74%, respectively. Spectroscopic differences were consistent with a decrease in the absolute contribution of collagen fluorescence, an increase in the absolute contribution of oxyhemoglobin attenuation, and an increase in the relative contribution of reduced nicotinamide dinucleotide phosphate [NAD(P)H] fluorescence as tissue progresses from normal to abnormal in the same patient. These results suggest that in vivo fluorescence spectroscopy of the cervix can be used to diagnose CIN at colposcopy.

  9. Abnormal movements in first-episode, nonaffective psychosis: dyskinesias, stereotypies, and catatonic-like signs

    PubMed Central

    Compton, Michael T.; Fantes, Francisco; Wan, Claire Ramsay; Johnson, Stephanie; Walker, Elaine F.

    2015-01-01

    Motor abnormalities represent a neurobehavioral domain of signs intrinsic to schizophrenia-spectrum disorders, though they are commonly attributed to medication side effects and remain understudied. Individuals with first-episode psychosis represent an ideal group to study innate movement disorders due to minimal prior antipsychotic exposure. We measured dyskinesias, stereotypies, and catatonic-like signs and examined their associations with: (1) age at onset psychotic symptoms and duration of untreated psychosis; (2) positive, negative, and disorganized symptoms; (3) neurocognition; and (4) neurological soft signs. Among 47 predominantly African American first-episode psychosis patients in a public-sector hospital, the presence and severity of dyskinesias, stereotypies, and catatonic-like features were assessed using approximately 30-minute video recordings. Movement abnormalities were rated utilizing three scales (Dyskinesia Identification System Condensed User Scale, Stereotypy Checklist, and Catatonia Rating Scale). Correlational analyses were conducted. Scores for each of three movement abnormality types were modestly inter-correlated (r=.29-.40). Stereotypy score was significantly associated with age at onset of psychotic symptoms (r=.32) and positive symptom severity scores (r=.29–.41). There were no meaningful or consistent associations with negative symptom severity, neurocognition, or neurological soft signs. Abnormal movements appear to represent a relatively distinct phenotypic domain deserving of further research. PMID:25619434

  10. Spreading Photoparoxysmal EEG Response is Associated with an Abnormal Cortical Excitability Pattern

    ERIC Educational Resources Information Center

    Siniatchkin, Michael; Groppa, Sergey; Jerosch, Bettina; Muhle, Hiltrud; Kurth, Christoph; Shepherd, Alex J.; Siebner, Hartwig; Stephani, Ulrich

    2007-01-01

    Photosensitivity or photoparoxysmal response (PPR) is a highly heritable electroencephalographic trait characterized by an abnormal cortical response to intermittent photic stimulation (IPS). In PPR-positive individuals, IPS induces spikes, spike-waves or intermittent slow waves. The PPR may be restricted to posterior visual areas (i.e. local PPR…

  11. A Volunteer Program for Abnormal Psychology Students: Eighteen Years and Still Going Strong.

    ERIC Educational Resources Information Center

    Scogin, Forrest; Rickard, Henry C.

    1987-01-01

    A volunteer experience in abnormal psychology is described. The program has been operating for 18 years, and student reactions have been quite positive. The program augments the traditional course offerings and provides reciprocal service for the University of Alabama and mental health facilities. Guidelines for implementing a volunteer program…

  12. [Acute hepatitis following amiodarone administration].

    PubMed

    Tagliamonte, E; Cice, G; Ducceschi, V; Mayer, M S; Iacono, A

    1997-09-01

    A 61 year old man, treated with amiodarone since 1993 for resistant supraventricular arrhythmias, developed acute hepatitis after an intravenous amiodarone administration. Kidney and liver function tests were performed and pointed out abnormal results. Symptoms ascribable to hepatotoxicity were absent. These changes returned to normal levels within 20 days from withdrawal of the drug. Amiodarone hepatotoxicity can be related to prolonged therapy with a high dose. Intravenous amiodarone may cause acute hepatic disease, but it is suggested that polysorbate 80, a solvent added to the intravenous infusion, is a more likely cause of this complication.

  13. Current medical management of endocrine-related male infertility

    PubMed Central

    Ring, Joshua D; Lwin, Aye A; Köhler, Tobias S

    2016-01-01

    Male factor contributes to 50%–60% of overall infertility but is solely responsible in only 20% of couples. Although most male factor infertility is ascertained from an abnormal semen analysis, other male factors can be contributory especially if the sample returns normal. Male infertility can be due to identifiable hormonal or anatomical etiologies that may be reversible or irreversible. This manuscript will highlight existing guidelines and our recommendations for hormone evaluation for male infertility and empiric therapies including multivitamins, estrogen receptor modulators (clomiphene), estrogen conversion blockers (anastrozole), and hormone replacement. PMID:27098657

  14. Timeliness of abnormal screening and diagnostic mammography follow-up at facilities serving vulnerable women.

    PubMed

    Goldman, L Elizabeth; Walker, Rod; Hubbard, Rebecca; Kerlikowske, Karla

    2013-04-01

    Whether timeliness of follow-up after abnormal mammography differs at facilities serving vulnerable populations, such as women with limited education or income, in rural areas, and racial/ethnic minorities is unknown. We examined receipt of diagnostic evaluation after abnormal mammography using 1998-2006 Breast Cancer Surveillance Consortium-linked Medicare claims. We compared whether time to recommended breast imaging or biopsy depended on whether women attended facilities serving vulnerable populations. We characterized a facility by the proportion of mammograms performed on women with limited education or income, in rural areas, or racial/ethnic minorities. We analyzed 30,874 abnormal screening examinations recommended for follow-up imaging across 142 facilities and 10,049 abnormal diagnostic examinations recommended for biopsy across 114 facilities. Women at facilities serving populations with less education or more racial/ethnic minorities had lower rates of follow-up imaging (4%-5% difference, P<0.05), and women at facilities serving more rural and low-income populations had lower rates of biopsy (4%-5% difference, P<0.05). Women undergoing biopsy at facilities serving vulnerable populations had longer times until biopsy than those at facilities serving nonvulnerable populations (21.6 vs. 15.6 d; 95% confidence interval for mean difference 4.1-7.7). The proportion of women receiving recommended imaging within 11 months and biopsy within 3 months varied across facilities (interquartile range, 85.5%-96.5% for imaging and 79.4%-87.3% for biopsy). Among Medicare recipients, follow-up rates were slightly lower at facilities serving vulnerable populations, and among those women who returned for diagnostic evaluation, time to follow-up was slightly longer at facilities that served vulnerable population. Interventions should target variability in follow-up rates across facilities, and evaluate effectiveness particularly at facilities serving vulnerable populations.

  15. Left lobe of the prostate during clinical prostate cancer screening: the dark side of the gland for right-handed examiners.

    PubMed

    Ploussard, G; Nicolaiew, N; Mongiat-Artus, P; Terry, S; Allory, Y; Vacherot, F; Abbou, C-C; Desgrandchamps, F; Salomon, L; de la Taille, A

    2014-06-01

    The predictive value of the abnormality side during digital rectal examination (DRE) has never been studied, suggesting that physicians examined the left lobe of the gland as well as the right lobe. We aimed to assess the predictive value of the side of DRE abnormality for prostate cancer (PCa) detection and aggressiveness in right-handed urologists. An analysis of a prospective database was carried out that included all consecutive men undergoing prostate biopsies between 2001 and 2012. The main end point was the predictive value of the abnormality side during DRE for cancer detection in clinically suspicious unilateral T2 disease. The diagnostic performance of left- versus right-sided abnormality was also assessed in terms of sensitivity, specificity and negative/positive predictive values. Overall, 308 patients had a suspicious unilateral clinical disease (detection rate 57.5%). The cancer detection rate was significantly higher in case of left-sided compared with right-sided clinical T2 stage (odds ratio 2.1). In case of left-sided disease, the number of positive cores, the rate of perineural invasion, the rate of primary grade 4 pattern and the percentage of cancer involvement per core were significantly higher compared with those reported for right-sided disease. The predictive value of abnormality laterality for cancer detection and aggressiveness remained statistically independent in multivariate models. The positive predictive value for cancer detection was 64.6 in case of suspicious left-sided disease versus 46.9 in case of right-sided disease. The risks of detecting PCa and aggressive disease on biopsy are significantly higher when DRE reveals a suspicious left-sided clinical disease as compared with right-sided disease. Right-handed physicians should be aware of this variance in diagnostic performance and potential underdetection of left-sided clinical disease, and should improve their examination of the left lobe of the gland by conducting longer exams or changing the patient's position.

  16. Cardiovascular screening in adolescents and young adults: a prospective study comparing the Pre-participation Physical Evaluation Monograph 4th Edition and ECG.

    PubMed

    Fudge, Jessie; Harmon, Kimberly G; Owens, David S; Prutkin, Jordan M; Salerno, Jack C; Asif, Irfan M; Haruta, Alison; Pelto, Hank; Rao, Ashwin L; Toresdahl, Brett G; Drezner, Jonathan A

    2014-08-01

    This study compares the accuracy of cardiovascular screening in active adolescents and young adults using a standardised history, physical examination and resting 12-lead ECG. Participants were prospectively screened using a standardised questionnaire based on the Pre-participation Physical Evaluation Monograph 4th Edition (PPE-4), physical examination and ECG interpreted using modern standards. Participants with abnormal findings had focused echocardiography and further evaluation. Primary outcomes included disorders associated with sudden cardiac arrest (SCA). From September 2010 to July 2011, 1339 participants underwent screening: age 13-24 (mean 16) years, 49% male, 68% Caucasian, 17% African-American and 1071 (80%) participating in organised sports. Abnormal history responses were reported on 916 (68%) questionnaires. After physician review, 495/916 (54%) participants with positive questionnaires were thought to have non-cardiac symptoms and/or a benign family history and did not warrant additional evaluation. Physical examination was abnormal in 124 (9.3%) participants, and 72 (5.4%) had ECG abnormalities. Echocardiograms were performed in 586 (44%) participants for abnormal history (31%), physical examination (8%) or ECG (5%). Five participants (0.4%) were identified with a disorder associated with SCA, all with ECG-detected Wolff-Parkinson-White. The false-positive rates for history, physical examination and ECG were 31.3%, 9.3% and 5%, respectively. A standardised history and physical examination using the PPE-4 yields a high false-positive rate in a young active population with limited sensitivity to identify those at risk for SCA. ECG screening has a low false-positive rate using modern interpretation standards and improves detection of primary electrical disease at risk of SCA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Frequency of Nucleic Acid Amplification Test Positivity Among Men Who Have Sex With Men Returning for a Test-of-Cure Visit 7 to 30 Days After Treatment of Laboratory-Confirmed Neisseria gonorrhoeae Infection at 2 Public Sexual Health Clinics, New York City, 2013 to 2016.

    PubMed

    Okah, Ebiere; Westheimer, Emily F; Jamison, Kelly; Schillinger, Julia A

    2018-03-01

    The Centers for Disease Control and Prevention 2015 Sexually Transmitted Disease Treatment Guidelines recommend that clinicians consider cephalosporin treatment failure in patients who deny interval sexual exposure and are nucleic acid amplification test (NAAT) positive for Neisseria gonorrhoeae (NG) at least 7 days after adequate treatment. We evaluate the real-world implications of the interval the Centers for Disease Control and Prevention recommends for a NAAT test-of-cure (TOC), by ascertaining the frequency of NG NAAT positivity at different anatomic sites among men who have sex with men (MSM) at TOC 7 to 30 days after treatment. We analyzed data from the medical records of MSM with laboratory-confirmed NG who were presumptively treated for NG during the period from June 2013 to April 2016 and returned for a TOC visit within 30 days. Data examined included symptoms, site of NG specimen collection, treatment regimen, follow-up testing, and intervening sexual activity. There were 1027 NG-positive specimens obtained from 763 MSM patients at 889 presumptive treatment visits. Of these, 44% (337/763) MSM returned for 1 or more TOC visits, and 413 specimens were collected a median of 10 days after presumptive treatment. Three percent (14/413) of specimens collected were NG NAAT positive at TOC a median of 13 days after treatment: 5% (12/256) of urethral specimens, 1% (1/147) of anorectal specimens (P = 0.037, urethral vs. anorectal), and 10% (1/10) of oropharyngeal specimens (P = 0.40, urethral vs. oropharyngeal). A small percent of patients were NG NAAT positive at TOC. Compared with anorectal specimens, urethral specimens were more frequently still positive at TOC. A large proportion of MSM will return for a TOC visit as part of standard clinical care.

  18. Short-term market reaction after trading halts in Chinese stock market

    NASA Astrophysics Data System (ADS)

    Xu, Hai-Chuan; Zhang, Wei; Liu, Yi-Fang

    2014-05-01

    In this paper, we study the dynamics of absolute return, trading volume and bid-ask spread after the trading halts using high-frequency data from the Shanghai Stock Exchange. We deal with all three types of trading halts, namely intraday halts, one-day halts and inter-day halts, of 203 stocks in Shanghai Stock Exchange from August 2009 to 2011. We find that absolute return, trading volume, and in case of bid-ask spread around intraday halts share the same pattern with a sharp peak and a power law relaxation after that. While for different types of trading halts, the peaks’ height and the relaxation exponents are different. From the perspective of halt reasons or halt durations, the relaxation exponents of absolute return after inter-day halts are larger than those after intraday halts and one-day halts, which implies that inter-day halts are most effective. From the perspective of price trends, the relaxation exponents of excess absolute return and excess volume for positive events are larger than those for negative events in case of intraday halts and one-day halts, implying that positive events are more effective than negative events for intraday halts and one-day halts. In contrast, negative events are more effective than positive events for inter-day halts.

  19. Orion Optical Navigation for Loss of Communication Lunar Return Contingencies

    NASA Technical Reports Server (NTRS)

    Getchius, Joel; Hanak, Chad; Kubitschek, Daniel G.

    2010-01-01

    The Orion Crew Exploration Vehicle (CEV) will replace the Space Shuttle and serve as the next-generation spaceship to carry humans back to the Moon for the first time since the Apollo program. For nominal lunar mission operations, the Mission Control Navigation team will utilize radiometric measurements to determine the position and velocity of Orion and uplink state information to support Lunar return. However, in the loss of communications contingency return scenario, Orion must safely return the crew to the Earth's surface. The navigation design solution for this loss of communications scenario is optical navigation consisting of lunar landmark tracking in low lunar orbit and star- horizon angular measurements coupled with apparent planetary diameter for Earth return trajectories. This paper describes the optical measurement errors and the navigation filter that will process those measurements to support navigation for safe crew return.

  20. Evaluation of ALK gene rearrangement in central nervous system metastases of non-small-cell lung cancer using two-step RT-PCR technique.

    PubMed

    Nicoś, M; Krawczyk, P; Wojas-Krawczyk, K; Bożyk, A; Jarosz, B; Sawicki, M; Trojanowski, T; Milanowski, J

    2017-12-01

    RT-PCR technique has showed a promising value as pre-screening method for detection of mRNA containing abnormal ALK sequences, but its sensitivity and specificity is still discussable. Previously, we determined the incidence of ALK rearrangement in CNS metastases of NSCLC using IHC and FISH methods. We evaluated ALK gene rearrangement using two-step RT-PCR method with EML4-ALK Fusion Gene Detection Kit (Entrogen, USA). The studied group included 145 patients (45 females, 100 males) with CNS metastases of NSCLC and was heterogeneous in terms of histology and smoking status. 21% of CNS metastases of NSCLC (30/145) showed presence of mRNA containing abnormal ALK sequences. FISH and IHC tests confirmed the presence of ALK gene rearrangement and expression of ALK abnormal protein in seven patients with positive result of RT-PCR analysis (4.8% of all patients, 20% of RT-PCR positive patients). RT-PCR method compared to FISH analysis achieved 100% of sensitivity and only 82.7% of specificity. IHC method compared to FISH method indicated 100% of sensitivity and 97.8% of specificity. In comparison to IHC, RT-PCR showed identical sensitivity with high number of false positive results. Utility of RT-PCR technique in screening of ALK abnormalities and in qualification patients for molecularly targeted therapies needs further validation.

  1. Evaluation of gonorrhea test of cure at 1 week in a Los Angeles community-based clinic serving men who have sex with men.

    PubMed

    Beymer, Matthew R; Llata, Eloisa; Stirland, Ali M; Weinstock, Hillard S; Wigen, Christine L; Guerry, Sarah L; Mejia, Everardo; Bolan, Robert K

    2014-10-01

    Because of the decreasing susceptibility of Neisseria gonorrhoeae to cephalosporin therapy, the Centers for Disease Control and Prevention recommends test of cure (TOC) 1 week after gonorrhea (GC) treatment if therapies other than ceftriaxone are used. In addition, the Centers for Disease Control and Prevention asks clinicians, particularly those caring for men who have sex with men (MSM) on the west coast, to consider retesting all MSM at 1 week. However, it is unclear if this is acceptable to providers and patients or if nucleic acid amplification tests (NAATs) are useful for TOC at 7 days. Between January and July 2012, MSM with GC were advised to return 1 week after treatment for TOC using NAAT. A multivariate logistic regression model was used to determine demographic and behavioral differences between MSM who returned for follow-up and MSM who did not. Of 737 men with GC, 194 (26.3%) returned between 3 and 21 days of treatment. Individuals who returned were more likely to have no GC history (P = 0.0001) and to report no initial symptoms (P = 0.02) when compared with individuals who did not return for TOC. Of those who returned, 0% of urethral samples, 7.4% of rectal samples, and 5.3% of pharyngeal samples were NAAT positive at TOC. Although TOC may be an important strategy in reducing complications and the spread of GC, low return rates may make implementation challenging. If implemented, extra efforts should be considered to enhance return rates among individuals with a history of GC. If TOCs are recommended at 1 week and NAATs are used, the interpretation of positive results, particularly those from extragenital sites, may be difficult.

  2. [A comparative analysis of anti-N-methyl-D-aspartate receptor encephalitis with or without abnormal findings on cranial magnetic resonance imaging].

    PubMed

    Zhang, Jian-Zhao; Chen, Qian; Zheng, Ping; Xie, Li-Na; Yi, Xiao-Li; Ren, Hai-Tao; Yang, Jian

    2018-01-01

    To investigate the clinical features of children with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis with normal or abnormal cranial magnetic resonance imaging (MRI) findings via a comparative analysis. A retrospective analysis was performed for the clinical data of 33 children with anti-NMDAR encephalitis. The clinical features and prognosis were compared between the children with normal and abnormal cranial MRI findings. In the 33 children with anti-NMDAR encephalitis, the most common initial symptoms were seizures (61%) and involuntary movement (61%), followed by language disorder (54%), mental and behavioral abnormalities (52%), and disturbance of consciousness (30%). All children had positive anti-NMDAR antibody in the cerebrospinal fluid, and 29 children (88%) had positive serum antibody. Of all the children, 15 (46%) had increased leukocytes in the cerebrospinal fluid, 3 (9%) had an increase in protein, and 29 (88%) had positive oligoclonal band; 26 children (79%) had electroencephalographic abnormalities (epileptic wave, slow wave, or a combination of these two types of waves). One child experienced respiratory failure. One child was found to have germinoma in the sellar region during follow-up. Of all the 33 children, 13 (39%) had abnormal cranial MRI findings, with hypointensity or isointensity on T1W1 and hyperintensity on T2WI and T2-FLAIR; 2 children had dural enhancement. As for the location of lesion, 5 children (38%) had lesions in the temporal lobe, 3 (23%) in the frontal lobe, 3 (23%) in the basal ganglia, 2 (15%) in the parietal lobe, 2 (15%) in the occipital lobe, 2 (15%) in the brainstem, 1 (8%) in the thalamus, and 1 (8%) in the cerebellum. Among the 13 children with abnormal cranial MRI findings, 5 (38%) had lesions mainly in the grey matter and 8 (62%) had lesions mainly in the white matter. Compared with the children with normal cranial MRI findings, the children with abnormal cranial MRI findings had significantly higher proportion of children with prodromal infection, incidence rate of disturbance of consciousness, probability of recurrence, Glasgow score, incidence rate of increased leukocytes in the cerebrospinal fluid, and application rate of second-line treatment (P<0.05). Children with anti-NMDAR encephalitis and abnormal cranial MRI findings have certain clinical features, which may provide guidance for the evaluation of disease conditions and the selection of diagnostic and treatment measures.

  3. Use of Factor Mixture Modeling to Capture Spearman's Law of Diminishing Returns

    ERIC Educational Resources Information Center

    Reynolds, Matthew R.; Keith, Timothy Z.; Beretvas, S. Natasha

    2010-01-01

    Spearman's law of diminishing returns (SLODR) posits that at higher levels of general cognitive ability the general factor ("g") performs less well in explaining individual differences in cognitive test performance. Research has generally supported SLODR, but previous research has required the a priori division of respondents into…

  4. Begin Again

    ERIC Educational Resources Information Center

    Circle, David

    2005-01-01

    Times have changed. Now classes often continue into June, and teachers return to their classrooms in the middle of August, if not before. Thinking positively, the benefit of a shortened summer is that students have less time away from school to forget what they learned. Therefore, teachers may not have as much reteaching when students return. One…

  5. Early Learning: Return on Investment. Annotated Bibliography

    ERIC Educational Resources Information Center

    Hite, Jenny

    2014-01-01

    Today's researchers seek to determine if contemporary pre-K programs provide the strong return on investment found by researchers in the 1960's High/Scope Perry Preschool Program and 1970's North Carolina Abecedarian Project. Research then showed that these two programs created positive academic effects that accompanied their students as they…

  6. Return Migration as Failure or Success?: The Determinants of Return Migration Intentions Among Moroccan Migrants in Europe.

    PubMed

    de Haas, Hein; Fokkema, Tineke; Fihri, Mohamed Fassi

    Different migration theories generate competing hypotheses with regard to determinants of return migration. While neoclassical migration theory associates migration to the failure to integrate at the destination, the new economics of labour migration sees return migration as the logical stage after migrants have earned sufficient assets and knowledge and to invest in their origin countries. The projected return is then likely to be postponed for sustained or indefinite periods if integration is unsuccessful. So, from an indication or result of integration failure return is rather seen as a measure of success. Drawing on recent survey data ( N  = 2,832), this article tests these hypotheses by examining the main determinants of return intention among Moroccan migrants across Europe. The results indicate that structural integration through labour market participation, education and the maintenance of economic and social ties with receiving countries do not significantly affect return intentions. At the same time, investments and social ties to Morocco are positively related, and socio-cultural integration in receiving countries is negatively related to return migration intentions. The mixed results corroborate the idea that there is no uniform process of (return) migration and that competing theories might therefore be partly complementary.

  7. A Positive Vestibular/Ocular Motor Screening (VOMS) Is Associated With Increased Recovery Time After Sports-Related Concussion in Youth and Adolescent Athletes.

    PubMed

    Anzalone, Anthony J; Blueitt, Damond; Case, Tami; McGuffin, Tiffany; Pollard, Kalyssa; Garrison, J Craig; Jones, Margaret T; Pavur, Robert; Turner, Stephanie; Oliver, Jonathan M

    2017-02-01

    Vestibular and ocular motor impairments are routinely reported in patients with sports-related concussion (SRC) and may result in delayed return to play (RTP). The Vestibular/Ocular Motor Screening (VOMS) assessment has been shown to be consistent and sensitive in identifying concussion when used as part of a comprehensive examination. To what extent these impairments or symptoms are associated with length of recovery is unknown. To examine whether symptom provocation or clinical abnormality in specific domains of the VOMS results in protracted recovery (time from SRC to commencement of RTP protocol). Cohort study (prognosis); Level of evidence, 2. A retrospective chart review was conducted of 167 patients (69 girls, 98 boys; mean ± SD age, 15 ± 2 years [range, 11-19 years]) presenting with SRC in 2014. During the initial visit, VOMS was performed in which symptom provocation or clinical abnormality (eg, unsmooth eye movements) was documented by use of a dichotomous scale (0 = not present, 1 = present). The VOMS used in this clinic consisted of smooth pursuits (SMO_PUR), horizontal and vertical saccades (HOR_SAC and VER_SAC), horizontal and vertical vestibular ocular reflex (HOR_VOR and VER_VOR), near point of convergence (NPC), and accommodation (ACCOM). Domains were also categorized into ocular motor (SMO_PUR, HOR_SAC, VER_SAC, NPC, ACCOM) and vestibular (HOR_VOR, VER_VOR). Cox proportional hazard models were used to explore the relationship between the domains and recovery. Alpha was set at P ≤ .05. Symptom provocation and/or clinical abnormality in all domains except NPC ( P = .107) and ACCOM ( P = .234) delayed recovery (domain, hazard ratio [95% CI]: SMO_PUR, 0.65 [0.47-0.90], P = .009; HOR_SAC, 0.68 [0.50-0.94], P = .018; VER_SAC, 0.55 [0.40-0.75], P < .001; HOR_VOR, 0.68 [0.49-0.94], P = .018; VER_VOR, 0.60 [0.44-0.83], P = .002). The lowest crude hazard ratio was for ocular motor category (0.45 [0.32-0.63], P < .001). These data suggest that symptom provocation/clinical abnormality associated with all domains except NPC and ACCOM can delay recovery after SRC in youth and adolescents. Thus, the VOMS not only may augment current diagnostic tools but also may serve as a predictor of recovery time in patients with SRC. The findings of this study may lead to more effective prognosis of concussion in youth and adolescents.

  8. Clinical Outcomes and Return to Sport After Arthroscopic Anterior, Posterior, and Combined Shoulder Stabilization

    PubMed Central

    Kraeutler, Matthew J.; Aberle, Nicholas S.; Brown, Colin C.; Ptasinski, Joseph J.; McCarty, Eric C.

    2018-01-01

    Background: Glenohumeral instability is a common abnormality, especially among athletes. Previous studies have evaluated outcomes after arthroscopic stabilization in patients with anterior or posterior shoulder instability but have not compared outcomes between groups. Purpose: To compare return-to-sport and other patient-reported outcomes in patients after primary arthroscopic anterior, posterior, and combined anterior and posterior shoulder stabilization. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent primary arthroscopic anterior, posterior, or combined anterior and posterior shoulder stabilization were contacted at a minimum 2-year follow-up. Patients completed a survey that consisted of return-to-sport outcomes as well as the Western Ontario Shoulder Instability Index (WOSI), Single Assessment Numeric Evaluation (SANE), American Shoulder and Elbow Sur’geons (ASES) score, and Shoulder Activity Scale. Results: A total of 151 patients were successfully contacted (anterior: n = 81; posterior: n = 22; combined: n = 48) at a mean follow-up of 3.6 years. No significant differences were found between the groups with regard to age at the time of surgery or time to follow-up. No significant differences were found between the groups in terms of WOSI (anterior: 76; posterior: 70; combined: 78; P = .28), SANE (anterior: 87; posterior: 85; combined: 87; P = .79), ASES (anterior: 88; posterior: 83; combined: 91; P = .083), or Shoulder Activity Scale (anterior: 12.0; posterior: 12.5; combined: 12.5; P = .74) scores. No significant difference was found between the groups in terms of the rate of return to sport (anterior: 73%; posterior: 68%; combined: 75%; P = .84). Conclusion: Athletes undergoing arthroscopic stabilization of anterior, posterior, or combined shoulder instability can be expected to share a similar prognosis. High patient-reported outcome scores and moderate to high rates of return to sport were achieved by all groups. PMID:29637085

  9. Correlation between CD34 expression and chromosomal abnormalities but not clinical outcome in acute myeloid leukemia.

    PubMed

    Fruchart, C; Lenormand, B; Bastard, C; Boulet, D; Lesesve, J F; Callat, M P; Stamatoullas, A; Monconduit, M; Tilly, H

    1996-11-01

    The hemopoietic stem cell marker CD34 has been reported to be a useful predictor of treatment outcome in acute myeloid leukemia (AML). Previous data suggested that CD34 expression may be associated with other poor prognosis factors in AML such as undifferentiated leukemia, secondary AML (SAML), and clonal abnormalities involving chromosome 5 and 7. In order to analyze the correlations between the clinicopathologic features, cytogenetic and CD34 expression in AML, we retrospectively investigated 99 patients with newly diagnosed AML: 85 with de novo disease and 14 with secondary AML (SAML). Eighty-six patients who received the same induction chemotherapy were available for clinical outcome. Defining a case as positive when > or = 20% of bone marrow cells collected at diagnosis expressed the CD34 antigen, forty-five patients were included in the CD34 positive group. Ninety patients had adequate cytogenetic analysis. Thirty-two patients (72%) with CD34 positive AML exhibited an abnormal karyotype whereas 15 patients (28%) with CD34 negative AML had abnormal metaphases (P < 0.01). Monosomy 7/7q- or monosomy 5/5q- occurred in 10 patients and 8 of them expressed the CD34 antigen (P < 0.05). All patients with t(8;21) which is considered as a favorable factor in AML had levels of CD34 >/= 20% (P < 0.05). We did not find any association between CD34 expression and attainment of complete remission, overall survival, or disease-free survival. In conclusion, the variations of CD34 expression in AML are correlated with cytogenetic abnormalities associated both with poor and favorable outcome. The evaluation of the correlations between CD34 antigen and clinical outcome in AML should take into account the results of pretreatment karyotype.

  10. Abnormal thymic maturation and lymphoproliferation in MRL-Fas lpr/lpr mice can be partially reversed by synthetic oligonucleotides: implications for systemic lupus erythematosus and autoimmune lymphoproliferative syndrome.

    PubMed

    Ashman, R F; Singh, N; Lenert, P S

    2017-06-01

    MRL-Fas lpr/lpr mice represent an excellent animal model for studying non-malignant lymphoproliferation, regeneration and systemic autoimmunity. Retro-transposon insertion into the second intron of the pro-apoptotic Fas gene appears to be responsible for both lymphoproliferation and autoimmunity, while other genes are more likely to contribute to the regenerative healing characteristic of this mouse strain. Previous studies have shown that neonatal thymectomy can halt the development of abnormal lymphoproliferation. Whereas at four weeks of age primary and secondary lymphoid organs appear to be grossly intact, vigorous lymphoproliferation and autoantibody production subsequently ensues. This is first noticeable at six weeks of age, at which time lymph nodes, spleens and thymuses, but not the bone marrow, become infiltrated with abnormal B220 + CD3 + CD4 - CD8 - T cells. Around the same time, thymuses show a significant drop in CD4 + CD8 + double-positive T cells generating an abnormal ratio between double-positive and single-positive thymocytes. The objective of current study was to evaluate the effect of synthetic oligonucleotides-toll-like receptor antagonists on early lymphoid development in this strain of mice. Herein, we demonstrate the ability of synthetic oligonucleotides made with the nuclease-resistant phosphorothioate backbone to partially reverse abnormal lymphoproliferation and thymic involution in pre-diseased MRL-Fas lpr/lpr mice when administered intraperitoneally starting from week four of age. This curative effect of oligonucleotides was primary sequence/secondary oligonucleotide structure-independent, suggesting an effect through the toll-like receptor 7. A similar approach may potentially benefit patients with autoimmune lymphoproliferative syndrome who, like MRL-Fas lpr/lpr mice, carry a mutation in the Fas gene.

  11. Ordering blood tests for patients with unexplained fatigue in general practice: what does it yield? Results of the VAMPIRE trial.

    PubMed

    Koch, Hèlen; van Bokhoven, Marloes A; ter Riet, Gerben; van Alphen-Jager, Jm Tineke; van der Weijden, Trudy; Dinant, Geert-Jan; Bindels, Patrick J E

    2009-04-01

    Unexplained fatigue is frequently encountered in general practice. Because of the low prior probability of underlying somatic pathology, the positive predictive value of abnormal (blood) test results is limited in such patients. The study objectives were to investigate the relationship between established diagnoses and the occurrence of abnormal blood test results among patients with unexplained fatigue; to survey the effects of the postponement of test ordering on this relationship; and to explore consultation-related determinants of abnormal test results. Cluster randomised trial. General practices of 91 GPs in the Netherlands. GPs were randomised to immediate or postponed blood-test ordering. Patients with new unexplained fatigue were included. Limited and expanded sets of blood tests were ordered either immediately or after 4 weeks. Diagnoses during the 1-year follow-up period were extracted from medical records. Two-by-two tables were generated. To establish independent determinants of abnormal test results, a multivariate logistic regression model was used. Data of 325 patients were analysed (71% women; mean age 41 years). Eight per cent of patients had a somatic illness that was detectable by blood-test ordering. The number of false-positive test results increased in particular in the expanded test set. Patients rarely re-consulted after 4 weeks. Test postponement did not affect the distribution of patients over the two-by-two tables. No independent consultation-related determinants of abnormal test results were found. Results support restricting the number of tests ordered because of the increased risk of false-positive test results from expanded test sets. Although the number of re-consulting patients was small, the data do not refute the advice to postpone blood-test ordering for medical reasons in patients with unexplained fatigue in general practice.

  12. Interrelationship Between Organizational and Relational Aspects and the Return-to-Work Process: A Case Study with Nursing Professionals at a Teaching Hospital in Brazil.

    PubMed

    Lancman, S; Barros, J O; Silva, M D; Pereira, A R; Jardim, T A

    2017-03-01

    Introduction The process of returning to work, especially for individuals with labor restrictions, impacts work teams and interferes with the labor reinsertion process. In this study, we aimed to understand the impact of these situations on a nursing team from both organizational and relational perspectives. Methods We conducted a qualitative research study at a university hospital in the municipality of São Paulo using three strategies: documentary analysis; semi-structured interviews with pairs of workers returning to a labor situation; and a focus group with nursing managers. Results Medical leaves of absence overburden the employees who remain working. Regarding the return to work, the participants reported both positive and negative aspects. One positive aspect reported was that those who return to work contribute to the division of labor, generating solidarity and cooperation. The negative aspects reported were related to the return of workers with labor restrictions who do not fully resume their activities, consequently generating conflicts within the work teams that interfere with the reintegration processes. The supervisors reported difficulties reorganizing work on a broad scale and assessing the workers' diagnoses and symptoms and the workers themselves in terms of the necessity of their leaves and the validity of their labor restrictions. Conclusion The organization of labor and social relationships among peers and supervisors is a significant contributor to the success or failure of the work reintegration process and therefore should be considered. We aimed to address this issue by highlighting the complexity of the return-to-work process among health workers.

  13. Health-promoting behaviors through pregnancy, maternity leave, and return to work: effects of role spillover and other correlates.

    PubMed

    Grace, Sherry L; Williams, Alysha; Stewart, Donna E; Franche, Renée-Louise

    2006-01-01

    Women's health-promoting behavior changes and their correlates across the transition to motherhood and return to work are insufficiently understood. The purpose of this study was to describe and compare women's health-promoting behaviors, particularly physical activity (PA), across these transitions. A prospective, observational design was employed to assess 243 female healthcare workers from 3 sites with regard to health-promoting behaviors, and their demographic (e.g., age, parity) and psychosocial (i.e., work-family role spillover) correlates. Forty-two participants were recruited while pregnant and re-assessed during maternity leave and upon return to work, and compared to 201 non-pregnant participants. No significant changes in health-promoting behaviors were observed from pregnancy through the postpartum. Pregnant participants reported better nutrition than comparison participants (p=.001), and were more likely to check their pulse when exercising (p=.004). During pregnancy, health-promoting behaviors were related to parental status, with first-time mothers engaging in more positive behaviors. Correlates of PA during maternity leave and return to work included family income and exercise history. Positive family-to-work spillover was significantly greater among pregnant women than among comparison participants (p<.001), and positive work-to-family spillover was related to greater PA upon return to work (p<.01). This study reveals little variability in health-promoting behaviors from the prenatal to the postpartum period. Both demographic and psychosocial factors have effects on health-promoting behaviors, and we must look to these correlates to promote increased PA.

  14. Rehabilitation After Hamstring-Strain Injury Emphasizing Eccentric Strengthening at Long Muscle Lengths: Results of Long-Term Follow-Up.

    PubMed

    Tyler, Timothy F; Schmitt, Brandon M; Nicholas, Stephen J; McHugh, Malachy P

    2017-04-01

    Hamstring-strain injuries have a high recurrence rate. To determine if a protocol emphasizing eccentric strength training with the hamstrings in a lengthened position resulted in a low recurrence rate. Longitudinal cohort study. Sports-medicine physical therapy clinic. Fifty athletes with hamstring-strain injury (age 36 ± 16 y; 30 men, 20 women; 3 G1, 43 G2, 4 G3; 25 recurrent injuries) followed a 3-phase rehabilitation protocol emphasizing eccentric strengthening with the hamstrings in a lengthened position. Injury recurrence; isometric hamstring strength at 80°, 60°, 40°, and 20° knee flexion in sitting with the thigh flexed to 40° above the horizontal and the seat back at 90° to the horizontal (strength tested before return to sport). Four of the 50 athletes sustained reinjuries between 3 and 12 mo after return to sport (8% recurrence rate). The other 42 athletes had not sustained a reinjury at an average of 24 ± 12 mo after return to sport. Eight noncompliant athletes did not complete the rehabilitation and returned to sport before initiating eccentric strengthening in the lengthened state. All 4 reinjuries occurred in these noncompliant athletes. At time of return to sport, compliant athletes had full restoration of strength while noncompliant athletes had significant hamstring weakness, which was progressively worse at longer muscle lengths (compliance × side × angle P = .006; involved vs noninvolved at 20°, compliant 7% stronger, noncompliant 43% weaker). Compliance with rehabilitation emphasizing eccentric strengthening with the hamstrings in a lengthened position resulted in no reinjuries.

  15. Prevalence, distribution, and progression of radiographic abnormalities in the lungs of cold-stunned Kemp's ridley sea turtles (Lepidochelys kempii): 89 cases (2002-2005).

    PubMed

    Stockman, Jonathan; Innis, Charles J; Solano, Mauricio; O'Sullivan Brisson, Jennifer; Kass, Philip H; Tlusty, Michael F; Weber, E Scott

    2013-03-01

    To evaluate the prevalence, distribution, and progression of radiographic abnormalities in the lungs of cold-stunned Kemp's ridley sea turtles (Lepidochelys kempii) and associations between these abnormalities and body weight, carapace length, and hematologic and plasma biochemical variables. Retrospective case series. 89 cold-stunned juvenile Kemp's ridley sea turtles. Medical records were reviewed. Dorsoventral and horizontal beam craniocaudal radiographs were evaluated for the presence, distribution, and progression of lung abnormalities. Turtles were categorized as having radiographically normal or abnormal lungs; those with abnormalities detected were further categorized according to the distribution of abnormalities (left lung, right lung, or both affected). Body weight, carapace length, and hematologic and plasma biochemical data were compared among categories. 48 of 89 (54%) turtles had radiographic abnormalities of the lungs. Unilateral abnormalities of the right or left lung were detected in 14 (16%) and 2 (2%), respectively; both lungs were affected in 32 (36%). Prevalence of unilateral abnormalities was significantly greater for the right lung than for the left lung. Evaluation of follow-up radiographs indicated clinical improvement over time for most (18/31 [58%]) turtles. Prevalence of bilateral radiographic abnormalities was positively correlated with body weight and carapace length. There was no significant association between radiographic category and hematologic or plasma biochemical variables. Radiographic abnormalities of the lungs were commonly detected in cold-stunned Kemp's ridley turtles. Results of this study may aid clinicians in developing effective diagnostic and treatment plans for these patients.

  16. The prevalence of chromosomal abnormalities in subgroups of infertile men.

    PubMed

    Dul, E C; Groen, H; van Ravenswaaij-Arts, C M A; Dijkhuizen, T; van Echten-Arends, J; Land, J A

    2012-01-01

    The prevalence of chromosomal abnormalities is assumed to be higher in infertile men and inversely correlated with sperm concentration. Although guidelines advise karyotyping infertile men, karyotyping is costly, therefore it would be of benefit to identify men with the highest risk of chromosomal abnormalities, possibly by using parameters other than sperm concentration. The aim of this study was to evaluate several clinical parameters in azoospermic and non-azoospermic men, in order to assess the prevalence of chromosomal abnormalities in different subgroups of infertile men. In a retrospective cohort of 1223 azoospermic men and men eligible for ICSI treatment, we studied sperm parameters, hormone levels and medical history for an association with chromosomal abnormalities. The prevalence of chromosomal abnormalities in the cohort was 3.1%. No association was found between chromosomal abnormalities and sperm volume, concentration, progressive motility or total motile sperm count. Azoospermia was significantly associated with the presence of a chromosomal abnormality [15.2%, odds ratio (OR) 7.70, P < 0.001]. High gonadotrophin levels were also associated with an increased prevalence of chromosomal abnormalities (OR 2.96, P = 0.013). Azoospermic men with a positive andrologic history had a lower prevalence of chromosomal abnormalities than azoospermic men with an uneventful history (OR 0.28, P = 0.047). In non-azoospermic men, we found that none of the studied variables were associated with the prevalence of chromosomal abnormalities. We show that the highest prevalence of chromosomal abnormalities is found in hypergonadotrophic azoospermic men with an uneventful andrologic history.

  17. Severity of psychosis syndrome and change of metabolic abnormality in chronic schizophrenia patients: severe negative syndrome may be related to a distinct lipid pathophysiology.

    PubMed

    Chen, S-F; Hu, T-M; Lan, T-H; Chiu, H-J; Sheen, L-Y; Loh, E-W

    2014-03-01

    Metabolic abnormality is common among schizophrenia patients. Some metabolic traits were found associated with subgroups of schizophrenia patients. We examined a possible relationship between metabolic abnormality and psychosis profile in schizophrenia patients. Three hundred and seventy-two chronic schizophrenia patients treated with antipsychotics for more than 2 years were assessed with the Positive and Negative Syndrome Scale. A set of metabolic traits was measured at scheduled checkpoints between October 2004 and September 2006. Multiple regressions adjusted for sex showed negative correlations between body mass index (BMI) and total score and all subscales; triglycerides (TG) was negatively correlated with total score and negative syndrome, while HDLC was positively correlated with negative syndrome. When sex interaction was concerned, total score was negatively correlated with BMI but not with others; negative syndrome was negatively correlated with BMI and positively with HDLC. No metabolic traits were correlated with positive syndrome or general psychopathology. Loss of body weight is a serious health problem in schizophrenia patients with severe psychosis syndrome, especially the negative syndrome. Schizophrenia patients with severe negative syndrome may have a distinct lipid pathophysiology in comparison with those who were less severe in the domain. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  18. Utility of genetic testing for the detection of late-onset hearing loss in neonates.

    PubMed

    Lim, B Gail; Clark, Reese H; Kelleher, Amy S; Lin, Zhili; Spitzer, Alan R

    2013-12-01

    The purpose of this study was to demonstrate the utility of molecular testing in the detection of potentially important causes of delayed hearing loss missed by current audiometric screening at birth. We enrolled infants who had received a newborn audiometric hearing screen and a filter paper blood collection for state newborn screening. A central laboratory ran the SoundGene® panel. Of 3,681 infants studied, 35 (0.95%) had a positive SoundGene panel, 16 had mitochondrial mutations, 9 had Pendred mutations, 5 were cytomegalovirus (CMV) DNA positive, 2 had connexin mutations, and 3 had a combination of different mutations. Infants with an abnormal SoundGene panel were at increased risk for hearing loss compared to neonates without mutations. Three (8.6%) of the 35 subjects had persistent hearing loss compared to 5 (0.21%) of 2,398 subjects with no report of mutation (p < .01). Of 3,681 infants studied, 8 (0.22%) had persistent hearing loss: 5 (62.5%) had abnormal newborn audiometric screens, 2 (25%) had an abnormal SoundGene panel (1 was CMV positive, 1 had a mitochondrial mutation), and 1 (12.5%) had no identifiable risk factors. A positive SoundGene panel identifies infants who are not identified by audiometric testing and may be at risk for hearing loss.

  19. The effect of scapular position on subacromial contact behavior: a cadaver study.

    PubMed

    Muraki, Takayuki; Yamamoto, Nobuyuki; Sperling, John W; Steinmann, Scott P; Cofield, Robert H; An, Kai-Nan

    2017-05-01

    Patients with subacromial impingement were reported to show abnormal scapular positions during shoulder elevation. However, the relationship between the scapular positions and subacromial impingement is unclear. The purpose of this study was to biomechanically determine the effect of scapular position on subacromial contact behavior by using fresh frozen cadavers. The peak contact pressure on the coracoacromial arch was measured with a flexible tactile force sensor in 9 fresh frozen cadaver shoulders. The measurement was performed during passive glenohumeral elevation in the scapular plane ranging from 30° to 75°. The scapular downward and internal rotations and anterior tilt were simulated by tilting the scapula in 5° increments up to 20°. The measurement was also performed with combination of scapular downward and internal rotations and anterior tilt positions. The peak contact pressure decreased linearly with anterior tilt, and a significant difference between neutral scapular position (1.06 ± 0.89 MPa) and anterior tilt by 20° (0.46 ± 0.18 MPa) was observed (P < .05). However, the scapular positioning in the other directions did not change the peak contact pressure significantly. Furthermore, any combination of abnormal scapular positions did not affect peak contact pressure significantly. Scapular anterior tilt decreased peak contact pressure during passive shoulder elevation. In addition, scapular downward and internal rotations had little effect on peak contact pressure. The abnormal scapular motion reported in previous studies might not be directly related to symptoms caused by subacromial impingement. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  20. Investigation of effect of leg support elevation timing on the horizontal force acting on the buttocks in a reclining wheelchair.

    PubMed

    Kobara, Kenichi; Takahashi, Hisashi; Fujita, Daisuke; Osaka, Hiroshi; Ito, Tomotaka; Suehiro, Tadanobu; Watanabe, Susumu

    2015-08-01

    [Purpose] The purpose of this study was to investigate the effect of the timing of leg support elevation on the horizontal force acting on the buttocks in a reclining wheelchair. [Subjects and Methods] The participants were 17 healthy men. Two experimental conditions were tested: the leg-down and leg-up conditions. The back support was reclined at increasing angles, from the initial upright position (IUP), proceeding to the fully reclined position (FRP), and returned to the upright position (RUP). The posterior inclination phase was from IUP to FRP, and the returning inclination phase was from FRP to RUP. [Results] The horizontal force under the leg-up condition was significantly higher than that under the leg-down condition in all positions of back support. [Conclusion] The leg supports should be positioned downward before reclining the back support of a wheelchair.

  1. Clinical and Financial Impact of Ordering an Echocardiogram in Children with Left Axis Deviation on Their Electrocardiogram.

    PubMed

    Ravi, Prasad; Ashwath, Ravi; Strainic, James; Li, Hong; Steinberg, Jon; Snyder, Christopher

    2016-01-01

    Left axis deviation (LAD) on the electrocardiogram (ECG) is associated with congenital heart disease (CHD), prompting the clinician to order further testing when evaluating a patient with this finding. The purpose is to (1) compare the physical examination (PE) by a pediatric cardiologist to echocardiogram (ECHO) findings in patients with LAD on resting ECG and (2) assess cost of performing ECHO on all patients with LAD on ECG. An IRB approved, retrospective cohort study was performed on patients with LAD (QRS axis ≥0° to -90°) on ECG between 01/02 and 12/12. age >0.25 and <18 years, non-postoperative, and PE and ECHO by pediatric cardiologist. A decision tree model analyzed cost of ECHO in patients with LAD and normal/abnormal PE. Cost of complete ECHO ($239.00) was obtained from 2014 Medicare reimbursement rates. A total of 146 patients met inclusion criteria with 46.5% (68) having normal PE and ECHO, 1.4% (2) having normal PE and abnormal ECHO, 47.3% (69) having abnormal PE and ECHO, and 4.8% (7) having an abnormal PE and normal ECHO. Sensitivity and specificity of PE for detecting abnormalities in this population was 97% and 90%. Positive and negative predictive value of PE was 91% and 97.5%. In patients with normal PE, the cost to identify an ECHO abnormality was $8365, and $263 for those with abnormal PE. In presence of LAD on ECG, the sensitivity, specificity, and positive and negative predictive values of PE by a pediatric cardiologist are excellent at identifying CHD. Performing an ECHO on patients with LAD on ECG is only cost effective in the presence of an abnormal PE. In the presence of normal PE, there is a possibility of missing incidental structural cardiac disease in approximately 2% if an ECHO is not performed. © 2015 Wiley Periodicals, Inc.

  2. A survey of physician receptivity to molecular diagnostic testing and readiness to act on results for early-stage colon cancer patients.

    PubMed

    Myers, Ronald E; Wolf, Thomas; Shwae, Phillip; Hegarty, Sarah; Peiper, Stephen C; Waldman, Scott A

    2016-10-03

    We sought to assess physician interest in molecular prognosic testing for patients with early stage colon cancer, and identify factors associated with the likelihood of test adoption. We identified physicians who care for patients with early-stage (pN0) colon cancer patients, mailed them a survey, and analyzed survey responses to assess clinician receptivity to the use of a new molecular test (GUCY2C) that identifies patients at risk for recurrence, and clinician readiness to act on abnormal test results. Of 104 eligible potential respondents, 41 completed and returned the survey. Among responding physicians, 56 % were receptive to using the new prognostic test. Multivariable analyses showed that physicians in academic medical centers were significantly more receptive to molecular test use than those in non-academic settings. Forty-one percent of respondents were ready to act on abnormal molecular test results. Physicians who viewed current staging methods as inaccurate and were confident in their capacity to incorporate molecular testing in practice were more likely to say they would act on abnormal test results. Physician receptivity to molecular diagnostic testing for early-stage colon cancer patients is likely to be influenced by practice setting and perceptions related to delivering quality care to patients. ClinicalTrials.gov Identifier: NCT01972737.

  3. Monitoring and treatment of coagulation abnormalities in burn patients. an international survey on current practices

    PubMed Central

    Lavrentieva, A.; Depetris, N.; Kaimakamis, E.; Berardino, M.; Stella, M.

    2016-01-01

    Summary The magnitude of coagulation abnormalities, and the definition and treatment of coagulopathy in burn patients are inadequately understood and continue to be discussed in the literature. We aimed to analyse physicians’ views on monitoring and treating coagulation abnormalities in burn patients. A total of 350 questionnaires were distributed electronically to burn ICU physicians. Participation was voluntary and anonymous. Responses were analysed electronically and comparisons were made according to the region of the ICU or the specialty of the physician. Of the 350 questionnaires distributed, 55 (15.7%) were returned. The majority of burn specialists consider sepsis-induced coagulopathy to be the most frequent coagulopathy in burn patients, and 74.5% declare that they do not use any specific definition/scoring system in their department to detect coagulopathy. The majority of specialists (70.8%) use standard coagulation tests. The most frequent indications for plasma transfusion are massive bleeding (32.8%) and Disseminated Intravascular Coagulation syndrome treatment (20%). The main specific factors reported in our study are cryoprecipitate (23.2%) and fibrinogen concentrate (18.9%). 21.1% of respondents state that they do not use any specific coagulation factor substitution in burn patients. Specific coagulation factor substitution is not a routine practice. The low response rate precludes the generalization of our results. PMID:28149244

  4. Inappropriate erythropoietin secretion in polycythemia vera

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

    Chikkappa, G.; Burlington, H.; Chanana, A.D.

    1977-01-01

    A patient with classical polycythemia vera (PV) was found to have an inappropriately elevated serum erythropoietin (Ep) level. Investigations did not reveal any lesion or blood abnormality known to be associated with excessive Ep production and erythrocytosis. Sudden withdrawal of blood to reduce the Hb and Hct from 18.5 gm% and 56% to 13.6 gm% and 41.5%, respectively, resulted in an increment of serum Ep to abnormal level. With iron treatment there was a brisk return of Hb and Hct to prebleeding levels which was associated with reduction in the serum Ep. The inverse relationship between the EP and Hbmore » or Hct is inconsistent with the presence of excessive Ep-producing lesion. These results suggested that the threshold for Ep secretion from normal Ep-secreting tissue to Hb and Hct levels is set at an abnormal level. This patient's marrow cells when cultured in vitro in the absence of Ep, unlike other PV patients' (except one) marrow cells, did not grow erythroid colonies. In the presence of Ep, however, the colonies comparable to those formed from normal marrow cultures were obtained. These results suggested that his marrow erythropoietic cells were neither Ep independent nor Ep-hyperresponsive, as has been suggested by some investigators for erythropoiesis in PV. This patient presents phenomena that hitherto have not been reported.« less

  5. Performance outcomes after repair of complete achilles tendon ruptures in national basketball association players.

    PubMed

    Amin, Nirav H; Old, Andrew B; Tabb, Loni P; Garg, Rohit; Toossi, Nader; Cerynik, Douglas L

    2013-08-01

    A complete rupture of the Achilles tendon is a devastating injury. Variables affecting return to competition and performance changes for National Basketball Association (NBA) players are not readily evident. Players in the NBA who ruptured their Achilles tendons and who underwent surgical repair would have more experience in the league, and the performance of those who were able to return to competition would be decreased when compared with their performance before injury and with their control-matched peers. Cohort study; Level of evidence, 3. Data for 18 basketball players with Achilles tendon repair over a 23-year period (1988-2011) were obtained from injury reports, press releases, and player profiles. Variables included age, body mass index (BMI), player position, and number of years playing in the league. Individual season statistics were obtained, and the NBA player efficiency rating (PER) was calculated for 2 seasons before and after injury. Controls were matched by playing position, number of seasons played, and performance statistics. Univariate and multivariate analyses were performed to assess the effect of each factor. At the time of injury, the average age was 29.7 years, average BMI was 25.6, and average playing experience was 7.6 years. Seven players never returned to play an NBA game, whereas 11 players returned to play 1 season, with 8 of those players returning for ≥2 seasons. Players who returned missed an average of 55.9 games. The PER was reduced by 4.57 (P = .003) in the first season and by 4.38 (P = .010) in the second season. When compared with controls, players demonstrated a significant decline in the PER the first season (P = .038) and second season (P = .081) after their return. The NBA players who returned to play after repair of complete Achilles tendon ruptures showed a significant decrease in playing time and performance. Thirty-nine percent of players never returned to play.

  6. Effects of sex and obesity on gait biomechanics before and six months after total knee arthroplasty: A longitudinal cohort study.

    PubMed

    Paterson, K L; Sosdian, L; Hinman, R S; Wrigley, T V; Kasza, J; Dowsey, M; Choong, P; Bennell, K L

    2018-03-01

    Gait biomechanics, sex, and obesity can contribute to suboptimal outcomes from primary total knee arthroplasty. The aims of this study were to i) determine if sex and/or obesity influence the amount of change in gait biomechanics from pre-surgery to six months post-surgery and; ii) assess if gait returns to normal in men and women. Three-dimensional gait analysis was performed on 43 patients undergoing primary total knee arthroplasty for knee osteoarthritis (pre- and six months post-operative) and 40 asymptomatic controls. Mixed linear regression models were fit to assess which factors influenced change in gait biomechanics within the arthroplasty cohort, and interaction terms were included to assess if biomechanics returned to normal following surgery. Male peak knee adduction moment (p < 0.001) and impulse (p < 0.001) decreased six months following arthroplasty, whilst gait in women remained unchanged after surgery. Obesity did not influence gait changes in men or women. Gait of female arthroplasty participants did not differ from female controls after surgery except for sagittal plane knee range of motion (p = 0.003), whilst men differed from controls for peak knee adduction moment (p = 0.011), knee range of motion (p < 0.001), and peak knee flexion moment (p < 0.001). Sex, but not obesity, influenced changes in gait biomechanics after arthroplasty. Men retained abnormal gait patterns after surgery, whilst women did not. Further research should determine the long-term implications of gait abnormalities seen in men after arthroplasty. Copyright © 2018 Elsevier B.V. All rights reserved.

  7. [Pulsatile total cavopulmonary shunt for hypoplastic right heart syndrome with abnormal systemic venous return--a case report].

    PubMed

    Oiwa, H; Kawauchi, M; Chikada, M; Yagyu, K; Kotsuka, Y; Furuse, A

    1995-01-01

    A pulsatile total cavopulmonary shunt was successfully performed on a 5-year-old girl with hypoplastic right heart syndrome associated with abnormal systemic venous return; at the same time, modified mitral valve replacement was performed for mitral regurgitation. The right atrium, tricuspid valve and right ventricle were all extremely dimunitive. The diameter of the tricuspid valve was 50% of normal and the volume of the right ventricle was 8.6% of normal. In addition, there were severe subpumonary stenosis, a restrictive ventricular septal defect (VSD) and an atrial septal defect (ASD). The bilateral superior venae cavae (SVCs) and the hepatic vein drained to the left atrium, and the inferior vena cava was infrahepatically interrupted with a hemiazygos connection to the left superior vena cava. At the operation, each SVC was anastomosed end-to-side to each branch of the pulmonary artery (PA). The restrictive ventricular septal defect and stenotic subpulmonary lesion were left. The diameter of the ASD was reduced from 12 mm to 7 mm. The main PA was neither divided nor banded. The pulsatile blood flow from the left heart to the PA was regurated by a native restrictive VSD and stenotic subpulmonary lesion, and that from the right heart via the ASD was limited by reducing the size of the ASD. These described anatomic arrangements produced adequate antegrade pulsatile flow in the PA, which might prevent the development of pulmonary arteriovenous fistulae and, besides permit transfer of drainage of the hepatic vein from the left to the right atrium via the ASD in future.

  8. Congenital heart defects in Williams syndrome.

    PubMed

    Yuan, Shi-Min

    2017-01-01

    Yuan SM. Congenital heart defects in Williams syndrome. Turk J Pediatr 2017; 59: 225-232. Williams syndrome (WS), also known as Williams-Beuren syndrome, is a rare genetic disorder involving multiple systems including the circulatory system. However, the etiologies of the associated congenital heart defects in WS patients have not been sufficiently elucidated and represent therapeutic challenges. The typical congenital heart defects in WS were supravalvar aortic stenosis, pulmonary stenosis (both valvular and peripheral), aortic coarctation and mitral valvar prolapse. The atypical cardiovascular anomalies include tetralogy of Fallot, atrial septal defects, aortic and mitral valvular insufficiencies, bicuspid aortic valves, ventricular septal defects, total anomalous pulmonary venous return, double chambered right ventricle, Ebstein anomaly and arterial anomalies. Deletion of the elastin gene on chromosome 7q11.23 leads to deficiency or abnormal deposition of elastin during cardiovascular development, thereby leading to widespread cardiovascular abnormalities in WS. In this article, the distribution, treatment and surgical outcomes of typical and atypical cardiac defects in WS are discussed.

  9. Retirement-from-sport considerations following pediatric sports-related concussion: case illustrations and institutional approach.

    PubMed

    Ellis, Michael J; McDonald, Patrick J; Cordingley, Dean; Mansouri, Behzad; Essig, Marco; Ritchie, Lesley

    2016-04-01

    The decision to advise an athlete to retire from sports following sports-related concussion (SRC) remains a persistent challenge for physicians. In the absence of strong empirical evidence to support recommendations, clinical decision making must be individualized and should involve a multidisciplinary team of experts in concussion and traumatic brain injury. Although previous authors have advocated for a more conservative approach to these issues in child and adolescent athletes, there are few reports outlining considerations for this process among this unique population. Here, the authors use multiple case illustrations to discuss 3 subgroups of clinical considerations for sports retirement among pediatric SRC patients including the following: those with structural brain abnormalities identified on neuroimaging, those presenting with focal neurological deficits and abnormalities on physical examination, and those in whom the cumulative or prolonged effects of concussion are suspected or demonstrated. The authors' evolving multidisciplinary institutional approach to return-to-play and retirement decision making in pediatric SRC is also presented.

  10. Immunoglobulins and dietary protein antibodies in childhood coeliac disease 1

    PubMed Central

    Kenrick, K. G.; Walker-Smith, J. A.

    1970-01-01

    Twenty-four children with coeliac disease were compared with a control group, comprising 17 children with a variety of gastroenterological disorders, with respect to serum immunoglobulins and dietary protein antibodies. Elevated levels of IgA and abnormally low levels of IgM were demonstrated in one third of the coeliac patients. Antibodies to at least one of eight dietary proteins were found in 50% of coeliac children. Three children with raised levels of serum IgA and two with deficient IgM were re-examined after varying periods on a gluten-free diet. Antibodies to dietary proteins had waned and immunoglobulin levels returned to normal in all cases. The raised IgA was considered to have resulted from an extensive immunological response to antigens of dietary origin which had entered through the abnormal gut mucosa. It is suggested that IgM deficiency was due to specific inhibition of IgM synthesis by dietary components which had also entered through the mucosa. PMID:4097173

  11. Clinical models of cardiovascular regulation after weightlessness

    NASA Technical Reports Server (NTRS)

    Robertson, D.; Jacob, G.; Ertl, A.; Shannon, J.; Mosqueda-Garcia, R.; Robertson, R. M.; Biaggioni, I.

    1996-01-01

    After several days in microgravity, return to earth is attended by alterations in cardiovascular function. The mechanisms underlying these effects are inadequately understood. Three clinical disorders of autonomic function represent possible models of this abnormal cardiovascular function after spaceflight. They are pure autonomic failure, baroreflex failure, and orthostatic intolerance. In pure autonomic failure, virtually complete loss of sympathetic and parasympathetic function occurs along with profound and immediate orthostatic hypotension. In baroreflex failure, various degrees of debuffering of blood pressure occur. In acute and complete baroreflex failure, there is usually severe hypertension and tachycardia, while with less complete and more chronic baroreflex impairment, orthostatic abnormalities may be more apparent. In orthostatic intolerance, blood pressure fall is minor, but orthostatic symptoms are prominent and tachycardia frequently occurs. Only careful autonomic studies of human subjects in the microgravity environment will permit us to determine which of these models most closely reflects the pathophysiology brought on by a period of time in the microgravity environment.

  12. Reinjury anxiety, coping, and return-to-sport outcomes: a multiple mediation analysis.

    PubMed

    Wadey, Ross; Podlog, Leslie; Hall, Morgan; Hamson-Utley, Jordan; Hicks-Little, Charlie; Hammer, Chris

    2014-08-01

    This study aimed to examine whether the dimensions of reinjury anxiety (i.e., intensity, frequency, and direction) predicted perceived return-to-sport outcomes and whether coping mediated this relationship. Using a cross-sectional research design, 335 participants (M age = 23.5; SD = 6.6) who had sustained a sports-related injury preventing participation in training and competition for a minimum of 4 weeks (M time loss = 98 days; SD = 96.8) completed measures of reinjury anxiety (RIA-RE subscale of the Reinjury Anxiety Inventory (RIAI); Walker, Thatcher, & Lavallee, 2010), coping (MCOPE; Crocker & Graham, 1995), and perceived return-to-sport outcomes (RSSIQ; Podlog & Eklund, 2005). Pearson product-moment correlation and Preacher and Hayes's (2008) bootstrapping procedure were used to analyze the data. Consistent with our hypotheses, results indicated a positive relationship between reinjury anxiety (intensity and frequency) and heightened return concerns, whereas reinjury anxiety interpreted as facilitative toward postinjury performance was associated with a positive renewed perspective on sport participation. Significant indirect effects for coping were found for wishful thinking, venting of emotions, denial, and behavioral disengagement. Future avenues of research that aim to provide a greater knowledge and understanding of the relationship between reinjury anxiety and return-to-sport outcomes are discussed, including the need for alternative theoretical perspectives and diverse methodologies.

  13. Method for non-destructive evaluation of ceramic coatings

    DOEpatents

    Peterson, Kristen A.; Rosen, Elias P.; Jordan, Eric H.; Shahbazmohamadi, Sina; Vakhtin, Andrei B.

    2016-11-08

    A method for evaluating the condition of a ceramic coating deposited on a substrate comprising illuminating the ceramic coating with light, measuring the intensity of light returned from the ceramic coating as function of depth in the coating and transverse position on the coating, and analyzing the measured light intensities to obtain one or more of intensity of the light returned from the exposed coating surface relative to the intensity of light returned from the coating/substrate interface, intensity of the light returned from the coating/substrate interface relative to the intensity of light returned from the bulk of the ceramic coating, determination of roughness at the exposed surface of the ceramic coating, and determination of roughness of the interface between the ceramic coating and underlying bond coat or substrate.

  14. Women's Career Investment and the Returns: Career Benefits and Barriers in the 21st Century Green Economy

    ERIC Educational Resources Information Center

    Johnson, Philomena M.

    2010-01-01

    The key to building successful strategies as a higher education practitioner promoting 21st century green economy career awareness for women attending urban universities, demands advocating for benefits, and subverting potential barriers, to positively influence career choices. Women's career investment and returns increase when proper strategies…

  15. 26 CFR 1.6694-2 - Penalty for understatement due to an unreasonable position.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... following examples: Example 1. An individual taxpayer hires Accountant R to prepare its income tax return. A... TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Additions to the Tax, Additional Amounts, and...) Proscribed conduct. Except as otherwise provided in this section, a tax return preparer is liable for a...

  16. 29 CFR 825.214 - Employee right to reinstatement.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Employee Leave Entitlements Under the Family and Medical Leave Act § 825.214 Employee right to reinstatement. General rule. On return from FMLA leave, an employee is entitled to be returned to the same position the employee held when leave commenced, or to an...

  17. 29 CFR 825.214 - Employee right to reinstatement.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Employee Leave Entitlements Under the Family and Medical Leave Act § 825.214 Employee right to reinstatement. General rule. On return from FMLA leave, an employee is entitled to be returned to the same position the employee held when leave commenced, or to an...

  18. 29 CFR 825.214 - Employee right to reinstatement.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Employee Leave Entitlements Under the Family and Medical Leave Act § 825.214 Employee right to reinstatement. General rule. On return from FMLA leave, an employee is entitled to be returned to the same position the employee held when leave commenced, or to an...

  19. 29 CFR 825.214 - Employee right to reinstatement.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Employee Leave Entitlements Under the Family and Medical Leave Act § 825.214 Employee right to reinstatement. General rule. On return from FMLA leave, an employee is entitled to be returned to the same position the employee held when leave commenced, or to an...

  20. Older Amateur Keyboard Players Learning for Self-Fulfilment

    ERIC Educational Resources Information Center

    Taylor, Angela

    2011-01-01

    This article investigates self-reported music learning experiences of 21 older amateur pianists and electronic keyboard players. Significant changes in their lives and the encouragement of friends were catalysts for returning to or taking up a keyboard instrument as an adult, although not all returners had positive memories of learning a keyboard…

  1. 7 CFR 3560.305 - Return on investment.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... accordance with the terms of their loan agreement and the following: (1) If there is a positive net cash flow... been taken, borrowers will be required to return any unauthorized ROI. (2) If there is negative cash flow in housing project operations, the Agency may authorize the borrower to take the ROI only after...

  2. 7 CFR 3560.305 - Return on investment.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... accordance with the terms of their loan agreement and the following: (1) If there is a positive net cash flow... been taken, borrowers will be required to return any unauthorized ROI. (2) If there is negative cash flow in housing project operations, the Agency may authorize the borrower to take the ROI only after...

  3. 7 CFR 3560.305 - Return on investment.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... accordance with the terms of their loan agreement and the following: (1) If there is a positive net cash flow... been taken, borrowers will be required to return any unauthorized ROI. (2) If there is negative cash flow in housing project operations, the Agency may authorize the borrower to take the ROI only after...

  4. 7 CFR 3560.305 - Return on investment.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... accordance with the terms of their loan agreement and the following: (1) If there is a positive net cash flow... been taken, borrowers will be required to return any unauthorized ROI. (2) If there is negative cash flow in housing project operations, the Agency may authorize the borrower to take the ROI only after...

  5. The Decline in the Standing of Educational Credentials in Australia.

    ERIC Educational Resources Information Center

    Marginson, Simon

    1995-01-01

    An analysis of the economic returns of education in Australia finds a rising need for education at a time of diminishing apparent returns. It is proposed that the notions of credentialism and education as a positional good provide a better explanation for this phenomenon than does the human capital approach. (MSE)

  6. 5 CFR 532.417 - Within-grade increases.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... absence to perform such service and returns to pay status through the exercise of a restoration right... Armed Forces, in the Regular or Reserve Corps of the Public Health Service after June 30, 1960, or as a... employee's return to a civilian position through the exercise of a reemployment right granted by law...

  7. Early Learning: Readiness for School. Annotated Bibliography

    ERIC Educational Resources Information Center

    Southern Regional Education Board (SREB), 2014

    2014-01-01

    Current research seeks to determine if today's pre-K programs provide strong returns on investment similar to the returns from the classic 1960's High/Scope Perry Preschool Program and 1970's North Carolina Abecedarian Project. These were known for the positive academic effects that children experienced as they moved through school. Policy-makers…

  8. Predictors of visitors' intention to return to a nature-based recreation area

    Treesearch

    Jee In Yoon; Gerard Kyle

    2010-01-01

    This study explored predictors of recreationists' intention to return to Santee Cooper Country (SCC), a popular destination for angling-based tourism in South Carolina. Our hypothesized model indicated that recreationists' experience use history and place satisfaction would positively affect four dimensions of place attachment to SCC. Place attachment was...

  9. Serious shoulder injuries in professional soccer: return to participation after surgery.

    PubMed

    Hart, David; Funk, Lennard

    2015-07-01

    An evidence base for the management and prevention of shoulder injuries in soccer is lacking. The aim of this study was to demonstrate the type, mechanism and recovery time after surgery associated with serious shoulder injuries sustained in professional soccer to build an evidence base foundation. Fifty-two professional soccer players underwent shoulder surgery for injuries sustained during match play. Of these, 25 fulfilled the inclusion criteria. Data were collected for injury mechanism and type; clinical, radiological and surgical findings and procedures; and return to full participation. Subjects were all managed by the same surgeon. Labral injuries represented the most common injury type affecting 21 (84 %) subjects; two rotator cuff (8 %) and two combined labral/rotator cuff (8 %) injuries were less common. Fourteen (56 %) subjects sustained a high-energy trauma injury in a combined abduction and external rotation position. Six (24 %) subjects sustained a low-energy trauma mechanism in variable positions, while five (20 %) had a gradual onset of symptoms. Twenty-two (88 %) subjects reported a dislocation as a feature of their presentation. All of the subjects with high- and low-energy trauma mechanisms reported a dislocation occurring at the time of injury. Eight (32 %) subjects had sustained a previous significant shoulder injury to the ipsilateral side. Goalkeepers did not sustain low-energy trauma injuries. Outfield players returned to full participation in a mean time of 11.6 weeks, while goalkeepers did so in 11.1 weeks post-surgery. Return to participation time ranged from 7 to 24 weeks with a median of 11 weeks. Professional soccer players can expect a return to participation within 12 weeks post-surgery. The majority of serious shoulder injuries in soccer occur at a positional extreme of external rotation and abduction in high-energy situations, while a significant number occur in low-energy situations away from this position. Most serious shoulder injuries in professional soccer are dislocations. Previous shoulder injury is considered a risk factor. IV.

  10. Abnormal movements in first-episode, nonaffective psychosis: dyskinesias, stereotypies, and catatonic-like signs.

    PubMed

    Compton, Michael T; Fantes, Francisco; Wan, Claire Ramsay; Johnson, Stephanie; Walker, Elaine F

    2015-03-30

    Motor abnormalities represent a neurobehavioral domain of signs intrinsic to schizophrenia-spectrum disorders, though they are commonly attributed to medication side effects and remain understudied. Individuals with first-episode psychosis represent an ideal group to study innate movement disorders due to minimal prior antipsychotic exposure. We measured dyskinesias, stereotypies, and catatonic-like signs and examined their associations with: (1) age at onset of psychotic symptoms and duration of untreated psychosis; (2) positive, negative, and disorganized symptoms; (3) neurocognition; and (4) neurological soft signs. Among 47 predominantly African American first-episode psychosis patients in a public-sector hospital, the presence and severity of dyskinesias, stereotypies, and catatonic-like features were assessed using approximately 30-min video recordings. Movement abnormalities were rated utilizing three scales (Dyskinesia Identification System Condensed User Scale, Stereotypy Checklist, and Catatonia Rating Scale). Correlational analyses were conducted. Scores for each of three movement abnormality types were modestly inter-correlated (r=0.29-0.40). Stereotypy score was significantly associated with age at onset of psychotic symptoms (r=0.32) and positive symptom severity scores (r=0.29-0.41). There were no meaningful or consistent associations with negative symptom severity, neurocognition, or neurological soft signs. Abnormal movements appear to represent a relatively distinct phenotypic domain deserving of further research. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Acetylated sialic acid residues and blood group antigens localise within the epithelium in microvillous atrophy indicating internal accumulation of the glycocalyx

    PubMed Central

    Phillips, A D; Brown, A; Hicks, S; Schüller, S; Murch, S H; Walker-Smith, J A; Swallow, D M

    2004-01-01

    Background: Microvillous atrophy, a disorder of intractable diarrhoea in infancy, is characterised by the intestinal epithelial cell abnormalities of abnormal accumulation of periodic acid-Schiff (PAS) positive secretory granules within the apical cytoplasm and the presence of microvillous inclusions. The identity of the PAS positive material is not known, and the aim of this paper was to further investigate its composition. Methods: Formaldehyde fixed sections were stained with alcian blue/PAS to identify the acidic or neutral nature of the material, phenylhydrazine blocking was employed to stain specifically for sialic acid, and saponification determined the presence of sialic acid acetylation. The specificity of sialic acid staining was tested by digestion with mild sulphuric acid. Expression of blood group related antigens was tested immunochemically. Results: Alcian blue/PAS staining identified a closely apposed layer of acidic material on the otherwise neutral (PAS positive) brush border in controls. In microvillous atrophy, a triple layer was seen with an outer acidic layer, an unstained brush border region, and accumulation within the epithelium of a neutral glycosubstance that contained acetylated sialic acid. Blood group antigens were detected on the brush border, in mucus, and within goblet cells in controls. In microvillous atrophy they were additionally expressed within the apical cytoplasm of epithelial cells mirroring the PAS abnormality. Immuno electron microscopy localised expression to secretory granules. Conclusions: A neutral, blood group antigen positive, glycosubstance that contains acetylated sialic acid accumulates in the epithelium in microvillous atrophy. Previous studies have demonstrated that the direct and indirect constitutive pathways are intact in this disorder and it is speculated that the abnormal staining pattern reflects accumulation of glycocalyx related material. PMID:15542511

  12. Diagnostic accuracy of 3D-transvaginal ultrasound in detecting uterine cavity abnormalities in infertile patients as compared with hysteroscopy.

    PubMed

    Apirakviriya, Chayanis; Rungruxsirivorn, Tassawan; Phupong, Vorapong; Wisawasukmongchol, Wirach

    2016-05-01

    To assess diagnostic accuracy of 3D transvaginal ultrasound (3D-TVS) compared with hysteroscopy in detecting uterine cavity abnormalities in infertile women. This prospective observational cross-sectional study was conducted during the July 2013 to December 2013 study period. Sixty-nine women with infertility were enrolled. In the mid to late follicular phase of each subject's menstrual cycle, 3D transvaginal ultrasound and hysteroscopy were performed on the same day in each patient. Hysteroscopy is widely considered to be the gold standard method for investigation of the uterine cavity. Uterine cavity characteristics and abnormalities were recorded. Diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and positive and negative likelihood ratios were evaluated. Hysteroscopy was successfully performed in all subjects. Hysteroscopy diagnosed pathological findings in 22 of 69 cases (31.8%). There were 18 endometrial polyps, 3 submucous myomas, and 1 septate uterus. Three-dimensional transvaginal ultrasound in comparison with hysteroscopy had 84.1% diagnostic accuracy, 68.2% sensitivity, 91.5% specificity, 79% positive predictive value, and 86% negative predictive value. The positive and negative likelihood ratios were 8.01 and 0.3, respectively. 3D-TVS successfully detected every case of submucous myoma and uterine anomaly. For detection of endometrial polyps, 3D-TVS had 61.1% sensitivity, 91.5% specificity, and 83.1% diagnostic accuracy. 3D-TVS demonstrated 84.1% diagnostic accuracy for detecting uterine cavity abnormalities in infertile women. A significant percentage of infertile patients had evidence of uterine cavity pathology. Hysteroscopy is, therefore, recommended for accurate detection and diagnosis of uterine cavity lesion. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Relationship of neuromotor disturbances to psychosis symptoms in first-episode neuroleptic-naive schizophrenia patients.

    PubMed

    Cortese, Leonardo; Caligiuri, Michael P; Malla, Ashok K; Manchanda, Rahul; Takhar, Jatinder; Haricharan, Raj

    2005-06-01

    From the very inception of the modern diagnostic scheme for psychotic disorders, abnormalities in motor function have been observed in these conditions. Despite convergence from multiple areas of research supporting the notion that multiple frontal-subcortical circuits regulate motor and limbic behavior, the precise relationship between motor abnormalities and psychopathology has not been elucidated. The goals of this study were to examine the prevalence of extrapyramidal signs (EPS) in first-episode schizophrenia patients and their relationships to three psychopathological dimensions (positive psychosis syndrome, negative syndrome, and disorganization). We assessed EPS using traditional observer-based as well as quantitative instrumental measures in 39 neuroleptic-naive first-episode schizophrenia subjects. Subjects were followed for 6 months after initiating antipsychotic treatment to examine the stability of motor-limbic relationships. Four main findings emerged from this study. First, depending on the measure used the prevalence of dyskinesia prior to treatment ranged from 13% to 20%. The prevalence of parkinsonism ranged from 18% to 28%. Second, severity of dyskinesia was associated with the positive psychotic syndrome; whereas parkinsonism was associated with the positive psychosis, negative syndrome and disorganization. Third, psychopathology improved significantly across all symptom dimensions following antipsychotic treatment, while EPS remained stable. This suggests that some motor abnormalities in schizophrenia may reflect trait characteristics. Fourth, abnormalities on the pre-treatment instrumental measure of parkinsonism predicted greater improvement on positive psychosis symptoms following treatment (p=0.008). Our findings support the notion that neuromotor disturbances may be a core feature of schizophrenia in a substantial proportion of patients and implicate multiple fronto-striatal circuits regulating limbic and neuromotor behavior in schizophrenia.

  14. The Effect of History of Abnormal Pap Smear or Preceding HPV infection on the Humoral Immune Response to Quadrivalent Human Papilloma virus (qHPV) Vaccine in Women with Systemic Lupus Erythematosus.

    PubMed

    Dhar, J Patricia; Essenmacher, Lynnette; Dhar, Renee; Magee, Ardella; Ager, Joel; Sokol, Robert J

    2018-04-30

    To determine if natural human papillomavirus (HPV) infection would induce an anamnestic response to quadrivalent (qHPV) vaccine in women with Systemic Lupus Erythematosus (SLE). Thirty four women (19-50 years) with mild to moderate and minimally active or inactive SLE received standard qHPV vaccine. Neutralizing antibody titers to HPV 6, 11, 16 and18 were evaluated pre- and post- vaccine using HPV competitive Luminex Immunoassay. For each HPV type, logistic regressions were performed to explore the relationship between a positive titer at baseline with their final geometric mean titer and with the rise in titer. Fisher's Exact Test was used to assess the association of at least one positive HPV antibody test at baseline and history of abnormal pap. History of abnormal pap smear/cervical neoplasia occurred in 52.9%. Baseline anti HPV antibody titers: 21% = negative for all 4 HPV types, 79% = positive for ≥1 of the HPV types. Statistical analysis showed: those with a history of abnormal pap smear/cervical neoplasia were likely to have a positive anti-HPV antibody result pre-vaccine to ≥ 1 of the 4 types, p = 0.035 Fisher's Exact Test. In general, HPV exposed women showed higher post vaccine GMTs than HPV unexposed women with higher point estimates. However, when examining the rise in titers using logistic regression, there was no evidence of an anamnestic response. Prior HPV infection and cervical neoplasia in SLE are linked with no anamnestic response to HPV vaccine. This supports not checking HPV-antibodies pre-vaccine. Women with SLE should be vaccinated for HPV.

  15. Effects on and recovery of microplankton and microbenthon to Gulf of Mexico oil spills impacting outer and mid shelfal, inner shelfal, and estuarine environments

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

    Casey, R.E.; Wigley, C.R.; Fisco, P.

    1982-01-01

    During 1979, 1980, and 1981 3 major and different environments of human interest and economic well-being were impacted by 3 different and major Gulf of Mexico oil spills. All the studied spills had pre-spill data. This study revealed 3 conclusions useful in the monitoring of spill recovery. (1) Immediately or continually impacted areas exhibited a mass mortality for microplankton in pelagic systems, and an abnormally high concentration (collection) of nematodes in nearshore sands. (2) Impacted benthonic areas exhibited increases in nematode standing corps followed by increases in benthonic forminiferal standing crops. (3) Recovery to pre-spill conditions may be indicated bymore » termination of red tide condition or mortality of susceptible microplankton; return to pre-spill standing crops, taxonomic character, and diversity of microbenthon or microplankton; and return to pre-spill seasonal fluctuation of peaks and lows in microbenthon and microplankton.« less

  16. Cardiac veins: collateral venous drainage pathways in chronic hemodialysis patients.

    PubMed

    Ozmen, Evrim; Algin, Oktay

    2016-07-12

    Venous anomalies are diagnostic and therapeutic challenges. Subclavian or superior vena cava stenosis can be developed and venous return can be achieved via cardiac veins and coronary sinus in patients with central venous catheter for long-term hemodialysis. These types of abnormalities are not extremely rare especially in patients with a history of central venous catheter placement. Detection of these anomalies and subclavian vein stenosis before the surgical creation of hemodialysis fistulae or tunneled central venous catheter placement may prevent unnecessary interventions in those patients. Multidetector computed tomography (MDCT) technique can give further information when compared with fluoroscopy or digital subtraction angiography in the management of these patients. This case report describes interesting aspects of central vein complications in hemodialysis patients. As a conclusion, there are limited data about thoracic venous return, and further prospective studies with large patient number are required. MDCT with 3D reconstruction is particularly useful for the accurate evaluation of venous patency, variations, and collateral circulation. Also it is an excellent tool for choosing and planning treatment.

  17. A cluster of Zika virus infection in a Chinese tour group returning from Fiji and Samoa

    PubMed Central

    Sun, Jimin; Fu, Tao; Mao, Haiyan; Wang, Zhen; Pan, Junhang; Rutherford, Shannon; Ren, Jiangping; Dong, Xuanjun; Chen, Yin; Zhu, Zhihong; Qi, Xiaohua; Gong, Zhenyu; Liu, Qiyong; Yu, Hongjie; Zhu, Liebo; Chen, Wenxian; Chen, Zhiping; Zhang, Yanjun; Chen, Enfu

    2017-01-01

    Zika virus is currently causing extensive outbreaks in a number of countries in South and Central America and the Caribbean and has been associated with foetal abnormalities. We report an outbreak of Zika virus infection in a Chinese tour-group returning from a nine day holiday in Fiji and Samoa. The index case was a 38-year old male who developed symptoms while travelling back from Fiji to Hong Kong on the 14th February, 2016. A field investigation was initiated to define the epidemiological, clinical and virological characteristics of Zika virus infection in this tour group and revealed two further symptomatic infections and one asymptomatic infection among the 33 travellers; an overall infection attack rate of 12% in these travellers. Active surveillance led to detection of Zika virus RNA in the serum of one case four days prior to onset of symptoms and detection of Zika virus in saliva from one asymptomatic infection.

  18. Valence Scaling of Dynamic Facial Expressions Is Altered in High-Functioning Subjects with Autism Spectrum Disorders: An FMRI Study

    ERIC Educational Resources Information Center

    Rahko, Jukka S.; Paakki, Jyri-Johan; Starck, Tuomo H.; Nikkinen, Juha; Pauls, David L.; Katsyri, Jari V.; Jansson-Verkasalo, Eira M.; Carter, Alice S.; Hurtig, Tuula M.; Mattila, Marja-Leena; Jussila, Katja K.; Remes, Jukka J.; Kuusikko-Gauffin, Sanna A.; Sams, Mikko E.; Bolte, Sven; Ebeling, Hanna E.; Moilanen, Irma K.; Tervonen, Osmo; Kiviniemi, Vesa

    2012-01-01

    FMRI was performed with the dynamic facial expressions fear and happiness. This was done to detect differences in valence processing between 25 subjects with autism spectrum disorders (ASDs) and 27 typically developing controls. Valence scaling was abnormal in ASDs. Positive valence induces lower deactivation and abnormally strong activity in ASD…

  19. Positive Emotions Speed Recovery from the Cardiovascular Sequelae of Negative Emotions.

    PubMed

    Fredrickson, Barbara L; Levenson, Robert W

    1998-03-01

    Two studies tested the hypothesis that certain positive emotions speed recovery from the cardiovascular sequelae of negative emotions. In Study 1, 60 subjects (Ss) viewed an initial fear-eliciting film, and were randomly assigned to view a secondary film that elicited: (a) contentment; (b) amusement; (c) neutrality; or (d) sadness. Compared to Ss who viewed the neutral and sad secondary films, those who viewed the positive films exhibited more rapid returns to pre-film levels of cardiovascular activation. In Study 2, 72 Ss viewed a film known to elicit sadness. Fifty Ss spontaneously smiled at least once while viewing this film. Compared to Ss who did not smile, those who smiled exhibited more rapid returns to pre-film levels of cardiovascular activation. We discuss these findings in terms of emotion theory and possible health-promoting functions of positive emotions.

  20. The 3-year disease management effect: understanding the positive return on investment.

    PubMed

    Nyman, John A; Jeffery, Molly Moore; Abraham, Jean M; Jutkowitz, Eric; Dowd, Bryan E

    2013-11-01

    Conventional wisdom suggests that health promotion programs yield a positive return on investment (ROI) in year 3. In the case of the University of Minnesota's program, a positive ROI was achieved in the third year, but it was due entirely to the effectiveness of the disease management (DM) program. The objective of this study is to investigate why. Differences-in-differences regression equations were estimated to determine the effect of DM participation on spending (overall and service specific), hospitalizations, and avoidable hospitalizations. Disease management participation reduced expenditures overall, and especially in the third year for employees, and reduced hospitalizations and avoidable hospitalizations. The positive ROI at Minnesota was due to increased effectiveness of DM in the third year (mostly due to fewer hospitalizations) but also to the simple durability of the average DM effect.

  1. Suppression of the heterotrimeric G protein causes abnormal morphology, including dwarfism, in rice

    PubMed Central

    Fujisawa, Yukiko; Kato, Teruhisa; Ohki, Shizuka; Ishikawa, Atsushi; Kitano, Hidemi; Sasaki, Takuji; Asahi, Tadashi; Iwasaki, Yukimoto

    1999-01-01

    Transgenic rice containing an antisense cDNA for the α subunit of rice heterotrimeric G protein produced little or no mRNA for the subunit and exhibited abnormal morphology, including dwarf traits and the setting of small seeds. In normal rice, the mRNA for the α subunit was abundant in the internodes and florets, the tissues closely related to abnormality in the dwarf transformants. The position of the α-subunit gene was mapped on rice chromosome 5 by mapping with the restriction fragment length polymorphism. The position was closely linked to the locus of a rice dwarf mutant, Daikoku dwarf (d-1), which is known to exhibit abnormal phenotypes similar to those of the transformants that suppressed the endogenous mRNA for the α subunit by antisense technology. Analysis of the cDNAs for the α subunits of five alleles of Daikoku dwarf (d-1), ID-1, DK22, DKT-1, DKT-2, and CM1361–1, showed that these dwarf mutants had mutated in the coding region of the α-subunit gene. These results show that the G protein functions in the formation of normal internodes and seeds in rice. PMID:10377457

  2. Motility abnormalities in esophageal body in GERD: are they truly related to reflux?

    PubMed

    Ciriza de los Ríos, C; García Menéndez, L; Díez Hernández, A; Fernández Eroles, A L; Vega Fernández, A; Enguix Armada, A

    2005-03-01

    Esophageal motility abnormalities have been observed in patients with gastroesophageal reflux disease. The aim of the present study was to determine if esophageal motor disorders in patients with a positive response to the omeprazole test are related to the existence of reflux or they are concomitant findings. A 24-hour pH monitoring and a stationary manometry were performed on 128 patients: 49 of them had normal manometry, 31 hypotensive lower esophageal sphincter, 29 motor disorder in esophageal body, and 19 hypotensive lower esophageal sphincter and motor disorder in esophageal body. We found an association between the presence of abnormal reflux and motor disorder in esophageal body (chi test; P < 0.05). However, ineffective esophageal motility was the disorder most strongly related to reflux, whereas the hypercontractile disorders were not clearly attributed to it. Esophageal manometric abnormalities should be considered cautiously before considering a motor disorder as a consequence of abnormal reflux.

  3. Current controversies in prenatal diagnosis 2: Cell-free DNA prenatal screening should be used to identify all chromosome abnormalities.

    PubMed

    Chitty, Lyn S; Hudgins, Louanne; Norton, Mary E

    2018-02-01

    Noninvasive prenatal testing (NIPT) using cell-free DNA (cfDNA) from maternal serum has been clinically available since 2011. This technology has revolutionized our ability to screen for the common aneuploidies trisomy 21 (Down syndrome), trisomy 18, and trisomy 13. More recently, clinical laboratories have offered screening for other chromosome abnormalities including sex chromosome abnormalities and copy number variants (CNV) without little published data on the sensitivity, specificity, and positive predictive value. In this debate, the pros and cons of performing prenatal screening via cfDNA for all chromosome abnormalities is discussed. At the time of the debate in 2017, the general consensus was that the literature does not yet support using this technology to screen for all chromosome abnormalities and that education is key for both providers and the patients so that the decision-making process is as informed as possible. © 2018 John Wiley & Sons, Ltd.

  4. Long memory of abnormal investor attention and the cross-correlations between abnormal investor attention and trading volume, volatility respectively

    NASA Astrophysics Data System (ADS)

    Fan, Xiaoqian; Yuan, Ying; Zhuang, Xintian; Jin, Xiu

    2017-03-01

    Taking Baidu Index as a proxy for abnormal investor attention (AIA), the long memory property in the AIA of Shanghai Stock Exchange (SSE) 50 Index component stocks was empirically investigated using detrended fluctuation analysis (DFA) method. The results show that abnormal investor attention is power-law correlated with Hurst exponents between 0.64 and 0.98. Furthermore, the cross-correlations between abnormal investor attention and trading volume, volatility respectively are studied using detrended cross-correlation analysis (DCCA) and the DCCA cross-correlation coefficient (ρDCCA). The results suggest that there are positive correlations between AIA and trading volume, volatility respectively. In addition, the correlations for trading volume are in general higher than the ones for volatility. By carrying on rescaled range analysis (R/S) and rolling windows analysis, we find that the results mentioned above are effective and significant.

  5. Grading of inflammatory disease activity in the sacroiliac joints with magnetic resonance imaging: comparison between short-tau inversion recovery and gadolinium contrast-enhanced sequences.

    PubMed

    Madsen, Karen Berenth; Egund, Niels; Jurik, Anne Grethe

    2010-02-01

    We investigated the potential concordance of 2 different magnetic resonance (MR) sequences - short-tau inversion recovery (STIR) and fat-saturated T1-weighted spin-echo after application of gadolinium (Gd) contrast medium to detect active bone marrow abnormalities at the sacroiliac joints (SIJ) in patients with spondyloarthritis (SpA). Blinded and using the Danish scoring method, we evaluated transaxial MR images of the 2 sequences in 40 patients with SpA with disease duration of 3-14 years. Both the cartilaginous and ligamentous portions of the SIJ were analyzed. There was a significant positive correlation between the activity scores obtained by STIR and Gd-enhanced sequences (p < 0.0001). Agreement in the detection of bone marrow abnormalities occurred in 60 of the 80 joints, 35 with and 25 without signs of active disease. Discordance with STIR-positive marrow activity scores occurred in only 11 joints; Gd-enhanced positive scores in 9 joints. The STIR sequence detected remnants of marrow activity in the periphery of chronic fatty replacement not seen or partly obscured on the Gd sequence. Small subchondral enhancing lesions may not be scored on the STIR sequence, mostly because of reduced image resolution. Active bone marrow abnormalities were detected nearly equally well with STIR and Gd-enhanced fat-suppressed T1 sequences in patients with SpA, with STIR being most sensitive to visualize active abnormalities in the periphery of chronic changes.

  6. Experimental study on acute toxicity of Qingnao tablet to mice

    NASA Astrophysics Data System (ADS)

    Xie, Guoqi; Wang, Huamin; Ma, Zhenzhen; Hao, Shaojun; Li, Jun; Wang, Hongyu; Wen, Zhonghua; Zhang, Zhengchen

    2018-04-01

    To investigate the effect of Qingnao tablets on acute toxicity in mice. Forty mice, half male and half female, were randomly divided into normal saline group and Qingnao tablet group. After fasting for 12 hours, the mice were given 0. 4 ml / 10 g in maximum volume. In 1st, the rats were perfused 3 times (every 8 hours). The rats in the saline group were perfused with the same volume of saline in the same way. The mice were observed continuously within 3 hours and then every hour. The mice were given a normal diet for 14 consecutive days, and the changes of autonomous activity, reaction, diet, stool, secretion, eye and nose were observed daily. The mice fasted on the 13th day and weighed on the 14th day. And then put the mice to death, The changes of the liver, heart, spleen, lung, kidney, stomach, intestines, and brain were observed by the naked eye. There was no obvious abnormality in normal saline group. The autonomous activity of mice in the administration group decreased after initial administration, and gradually returned to normal after 2 hours of administration. On the day of administration, the stool of the mice became dark brown, and the feces returned to normal after 1.1 days of normal urination. No other mice had abnormal secretion, reaction, eye nose, diet, etc. On the 14th day, there were no visible heart, liver, spleen, lung, kidney, gastrointestinal tract in normal saline group and Qingnao tablet group. Abnormal changes in brain and other organs (edema, color, etc.). In the normal saline group and Qingnao tablet group, the initial weight of the mice was: 21.70 ± 0.97N 21.71 ± 1.13, and the weight of the mice on the 7th day was 29.70 ± 2.4c28.65 ± 3.11. On the 14th day, the body weight was 32.38 ± 3.40, 33.77 ± 3.82. Qingnao tablet has no obvious toxicity to the main organs of mice, so it can be considered safe in clinical use.

  7. New daily persistent headache: A lack of an association with white matter abnormalities on neuroimaging.

    PubMed

    Rozen, Todd D

    2016-09-01

    To provide results from the largest study of new daily persistent headache patients to date and specifically evaluate if patients with primary new daily persistent headache develop white matter abnormalities or infarct-like lesions on neuroimaging. Retrospective analysis of patient medical records utilizing an electronic medical record system. All patients were seen at a headache specialty clinic by a single headache neurologist and diagnosed with primary new daily persistent headache during the time period of January 2009 to January 2013. Altogether, 97 patients were diagnosed with primary new daily persistent headache (65 women and 32 men). The mean average age of onset was slightly younger in women than men: 32.4 years vs. 35.8 years. In total, 84 of the 97 new daily persistent headache patients had no white matter abnormalities or infarct-like lesions on magnetic resonance imaging with a gender distribution of 56 women and 28 men. The mean age of onset of this white matter negative subgroup was 31.1 years. Of these individuals, 36% had cardiovascular/cerebrovascular risk factors and 44% had a history of migraine. Only 13 new daily persistent headache patients (nine women, four men) demonstrated white matter abnormalities on magnetic resonance imaging. None had infarct-like lesions. The mean age of onset of this white matter positive subgroup was 54.2 years, significantly older than the white matter negative population (p < .05). All new daily persistent headache patients in the white matter positive subgroup had cardiovascular/cerebrovascular risk factors and dual risk factors were noted in seven of 13 patients. Only 23% had a migraine history. Almost 40% of the patients in the white matter negative group were imaged 3 years after headache onset and at least six patients were imaged at least 9 years or more after onset of new daily persistent headache. Triggering events in both white matter lesion positive and negative populations were typical of the new daily persistent headache population as a whole and not specific to the presence or absence of brain imaging lesions except for a post-surgery trigger, which was significantly more likely to occur in the white matter positive group. Migraine associated symptoms occurred in 77% of the white matter negative subgroup compared with 46% of the white matter positive subgroup, which was a significant difference. White matter abnormalities and infarct-like lesions do not appear to occur in primary new daily persistent headache patients. Only new daily persistent headache patients with risk factors (cardiovascular/cerebrovascular or migraine) developed white matter abnormalities on brain magnetic resonance imaging. No patient with new daily persistent headache developed infarct-like lesions. New daily persistent headache triggering events (outside of possibly post-surgery) or the presence of migrainous symptoms did not appear to enhance the development of white matter abnormalities. © International Headache Society 2015.

  8. The efficacy of periodic +Gz exposure in the prevention of bedrest induced orthostatic intolerance

    NASA Technical Reports Server (NTRS)

    Ludwig, D. A.; Vernikos, J.; Duvoisin, M. R; Stinn, J. L.

    1992-01-01

    What is the most efficient dosage of periodic exposure to positive 1G(z) during microgravity to maintain a functional upright position after returning to a positive 1G(z) environment? The answer has implications for the type of countermeasures astronauts will be required to perform during long term space flight. Methods: Nine males were subjected to four different positive 1G exposure protocols plus a control protocol ('zero G(z)') during four days of continuous bedrest. The four positive 1G(z) exposures consisted of periodic standing or walking, each for a total period of two or four hours. Each subject was returned for bedrest on five different occasions over a period of approximately one year to obtain data on each of the nine subjects across all four positive 1G(z) treatments and the control. A 30 min tilt test was used to measure orthostatic response during pre and post bedrest. Results: In terms of survival rate (percentage of subjects who did not faint after 30 sec of tilt), four hours of intermittent standing was the only protocol that maintained a rate comparable to pre bedrest levels (87.5 percent). Although the other three positive 1G(z) protocols performed better than the 'zero G(z) control (22.2 percent), only the four hour standing returned post bedrest survival rates to pre bedrest levels. Conclusions: The results will need to be evaluated with regards to a variety of other physiological systems which are known to decondition during microgravitry.

  9. Insomnia, excessive sleepiness, excessive fatigue, anxiety, depression and shift work disorder in nurses having less than 11 hours in-between shifts.

    PubMed

    Eldevik, Maria Fagerbakke; Flo, Elisabeth; Moen, Bente Elisabeth; Pallesen, Ståle; Bjorvatn, Bjørn

    2013-01-01

    To assess if less than 11 hours off work between work shifts (quick returns) was related to insomnia, sleepiness, fatigue, anxiety, depression and shift work disorder among nurses. A questionnaire including established instruments measuring insomnia (Bergen Insomnia Scale), sleepiness (Epworth Sleepiness Scale), fatigue (Fatigue Questionnaire), anxiety/depression (Hospital Anxiety and Depression Scale) and shift work disorder was administered. Among the 1990 Norwegian nurses who participated in the study; 264 nurses had no quick returns, 724 had 1-30 quick returns and 892 had more than 30 quick returns during the past year. 110 nurses did not report the number of quick returns during the past year. The prevalence of insomnia, excessive sleepiness, excessive fatigue, anxiety, depression and shift work disorder was calculated within the three groups of nurses. Crude and adjusted logistic regression analyses were performed to assess the relation between quick returns and such complaints. We found a significant positive association between quick returns and insomnia, excessive sleepiness, excessive fatigue and shift work disorder. Anxiety and depression were not related to working quick returns. There is a health hazard associated with quick returns. Further research should aim to investigate if workplace strategies aimed at reducing the number of quick returns may reduce complaints among workers.

  10. Method for producing size selected particles

    DOEpatents

    Krumdick, Gregory K.; Shin, Young Ho; Takeya, Kaname

    2016-09-20

    The invention provides a system for preparing specific sized particles, the system comprising a continuous stir tank reactor adapted to receive reactants; a centrifugal dispenser positioned downstream from the reactor and in fluid communication with the reactor; a particle separator positioned downstream of the dispenser; and a solution stream return conduit positioned between the separator and the reactor. Also provided is a method for preparing specific sized particles, the method comprising introducing reagent into a continuous stir reaction tank and allowing the reagents to react to produce product liquor containing particles; contacting the liquor particles with a centrifugal force for a time sufficient to generate particles of a predetermined size and morphology; and returning unused reagents and particles of a non-predetermined size to the tank.

  11. Role of Thyroxine in Space-Developed Jellyfish

    NASA Technical Reports Server (NTRS)

    Spangenberg, Dorothy B.

    1997-01-01

    The Aurelia Metamorphosis Test System was previously used to determine the effects of the space environment on the development and behavior of tiny (1-2 mm) jellyfish ephyrae during the SLS-1 and IML-2 missions. Results from the SLS-1 experiment included the discovery that statolith numbers were significantly reduced in Earth-formed ephyrae flown for nine days in space as compared with ground-based controls. In addition, upon return to Earth, six times more ephyrae which had developed in space than those developed on Earth had pulsing abnormalities, indicating that either these animals did not form their neuromuscular structures normally while in space or they were unable to adapt to the Ig environment upon return to Earth. The metamorphosis process, which enables the formation of ephyrae from polyps is influenced by a hormone, Jf-T4 Oellyfish thyroxine) which is synthesized following iodine administration. Two groups of polyps in space, however, formed ephyrae without iodine administration indicating that Jf-T4 synthesis, utilization, or excretion was different in. the ephyrae. Increased synthesis or build-up in the media of the hormone may also be linked to the increased demineralization of statoliths found in space-exposed ephyrae. In previous experiments, we found that externally administered thyroxine causes increased demineralization of statoliths on Earth. Abnormal pulsina in ephyrae following return to Earth during the SLS-1 mission may also be traced to increased Jf-T4 levels. Thyroxine is known to be important to the normal development and function of the nervous system, heart, and skeletal muscles in higher animals. For this third Jellyfish-in-Space experiment, we proposed to quantitate the levels of Jf- T4 and of T4 receptors in space-developed ephyrae and media and to compare these levels with those of animals developing and at Ig in space and on Earth. We expected to be able to determine whether Jf-T4 synthesis and/or secretion is different in space-flownjellyfish than in controls and to determine which cells (nerve, muscle, lithocytes, etc.)may have enhanced Jf-T4 levels. However, NASA deselected this experiment in August, 1997.

  12. Night club patrons who feel safe will return: Evidence to encourage management to address club violence.

    PubMed

    Johnson, Mark B; Voas, Robert; Miller, Brenda A; Byrnes, Hilary; Bourdeau, Beth

    2016-02-01

    There is substantial evidence that heavy drinking is associated with aggression and violence. Most managers of drinking establishments are required to maintain a security staff to deal with disruptive patrons who threaten an organization's business or legal status. However, managers may focus little on minor instances of aggression even though these may escalate into more serious events. We hypothesize that proactive security efforts may positively affect patrons' perceptions of nighttime safety and influence their decisions to return to the club, thereby affecting the club's bottom line. Data for this study were collected from entry and exit surveys with 1714 attendees at 70 electronic music dance events at 10 clubs in the San Francisco Bay Area (2010-2012). Participants were asked to report on observations and experiences with aggressive behavior while in the club, their overall perception of club safety, and their plans to return to the same club in the next 30 days. Mediational multiple regression analysis was used to relate observations of club security to perceptions of personal safety and plans to return to the club. Reported observations of an active club security staff were positively related to perceptions of personal safety. Safety perceptions, in turn, were significantly related to plans to return to the club. The indirect path between perceptions of security and plans to return was significant as well. The results suggest that an active security presence inside clubs can encourage club attendance by providing an environment where minor altercations are minimized, contributing to the perception of club safety. Evidence that proactive security efforts appear to increase return customers might motivate managers to implement better security policies. Copyright © 2015 Elsevier Ltd and National Safety Council. All rights reserved.

  13. The impact of prior psychiatric medical treatment on return to work after a diagnosis of breast cancer: A registry based study.

    PubMed

    Jensen, Laura Schärfe; Overgaard, Charlotte; Garne, Jens Peter; Bøggild, Henrik; Fonager, Kirsten

    2017-08-01

    Breast cancer and psychiatric disorders negatively impact work life, both positively associated with unemployment and early retirement. Our purpose was to assess whether being prescribed psychiatric medication, 2-4 yrs prior to a diagnosis of breast cancer, could impact the likelihood of returning to work after cancer therapy. 16,868 self-supporting women, diagnosed with breast cancer in Denmark from 2000 to 2012, were identified from a population-based clinical database, then cross-referenced to data held for psychiatric medication usage, sociodemographics, and labour-market participation. The association between historic psychiatric medication and return to work was estimated using a modified Poisson regression model. 'Return to work' was defined as being self-supporting one year after diagnosis of breast cancer. 16% of our cohort had used psychiatric medical treatment 2-4 years before their diagnosis. Sixty-three per cent of these individuals had returned to work one year later, compared to 69% of the patient group with no prior history of using psychiatric medication treatments. In the fully adjusted model, prior use of psychiatric medication diminished the likelihood of returning to work one year after cancer diagnosis (RR = 0.91 (0.87-0.94)). High income and older age were positively associated with returning to work; negative correlates included those related to disease severity. Historic use of psychiatric medication provoked a minor, although statistically significant reduction in the resumption of working life one year after a diagnosis of breast cancer. Although historic use of psychiatric medication may incur a minor effect on working life, further research is needed on the long-term social consequences for sub-groups.

  14. The net return from animal activity in agro-ecosystems: trading off benefits from ecosystem services against costs from crop damage.

    PubMed

    Luck, Gary W

    2013-01-01

    Animals provide benefits to agriculture through the provision of ecosystem services, but also inflict costs such as damaging crops. These benefits and costs are mostly examined independently, rather than comparing the trade-offs of animal activity in the same system and quantifying the net return from beneficial minus detrimental activities. Here, I examine the net return associated with the activity of seed-eating birds in almond orchards by quantifying the economic costs and benefits of bird consumption of almonds. Pre-harvest, the consumption of harvestable almonds by birds cost growers AUD$57.50 ha (-1) when averaged across the entire plantation. Post-harvest, the same bird species provide an ecosystem service by removing mummified nuts from trees that growers otherwise need to remove to reduce threats from fungal infection or insect pest infestations. The value of this ecosystem service ranged from AUD$82.50 ha (-1)-$332.50 ha (-1) based on the replacement costs of mechanical or manual removal of mummified nuts, respectively. Hence, bird consumption of almonds yielded a positive net return of AUD$25-$275 ha (-1) averaged across the entire plantation. However, bird activity varied spatially resulting in positive net returns occurring primarily at the edges of crops where activity was higher, compared to negative net returns in crop interiors. Moreover, partial mummy nut removal by birds meant that bird activity may only reduce costs to growers rather than replace these costs completely. Similar cost-benefit trade-offs exist across nature, and quantifying net returns can better inform land management decisions such as when to control pests or promote ecosystem service provision.

  15. Measuring the impact of a burns school reintegration programme on the time taken to return to school: A multi-disciplinary team intervention for children returning to school after a significant burn injury.

    PubMed

    Arshad, Sira N; Gaskell, Sarah L; Baker, Charlotte; Ellis, Nicola; Potts, Jennie; Coucill, Theresa; Ryan, Lynn; Smith, Jan; Nixon, Anna; Greaves, Kate; Monk, Rebecca; Shelmerdine, Teresa; Leach, Alison; Shah, Mamta

    2015-06-01

    Returning to school can be a major step for burn-injured children, their family, and staff and pupils at the receiving school. Previous literature has recognised the difficulties children may face after a significant injury and factors that may influence a successful reintegration. A regional paediatric burns service recognised that some patients were experiencing difficulties in returning to school. A baseline audit confirmed this and suggested factors that hindered or facilitated this process, initiating the development of a school reintegration programme (SRP). Since the programme's development in 2009, it has been audited annually. The aim of this paper was to evaluate the impact of the SRP by presenting data from the 2009 to 2011 audits. For the baseline audit, the burn care team gathered information from clinical records (age, gender, total body surface area burned (TBSA), skin grafting and length of stay) and telephone interviews with parents and teachers of the school returners. For the re-audits, the same information was gathered from clinical records and feedback questionnaires. Since its introduction, the mean length of time from discharge to return to school has dropped annually for those that opted into the programme, when compared to the baseline by 62.3% (53 days to 20 days). Thematic analysis highlights positive responses to the programme from all involved. Increased awareness and feeling supported were amongst the main themes to emerge. Returning to school after a significant burn injury can be challenging for all involved, but we hypothesise that outreach interventions in schools by burns services can have a positive impact on the time it takes children to successfully reintegrate. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  16. Night club patrons who feel safe will return: Evidence to encourage management to address club violence

    PubMed Central

    Johnson, Mark B.; Voas, Robert; Miller, Brenda A.; Byrnes, Hilary; Bourdeau, Beth

    2017-01-01

    Introduction There is substantial evidence that heavy drinking is associated with aggression and violence. Most managers of drinking establishments are required to maintain a security staff to deal with disruptive patrons who threaten an organization’s business or legal status. However, managers may focus little on minor instances of aggression even though these may escalate into more serious events. We hypothesize that proactive security efforts may positively affect patron’s perceptions of nighttime safety and influence their decisions to return to the club, thereby affecting the club’s bottom line. Method Data for this study were collected from entry and exit surveys with 1,714 attendees at 70 electronic music dance events at 10 clubs in the San Francisco Bay Area (2010–2012). Participants were asked to report on observations and experiences with aggressive behavior while in the club, their overall perception of club safety, and their plans to return to the same club in the next 30 days. Mediational multiple regression analysis was used to relate observations of club security to perceptions of personal safety and plans to return to the club. Results Reported observations of an active club security staff were positively related to perceptions of personal safety. Safety perceptions, in turn, were significantly related to plans to return to the club. The indirect path between perceptions of security and plans to return was significant as well. Conclusions The results suggest that an active security presence inside clubs can encourage club attendance by providing an environment where minor altercations are minimized, contributing to the perception of club safety. Practical Applications Evidence that proactive security efforts appear to increase return customers might motivate managers to implement better security policies. PMID:26875162

  17. The net return from animal activity in agro-ecosystems: trading off benefits from ecosystem services against costs from crop damage

    PubMed Central

    Luck, Gary W

    2014-01-01

    Animals provide benefits to agriculture through the provision of ecosystem services, but also inflict costs such as damaging crops. These benefits and costs are mostly examined independently, rather than comparing the trade-offs of animal activity in the same system and quantifying the net return from beneficial minus detrimental activities. Here, I examine the net return associated with the activity of seed-eating birds in almond orchards by quantifying the economic costs and benefits of bird consumption of almonds. Pre-harvest, the consumption of harvestable almonds by birds cost growers AUD$57.50 ha -1 when averaged across the entire plantation. Post-harvest, the same bird species provide an ecosystem service by removing mummified nuts from trees that growers otherwise need to remove to reduce threats from fungal infection or insect pest infestations. The value of this ecosystem service ranged from AUD$82.50 ha -1–$332.50 ha -1 based on the replacement costs of mechanical or manual removal of mummified nuts, respectively. Hence, bird consumption of almonds yielded a positive net return of AUD$25–$275 ha -1 averaged across the entire plantation. However, bird activity varied spatially resulting in positive net returns occurring primarily at the edges of crops where activity was higher, compared to negative net returns in crop interiors. Moreover, partial mummy nut removal by birds meant that bird activity may only reduce costs to growers rather than replace these costs completely. Similar cost-benefit trade-offs exist across nature, and quantifying net returns can better inform land management decisions such as when to control pests or promote ecosystem service provision. PMID:25285202

  18. Storm surges and coastal impacts at Mar del Plata, Argentina

    NASA Astrophysics Data System (ADS)

    Fiore, Mónica M. E.; D'Onofrio, Enrique E.; Pousa, Jorge L.; Schnack, Enrique J.; Bértola, Germán R.

    2009-07-01

    Positive storm surges (PSS) lasting for several days can raise the water level producing significant differences between the observed level and the astronomical tide. These storm events can be more severe if they coincide with a high tide or if they bracket several tidal cycles, particularly in the case of the highest astronomical tide. Besides, the abnormal sea-level elevation near the coast can cause the highest waves generated to attack the upper beach. This combination of factors can produce severe erosion, threatening sectors located along the coastline. These effects would be more serious if the storm surge height and duration increase as a result of a climatic change. The Mar del Plata (Argentina) coastline and adjacent areas are exposed to such effects. A statistical characterization of PSS based on their intensity, duration and frequency, including a surge event classification, was performed utilizing tide-gauge records over the period 1956-2005. A storm erosion potential index (SEPI) was calculated from observed levels based on hourly water level measurements. The index was related to beach profile responses to storm events. Also, a return period for extreme SEPI values was calculated. Results show an increase in the average number of positive storm surge events per decade. Considering all the events, the last decade (1996-2005) exhibits an average 7% increase compared to each one of the previous decades. A similar behavior was found for the decadal average of the heights of maximum annual positive storm surges. In this case the average height of the last two decades exceeds that of the previous decades by approximately 8 cm. The decadal average of maximum annual duration of these meteorological events shows an increase of 2 h in the last three decades. A possible explanation of the changes in frequency, height and duration of positive storm surges at Mar del Plata would seem to lie in the relative mean sea-level rise.

  19. Pseudopolycythemia, pseudothrombocytopenia, and pseudoleukopenia due to overfilling of blood collection vacuum tubes.

    PubMed

    Pewarchuk, W; VanderBoom, J; Blajchman, M A

    1992-01-01

    A patient blood sample with an unexpectedly high hemoglobin level, high hematocrit, low white blood cell count, and low platelet count was recognized as being spurious based on previously available data. Repeated testing of the original sample showed a gradual return of all parameters to expected levels. We provide evidence that the overfilling of blood collection vacuum tubes can lead to inadequate sample mixing and that, in combination with the settling of the cellular contents in the collection tubes, can result in spuriously abnormal hematological parameters as estimated by an automated method.

  20. Blood glucose may condition factor VII levels in diabetic and normal subjects.

    PubMed

    Ceriello, A; Giugliano, D; Quatraro, A; Dello Russo, P; Torella, R

    1988-12-01

    Increased factor VII levels have been reported in Type 1 (insulin-dependent) diabetic subjects. A direct correlation between fasting plasma glucose and factor VII level was found to exist in both diabetic and normal subjects. Induced-hyperglycaemia was able to increase factor VII levels in both diabetic patients and normal control subjects while, when euglycaemia was achieved in diabetic patients, factor VII values returned to normal range. This study shows that the level of factor VII may be directly conditioned by circulating blood glucose and, therefore, stresses the role of hyperglycaemia in conditioning coagulation abnormalities in diabetes mellitus.

  1. Impaired fatty acid oxidation in propofol infusion syndrome.

    PubMed

    Wolf, A; Weir, P; Segar, P; Stone, J; Shield, J

    2001-02-24

    Propofol infusion syndrome is a rare but frequently fatal complication in critically ill children given long-term propofol infusions. We describe a child who developed all the clinical features of propofol infusion syndrome and was treated successfully with haemofiltration. Biochemical analysis before haemofiltration showed a large rise in plasma concentrations of malonylcarnitine (3.3 micromol/L) and C5-acylcarnitine (8.4 micromol/L), which returned to normal after recovery. Abnormalities are consistent with specific disruption of fatty-acid oxidation caused by impaired entry of long-chain acylcarnitine esters into the mitochondria and failure of the mitochondrial respiratory chain at complex 11.

  2. Achieving donor repetition and motivation by block leaders among current blood donors.

    PubMed

    Martín-Santana, Josefa D; Beerli-Palacio, Asunción

    2012-12-01

    This paper presents an explicative model on the recommendation of donating blood made to relatives and friends by current donors. This model establishes satisfaction and intention to return as direct antecedents, and the quality perceived in the donation process and the existence of inhibitors as indirect antecedents. The results show that (1) the perceived quality has a positive influence on satisfaction and intention to return; (2) the intention to donate again depends positively on satisfaction, but negatively on the existence of internal and external inhibitors; and lastly (3) the recommendation to donate depends on donor satisfaction and their intention to return to donate, this being the most influential factor. At the same time, we contrasted how the model does not vary, whether it is a first-time donor or a repeat donor. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Subtle membrane changes in cryopreserved bull semen in relation with sperm viability, chromatin structure, and field fertility.

    PubMed

    Januskauskas, A; Johannisson, A; Rodriguez-Martinez, H

    2003-09-01

    This study investigated the use of annexin-V/PI assay to assess sub lethal changes in bull spermatozoa post-thawing, and to further relate these changes to results obtained by fluorometric assessment of sperm viability and sperm chromatin structure assay (SCSA), as well as field fertility (as 56-day non-return rates, 56-day NRR) after AI. Frozen-thawed semen samples were obtained from 18 Swedish Red and White bulls (one to three semen batches/bull) and fertility data was based on 6900 inseminations. The annexin-V/PI assay revealed that post-thaw semen samples contained on average 41.8+/-7.5% annexin-V-positive cells. Most of the annexin-V-positive cells were dying cells, i.e. also PI-positive. The incidence of annexin-V-positive cells was negatively related (r=-0.59, P<0.01) to the percentage of viable cells, as detected by fluorometry. The incidence of annexin-V-positive spermatozoa significantly correlated to the SCSA variable xalphat (r=0.53, P<0.05). The incidence of annexin-V-negative, dead cells was the only annexin-V/PI assay variable that correlated significantly with fertility both at batch (r=-0.40, P<0.05), and bull (r=-0.56, P<0.05) levels. Among sperm viability variables, subjectively assessed sperm motility (r=0.52-0.59, P<0.01), CASA-assessed sperm motility (r=0.43-0.61, P<0.05), and the incidence of live spermatozoa, expressed as total numbers (r=0.39-0.54, P<0.05), or percentage values (r=0.68-0.68, P<0.01), correlated significantly with field fertility both at batch, and bull levels. Among the SCSA variables, only the COMP alphat correlated significantly (r=0.33-0.51, P<0.05) with fertility results. The results indicate a certain proportion of bull spermatozoa express PS on their surface after thawing, e.g. they have altered membrane function, and that the incidence of such cells is inversely correlated to sperm viability, and positively correlated to abnormal sperm chromatin condensation since they eventually undergo necrosis.

  4. 77 FR 67707 - Self-Regulatory Organizations; NYSE Arca, Inc.; Order Granting Approval of Proposed Rule Change...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-13

    ... and expenses) that correlate positively to three times (300%) the daily return of a target benchmark, meaning a Leveraged Bull Fund will attempt to move in the same direction as the target benchmark. The... inverse (opposite) of three times the return of a target benchmark, meaning that the Leveraged Bear Funds...

  5. A Longitudinal Study of Student Outcomes from Participation in an International Study Tour: Some Preliminary Findings

    ERIC Educational Resources Information Center

    Tucker, Mark; Weaver, Debbi

    2013-01-01

    Students returning from an international business study tour program were interviewed about their experiences and perceptions of the professional and personal impact of the program. When interviews were conducted within 3-4 months of the students' return, mixed responses were received, with some students highly positive about their experiences,…

  6. Traumatic Brain Injury in K-12 Students II: Response to Instruction--When Will They Ever Learn?

    ERIC Educational Resources Information Center

    Schutz, Larry E.; McNamara, Elizabeth A.

    2011-01-01

    Most students who have sustained severe traumatic brain injury (TBI) appear normal when they return to school. Hopeful parents, encouraged by deceptively positive medical feedback, expect a return to regular education. In the classroom, the students initially seem almost ready to resume learning, but instead they fall farther behind grade level…

  7. Relationship between spinal morphology and function and adolescent non-specific back pain: A cross-sectional study.

    PubMed

    Feng, Qiang; Jiang, Chongmin; Zhou, Yu; Huang, Yun; Zhang, Ming

    2017-01-01

    Non-specific back pain has become a public health problem affecting adolescent health. To examine the relationships between abnormalities in spinal morphology and non-specific back pain among adolescents. Cross-sectional study. Junior and senior high schools. Participants were screened using a questionnaire regarding back pain. Students in the pain group (n= 273, 121 boys and 152 girls) reported experiencing upper and/or lower back pain within the previous month, and those who did not report pain were assigned to the group without pain (n= 127, 63 boys and 64 girls). Participants who had experienced acute upper and/or lower back injuries within the previous month or received a definitive diagnose of disease were excluded. The SpinalMouse® was used to measure the thoracic kyphosis angle (TKA), lumbar lordosis angle (LLA), sacrum/hip angle (SA), and incline angle (INA) in both the standing position and sitting position. The SpinalMouse® also was used to measure the sacral, thoracic, and lumbar range of motion (ROM) in the fully flexed position and fully extended position in the sagittal plane. The thoracic and lumbar ROM in left/right lateral flexion was recorded. The Matthiass test was used to assess changes in the measured angles upon loading. Among junior high school students, 47.0% of boys and 53% of girls had an abnormal TKA. Among senior high school students, 52.6% of boys and 46.99% of girls had an abnormal TKA. The incidence of LLA abnormality was significantly higher among junior high boys than girls (p< 0.05), as was the incidence of hypolordosis (p< 0.05). Significantly fewer senior high boys than girls had a normal LLA value (p< 0.05). An excessive TKA (p< 0.05, odds ratio = 1.236) and limited lumbar ROM (p< 0.01, odds ratio = 0.975) were correlated with back pain in adolescents. The incidences of TKA and LLA abnormality are high among Chinese adolescents, and an excessive TKA and insufficient total lumbar ROM may be risk factors for non-specific back pain in adolescents.

  8. Diagnostic Value of 18F-FDG PET/CT Versus MRI in the Setting of Antibody-Specific Autoimmune Encephalitis.

    PubMed

    Solnes, Lilja B; Jones, Krystyna M; Rowe, Steven P; Pattanayak, Puskar; Nalluri, Abhinav; Venkatesan, Arun; Probasco, John C; Javadi, Mehrbod S

    2017-08-01

    Diagnosis of autoimmune encephalitis presents some challenges in the clinical setting because of varied clinical presentations and delay in obtaining antibody panel results. We examined the role of neuroimaging in the setting of autoimmune encephalitides, comparing the utility of 18 F-FDG PET/CT versus conventional brain imaging with MRI. Methods: A retrospective study was performed assessing the positivity rate of MRI versus 18 F-FDG PET/CT during the initial workup of 23 patients proven to have antibody-positive autoimmune encephalitis. 18 F-FDG PET/CT studies were analyzed both qualitatively and semiquantitatively. Areas of cortical lobar hypo (hyper)-metabolism in the cerebrum that were 2 SDx from the mean were recorded as abnormal. Results: On visual inspection, all patients were identified as having an abnormal pattern of 18 F-FDG uptake. In semiquantitative analysis, at least 1 region of interest with metabolic change was identified in 22 of 23 (95.6%) patients using a discriminating z score of 2. Overall, 18 F-FDG PET/CT was more often abnormal during the diagnostic period than MRI (10/23, 43% of patients). The predominant finding on brain 18 F-FDG PET/CT imaging was lobar hypometabolism, being observed in 21 of 23 (91.3%) patients. Hypometabolism was most commonly observed in the parietal lobe followed by the occipital lobe. An entire subset of antibody-positive patients, anti- N -methyl-d-aspartate receptor (5 patients), had normal MRI results and abnormal 18 F-FDG PET/CT findings whereas the other subsets demonstrated a greater heterogeneity. Conclusion: Brain 18 F-FDG PET/CT may play a significant role in the initial evaluation of patients with clinically suspected antibody-mediated autoimmune encephalitis. Given that it is more often abnormal when compared with MRI in the acute setting, this molecular imaging technique may be better positioned as an early biomarker of disease so that treatment may be initiated earlier, resulting in improved patient outcomes. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

  9. Magnetic resonance imaging findings in pediatric bilateral vocal fold dysfunction.

    PubMed

    Steiner, Joel I; Fink, A Michelle; Berkowitz, Robert G

    2013-07-01

    We studied the findings of brain magnetic resonance imaging (MRI) in infants with idiopathic congenital bilateral vocal fold dysfunction (CBVFD). We performed a retrospective investigation of a case series. We identified 26 children (14 male, 12 female) over 11 years. Three children were excluded. Thirteen patients required airway interventions, including continuous positive airway pressure (4 patients), endotracheal intubation (1), and tracheostomy (8). The findings on brain MRI were abnormal in 8 patients (35%). Tracheostomy was required in 3 patients (38%) with abnormal MRI findings, as compared with 5 of 15 patients (33%) with normal MRI findings. The MRI abnormalities involved evidence of white matter injury (2), abnormal white matter signal (1), subdural blood (3), cerebral swelling (1), and perisylvian polymicrogyria (1). The cranial ultrasound findings were abnormal in 4 of 11 patients. The MRI findings were abnormal in 2 of 7 children in whom the cranial ultrasound findings were normal, and in 2 of the 4 patients in whom the cranial ultrasound findings were abnormal. The MRI abnormalities were nonspecific; however, they may indicate unrecognized perinatal intracranial injury as being related to CBVFD. In addition, MRI may reveal an underlying structural brain anomaly. Cranial ultrasound has poor sensitivity and specificity. Hence, MRI should be considered as part of the routine assessment of neonates with CBVFD.

  10. Why does negative CG lightning have subsequent return strokes?

    NASA Astrophysics Data System (ADS)

    Wilkes, R. A.; Kotovsky, D. A.; Uman, M. A.; Carvalho, F. L.; Jordan, D.

    2017-12-01

    It is not understood why cloud-to-ground (CG) lightning flashes lowering negative charge often produce discrete dart-leader/return-stroke sequences rather than having the first stroke drain the available cloud charge, as is almost always the case for CG lightning lowering positive charge. Triggered lightning data obtained at the International Center for Lightning Research and Testing (ICLRT) in north-central Florida have been analyzed to clarify the subsequent return-stroke process. In summers 2013 through 2016 at the ICLRT, 53% of the rocket launches did not initiate any part of a lightning flash, 13% of the rocket launches created an initial stage only (ISO) and failed to produce a following dart-leader/return-stroke sequences, and 34% of rocket launches produced an initial stage (IS) followed by return strokes. The IS of the triggered lightning consists of the upward positive leader and a following initial continuing current, both being responsible for transporting negative charge from the cloud to ground. Our ISO events may well have some commonality with the roughly 20 percent of natural CG flashes that fail to produce a dart-leader/return-stroke. We have analyzed the IS of 41 triggered lightning flashes with (19 cases) and without (22 cases) following return strokes and compared areas and heights of the flash using data collected by a Lightning Mapping Array (LMA). In our preliminary analysis, we can find no geometrical feature of the lightning channel during the IS that will predict the occurrence or lack of occurrence of following return strokes. We also have compared the triggered-lightning electrical current and charge transfer observed at the ground. We found that the average current, duration, and charge transfer during the IS for ISO events is each about half that of ISs analyzed which are followed by dart-leader/return-stroke sequences, contrary to the results presented from the GCOELD in China. Summarizing, there appear to be no differences in the channel geometry between initial stages that do or do not yield dart-leader/return-stroke sequences. In contrast, we find that particular electrical characteristics of the initial stage may indicate whether or not a dart-leader/return-stroke sequence may follow, potentially shedding light on the physical processes necessary for dart-leader initiation.

  11. 75 FR 60371 - Requirements of a Statement Disclosing Uncertain Tax Positions; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-30

    ... Requirements of a Statement Disclosing Uncertain Tax Positions; Correction AGENCY: Internal Revenue Service... the IRS to require corporations to file a schedule disclosing uncertain tax positions related to the tax return as required by the IRS. FOR FURTHER INFORMATION CONTACT: Kathryn Zuba, (202) 622-3400 (not...

  12. Frequency of brain MRI abnormalities in neuromyelitis optica spectrum disorder at presentation: A cohort of Latin American patients.

    PubMed

    Carnero Contentti, Edgar; Daccach Marques, Vanessa; Soto de Castillo, Ibis; Tkachuk, Veronica; Antunes Barreira, Amilton; Armas, Elizabeth; Chiganer, Edson; de Aquino Cruz, Camila; Di Pace, José Luis; Hryb, Javier Pablo; Lavigne Moreira, Carolina; Lessa, Carmen; Molina, Omaira; Perassolo, Monica; Soto, Arnoldo; Caride, Alejandro

    2018-01-01

    Brain magnetic resonance imaging (BMRI) lesions were classically not reported in neuromyelitis optica (NMO). However, BMRI lesions are not uncommon in NMO spectrum disorder (NMOSD) patients. To report BMRI characteristic abnormalities (location and configuration) in NMOSD patients at presentation. Medical records and BMRI characteristics of 79 patients with NMOSD (during the first documented attack) in Argentina, Brazil and Venezuela were reviewed retrospectively. BMRI abnormalities were observed in 81.02% of NMOSD patients at presentation. Forty-two patients (53.1%) showed typical-NMOSD abnormalities. We found BMRI abnormalities at presentation in the brainstem/cerebellum (n = 26; 32.9%), optic chiasm (n = 16; 20.2%), area postrema (n = 13; 16.4%), thalamus/hypothalamus (n = 11; 13.9%), corpus callosum (n = 11; 13.9%), periependymal-third ventricle (n = 9; 11.3%), corticospinal tract (n = 7; 8.8%), hemispheric white matter (n = 1; 1.2%) and nonspecific areas (n = 49; 62.03%). Asymptomatic BMRI lesions were more common. The frequency of brain MRI abnormalities did not differ between patients who were positive and negative for aquaporin 4 antibodies at presentation. Typical brain MRI abnormalities are frequent in NMOSD at disease onset. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Return to Golf Following Left Total Hip Arthroplasty in a Golfer Who is Right Handed

    PubMed Central

    Betlach, Michael; Senkarik, Ryan; Smith, Robyn; Voight, Michael

    2007-01-01

    Background Research indicates return to golf is a safe activity following total hip arthroplasty (THA). Frequently, individuals have shown both physical faults and swing faults after THA, which can persist even following rehabilitation. Physical limitations and pain often lead to faults in the golfers swing, most notably “hanging back.” These problems may not be improved after surgery unless the proper re-training takes place. Objectives Using pre-surgical as well as post-surgical information, physical faults and swing faults were identified. A corrective training protocol was developed to normalize physical and swing limitations. Case description The patient is a 52-year old male golfer who underwent left total hip arthroplasty secondary to left hip osteoarthritis. Video analysis both pre and post surgery indicated the patient was “hanging back.” This “hanging back” can lead to an inefficient golf swing and potential injury. Following a physical evaluation, a training protocol was designed to correct abnormal physical findings to assist the patient in creating an efficient golf swing. Outcomes The patient was able to swing the golf club with proper weighting of the lead lower extremity, significant improvement of swing efficiency, and return to play at a zero handicap following a corrective training protocol. Discussion A return to full weight bearing, functional strength, range of motion, stability, and balance are critical to regaining the physical skills necessary to properly swing the golf club. Further, mastery of these objective components lend themselves to the trust needed to load the lead leg with confidence during the golf swing. PMID:21509144

  14. Can hip impingement be mistaken for tendon pain in the groin? A long-term follow-up of tenotomy for groin pain in athletes.

    PubMed

    Sansone, Mikael; Ahldén, Mattias; Jonasson, Pall; Thomeé, Roland; Falk, Anders; Swärd, Leif; Karlsson, Jón

    2014-04-01

    There are several reports on the association between pubalgia and intra-articular hip disorders. The purpose of this study was to evaluate the long-term outcome in athletes who underwent tenotomy due to long-standing groin pain. A secondary purpose was evaluating the frequency of femoro-acetabular impingement (FAI) and its impact on the long-term outcome. Thirty-two high-level male athletes treated with adductor tenotomy, rectus abdominis tenotomy or both were included. At a median follow-up time of 6 years after the tenotomy, the subjects underwent standardised clinical examination, plain radiographs, completed web-based health-related patient-reported outcomes, including iHOT12, HAGOS (six subscales), EQ-5D (two subscales), HSAS for physical activity level and a VAS for overall hip function. Furthermore, patient satisfaction and return to sports were documented. Twenty-four of the 32 (75 %) athletes were satisfied with the outcome of the tenotomy, and 22 of the athletes (69 %) were able to return to their pre-injury sport. Before the long-term follow-up, two of these satisfied athletes had undergone repeat surgery (one hip arthroscopy due to FAI and one repeat tenotomy). Of the 24 satisfied athletes, eight (33 %) had a positive hip impingement test at the follow-up. Of the remaining eight athletes not satisfied with the outcome, only one returned to their pre-injury sport and three had undergone hip arthroscopy prior to follow-up. Five had positive hip impingement tests which was significantly more frequently than in the satisfied group (p = 0.008). The group with a positive hip impingement test reported significantly more pain and symptoms, more hip problems during sports and physical activity, as well as lower hip-related quality of life according to the HAGOS scores (p < 0.05), at follow-up. Tenotomy for pubalgia yielded a satisfactory long-term outcome, with three of four athletes being able to return to their pre-injury sport. The athletes that did not return to their pre-injury sport had higher frequency of positive hip impingement test and inferior functional outcome compared with the athletes that did return to their pre-injury sport. It is therefore recommended that the hip should be carefully evaluated for hip impingement before tenotomy is considered as treatment for athletes with pubalgia.

  15. Effect of temperature shock and inventory surprises on natural gas and heating oil futures returns.

    PubMed

    Hu, John Wei-Shan; Hu, Yi-Chung; Lin, Chien-Yu

    2014-01-01

    The aim of this paper is to examine the impact of temperature shock on both near-month and far-month natural gas and heating oil futures returns by extending the weather and storage models of the previous study. Several notable findings from the empirical studies are presented. First, the expected temperature shock significantly and positively affects both the near-month and far-month natural gas and heating oil futures returns. Next, significant temperature shock has effect on both the conditional mean and volatility of natural gas and heating oil prices. The results indicate that expected inventory surprises significantly and negatively affects the far-month natural gas futures returns. Moreover, volatility of natural gas futures returns is higher on Thursdays and that of near-month heating oil futures returns is higher on Wednesdays than other days. Finally, it is found that storage announcement for natural gas significantly affects near-month and far-month natural gas futures returns. Furthermore, both natural gas and heating oil futures returns are affected more by the weighted average temperature reported by multiple weather reporting stations than that reported by a single weather reporting station.

  16. Effect of Temperature Shock and Inventory Surprises on Natural Gas and Heating Oil Futures Returns

    PubMed Central

    Hu, John Wei-Shan; Lin, Chien-Yu

    2014-01-01

    The aim of this paper is to examine the impact of temperature shock on both near-month and far-month natural gas and heating oil futures returns by extending the weather and storage models of the previous study. Several notable findings from the empirical studies are presented. First, the expected temperature shock significantly and positively affects both the near-month and far-month natural gas and heating oil futures returns. Next, significant temperature shock has effect on both the conditional mean and volatility of natural gas and heating oil prices. The results indicate that expected inventory surprises significantly and negatively affects the far-month natural gas futures returns. Moreover, volatility of natural gas futures returns is higher on Thursdays and that of near-month heating oil futures returns is higher on Wednesdays than other days. Finally, it is found that storage announcement for natural gas significantly affects near-month and far-month natural gas futures returns. Furthermore, both natural gas and heating oil futures returns are affected more by the weighted average temperature reported by multiple weather reporting stations than that reported by a single weather reporting station. PMID:25133233

  17. Positive Emotions Speed Recovery from the Cardiovascular Sequelae of Negative Emotions

    PubMed Central

    Fredrickson, Barbara L.; Levenson, Robert W.

    2011-01-01

    Two studies tested the hypothesis that certain positive emotions speed recovery from the cardiovascular sequelae of negative emotions. In Study 1, 60 subjects (Ss) viewed an initial fear-eliciting film, and were randomly assigned to view a secondary film that elicited: (a) contentment; (b) amusement; (c) neutrality; or (d) sadness. Compared to Ss who viewed the neutral and sad secondary films, those who viewed the positive films exhibited more rapid returns to pre-film levels of cardiovascular activation. In Study 2, 72 Ss viewed a film known to elicit sadness. Fifty Ss spontaneously smiled at least once while viewing this film. Compared to Ss who did not smile, those who smiled exhibited more rapid returns to pre-film levels of cardiovascular activation. We discuss these findings in terms of emotion theory and possible health-promoting functions of positive emotions. PMID:21852890

  18. False positive malaria rapid diagnostic test in returning traveler with typhoid fever.

    PubMed

    Meatherall, Bonnie; Preston, Keith; Pillai, Dylan R

    2014-07-09

    Rapid diagnostic tests play a pivotal role in the early diagnosis of malaria where microscopy or polymerase chain reaction are not immediately available. We report the case of a 39 year old traveler to Canada who presented with fever, headache, and abdominal pain after visiting friends and relatives in India. While in India, the individual was not ill and had no signs or symptoms of malaria. Laboratory testing upon his return to Canada identified a false positive malaria rapid diagnostic (BinaxNOW® malaria) result for P. falciparum with coincident Salmonella Typhi bacteraemia without rheumatoid or autoimmune factors. Rapid diagnostic test false positivity for malaria coincided with the presence or absence of Salmonella Typhi in the blood. Clinicians should be aware that Salmonella Typhi infection may result in a false positive malaria rapid diagnostic test. The mechanism of this cross-reactivity is not clear.

  19. Cancer survivors' perspectives and experiences regarding behavioral determinants of return to work and continuation of work.

    PubMed

    Duijts, Saskia F A; van Egmond, Martine P; Gits, Maxime; van der Beek, Allard J; Bleiker, Eveline M

    2017-10-01

    Supportive interventions to enhance return to work (RTW) in cancer survivors hardly showed positive effects so far. Behavioral determinants might have to be considered in the development of interventions to achieve sustained employability. This study aimed to explore cancer survivors' perspectives and experiences regarding behavioral determinants of RTW and continuation of work. In this qualitative study, semi-structured telephone interviews were held with 28 cancer survivors. All participants were at working age, 1-2 years after diagnosis and employed at time of diagnosis. Thematic content analysis was performed. Work turned out to be a meaningful aspect of cancer survivors' life, and most participants reported a positive attitude towards their job. Social support to RTW or to continue working was mainly received from family and friends, but pressure to RTW from the occupational physician was also experienced. Changes in expectations regarding work ability from negative to positive during the treatment process were observed. Those who applied active coping mechanisms felt equipped to deal with difficulties regarding work. Behavioral determinants should be taken into account in the development of future interventions to support cancer survivors' RTW. However, the causal relationship still has to be determined. Implications for rehabilitation Factors influencing occupational motivation among cancer survivors need to be understood in more detail. Previous studies in non-cancer populations have demonstrated that behavioral determinants, such as a positive attitude towards work, high social support and self-efficacy may increase return to work rates or shorten the time to return to work. Addressing behavioral determinants in future development of work-related interventions for cancer survivors is essential in achieving sustained employability.

  20. Performance and Return to Sport After Nonoperative Treatment of Clavicle Fractures in National Football League Players.

    PubMed

    Jack, Robert A; Sochacki, Kyle R; Navarro, Sergio M; McCulloch, Patrick C; Lintner, David M; Harris, Joshua D

    2017-09-01

    Clavicle fractures are often seen in contact sports. The purpose of this study was to determine (1) return-to-sport (RTS) rate of National Football League (NFL) players following nonoperative treatment of clavicle fractures, (2) posttreatment career length and games per season, (3) pre- and posttreatment performance, and (4) posttreatment performance compared with control players matched by position, age, years of experience, and performance. Public records were used to identify NFL players who underwent nonoperative treatment of clavicle fractures. Demographic and performance data were collected for each player. Matched controls (position, age, experience, and performance) were identified. Control and case performance scores were calculated using a standardized scoring system. Return to sport was defined as playing a minimum of 1 game after treatment. Comparisons between the 2 groups and pre- and posttreatment time points were made using paired-samples Student's t tests. Thirty players (32 fractures) were analyzed. Two players fractured their contralateral clavicle. Of the players analyzed, 96.9% were able to RTS at a mean of 244.6±119.6 days. Eight players (27.6%) returned within the same season as their injury. Overall 1-year survival rate posttreatment was 93.5%. Players with nonoperative treatment had career lengths similar to those of controls (P>.05). No significant (P>.05) differences existed in demographic, performance, or games per season data between position groups for cases and matched controls pretreatment and preindex and in posttreatment compared with pretreatment performance scores. Wide receivers played fewer games per season (P=.043) following treatment. No position group had significantly worse posttreatment performance scores when compared with postindex matched controls. [Orthopedics. 2017; 40(5):e836-e843.]. Copyright 2017, SLACK Incorporated.

  1. Range-based volatility, expected stock returns, and the low volatility anomaly

    PubMed Central

    2017-01-01

    One of the foundations of financial economics is the idea that rational investors will discount stocks with more risk (volatility), which will result in a positive relation between risk and future returns. However, the empirical evidence is mixed when determining how volatility is related to future returns. In this paper, we examine this relation using a range-based measure of volatility, which is shown to be theoretically, numerically, and empirically superior to other measures of volatility. In a variety of tests, we find that range-based volatility is negatively associated with expected stock returns. These results are robust to time-series multifactor models as well as cross-sectional tests. Our findings contribute to the debate about the direction of the relationship between risk and return and confirm the presence of the low volatility anomaly, or the anomalous finding that low volatility stocks outperform high volatility stocks. In other tests, we find that the lower returns associated with range-based volatility are driven by stocks with lottery-like characteristics. PMID:29190652

  2. Decline in economic returns from new drugs raises questions about sustaining innovations.

    PubMed

    Berndt, Ernst R; Nass, Deanna; Kleinrock, Michael; Aitken, Murray

    2015-02-01

    The sales and financial returns realized by pharmaceutical companies are a frequent topic of discussion and debate. In this study we analyzed the economic returns for four cohorts of new prescription drugs launched in the United States (in 1991-94, 1995-99, 2000-04, and 2005-09) and compared fluctuations in revenues with changing average research and development (R&D) and other costs to determine patterns in rewards for pharmaceutical innovation. We found that the average present values of lifetime net economic returns were positive and reached a peak with the 1995-99 and 2000-04 new drug cohorts. However, returns have fallen sharply since then, with those for the 2005-09 cohort being very slightly negative and, on average, failing to recoup research and development and other costs. If this level of diminished returns persists, we believe that the rewards for innovation will not be sufficient for pharmaceutical manufacturers to maintain the historical rates of investments needed to sustain biomedical innovation. Project HOPE—The People-to-People Health Foundation, Inc.

  3. Range-based volatility, expected stock returns, and the low volatility anomaly.

    PubMed

    Blau, Benjamin M; Whitby, Ryan J

    2017-01-01

    One of the foundations of financial economics is the idea that rational investors will discount stocks with more risk (volatility), which will result in a positive relation between risk and future returns. However, the empirical evidence is mixed when determining how volatility is related to future returns. In this paper, we examine this relation using a range-based measure of volatility, which is shown to be theoretically, numerically, and empirically superior to other measures of volatility. In a variety of tests, we find that range-based volatility is negatively associated with expected stock returns. These results are robust to time-series multifactor models as well as cross-sectional tests. Our findings contribute to the debate about the direction of the relationship between risk and return and confirm the presence of the low volatility anomaly, or the anomalous finding that low volatility stocks outperform high volatility stocks. In other tests, we find that the lower returns associated with range-based volatility are driven by stocks with lottery-like characteristics.

  4. Current status and environment impact of direct straw return in China's cropland - A review.

    PubMed

    Li, Hui; Dai, Mingwei; Dai, Shunli; Dong, Xinju

    2018-09-15

    With the development of grain production technologies and improvement of rural living standard, the production and utilization of straw have significantly been changed in China. More than 1 billion tones of straw are produced per year, and vast amount of them are discarded without effective utilization, leading various environmental and social impacts. Straw return is an effective approach of the straw utilization that has been greatly recommended by government and scientists in China. This paper discussed the current status of the straw return in China. Specifically, the production and models of straw return were explored and their environmental impacts were extensively evaluated. It was concluded that straw could be positively effective on the improvement of the soil quality and the grain production. However, it appeared that the straw return also had several neglect negative effects, implying that further research and assessment on the returned straw are required before its large-scale promotion in China. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. [Neuropathology of Natalizumab-Associated Progressive Multifocal Leukoencephalopathy].

    PubMed

    Kanda, Takashi

    2015-07-01

    The pathological findings of natalizumab-associated progressive multifocal leukoencephalopathy (PML) are reviewed. In addition to the classical pathology of PML including the presence of enlarged abnormal astrocytes, intranuclear inclusions mainly found within large swollen oligodendrocytes and abundant myelin-laden macrophages/microglia, massive perivascular and parenchymal mononuclear cell infiltration was observed. The latter pathologic picture is that of immune reconstitution inflammatory syndrome (IRIS), and most of these infiltrating cells are CD8-positive T cells. Because IRIS inevitably occurs after the cessation of natalizumab therapy due to the development of PML and subsequent plasma exchange, most of the published pathologic pictures of natalizumab-associated PML patients were a mixture of PML and PML-IRIS. PML-IRIS is also characterized by fewer oligodendroglial viral inclusions and fewer cells that are immunoreactive against anti-JCV antibodies. These findings suggest the effective removal of JCV after the return of normal immune-surveillance in the central nervous system, but clinicians should be aware that JCV elimination is not complete under the IRIS condition, and the immunosuppressive therapy against IRIS should be carefully performed. Mononuclear cell infiltration in natalizumab-associated PML-IRIS patients was much more prominent than that in HIV-associated PML-IRIS patients, reflecting the retained, even enhanced, systemic immunities in patients treated by natalizumab.

  6. Atmosphere-Ionosphere Response to the M9 Tohoku Earthquake Revealed by Joined Satellite and Ground Observations. Preliminary Results

    NASA Technical Reports Server (NTRS)

    Ouzounov, Dimitar; Pulinets, Sergey; Romanov, Alexey; Tsybulya, Konstantin; Davidenko, Dimitri; Kafatos, Menas; Taylor, Patrick

    2011-01-01

    The recent M9 Tohoku Japan earthquake of March 11, 2011 was the largest recorded earthquake ever to hit this nation. We retrospectively analyzed the temporal and spatial variations of four different physical parameters - outgoing long wave radiation (OLR), GPS/TEC, Low-Earth orbit tomography and critical frequency foF2. These changes characterize the state of the atmosphere and ionosphere several days before the onset of this earthquake. Our first results show that on March 8th a rapid increase of emitted infrared radiation was observed from the satellite data and an anomaly developed near the epicenter. The GPS/TEC data indicate an increase and variation in electron density reaching a maximum value on March 8. Starting on this day in the lower ionospheric there was also confirmed an abnormal TEC variation over the epicenter. From March 3-11 a large increase in electron concentration was recorded at all four Japanese ground based ionosondes, which return to normal after the main earthquake. We found a positive correlation between the atmospheric and ionospheric anomalies and the Tohoku earthquake. This study may lead to a better understanding of the response of the atmosphere/ionosphere to the Great Tohoku earthquake.

  7. Sensorineural hearing loss in a pediatric population: association of congenital cytomegalovirus infection with intracranial abnormalities.

    PubMed

    Kimani, Jane W; Buchman, Craig A; Booker, Jessica K; Huang, Benjamin Y; Castillo, Mauricio; Powell, Cynthia M; Weck, Karen E

    2010-10-01

    To examine the incidence of congenital cytomegalovirus (CMV) infection relative to common genetic etiologies of hearing loss in a pediatric population with sensorineural hearing loss (SNHL), and to characterize intracranial radiological abnormalities in patients with CMV-associated hearing loss. Retrospective study. Academic tertiary care center. A total of 112 pediatric patients with confirmed SNHL. The association of congenital CMV infection status with abnormal brain magnetic resonance imaging (MRI) scans and the frequencies of congenital CMV infection, gap junction β-2 (GJB2) mutations, and the mitochondrial DNA (mtDNA) 1555A>G mutation in children with SNHL. Of 109 patients, 11 (10%) had positive results for CMV DNA; 10 of the 11 had normal GJB2 sequence and had negative test results for the mtDNA 1555A>G mutation. Brain MRI scans for 97 patients demonstrated a higher proportion of abnormalities in patients with positive CMV test results (80%) compared with those with no detectable CMV DNA (33%) (P = .006). GJB2 mutations and the mtDNA 1555A>G mutation were seen in 10 of 88 patients (11%) and 1 of 97 patients (1%) with SNHL, respectively. The presence of brain abnormalities in most patients with congenital CMV infection suggests that neurological damage in otherwise asymptomatic patients may not be limited to SNHL. Congenital CMV infection accounted for a significant proportion of patients with SNHL, with an incidence rate comparable with that of GJB2-related SNHL.

  8. Sensitivity and specificity of a urinary screening test used in an emergency setting to detect abnormal first trimester pregnancies.

    PubMed

    Teixeira, João L G; Rabaioli, Paola; Savaris, Ricardo F

    2015-01-01

    To evaluate the performance of a commercial urinary test to screen for abnormal first trimester pregnancies in women presenting to an emergency room. In this prospective observational cohort, women with a confirmed first trimester pregnancy (gestational age <12 weeks) provided a urine sample for diagnosing the viability of their gestation. Pregnancy viability and location testing were confirmed by ultrasound and/or laparoscopy. From 815 eligible patients for the study, 12 were excluded for not having a confirmed pregnancy (n = 6) or were lost to follow-up (n = 6). A total of 803 patients underwent testing and completed follow-up. The pretest probability of an abnormal pregnancy was 44% (9% for ectopic pregnancy and 35% for miscarriage). The test had the following parameters to identify an abnormal first-trimester pregnancy (sensitivity, 13%; 95% confidence interval [CI], 10-17; specificity, 82%; 95% CI, 78-86; positive predictive value, 36; 95% CI, 28-46; negative predictive value, 54; 95% CI, 50-58; accuracy, 47%; positive likelihood ratio, 0.74; 95% CI, 0.53-1.03; negative likelihood ratio, 1.06; 95% CI, 1-1.12). The reproducibility of the test in our study was high (kappa index between readers, 0.89; 95% CI, 0.77-1). In our emergency setting, we were not able to confirm that the commercial test is adequate to detect or exclude an abnormal first-trimester pregnancy. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Athlete's heart patterns in elite rugby players: effects of training specificities.

    PubMed

    Chevalier, Laurent; Kervio, Gaëlle; Corneloup, Luc; Vincent, Marie-Pierre; Baudot, Christophe; Rebeyrol, Jean-Louis; Merle, Francis; Gencel, Laurent; Carré, François

    2013-02-01

    Athlete's heart patterns have been widely described. However, to our knowledge, few studies have focused on professional rugby players, who train differently according to their field position. To describe electrocardiographic and echocardiographic patterns observed in elite rugby players according to their field position. One hundred and thirty-five professional rugby players at the end of the competitive season were included. According to a modified Pelliccia's classification, 68.1% of electrocardiograms were normal or had minor abnormalities, 27.2% were mildly abnormal and 3.7% were distinctly abnormal. Heart rate was higher in scrum first-row players (P<0.05). Absolute and indexed left ventricular end-diastolic internal diameters (LVIDd; absolute value 59.3±4.7 mm) exceeded 65 mm and 32 mm/m2 in 13% and 1.5% of players, respectively. Indexed LVIDd values were higher in back players (P<0.001). Left ventricular interventricular septum and posterior wall thicknesses (absolute values 9.4±1.7 mm and 9.2±1.6 mm, respectively) exceeded 13 mm in 3.7% of players. Concentric cardiac hypertrophy was noted in 3.7% of players. Except for one Wolff-Parkinson-White pattern, players with significant ECG or echocardiographic abnormalities showed no cardiovascular event or disease during follow-up. Thus, elite rugby players present similar heart patterns to elite athletes in other sports. Major electrocardiographic and echocardiographic abnormalities are quite rare. Eccentric cardiac remodelling is more frequent in back players. Copyright © 2013. Published by Elsevier Masson SAS.

  10. p53 mutation and expression in lymphoma.

    PubMed Central

    Adamson, D. J.; Thompson, W. D.; Dawson, A. A.; Bennett, B.; Haites, N. E.

    1995-01-01

    Mutation and abnormal expression of p53 was studied in 38 lymphomas [five Hodgkin's disease and 33 non-Hodgkin's lymphoma (NHL)]. CM1 polyclonal antibody was used to detect overexpression of p53. Three missense mutations were characterised in three cases of NHL after screening exons 5-8 of p53 of all the tumours with single-strand conformation polymorphism (SSCP) analysis. Only two out of three tumours with a missense mutation showed abnormal expression of p53 as measured by CM1. Conversely, seven out of nine tumours with positive CM1 staining had no point mutation demonstrated. Overexpression of p53 in the cases of NHL occurred in three out of twenty four low-grade tumours and five out of nine high-grade tumours (Kiel classification). The results suggest that abnormalities of p53 are commoner in high-grade than low-grade NHL, and that positive immunocytochemistry cannot be used to determine which tumours have mutations of p53. Images Figure 1 Figure 2 PMID:7599045

  11. Distal Predominance of Electrodiagnostic Abnormalities in Early Stage Amyotrophic Lateral Sclerosis.

    PubMed

    Shayya, Luay; Babu, Suma; Pioro, Erik P; Li, Jianbo; Li, Yuebing

    2018-05-09

    We compare the electrodiagnostic (EDX) yield of limb muscles in revealing lower motor neuron (LMN) dysfunction by electromyography (EMG) in early stage amyotrophic lateral sclerosis (ALS). Single-site retrospective review Results: This study includes 122 consecutive patients with possible ALS as defined by revised El Escorial Criteria. Distal limb muscles show more frequent EMG abnormalities than proximal muscles. EDX yield is higher in the limb where weakness begins and when clinical signs of LMN dysfunction are evident. Adoption of Awaji criteria increases the yield of EMG positive segments significantly in the cervical (p<0.0005) and lumbosacral regions (P<0.0001), and upgrades 19 patients into probable and 1 patient into definite categories. Electromyographic abnormalities are distal limb-predominant in early stage ALS. A redefinition of an EDX-positive cervical or lumbosacral segment, with an emphasis on distal limb muscles, may result in an earlier ALS diagnosis. This article is protected by copyright. All rights reserved. © 2018 Wiley Periodicals, Inc.

  12. Asking for work adjustments or initiating behavioural changes - what makes a 'problematic co-worker' score Brownie points? An experimental study on the reactions towards colleagues with a personality disorder.

    PubMed

    Muschalla, Beate; Fay, Doris; Seemann, Anne

    2016-10-01

    People with mental disorders, especially personality disorders, often face low acceptance at work. This is particularly problematic when returning to work after sick leave, because it impedes reintegration into the former workplace. This study explores colleagues' reactions towards a problematic worker dependent on the returning person's reintegration strategy: The returning person undertaking changes in their behaviour is compared with the person requesting adjustments of the workplace. In an experimental study, 188 employed persons read one of four vignettes that described a return-to-work-situation of a problematic co-worker. Across all vignettes, the co-worker was depicted as having previously caused problems in the work team. In the first vignette, the co-worker did not change anything (control condition) when she returned to work; in the second, she asked for workplace adjustments; in the third vignette she initiated efforts to change her own behaviour; and the fourth vignette combined both workplace adjustments and behavioural change. Study participants were asked for their reactions towards the problematic co-worker. Vignettes that included a behavioural change evoked more positive reactions towards the co-worker than vignettes without any behavioural change. Asking for workplace adjustments alone did not yield more positive reactions compared to not initiating any change. When preparing employees with interactional problems for their return to work, it is not effective to only instruct them on their statutory entitlement for workplace adjustments. Instead, it is advisable to encourage them to proactively strive for behaviour changes.

  13. Abnormalities associated with congenital scoliosis: a retrospective study of 226 Chinese surgical cases.

    PubMed

    Shen, Jianxiong; Wang, Zijia; Liu, Jiaming; Xue, Xuhong; Qiu, Guixing

    2013-05-01

    Retrospective study of a series of 226 consecutive Chinese patients with congenital scoliosis. To identify the incidence of intraspinal abnormalities and other organ defects in surgical patients with congenital scoliosis in Chinese population. Previous studies have revealed high rates of intraspinal anomalies and other organ defects in patients with congenital scoliosis. The incidence of abnormalities in patients with congenital scoliosis in Chinese population has not been reported. A total of 226 patients with congenital scoliosis underwent surgical treatment in Peking Union Medical College Hospital between January 2005 and March 2011 were identified. A definitive diagnosis of congenital scoliosis for all patients was made. Complete data were reviewed, including medical records, plain radiograph, magnetic resonance (MR) image of the whole spine, echocardiography, and renal ultrasound. The incidence of intraspinal abnormalities and other organ defects were analyzed. Intraspinal abnormalities were found in 99 (43%) patients. Diastematomyelia was identified to be the most common intraspinal pathological anomaly, which was different from the previous reports. The incidence of intraspinal anomaly in patients with failures of segmentation and mixed defects were significantly higher than those with failures of formation. Patients with thoracic hemivertebrae were found to have a higher incidence of intraspinal abnormalities than patients with lumbar hemivertebrae. Patients with intraspinal abnormality had a higher incidence of positive clinical findings than those with normal magnetic resonance imaging. However, the difference between the 2 groups was not statistically significant. Other organic defects were found in 91(40%) patients. Cardiac defects were detected in 18%, urogenital anomalies in 12%, and gastrointestinal anomalies in 5% of the patients in this study. Diastematomyelia was found to be the most common intraspinal pathological anomaly and cardiac defects were the most common extraspinal anomaly in surgical patients with congenital scoliosis in this study. Magnetic resonance imaging, echocardiography, and ultrasound should be part of routine evaluation in all congenital cases before surgery, no matter positive clinical findings were found or not. 3.

  14. The Automatic Recognition of the Abnormal Sky-subtraction Spectra Based on Hadoop

    NASA Astrophysics Data System (ADS)

    An, An; Pan, Jingchang

    2017-10-01

    The skylines, superimposing on the target spectrum as a main noise, If the spectrum still contains a large number of high strength skylight residuals after sky-subtraction processing, it will not be conducive to the follow-up analysis of the target spectrum. At the same time, the LAMOST can observe a quantity of spectroscopic data in every night. We need an efficient platform to proceed the recognition of the larger numbers of abnormal sky-subtraction spectra quickly. Hadoop, as a distributed parallel data computing platform, can deal with large amounts of data effectively. In this paper, we conduct the continuum normalization firstly and then a simple and effective method will be presented to automatic recognize the abnormal sky-subtraction spectra based on Hadoop platform. Obtain through the experiment, the Hadoop platform can implement the recognition with more speed and efficiency, and the simple method can recognize the abnormal sky-subtraction spectra and find the abnormal skyline positions of different residual strength effectively, can be applied to the automatic detection of abnormal sky-subtraction of large number of spectra.

  15. The utility of clinical findings to predict laboratory values in hypertensive disorders of pregnancy.

    PubMed

    So, Jane; Young, Elizabeth; Crnosija, Natalie; Chappelle, Joseph

    2016-04-01

    Preeclampsia is the 2nd leading cause of maternal mortality in the United States. Women with new-onset or worsening hypertension are commonly evaluated for laboratory abnormalities. We aim to investigate whether demographic and/or clinical findings correlate with abnormal laboratory values. A retrospective chart review of women who presented for evaluation of hypertension in pregnancy during 2010. Demographic information, medical history, symptoms, vital signs, and laboratory results were collected. Bivariate analysis was used to investigate associations between predictors and the outcome. Of the 481 women in the sample, 22 were identified as having abnormal laboratory test results (4.6%). Women who reported right upper quadrant pain or tenderness had significantly increased likelihood of having laboratory abnormalities compared to those without the complaint. Only a small percentage of women evaluated were determined to have abnormal laboratory findings, predominantly among women with severe preeclampsia. Right upper quadrant pain or tenderness was positively correlated with laboratory abnormalities. The restriction of laboratory analysis in women with clinical evidence of severe disease may be warranted - a broader study should, however, first be used to confirm our findings.

  16. Levamisole-Adulterated Cocaine-Induced Skin Lesions: A Case Report and Literature Review.

    PubMed

    Khanapara, Dipen B; Panwala, Amruta; Dedania, Bhavtosh; Naut, Edgar R

    2017-02-01

    Levamisole is used as an agent to increase the total weight of street cocaine. We report the case of a 28-year-old female who presented with multiple painful, ulcerating lesions. She tested positive for cocaine and levamisole. Her skin lesions improved with abstinence from cocaine. Patients with levamisole-induced toxicity most often present with skin manifestations or joint pain. Leukopenia, neutropenia, and agranulocytosis are common lab abnormalities seen in these patients. Complete resolution of the skin lesions are observed approximatelythree weeks after abstinence. Patients known to use street drugs, who present with unexplained skin rash, neutropenia, and multiple immunological abnormalities, should be tested for both cocaine and levamisole. Urine toxicology screen is positive for cocaine approximately 72 hours after ingestion. Levamisole requires specialized testing that is not readily available commercially andis positive forless than 48 hours after exposure.

  17. The prevalence of affective disorder and in particular of a rapid cycling of bipolar disorder in patients with abnormal thyroid function tests.

    PubMed

    Oomen, H A; Schipperijn, A J; Drexhage, H A

    1996-08-01

    Cognitive and affective functioning is sensitive to changes in thyroid hormones. We have sought to determine: (1) the prevalence of thyroid function abnormalities in a psychiatric population on admission (as compared to the prevalence in a normal population), and (2) whether such thyroid function abnormalities are associated with the occurrence or development of cognitive and affective disorders. Serum was collected 2-3 weeks after hospitalization in 3 major clinics from 3756 psychiatric patients in 1987-1990, stored, and assayed in 1993 for the presence of antibodies against the TSH-receptor and thyroperoxidase (TPO-Ab) and for TSH levels. The psychiatric cohort was matched with a control population of healthy individuals living in the same area (n = 1877). The prevalence study was followed by a case-control study involving patients from one clinic that had routinely assigned a DSM-IIIR classification to its patients. Cases were those admissions with thyroid abnormalities and three subgroups of cases were randomly formed demonstrating either TSH less than 0.4 mU/l (n = 44) or over 4.0 mU/l (n = 44), or TPO-Ab positivity (n = 50). Cases were compared to random controls from the same psychiatric population, viz patients without thyroid abnormalities (n = 83). Comparison was with respect to their psychiatric follow-up diagnosis (the investigator was blinded to the thyroid test results). Prevalence study. The percentage of patients positive for TSH-receptor-Ab was 0.26 (9/3504), for TPO-Ab was 10.0 (331/3316) and outside the TSH range of 0.4-4.0 mU/l was 10.0 ((332/3316): 5.9% (198/3316) > 4.0 mU/l and 4.1% (134/3316) < 0.4 mU/l). Abnormal total thyroxine levels were found in only 9.8% of subjects with abnormal TSH, indicating the predominantly subclinical character of the thyroid alteration. In comparison, the healthy area controls over 55 years of age showed the same prevalence of positive TPO-antibodies and TSH under 0.4 mU/l, but a higher prevalence of TSH over 4.0 mU/l. CASE-CONTROL STUDY: In the case control analysis differences could not be noticed with regard to prevalences of dementia, schizophrenia or other psychiatric illnesses apart from the prevalence of affective disorders which were more prevalent in TPO-Ab positive patients and patients with a low serum TSH. Since prior use of lithium, carbamezapine, carbimazole and/or thyroxine could be a factor of importance in this association, analyses were also carried out excluding patients with such prior drug use. In these analyses affective disorders were still more prevalent in patients with a low serum TSH (particularly in males, 40% in cases vs 9% in controls, P < 0.05). The most significant association was however between TPO-antibody positivity (and in particular with high titre and/or with TSH > 4.0 mU/l) and a subgroup of the affective disorders, viz with a rapid cycling of bipolar disorder (18% in cases vs 0% in controls, P < 0.001). Though causal relations cannot be determined from this cross-sectional study, this admission survey found early forms of autoimmune thyroid disease, sometimes characterized only by TPO-Abs, highly significantly associated with rapid cycles of a bipolar disorder. It also found a weak association between subclinical hyperthyroidism (low serum TSH without TPO-Ab positivity) and affective disorder.

  18. The Labor Market Returns to Math Courses in Community College. A CAPSEE Working Paper

    ERIC Educational Resources Information Center

    Belfield, Clive; Liu, Vivian Yuen Ting

    2015-01-01

    This paper examines the returns to math courses relative to courses in other subjects for students in community college. Using matched college transcript and earnings data on over 80,000 students entering community college during the 2000s, we find that college-level math coursework has an indirect positive effect on award completion that is…

  19. The Roles of Beaconing and Dead Reckoning in Human Virtual Navigation

    ERIC Educational Resources Information Center

    Bodily, Kent D.; Daniel, Thomas A.; Sturz, Bradley R.

    2012-01-01

    Beaconing is a process in which the distance between a visual landmark and current position is reduced in order to return to a location. In contrast, dead reckoning is a process in which vestibular, kinesthetic and/or optic flow cues are utilized to update speed of movement, elapsed time of movement, and direction of movement to return to a…

  20. Symbols of Success: Youth, Peer Pressure and the Role of Adulthood among Juvenile Male Return Migrants in Ghana

    ERIC Educational Resources Information Center

    Ungruhe, Christian

    2010-01-01

    Independent youth migration is socially embedded in many African societies. While it is often exclusively perceived of as a process of intergenerational negotiation which leads to higher social positions after returning home, this article points out that peer influences play a major role in the process of decision-making of leaving and returning…

  1. Civic Returns to Higher Education: A Note on Heterogeneous Effects

    PubMed Central

    Brand, Jennie E.

    2011-01-01

    American educational leaders and philosophers have long valued schooling for its role in preparing the nation’s youth to be civically engaged citizens. Numerous studies have found a positive relationship between education and subsequent civic participation. However, little is known about possible variation in effects by selection into higher education, a critical omission considering education’s expressed role as a key mechanism for integrating disadvantaged individuals into civic life. I disaggregate effects and examine whether civic returns to higher education are largest for disadvantaged low likelihood or advantaged high likelihood college goers. I find evidence for significant effect heterogeneity: civic returns to college are greatest among individuals who have a low likelihood for college completion. Returns decrease as the propensity for college increases. PMID:22223924

  2. Reintegration of Pakistani return migrants from the Middle East in the domestic labour market.

    PubMed

    Arif, G M

    1998-01-01

    This study compared the unemployment rates among return migrants and nonmigrants and examined the reintegration pattern of returnees in the domestic labor market. The study utilized three data sets: the 1980 World Bank Survey of Return Migrant Households; the 1986 ILO/ARTEP Survey of Return Migrant Households; the 1991 Pakistan Integrated Household Survey. Findings showed that unemployment rates were much higher among return migrants than nonmigrants. Although this difference narrowed with the passage of time, even among those who returned to Pakistan at least 18 months prior to the surveys, more than 10% of workers were unemployed. The multivariate analysis further showed that returnees, irrespective of the period elapsed since their return, were more likely to be unemployed than nonmigrants. With respect to the reintegration pattern of return migrants, the study revealed that variables indicating their human capital, such as occupation and pre-migration and during-migration work experience, appear to have a greater influence on their post-return adjustment than the variables related to economic positions such as savings. The results also showed that the types of jobs unemployed returnees were looking for differed substantially from those held by employed return migrants. A possibility was that unemployed returnees could not save enough from their overseas earnings to become self-employed. Thus, provision of credit for self-employment seems to be the right way to accommodate these workers.

  3. An Economic Analysis and Approach for Health Care Preparedness in a Substate Region.

    PubMed

    Stryckman, Benoit; Grace, Thomas L; Schwarz, Peter; Marcozzi, David

    2015-08-01

    To demonstrate the application of economics to health care preparedness by estimating the financial return on investment in a substate regional emergency response team and to develop a financial model aimed at sustaining community-level disaster readiness. Economic evaluation methods were applied to the experience of a regional Pennsylvania response capability. A cost-benefit analysis was performed by using information on funding of the response team and 17 real-world events the team responded to between 2008 and 2013. By use of the results of the cost-benefit analysis as well as information on the response team's catchment area, a risk-based insurance-like membership model was built. The cost-benefit analysis showed a positive return after 6 years of investment in the regional emergency response team. Financial modeling allowed for the calculation of premiums for 2 types of providers within the emergency response team's catchment area: hospitals and long-term care facilities. The analysis indicated that preparedness activities have a positive return on their investment in this substate region. By applying economic principles, communities can estimate their return on investment to make better business decisions in an effort to increase the sustainability of emergency preparedness programs at the regional level.

  4. KENNEDY SPACE CENTER, FLA. - The Space Shuttle orbiter Atlantis is turned into position outside the Orbiter Processing Facility (OPF) for its tow to the Vehicle Assembly Building (VAB). The move will allow work to be performed in the OPF that can only be accomplished while the bay is empty. Work scheduled in the processing facility includes annual validation of the bay's cranes, work platforms, lifting mechanisms, and jack stands. Atlantis will remain in the VAB for about 10 days, then return to the OPF as work resumes to prepare it for launch in September 2004 on the first return-to-flight mission, STS-114.

    NASA Image and Video Library

    2003-12-05

    KENNEDY SPACE CENTER, FLA. - The Space Shuttle orbiter Atlantis is turned into position outside the Orbiter Processing Facility (OPF) for its tow to the Vehicle Assembly Building (VAB). The move will allow work to be performed in the OPF that can only be accomplished while the bay is empty. Work scheduled in the processing facility includes annual validation of the bay's cranes, work platforms, lifting mechanisms, and jack stands. Atlantis will remain in the VAB for about 10 days, then return to the OPF as work resumes to prepare it for launch in September 2004 on the first return-to-flight mission, STS-114.

  5. KENNEDY SPACE CENTER, FLA. - The Space Shuttle orbiter Atlantis is almost in position in high bay 4 of the Vehicle Assembly Building (VAB). It was towed from the Orbiter Processing Facility (OPF) to allow work to be performed in the bay that can only be accomplished while it is empty. Work scheduled in the processing facility includes annual validation of the bay's cranes, work platforms, lifting mechanisms, and jack stands. Atlantis will remain in the VAB for about 10 days, then return to the OPF as work resumes to prepare it for launch in September 2004 on the first return-to-flight mission, STS-114.

    NASA Image and Video Library

    2003-12-05

    KENNEDY SPACE CENTER, FLA. - The Space Shuttle orbiter Atlantis is almost in position in high bay 4 of the Vehicle Assembly Building (VAB). It was towed from the Orbiter Processing Facility (OPF) to allow work to be performed in the bay that can only be accomplished while it is empty. Work scheduled in the processing facility includes annual validation of the bay's cranes, work platforms, lifting mechanisms, and jack stands. Atlantis will remain in the VAB for about 10 days, then return to the OPF as work resumes to prepare it for launch in September 2004 on the first return-to-flight mission, STS-114.

  6. Cam Deformities and Limited Hip Range of Motion Are Associated With Early Osteoarthritic Changes in Adolescent Athletes: A Prospective Matched Cohort Study.

    PubMed

    Wyles, Cody C; Norambuena, Germán A; Howe, Benjamin M; Larson, Dirk R; Levy, Bruce A; Yuan, Brandon J; Trousdale, Robert T; Sierra, Rafael J

    2017-11-01

    The natural history of femoroacetabular impingement (FAI) remains incompletely understood. In particular, there is limited documentation of joint damage in adolescent patients with limited range of motion (LROM) of the hip, which is commonly associated with FAI. To evaluate changes in magnetic resonance imaging (MRI), radiographs, and clinical examinations over 5 years in a group of athletes from a wide variety of sports with asymptomatic LROM of the hip compared with matched controls. Cohort study (prognosis); Level of evidence, 2. The authors screened 226 male and female athletes aged 12 to 18 years presenting for preparticipation sports physical examinations. Using a goniometer, we identified 13 participants with at least one hip having internal rotation <10° with the hip flexed to 90°. Overall, 21 of 26 hips (81%) had internal rotation <10°. These participants were age- and sex-matched to 13 controls with internal rotation >10°. At the time of enrollment, all participants were asymptomatic and underwent a complete hip examination and radiographic imaging with radiographs (anteroposterior [AP] and von Rosen views) and non-arthrogram MRI. Participants returned at 5-year follow-up and underwent repeat hip examinations, imaging (AP and lateral radiographs and non-arthrogram MRI), and hip function questionnaires. MRI scans were classified as "normal" versus "abnormal" based on the presence of any of 13 scored chondral, labral, or osseous abnormalities. Comparisons between the LROM group and control group were performed using generalized linear models (either linear, logistic, or log-binomial regression as appropriate for the outcome) with generalized estimating equations to account for the within-participant correlation due to patients having both hips included. Relative risk (RR) estimates are reported with 95% CIs. At the time of study enrollment, 16 of 26 hips (62%) in the LROM group had abnormal MRI findings within the acetabular labrum or cartilage compared with 8 of 26 hips (31%) in the control group (RR, 2.0; 95% CI, 0.95-4.2; P = .067). The mean alpha angle measured from radial MRI sequences was 58° in the LROM group versus 44° in the control group ( P < .0001). In the LROM group, 13 of 26 hips (50%) had a positive anterior impingement sign, whereas 0 of 26 hips (0%) had a positive anterior impingement sign in the control group. At 5-year follow-up, 18 of 19 hips (95%) in the LROM group had abnormal MRI findings compared with 14 of 26 hips (54%) in the control group (RR, 1.7; 95% CI, 1.1-2.7; P = .014). New or progressive findings were documented on MRI in 15 of 20 hips in the LROM group compared with 8 of 26 hips in the control group (RR, 2.4; 95% CI, 1.2-4.8; P = .011). Six of 22 hips (27%) in the LROM group progressed from Tönnis grade 0 to Tönnis grade 1 in degenerative changes, whereas all 26 hips in the control group remained at Tönnis grade 0 on hip radiographs. In the LROM group, 11 of 22 hips (50%) had a positive anterior impingement sign, whereas 1 of 26 hips (4%) had a positive anterior impingement sign in the control group. A cam deformity (alpha angle >55° on lateral radiographs) was present in 20 of 22 hips (91%) in the LROM group and 12 of 26 hips (46%) in the control group ( P = .0165). The following variables at baseline were associated with an increased risk of degenerative changes at 5-year follow-up for the entire cohort: decreased hip internal rotation, positive anterior impingement sign, decreased hip flexion, increased alpha angle, and presence of a cam lesion. At 5 years, young athletes with LROM of the hip showed increased progressive degenerative changes on MRI and radiographs compared with matched controls. Although the majority of these participants remained asymptomatic, those with features of FAI had radiographic findings consistent with early osteoarthritis. These outcomes suggest that more aggressive screening and counseling of young active patients may be helpful to prevent hip osteoarthritis in those with FAI.

  7. Triheptanoin improves brain energy metabolism in patients with Huntington disease

    PubMed Central

    Adanyeguh, Isaac Mawusi; Rinaldi, Daisy; Henry, Pierre-Gilles; Caillet, Samantha; Valabregue, Romain; Durr, Alexandra

    2015-01-01

    Objective: Based on our previous work in Huntington disease (HD) showing improved energy metabolism in muscle by providing substrates to the Krebs cycle, we wished to obtain a proof-of-concept of the therapeutic benefit of triheptanoin using a functional biomarker of brain energy metabolism validated in HD. Methods: We performed an open-label study using 31P brain magnetic resonance spectroscopy (MRS) to measure the levels of phosphocreatine (PCr) and inorganic phosphate (Pi) before (rest), during (activation), and after (recovery) a visual stimulus. We performed 31P brain MRS in 10 patients at an early stage of HD and 13 controls. Patients with HD were then treated for 1 month with triheptanoin after which they returned for follow-up including 31P brain MRS scan. Results: At baseline, we confirmed an increase in Pi/PCr ratio during brain activation in controls—reflecting increased adenosine triphosphate synthesis—followed by a return to baseline levels during recovery (p = 0.013). In patients with HD, we validated the existence of an abnormal brain energy profile as previously reported. After 1 month, this profile remained abnormal in patients with HD who did not receive treatment. Conversely, the MRS profile was improved in patients with HD treated with triheptanoin for 1 month with the restoration of an increased Pi/PCr ratio during visual stimulation (p = 0.005). Conclusion: This study suggests that triheptanoin is able to correct the bioenergetic profile in the brain of patients with HD at an early stage of the disease. Classification of evidence: This study provides Class III evidence that, for patients with HD, treatment with triheptanoin for 1 month restores an increased MRS Pi/PCr ratio during visual stimulation. PMID:25568297

  8. Linked functional network abnormalities during intrinsic and extrinsic activity in schizophrenia as revealed by a data-fusion approach.

    PubMed

    Hashimoto, Ryu-Ichiro; Itahashi, Takashi; Okada, Rieko; Hasegawa, Sayaka; Tani, Masayuki; Kato, Nobumasa; Mimura, Masaru

    2018-01-01

    Abnormalities in functional brain networks in schizophrenia have been studied by examining intrinsic and extrinsic brain activity under various experimental paradigms. However, the identified patterns of abnormal functional connectivity (FC) vary depending on the adopted paradigms. Thus, it is unclear whether and how these patterns are inter-related. In order to assess relationships between abnormal patterns of FC during intrinsic activity and those during extrinsic activity, we adopted a data-fusion approach and applied partial least square (PLS) analyses to FC datasets from 25 patients with chronic schizophrenia and 25 age- and sex-matched normal controls. For the input to the PLS analyses, we generated a pair of FC maps during the resting state (REST) and the auditory deviance response (ADR) from each participant using the common seed region in the left middle temporal gyrus, which is a focus of activity associated with auditory verbal hallucinations (AVHs). PLS correlation (PLS-C) analysis revealed that patients with schizophrenia have significantly lower loadings of a component containing positive FCs in default-mode network regions during REST and a component containing positive FCs in the auditory and attention-related networks during ADR. Specifically, loadings of the REST component were significantly correlated with the severities of positive symptoms and AVH in patients with schizophrenia. The co-occurrence of such altered FC patterns during REST and ADR was replicated using PLS regression, wherein FC patterns during REST are modeled to predict patterns during ADR. These findings provide an integrative understanding of altered FCs during intrinsic and extrinsic activity underlying core schizophrenia symptoms.

  9. Correlated observations of three triggered lightning flashes

    NASA Technical Reports Server (NTRS)

    Idone, V. P.; Orville, R. E.; Hubert, P.; Barret, L.; Eybert-Berard, A.

    1984-01-01

    Three triggered lightning flashes, initiated during the Thunderstorm Research International Program (1981) at Langmuir Laboratory, New Mexico, are examined on the basis of three-dimensional return stroke propagation speeds and peak currents. Nonlinear relationships result between return stroke propagation speed and stroke peak current for 56 strokes, and between return stroke propagation speed and dart leader propagation speed for 32 strokes. Calculated linear correlation coefficients include dart leader propagation speed and ensuing return stroke peak current (32 strokes; r = 0.84); and stroke peak current and interstroke interval (69 strokes; r = 0.57). Earlier natural lightning data do not concur with the weak positive correlation between dart leader propagation speed and interstroke interval. Therefore, application of triggered lightning results to natural lightning phenomena must be made with certain caveats. Mean values are included for the three-dimensional return stroke propagation speed and for the three-dimensional dart leader propagation speed.

  10. Household Composition and Longitudinal Health Outcomes for Older Mexican Return Migrants

    PubMed Central

    Mudrazija, Stipica; López-Ortega, Mariana; Vega, William A.; Robledo, Luis Miguel Gutiérrez; Sribney, William

    2016-01-01

    Mexican return migrant population is increasing, yet our knowledge about their lives after resettlement in Mexico remains fragmentary. Using 2001–2012 longitudinal data from the Mexican Health and Aging Study, we investigate difference in household composition for older migrants who returned from the United States compared to nonmigrants. Furthermore, we fit a Cox proportional hazards model to assess the relationship between household composition and health and functional trajectories of return migrants and nonmigrants. The results indicate that return migrants with long duration of U.S. stay have different household composition than nonmigrants or short-term migrants: On average, they have smaller household size, including fewer females who may be available to offer assistance to older adults. Presence of middle-age females in the household has positive effects on health and functional trajectories. We highlight implications of this research for policy makers in Mexico and the United States. PMID:26966255

  11. HMO behavior and stock market valuation: what does Wall Street reward and punish?

    PubMed

    Pauly, M V; Hillman, A L; Furukawa, M F; McCullough, J S

    2001-01-01

    This article analyzes the variation in returns to owning stock in investor-owned health maintenance organizations (IOHMOs) for the period 1994-1997. The average return (measured by the change in the market value of the stock plus dividends) was close to zero, but returns were positive and high for firms operating in local markets that were and remained less competitive, with large nationwide scope, and with less rapidly growing panels of contracted physicians. Indicators of a firm's strategic direction were abstracted from their annual reports; firms pursuing a merger or acquisition strategy, and those emphasizing a utilization review strategy, showed lower returns than those that did not. Other strategy and market variables were not related to stock market returns over this period, and were also generally not related to price-earnings ratios. This analysis supports the view that competitive HMO markets best constrain profits to investor-owned firms.

  12. 76 FR 59410 - Government-Owned Inventions; Availability for Licensing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-26

    ... tumors. The experimental results (average of 91.4% true positive volume fraction and 4.0% of false... test for the tumor marker CA-125. The CA-125 test only returns a true positive result for about 50% of...

  13. The growth pattern of the human intestine and its mesentery.

    PubMed

    Soffers, Jelly H M; Hikspoors, Jill P J M; Mekonen, Hayelom K; Koehler, S Eleonore; Lamers, Wouter H

    2015-08-22

    It remains unclear to what extent midgut rotation determines human intestinal topography and pathology. We reinvestigated the midgut during its looping and herniation phases of development, using novel 3D visualization techniques. We distinguished 3 generations of midgut loops. The topography of primary and secondary loops was constant, but that of tertiary loops not. The orientation of the primary loop changed from sagittal to transverse due to the descent of ventral structures in a body with a still helical body axis. The 1st secondary loop (duodenum, proximal jejunum) developed intraabdominally towards a left-sided position. The 2nd secondary loop (distal jejunum) assumed a left-sided position inside the hernia before returning, while the 3rd and 4th secondary loops retained near-midline positions. Intestinal return into the abdomen resembled a backward sliding movement. Only after return, the 4th secondary loop (distal ileum, cecum) rapidly "slid" into the right lower abdomen. The seemingly random position of the tertiary small-intestinal loops may have a biomechanical origin. The interpretation of "intestinal rotation" as a mechanistic rather than a descriptive concept underlies much of the confusion accompanying the physiological herniation. We argue, instead, that the concept of "en-bloc rotation" of the developing midgut is a fallacy of schematic drawings. Primary, secondary and tertiary loops arise in a hierarchical fashion. The predictable position and growth of secondary loops is pre-patterned and determines adult intestinal topography. We hypothesize based on published accounts that malrotations result from stunted development of secondary loops.

  14. Doppler sonographic screening of the flow in the basilar artery during head rotation reduces the risk for sudden infant death.

    PubMed

    Deeg, K-H; Reisig, A

    2010-10-01

    Position-dependent hypoperfusion of the brain stem may be a risk factor of sudden infant death. From 1998 to 2009 we performed Doppler sonographic flow measurements in the basilar artery of 18 194 newborns, 9322 boys and 8872 girls, in five different positions: the neutral position with the head in the midline and during head rotation to the left and right in a supine or prone position. The peak systolic and the time average flow velocity were measured from the flow profile. The flow velocities during head rotation were converted to % of the flow in the neutral position. A decrease in the velocities during head rotation below 50 % was thought to be abnormal. Biphasic flow, flow oscillating around the zero line or retrograde flow during rotation was considered to be pathological. Head rotations, which had caused abnormal and pathological flow, were avoided. The incidence of SIDS in our study group was evaluated and compared with the incidence in a control group of 3 519 newborns. In 17 929 newborns (98.54 %) the blood flow in the basilar artery was independent of head rotation and body position. In 204 newborns (1.12 %) we found an abnormal decrease under 50 %. Pathological flow alterations could be found in 61 patients (0.33 %). The overall incidence rate of SIDS in the study group was 0.055 ‰ (1:18 194). The incidence rate of SIDS in the control group was 1.14 ‰ (4:3519). The comparison of both groups showed a statistically significant (p < 0.0030) lower incidence rate in the study group. Hypoperfusion of the brain stem may be a significant risk factor of SIDS. © Georg Thieme Verlag KG Stuttgart · New York.

  15. High levels of bcl-2 protein expression do not correlate with genetic abnormalities but predict worse prognosis in patients with lymphoblastic lymphoma.

    PubMed

    Gu, Yajun; Pan, Yi; Meng, Bin; Guan, Bingxin; Fu, Kai; Sun, Baocun; Zheng, Fang

    2013-06-01

    We aimed to investigate bcl-2, bcl-6, and c-myc rearrangements in patients with lymphoblastic lymphoma (LBL), especially focus on the correlation of protein expression with genetic abnormalities. Moreover, their prognostic significance was further analyzed in LBL. Protein expression and genetic abnormalities of bcl-2, bcl-6, and c-myc were investigated in microarrayed tumors from 33 cases of T cell LBL and eight cases of B cell lineage. Immunohistochemical (IHC) staining was performed to evaluate protein expression, including bcl-2, bcl-6, c-myc, TdT, CD1α, CD34, Ki-67, PAX-5, CD2, CD3, CD4, CD8, and CD20. Genetic abnormalities of bcl-2, bcl-6, and c-myc were detected by dual color fluorescence in situ hybridization (FISH). Bcl-2 protein was positive in 51.2 % (21/41) of the patients, bcl-6 protein in 7.3 % (three out of 41), and c-myc protein in 78.0 % (32/41). Bcl-2 breakpoint was found in two cases by FISH analysis. There was no evidence of bcl-6 or c-myc rearrangement in patients with LBL. However, both gene gain and loss events occurred in bcl-2, bcl-6, and c-myc. A univariate analysis showed that stage III or IV, elevated lactate dehydrogenase (LDH), and positivity for bcl-2 protein were associated with shorter survival (p<0.05). Enhanced protein expression and detectable genetic abnormalities of bcl-2, bcl-6, and c-myc were observed in patients with LBL. No statistical correlation was found between IHC results and cytogenetic findings. Stage III or IV, elevated LDH, and positivity for bcl-2 protein were identified as adverse prognostic factors. The patients with more adverse factors would have increasingly worse prognosis.

  16. Cell-free fetal DNA concentration in plasma of patients with abnormal uterine artery Doppler waveform and intrauterine growth restriction--a pilot study.

    PubMed

    Caramelli, Elisabetta; Rizzo, Nicola; Concu, Manuela; Simonazzi, Giuliana; Carinci, Paolo; Bondavalli, Corrado; Bovicelli, Luciano; Farina, Antonio

    2003-05-01

    To evaluate if an increased amount of fetal DNA concentration can be found in women screened positive for intrauterine growth restriction because of abnormal uterine artery Doppler waveforms. We enrolled eight pregnant women (each bearing a male fetus), with the evidence of abnormal uterine artery Doppler waveforms, and 16 control patients for a case-control study matched for gestational age (1 : 2). Uterine artery Doppler was carried out at 20 to 35 weeks' gestation (median 29). The mean uterine artery resistance index (RI) was subsequently calculated, and a value >0.6 was considered positive for the clinical features of pre-eclampsia. The SRY locus was used to determine the amount of male fetal DNA in the maternal plasma at the time of Doppler analysis. Two controls (normal Doppler) were excluded from the final analysis because they had a pre-term delivery. One case (abnormal Doppler) had evidence of intrauterine growth restriction at the time of enrolment. In four out of eight cases (abnormal Doppler), intrauterine growth restriction was subsequently observed. Multiples of median (MoM) conversion of the fetal DNA values showed an increase of 1.81 times in the cases when compared to the controls. An increase of 2.16 times was instead observed for the cases with a growth-restricted fetus (5 cases out of 8) in comparison with the controls (14 cases). In subjects positive to uterine artery Doppler velocimetry analysis (Doppler analysis for pre-eclampsia screening), the fetal DNA concentration is higher than expected, in the absence of any other clinical feature. Since the increase in fetal DNA seems to be related to the presence or to the future development of intrauterine growth restriction, this paper suggests a possible integration between ultrasound and molecular markers for predicting the disease in some cases. Copyright 2003 John Wiley & Sons, Ltd.

  17. Microarray detection of human papilloma virus genotypes among Turkish women with abnormal cytology at a colposcopy unit

    PubMed Central

    Uzun Çilingir, Işıl; Bengisu, Ergin; Ağaçfidan, Ali; Koksal, Muammer Osman; Topuz, Samet; Berkman, Sinan; İyibozkurt, Ahmet Cem

    2013-01-01

    Objective: There is a well-known association between human papilloma virus (HPV) and cervical neoplasia. The aim of this study was to investigate the types of HPV DNA and to compare the results with colposcopic findings among women with abnormal cytology. Material and Methods: A series of 76 consecutive women attending the clinic with the usual referral indications (ASC-US or higher in Pap) were examined by the conventional diagnostic tools (PAP smear, colposcopy,punch biopsy) and subjected to HPV testing. For HPV genotyping, we used a commercially avaliable HPV DNA chip (Genomica-CLART) which is a PCR based microarray system.The HPV test detected 35types of HPV (HPV-6/-11/-16/-18/-26/-31/-33/-35/-39/-40/-42/-43/-44/-45/-51/-52/-53/-54/-56/-58/-59/-61/-62/-66/-70/-71/-72/-73/-81/-83/84/-85/-89). Results: Overall, 44.7% of all patients were HPV positive. HPV was positive in 35%, 51.9%, 77.7% of the ASCUS, LSIL and HSIL groups respectively and HPV 16 was the most prevalent type in all groups. 6 %of patients had mutiple infections. 57.8% of biopsy proven SIL’s were HPV positive. The most prevalent HPV type was HPV 16 (54.5%).Colposcopic assessment revealed pathologic findings in 94.7% of biopsy proven SIL cases. Conclusion: Although it has been reported that the prevalence of HPV in the general population is lower than Western countries, and the prevalence and distribution of genotypes are smilar in patients with abnormal cytology. Further population based studies are needed to determine the prevalance and type distribution of HPV with normal and abnormal cytology in Turkish women. Despite the new technological progress in HPV virion, colposcopy is still very important diagnostic tool in the management of abnormal smears. PMID:24592066

  18. Automated haematology analysis to diagnose malaria

    PubMed Central

    2010-01-01

    For more than a decade, flow cytometry-based automated haematology analysers have been studied for malaria diagnosis. Although current haematology analysers are not specifically designed to detect malaria-related abnormalities, most studies have found sensitivities that comply with WHO malaria-diagnostic guidelines, i.e. ≥ 95% in samples with > 100 parasites/μl. Establishing a correct and early malaria diagnosis is a prerequisite for an adequate treatment and to minimizing adverse outcomes. Expert light microscopy remains the 'gold standard' for malaria diagnosis in most clinical settings. However, it requires an explicit request from clinicians and has variable accuracy. Malaria diagnosis with flow cytometry-based haematology analysers could become an important adjuvant diagnostic tool in the routine laboratory work-up of febrile patients in or returning from malaria-endemic regions. Haematology analysers so far studied for malaria diagnosis are the Cell-Dyn®, Coulter® GEN·S and LH 750, and the Sysmex XE-2100® analysers. For Cell-Dyn analysers, abnormal depolarization events mainly in the lobularity/granularity and other scatter-plots, and various reticulocyte abnormalities have shown overall sensitivities and specificities of 49% to 97% and 61% to 100%, respectively. For the Coulter analysers, a 'malaria factor' using the monocyte and lymphocyte size standard deviations obtained by impedance detection has shown overall sensitivities and specificities of 82% to 98% and 72% to 94%, respectively. For the XE-2100, abnormal patterns in the DIFF, WBC/BASO, and RET-EXT scatter-plots, and pseudoeosinophilia and other abnormal haematological variables have been described, and multivariate diagnostic models have been designed with overall sensitivities and specificities of 86% to 97% and 81% to 98%, respectively. The accuracy for malaria diagnosis may vary according to species, parasite load, immunity and clinical context where the method is applied. Future developments in new haematology analysers such as considerably simplified, robust and inexpensive devices for malaria detection fitted with an automatically generated alert could improve the detection capacity of these instruments and potentially expand their clinical utility in malaria diagnosis. PMID:21118557

  19. Timeliness of abnormal screening and diagnostic mammography follow-up at facilities serving vulnerable women

    PubMed Central

    Goldman, L. Elizabeth; Walker, Rod; Hubbard, Rebecca; Kerlikowske, Karla

    2013-01-01

    Background Whether timeliness of follow-up after abnormal mammography differs at facilities serving vulnerable populations such as women with limited education or income, in rural areas, and racial/ethnic minorities is unknown. Methods We examined receipt of diagnostic evaluation following abnormal mammography using 1998-2006 Breast Cancer Surveillance Consortium-linked Medicare claims. We compared whether time to recommended breast imaging or biopsy depended on whether women attended facilities serving vulnerable populations. We characterized a facility by the proportion of mammograms performed on women with limited education or income, in rural areas, or racial/ethnic minorities. Results We analyzed 30,874 abnormal screening examinations recommended for follow-up imaging across 142 facilities and 10,049 abnormal diagnostic examinations recommended for biopsy across 114 facilities. Women at facilities serving populations with less education or more racial/ethnic minorities had lower rates of follow-up imaging (4-5% difference, p<0.05), and women at facilities serving more rural and low income populations had lower rates of biopsy (4-5% difference, p<0.05). Women undergoing biopsy at facilities serving vulnerable populations had longer times until biopsy than those at facilities serving non-vulnerable populations (21.6 days vs. 15.6 days; 95% CI for mean difference 4.1-7.7). The proportion of women receiving recommended imaging within 11 months and biopsy within 3 months varied across facilities (interquartile range 85.5%-96.5% for imaging and 79.4%-87.3% for biopsy). Conclusions Among Medicare recipients, follow-up rates were slightly lower at facilities serving vulnerable populations, and among those women who returned for diagnostic evaluation, time to follow-up was slightly longer at facilities that served vulnerable population. Interventions should target variability in follow-up rates across facilities, and evaluate effectiveness particularly at facilities serving vulnerable populations. PMID:23358386

  20. Early Critical Care Decisions and Outcomes after SCI: Track-SCI

    DTIC Science & Technology

    2017-09-01

    Integrated Machine Learning Algorithms Can Predict Neurologic Impairment in Acute Spinal Cord Injury. American Roentgen Ray Society Annual Meeting...related to AIS at discharge. MCC, MSCC, and TLICS also loaded positively on PC2 (22.7% of variance), while variables concerning cord signal abnormality ...loaded negatively on PC2. PC2 was highly related to the patient undergoing surgical decompression. Variables of signal abnormality were all negatively

  1. Effect of psychological stress on fertility hormones and seminal quality in male partners of infertile couples.

    PubMed

    Bhongade, M B; Prasad, S; Jiloha, R C; Ray, P C; Mohapatra, S; Koner, B C

    2015-04-01

    The present study evaluated the effect of psychological stress on male fertility hormones and seminal quality in male partner of infertile couples. Seventy male partners of infertile couples were evaluated for level of psychological stress using Hospital Anxiety and Depression Score (HADS) questionnaire, serum total testosterone, luteinising hormone (LH) and follicle-stimulating hormone (FSH) by electrochemiluminescence assay and serum GnRH by ELISA. Seminal analysis was performed as per WHO guideline. Nineteen (27%) of them had HADS anxiety and depression score ≥8 (abnormal HADS score). The persons having abnormal HADS had lower serum total testosterone, higher serum FSH and LH than those of persons having normal HADS. Serum total testosterone correlated negatively with HADS, but LH and FSH correlated positively. There was no change in GnRH with the change in stress or testosterone levels. Sperm count, motility and morphologically normal spermatozoa were lower in persons having abnormal HADS. Sperm count correlated positively with total testosterone and negatively with FSH and LH. Abnormal sperm motility and morphology were related to lower testosterone and higher LH and FSH levels. Psychological stress primarily lowers serum total testosterone level with secondary rise in serum LH and FSH levels altering seminal quality. Stress management is warranted for male infertility cases. © 2014 Blackwell Verlag GmbH.

  2. Vestibular evoked myogenic potentials in patients with BPPV.

    PubMed

    Korres, Stavros; Gkoritsa, Eleni; Giannakakou-Razelou, Dimitra; Yiotakis, Ioannis; Riga, Maria; Nikolpoulos, Thomas P

    2011-01-01

    The probable cause of Benign Paroxysmal Positional Vertigo (BPPV) is a degeneration of the oto lithic organs (utricle and saccule). The aim of the study is to find possible alterations in Vestibular Evoked Myogenic Potentials (VEMP) recordings in BPPV patients, because the saccule is part of the VEMP pathway. 27 BPPV patients (24 unilateral and 3 bilateral) aged 20 to 70 years and 30 healthy age matched controls. BPPV was diagnosed by the upbeating geotropic nystagmus found in the supine position with the head overextended towards one side. The subjects were investigated with pure tone audiometry, bi-thermal caloric test with electronystagmographic (ENG) recording, and VEMP recording. P1 latency and N1 latency did not present any statistical difference between control ears and affected ears of the BPPV population. The percentage of abnormal VEMP in the BPPV population was statistically higher than in the control ears (p < 0.005). No significant relationship could be shown between the occurrence of Canal Paresis and abnormal VEMP. No relationship was found between the side (right or left ear) where BPPV appeared clinically and the side where abnormal VEMP was registered. BPPV is a clinical entity associated with increased occurrence of abnormal VEMP recordings, possibly due to degeneration of the saccular macula, which is part of the neural VEMP pathway.

  3. The results of vestibular evoked myogenic potentials, with consideration of age-related changes, in vestibular neuritis, benign paroxysmal positional vertigo, and Meniere's disease.

    PubMed

    Hong, Seok Min; Yeo, Seung Geun; Kim, Sung Wan; Cha, Chang Il

    2008-08-01

    We interpreted VEMP findings in patients with the three major peripheral vertigo diseases, taking age-related changes into consideration. We found different abnormal VEMP rates among the three diseases, as well as differences in the proportion of parameters that were abnormal, according to the type of disease. Vestibular neuritis, benign paroxysmal positional vertigo (BPPV), and Meniere's disease, common diseases that cause peripheral vertigo, often affect the saccule or inferior vestibular nerve, which are pathways of vestibular evoked myogenic potential (VEMP). Also, aging could have a primary effect on diminished VEMP responses. Our study investigated VEMP the findings in patients with the diseases in relation to their age. A total of 134 patients with vestibular neuritis, 62 with BPPV, and 29 with Meniere's disease were enrolled in this study. The VEMP findings in patients within the three disease groups were interpreted using our own normative ranges according to age. Abnormal VEMP rates in the vestibular neuritis, BPPV, and Meniere's disease groups were 36.6%, 25.8%, and 69%, respectively. The proportion of prolonged p13 latency in BPPV patients with abnormal VEMP responses was relatively high compared with the other two diseases. VEMP asymmetry in the patients with Meniere's disease was relatively high.

  4. Abnormal Head Position

    MedlinePlus

    American Association for Pediatric Ophthalmology and Strabismus Home About AAPOS Patient Info Resources Allied Health News & Events Meetings J AAPOS American Association for Pediatric Ophthalmology ...

  5. Retrospectively exploring the importance of items in the decision to leave the emergency medical services (EMS) profession and their relationships to life satisfaction after leaving EMS and likelihood of returning to EMS.

    PubMed

    Blau, Gary; Chapman, Susan

    2011-01-01

    An exit survey was returned by a sample of 127 respondents in fully compensated positions who left the EMS profession, most within 12 months prior to filling out the exit survey. A very high percentage continued to work after leaving EMS. Respondents were asked to rate the importance of each of 17 items in affecting their decision to leave EMS. A higher than anticipated response to a "not applicable" response choice affected the usability of 8 of these items. Nine of the 17 items had at least 65 useable responses and were used for further analysis. Within these 9, stress/burnout and lack of job challenges had the highest importance in affecting the decision to leave EMS, while desire for better pay and benefits had the lowest importance. Desire for career change was positively related to life satisfaction after leaving EMS and negatively related to likelihood of returning to EMS. Stress/burnout was positively related to life satisfaction after leaving EMS. Study limitations and future research issues are briefly discussed.

  6. Health and turnover of working mothers after childbirth via the work-family interface: an analysis across time.

    PubMed

    Carlson, Dawn S; Grzywacz, Joseph G; Ferguson, Merideth; Hunter, Emily M; Clinch, C Randall; Arcury, Thomas A

    2011-09-01

    This study examined organizational levers that impact work-family experiences, participant health, and subsequent turnover. Using a sample of 179 women returning to full-time work 4 months after childbirth, we examined the associations of 3 job resources (job security, skill discretion, and schedule control) with work-to-family enrichment and the associations of 2 job demands (psychological requirements and nonstandard work schedules) with work-to-family conflict. Further, we considered subsequent impact of work-to-family conflict and enrichment on women's health (physical and mental health) 8 months after women returned to work and the impact of health on voluntary turnover 12 months after women returned to work. Having a nonstandard work schedule was directly and positively related to conflict, whereas schedule control buffered the effect of psychological requirements on conflict. Skill discretion and job security, both job resources, directly and positively related to enrichment. Work-to-family conflict was negatively related to both physical and mental health, but work-to-family enrichment positively predicted only physical health. Physical health and mental health both negatively influenced turnover. We discuss implications and opportunities for future research. PsycINFO Database Record (c) 2011 APA, all rights reserved

  7. Health and Turnover of Working Mothers After Childbirth Via the Work–Family Interface: An Analysis Across Time

    PubMed Central

    Carlson, Dawn S.; Grzywacz, Joseph G.; Ferguson, Merideth; Hunter, Emily M.; Clinch, C. Randall; Arcury, Thomas A.

    2013-01-01

    This study examined organizational levers that impact work–family experiences, participant health, and subsequent turnover. Using a sample of 179 women returning to full-time work 4 months after childbirth, we examined the associations of 3 job resources (job security, skill discretion, and schedule control) with work-to-family enrichment and the associations of 2 job demands (psychological requirements and nonstandard work schedules) with work-to-family conflict. Further, we considered subsequent impact of work-to-family conflict and enrichment on women’s health (physical and mental health) 8 months after women returned to work and the impact of health on voluntary turnover 12 months after women returned to work. Having a nonstandard work schedule was directly and positively related to conflict, whereas schedule control buffered the effect of psychological requirements on conflict. Skill discretion and job security, both job resources, directly and positively related to enrichment. Work-to-family conflict was negatively related to both physical and mental health, but work-to-family enrichment positively predicted only physical health. Physical health and mental health both negatively influenced turnover. We discuss implications and opportunities for future research. PMID:21604833

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

    Reiss, T.F.; Golden, J.

    Pneumocystis carinii pneumonia was suggested by a diffuse, bilateral pulmonary uptake of gallium-67 in an asymptomatic, homosexual male with the antibody to the immunodeficiency virus (HIV) who was undergoing staging evaluation for lymphoma clinically localized to a left inguinal lymph node. Chest radiograph and pulmonary function evaluation, including lung volumes, diffusing capacity and arterial blood gases, were within normal limits. Bronchoalveolar lavage revealed Pneumocystis carinii organisms. In this asymptomatic, HIV-positive patient, active alveolar infection, evidenced by abnormal gallium-67 scanning, predated pulmonary physiologic abnormalities. This observation raises questions concerning the natural history of this disease process and the specificity of physiologicmore » tests for excluding disease. It also has implications for the treatment of neoplasia in the HIV-positive patient population.« less

  9. Return to play after treatment of superior labral tears in professional baseball players.

    PubMed

    Fedoriw, Wasyl W; Ramkumar, Prem; McCulloch, Patrick C; Lintner, David M

    2014-05-01

    The published return-to-play (RTP) rates for athletes who have undergone surgical repair of superior labrum anterior-posterior (SLAP) tears vary widely and are generally accepted to be lower in the subset of competitive throwers. The efficacy of nonsurgical treatment for this group is unknown. Nonsurgical treatment of SLAP tears in professional baseball players leads to RTP before consideration of surgical treatment. Incorporating performance statistics and level of competition will result in lower calculated RTP rates than have been previously reported. Case series; Level of evidence, 4. A retrospective review of 119 consecutive patients in a single professional baseball organization with persistent shoulder pain that limited the ability to compete was performed. Sixty-eight patients had magnetic resonance imaging-documented SLAP lesions. All patients had failed 1 attempt at rehabilitation but had continued with supervised physical therapy. Treatment was according to an algorithm focusing on the correction of scapular dyskinesia and posterior capsular contracture with glenohumeral internal rotation deficit (GIRD), followed by pain-free return to throwing. Those who failed 2 cycles of nonsurgical treatment were treated surgically. Success was defined by 2 different standards: (1) RTP, in accordance with previous studies; and (2) a more stringent standard of return to the same level/quality of professional competition (A, AA, AAA, etc) with the incorporation of a return to preinjury individual performance statistics (earned run average, walks plus hits per inning pitched), termed "return to prior performance" (RPP). Sixty-eight athletes were identified with SLAP lesions. Twenty-one pitchers successfully completed the nonsurgical algorithm and attempted a return. Their RTP rate was 40%, and their RPP rate was 22%. The RTP rate for 27 pitchers who underwent 30 procedures was 48%, and the RPP rate was 7%. For 10 position players treated nonsurgically, the RTP rate was 39%, and the RPP rate was 26%. The RTP rate for 13 position players who underwent 15 procedures was 85%, with an RPP rate of 54%. Nonsurgical treatment correcting scapular dyskinesia and GIRD had a reasonable success rate in professional baseball players with painful shoulders and documented SLAP lesions. The rate of return after surgical treatment of SLAP lesions was low for pitchers. The RTP and RPP rates were higher for position players than for pitchers. Nonsurgical treatment should be considered for professional baseball players with documented SLAP lesions, as it can lead to acceptable RTP and RPP rates.

  10. Harmonic engine

    DOEpatents

    Bennett, Charles L.; Sewall, Noel; Boroa, Carl

    2014-08-19

    An engine based on a reciprocating piston engine that extracts work from pressurized working fluid. The engine includes a harmonic oscillator inlet valve capable of oscillating at a resonant frequency for controlling the flow of working fluid into of the engine. In particular, the inlet valve includes an inlet valve head and a spring arranged together as a harmonic oscillator so that the inlet valve head is moveable from an unbiased equilibrium position to a biased closed position occluding an inlet. Upon releasing the inlet valve the inlet valve head undergoes a single oscillation past the equilibrium positio to a maximum open position and returns to a biased return position close to the closed position to choke the flow and produce a pressure drop across the inlet valve causing the inlet valve to close. Protrusions carried either by the inlet valve head or piston head are used to bump open the inlet valve from the closed position and initiate the single oscillation of the inlet valve head, and protrusions carried either by the outlet valve head or piston head are used to close the outlet valve ahead of the bump opening of the inlet valve.

  11. The changes on physical characteristics of lightning discharge plasma during individual return stroke process

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

    Xu, He; Yuan, Ping; Cen, Jian-Yong

    2014-03-15

    A cloud-to-ground lightning with six return strokes has been recorded with a slit-less spectrograph in Qinghai province. According to the spectra of return strokes without continuous current, the electron density, the channel temperature, and the gas pressure have been calculated. Then, the correlativity of these parameters has been analyzed. The results indicate that the total intensity of spectra is positive correlated to the intensity of spectral line, they both decrease with time rapidly; furthermore, the channel temperature and the gas pressure decrease with time slowly in the similar trends.

  12. Rationale and design of the HOME trial: A pragmatic randomized controlled trial of home-based human papillomavirus (HPV) self-sampling for increasing cervical cancer screening uptake and effectiveness in a U.S. healthcare system.

    PubMed

    Winer, Rachel L; Tiro, Jasmin A; Miglioretti, Diana L; Thayer, Chris; Beatty, Tara; Lin, John; Gao, Hongyuan; Kimbel, Kilian; Buist, Diana S M

    2018-01-01

    Women who delay or do not attend Papanicolaou (Pap) screening are at increased risk for cervical cancer. Trials in countries with organized screening programs have demonstrated that mailing high-risk (hr) human papillomavirus (HPV) self-sampling kits to under-screened women increases participation, but U.S. data are lacking. HOME is a pragmatic randomized controlled trial set within a U.S. integrated healthcare delivery system to compare two programmatic approaches for increasing cervical cancer screening uptake and effectiveness in under-screened women (≥3.4years since last Pap) aged 30-64years: 1) usual care (annual patient reminders and ad hoc outreach by clinics) and 2) usual care plus mailed hrHPV self-screening kits. Over 2.5years, eligible women were identified through electronic medical record (EMR) data and randomized 1:1 to the intervention or control arm. Women in the intervention arm were mailed kits with pre-paid envelopes to return samples to the central clinical laboratory for hrHPV testing. Results were documented in the EMR to notify women's primary care providers of appropriate follow-up. Primary outcomes are detection and treatment of cervical neoplasia. Secondary outcomes are cervical cancer screening uptake, abnormal screening results, and women's experiences and attitudes towards hrHPV self-sampling and follow-up of hrHPV-positive results (measured through surveys and interviews). The trial was designed to evaluate whether a programmatic strategy incorporating hrHPV self-sampling is effective in promoting adherence to the complete screening process (including follow-up of abnormal screening results and treatment). The objective of this report is to describe the rationale and design of this pragmatic trial. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. [Immunohistochemical expression of the E-cadherin-catenin complex in gastric cancer].

    PubMed

    Guzmán, Pablo; Araya, Juan; Villaseca, Miguel; Roa, Iván; Melo, Angélica; Muñoz, Sergio; Roa, Juan

    2006-08-01

    The E-cadherin/catenin complex plays an essential role in the control of epithelial differentiation. Abnormal expression in tumors correlates with histological grade, advanced stage and poor prognosis. To evaluate the expression pattern of E-cadherin/catenin complex in gastric carcinoma and analyze their association with tumor clinicopathological features and patient survival. Inmunohistochemical staining of E-cadherin, alpha and ss-catenin was performed from paraffin specimens of 65 gastric carcinomas. Abnormal expression of E-cadherin, alpha and ss-catenin was demonstrated in 82%, 85% and 88% of gastric carcinomas, respectively. There was a significant correlation between abnormal expression and Lauren pathological classification and depth of infiltration, but not with tumor stage, positive lymph node metastases and survival. Abnormal expression of E-cadherin, alpha and ss-catenin occurs frequently in gastric carcinoma and correlates with histological grade.

  14. 75 FR 54802 - Requirement of a Statement Disclosing Uncertain Tax Positions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-09

    ... return. Corporations that prepare financial statements are required by generally accepted accounting principles to identify and quantify all uncertain tax positions as described in Financial Accounting..., including International Financial Reporting Standards and country-specific generally accepted accounting...

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

    Lowe, V.J.; Patz, E.; Harris, P.L.

    Pleural abnormalities identified on anatomical studies are often nonspecific and may represent benign or malignant disease. We prospectively evaluated the ability of FDG-PET to identify malignancy in patients with pleural abnormalities detected on chest radiographs or chest CT. Thirty-two patients with pleural abnormalities (pleural masses, thickening or effusions) found on chest radiographs or CT were evaluated by FDG-PET. Regions of interest (ROI) were identified on the PET images correlating to anatomic abnormalities and standard uptake ratios (SUR`s) of these ROI`s were calculated. A SUR value of 2.5 or greater was considered positive for malignancy. Physicians blinded to biopsy results gradedmore » their confidence of malignancy (1-5 scale) and graded lesion FDG uptake with respect to mediastinal radioactivity. Twenty-three of the patients had definitive diagnoses by tissue biopsy. Seventeen of these patients had malignant (SUR=7.9{plus_minus}3.8) and 6 had benign (SUR=2.8{plus_minus}2.4) causes of their pleural abnormalities (p=0.001). All but two malignant cases had SURs higher than 2.5 and one of these two was correctly interpreted by the observers. SURs lower than 2.5 were seen in four of the six (67%) benign pleural abnormalities. Using a combination of both visual and semiquantitative analysis, the sensitivity of FDG-PET for detecting malignant pleural abnormalities was 94%. Active infections in the pleural space had increased FDG uptake on PET studies while other benign pleural abnormalities did not. FDG-PET has very high sensitivity for detecting malignant pleural abnormalities and can differentiate benign from malignant pleural abnormalities.« less

  16. Heart rate variability and turbulence in hyperthyroidism before, during, and after treatment.

    PubMed

    Osman, Faizel; Franklyn, Jayne A; Daykin, Jacqueline; Chowdhary, Saqib; Holder, Roger L; Sheppard, Michael C; Gammage, Michael D

    2004-08-15

    Patients with subclinical and treated overt hyperthyroidism have an excess vascular mortality rate. Several symptoms and signs in overt hyperthyroidism suggest abnormality of cardiac autonomic function that may account in part for this excess mortality rate, but few studies have examined cardiac autonomic function in untreated and treated hyperthyroidism. We assessed heart rate turbulence (HRT) and time-domain parameters of heart rate variability in a large, unselected cohort of patients with overt hyperthyroidism referred to our thyroid clinic (n = 259) and compared findings with a group of normal subjects with euthyroidism (n = 440). These measures were also evaluated during antithyroid therapy (when serum-free thyroxine and triiodothyronine concentrations returned to normal but thyrotropin remained suppressed (i.e., subclinical hyperthyroidism, n = 110) and when subjects were rendered clinically and biochemically euthyroid (normal serum thyrotropin, free thyroxine and triiodothyronine concentrations, n = 219). We found that overall measures of heart rate variability and those specific for cardiac vagal modulation were attenuated in patients with overt hyperthyroidism compared with normal subjects; measurements of overall heart rate variability remained low in those with low levels of serum thyrotropin but returned to normal in patients with biochemical euthyroidism. Measurements of HRT (onset and slope) were also decreased in patients with overt hyperthyroidism, but HRT slope returned to normal values with antithyroid treatment. This study is the first to evaluate HRT in overt and treated hyperthyroidism.

  17. PHACK: An Efficient Scheme for Selective Forwarding Attack Detection in WSNs.

    PubMed

    Liu, Anfeng; Dong, Mianxiong; Ota, Kaoru; Long, Jun

    2015-12-09

    In this paper, a Per-Hop Acknowledgement (PHACK)-based scheme is proposed for each packet transmission to detect selective forwarding attacks. In our scheme, the sink and each node along the forwarding path generate an acknowledgement (ACK) message for each received packet to confirm the normal packet transmission. The scheme, in which each ACK is returned to the source node along a different routing path, can significantly increase the resilience against attacks because it prevents an attacker from compromising nodes in the return routing path, which can otherwise interrupt the return of nodes' ACK packets. For this case, the PHACK scheme also has better potential to detect abnormal packet loss and identify suspect nodes as well as better resilience against attacks. Another pivotal issue is the network lifetime of the PHACK scheme, as it generates more acknowledgements than previous ACK-based schemes. We demonstrate that the network lifetime of the PHACK scheme is not lower than that of other ACK-based schemes because the scheme just increases the energy consumption in non-hotspot areas and does not increase the energy consumption in hotspot areas. Moreover, the PHACK scheme greatly simplifies the protocol and is easy to implement. Both theoretical and simulation results are given to demonstrate the effectiveness of the proposed scheme in terms of high detection probability and the ability to identify suspect nodes.

  18. PHACK: An Efficient Scheme for Selective Forwarding Attack Detection in WSNs

    PubMed Central

    Liu, Anfeng; Dong, Mianxiong; Ota, Kaoru; Long, Jun

    2015-01-01

    In this paper, a Per-Hop Acknowledgement (PHACK)-based scheme is proposed for each packet transmission to detect selective forwarding attacks. In our scheme, the sink and each node along the forwarding path generate an acknowledgement (ACK) message for each received packet to confirm the normal packet transmission. The scheme, in which each ACK is returned to the source node along a different routing path, can significantly increase the resilience against attacks because it prevents an attacker from compromising nodes in the return routing path, which can otherwise interrupt the return of nodes’ ACK packets. For this case, the PHACK scheme also has better potential to detect abnormal packet loss and identify suspect nodes as well as better resilience against attacks. Another pivotal issue is the network lifetime of the PHACK scheme, as it generates more acknowledgements than previous ACK-based schemes. We demonstrate that the network lifetime of the PHACK scheme is not lower than that of other ACK-based schemes because the scheme just increases the energy consumption in non-hotspot areas and does not increase the energy consumption in hotspot areas. Moreover, the PHACK scheme greatly simplifies the protocol and is easy to implement. Both theoretical and simulation results are given to demonstrate the effectiveness of the proposed scheme in terms of high detection probability and the ability to identify suspect nodes. PMID:26690178

  19. Distinct neuronal patterns of positive and negative moral processing in psychopathy.

    PubMed

    Fede, Samantha J; Borg, Jana Schaich; Nyalakanti, Prashanth K; Harenski, Carla L; Cope, Lora M; Sinnott-Armstrong, Walter; Koenigs, Mike; Calhoun, Vince D; Kiehl, Kent A

    2016-12-01

    Psychopathy is a disorder characterized by severe and frequent moral violations in multiple domains of life. Numerous studies have shown psychopathy-related limbic brain abnormalities during moral processing; however, these studies only examined negatively valenced moral stimuli. Here, we aimed to replicate prior psychopathy research on negative moral judgments and to extend this work by examining psychopathy-related abnormalities in the processing of controversial moral stimuli and positive moral processing. Incarcerated adult males (N = 245) completed a functional magnetic resonance imaging protocol on a mobile imaging system stationed at the prison. Psychopathy was assessed using the Hare Psychopathy Checklist-Revised (PCL-R). Participants were then shown words describing three types of moral stimuli: wrong (e.g., stealing), not wrong (e.g., charity), and controversial (e.g., euthanasia). Participants rated each stimulus as either wrong or not wrong. PCL-R total scores were correlated with not wrong behavioral responses to wrong moral stimuli, and were inversely related to hemodynamic activity in the anterior cingulate cortex in the contrast of wrong > not wrong. In the controversial > noncontroversial comparison, psychopathy was inversely associated with activity in the temporal parietal junction and dorsolateral prefrontal cortex. These results indicate that psychopathy-related abnormalities are observed during the processing of complex, negative, and positive moral stimuli.

  20. Revisiting physical examination: Abadie's sign and Achilles intratendinous changes in subjects with diabetes.

    PubMed

    Abate, Michele; Schiavone, Cosima; Salini, Vincenzo; Andia, Isabel

    2014-01-01

    The aim of this study was to evaluate whether or not the positivity of Abadie's sign could be an indicator of asymptomatic Achilles intratendinous changes. A total of 18 patients (36 tendons) suffering from diabetes, with at least 1 Achilles tendon positive to Abadie's sign, were compared to matched subjects with diabetes bilaterally negative to Abadie's sign. Anthropometric measures and the Toronto Clinical Neuropathy Score were registered. Echotexture was evaluated and degenerative features classified as absent, mild, moderate and severe. The frequencies of structural abnormalities, according to both Abadie's sign and the Toronto Clinical Neuropathy Score, were determined. In the first group 26 out of 36 tendons (72.2%) showed positive Abadie's sign and a significantly higher frequency of moderate and severe (65.3%) structural abnormalities compared to Achilles tendons with negative sign (4.3%; p < 0.0001). This frequency was similar to that observed in the subjects with the highest Toronto Clinical Neuropathy Score (64.2%). This study showed that Abadie's sign was a useful tool for assisting in the diagnosis of asymptomatic Achilles intratendinous changes, which, when detected early, could help prevent unexpected tendon rupture. The concordance between Abadie's sign and Achilles sonographic abnormalities needs to be evaluated in a larger sample to consider it useful for practical purposes. © 2013 S. Karger AG, Basel.

  1. Prevention. How much harm? How much benefit? 3. Physical, psychological and social harm.

    PubMed Central

    Marshall, K G

    1996-01-01

    Harm caused by preventive programs may be physical, psychological, social or, if informed consent has not been obtained, ethical. Adverse effects of preventive screening programs may occur at any of the three levels of the "screening cascade", the screening procedure itself, the investigation of abnormal results of screening tests or the treatment of detected abnormalities or diseases. The greatest harm occurs at the second and third levels. Examples of procedures that may cause physical harm are venipuncture, mammography, colonoscopy, breast biopsy, transrectal ultrasonography, prostate biopsy, weight-reducing and cholesterol-lowering diets and radical prostatectomy. The psychological and social harm of preventive programs involves anticipated discomfort or perception of adverse effects of preventive interventions; unpleasant interactions with health care workers, time required for preventive programs, excessive overall awareness of health, anxiety over the results of a screening test implications of a positive screening test, consequences of being labelled as "sick" or "at risk," psychopathologic effects induced directly by preventive programs and, in the case of a false-negative test result, false assurance of disease-free status. Since the positive predictive value of screening tests in the general population is always low, most abnormal test results are "false-positive," these engender a great deal of psychological discuss among patients. PMID:8800074

  2. The relationship between trans-femoral prosthesis alignment and the center trajectory of plantar pressure in the frontal plane

    PubMed Central

    Nomura, Tomohiro; Watanabe, Kota; Nosaka, Toshiya; Matsubara, Hiroyuki; Akiyama, Masaharu; Inui, Kimiharu

    2016-01-01

    [Purpose] It is difficult to identify by visual observation whether alignment abnormalities in trans-femoral prostheses in the frontal plane are attributable to the adduction angle or the abnormal alignment of the positions of the medial and lateral sides of the socket in relation to the foot. Therefore, we focused on the trajectory of the center of plantar pressure during walking, and we proposed a method for differentiating these two alignment abnormalities. [Subjects and Methods] We recruited 4 trans-femoral unilateral amputees. Bench alignment was achieved initially. We compared the amplitude of the trajectory of the center of plantar pressure when walking under 2 conditions: 1) when changing the adduction angle and 2) when changing the positional relationship between the socket and the foot. [Results] It was not possible to distinguish between the 2 types of malalignment on the prosthesis side. There was a significant difference when changing the positional relationship on the contralateral side. Thereby, the plantar pressure of the contralateral side could be used to distinguish between the 2 types of malalignment. [Conclusion] The results of this study suggested that trans-femoral prosthesis malalignment could be evaluated through the plantar pressure of the contralateral side in amputees. PMID:27065546

  3. High Fat Diet Induced Developmental Defects in the Mouse: Oocyte Meiotic Aneuploidy and Fetal Growth Retardation/Brain Defects

    PubMed Central

    Purcell, Scott H.; Chi, Maggie; Jimenez, Patricia T.; Grindler, Natalia; Schedl, Tim; Moley, Kelle H.

    2012-01-01

    Background Maternal obesity is associated with poor outcomes across the reproductive spectrum including infertility, increased time to pregnancy, early pregnancy loss, fetal loss, congenital abnormalities and neonatal conditions. Furthermore, the proportion of reproductive-aged woman that are obese in the population is increasing sharply. From current studies it is not clear if the origin of the reproductive complications is attributable to problems that arise in the oocyte or the uterine environment. Methodology/Principal Findings We examined the developmental basis of the reproductive phenotypes in obese animals by employing a high fat diet mouse model of obesity. We analyzed very early embryonic and fetal phenotypes, which can be parsed into three abnormal developmental processes that occur in obese mothers. The first is oocyte meiotic aneuploidy that then leads to early embryonic loss. The second is an abnormal process distinct from meiotic aneuploidy that also leads to early embryonic loss. The third is fetal growth retardation and brain developmental abnormalities, which based on embryo transfer experiments are not due to the obese uterine environment but instead must be from a defect that arises prior to the blastocyst stage. Conclusions/Significance Our results suggest that reproductive complications in obese females are, at least in part, from oocyte maternal effects. This conclusion is consistent with IVF studies where the increased pregnancy failure rate in obese women returns to the normal rate if donor oocytes are used instead of autologous oocytes. We postulate that preconceptional weight gain adversely affects pregnancy outcomes and fetal development. In light of our findings, preconceptional counseling may be indicated as the preferable, earlier target for intervention in obese women desiring pregnancy and healthy outcomes. PMID:23152876

  4. Gestational diabetes mellitus and the risk of metabolic syndrome: a population-based study in Lausanne, Switzerland.

    PubMed

    Noussitou, P; Monbaron, D; Vial, Y; Gaillard, R C; Ruiz, J

    2005-09-01

    To investigate the relationships between gestational diabetes mellitus (GDM) and the metabolic syndrome (MS), as it was suggested that insulin resistance was the hallmark of both conditions. To analyse post-partum screening in order to identify risk factors for the subsequent development of type 2 diabetes mellitus (DM). A retrospective analysis of all singleton pregnancies diagnosed with GDM at the Lausanne University Hospital for 3 consecutive years. Pre-pregnancy obesity, hypertension and dyslipidaemia were recorded as constituents of the MS. For 5788 deliveries, 159 women (2.7%) with GDM were identified. Constituents of the MS were present before GDM pregnancy in 26% (n = 37/144): 84% (n = 31/37) were obese, 38% (n = 14/37) had hypertension and 22% (n = 8/37) had dyslipidaemia. Gestational hypertension was associated with obesity (OR = 3.2, P = 0.02) and dyslipidaemia (OR = 5.4, P=0.002). Seventy-four women (47%) returned for post-partum OGTT, which was abnormal in 20 women (27%): 11% (n = 8) had type 2 diabetes and 16% (n = 12) had impaired glucose tolerance. Independent predictors of abnormal glucose tolerance in the post-partum were: having > 2 abnormal values on the diagnostic OGTT during pregnancy and presenting MS constituents (OR = 5.2, CI 1.8-23.2 and OR = 5.3, CI 1.3-22.2). In one fourth of GDM pregnancies, metabolic abnormalities precede the appearance of glucose intolerance. These women have a high risk of developing the MS and type 2 diabetes in later years. Where GDM screening is not universal, practitioners should be aware of those metabolic risks in every pregnant woman presenting with obesity, hypertension or dyslipidaemia, in order to achieve better diagnosis and especially better post-partum follow-up and treatment.

  5. An Assessment of the Available Evidence on the Returns to Military Training

    DTIC Science & Technology

    1977-07-01

    Hanushek Kassing McCall and Wallace Mason (1970) Nathan Associates Weinstein et al. Richardson (1967) Thorndike and Hagen (1957) u.s...Biderman Cutright Freeman Hanushek Kassing McCall and Wallace Mason (1970) Primary Purpose of the Study Analyze the vocational readjustment...that veterans do not receive a positive economic return from military voca- tional training. Mason (1970), Hanushek , Cutright, and Kassing reach

  6. Persistence of Positive Carryover Effects in the Oyster, Saccostrea glomerata, following Transgenerational Exposure to Ocean Acidification.

    PubMed

    Parker, Laura M; O'Connor, Wayne A; Raftos, David A; Pörtner, Hans-Otto; Ross, Pauline M

    2015-01-01

    Ocean acidification (OA) is predicted to have widespread implications for marine organisms, yet the capacity for species to acclimate or adapt over this century remains unknown. Recent transgenerational studies have shown that for some marine species, exposure of adults to OA can facilitate positive carryover effects to their larval and juvenile offspring that help them to survive in acidifying oceanic conditions. But whether these positive carryover effects can persist into adulthood or the next generation is unknown. Here we tested whether positive carryover effects found in larvae of the oyster, Saccostrea glomerata following transgenerational exposure to elevated CO2, could persist into adulthood and whether subsequent transgenerational exposure of adults to elevated CO2 would facilitate similar adaptive responses in the next generation of larvae and juveniles. Following our previous transgenerational exposure of parental adults and first generation (F1) larvae to ambient (385 μatm) and elevated (856 μatm) CO2, newly settled F1 juveniles were transferred to the field at ambient CO2 for 14 months, until they reached reproductive maturity. At this time, the F1 adults were returned to the laboratory and the previous transgenerational CO2 exposure was repeated to produce F2 offspring. We found that the capacity of adults to regulate extracellular pH at elevated CO2 was improved if they had a prior history of transgenerational exposure to elevated CO2. In addition, subsequent transgenerational exposure of these adults led to an increase in the resilience of their larval and juvenile offspring. Offspring with a history of transgenerational exposure to elevated CO2 had a lower percentage abnormality, faster development rate, faster shell growth and increased heart rate at elevated CO2 compared with F2 offspring with no prior history of exposure to elevated CO2. Our results suggest that positive carryover effects originating during parental and larval exposure will be important in mediating some of the impacts of OA for later life-history stages and generations.

  7. Prediction of Pathological Stage in Patients with Prostate Cancer: A Neuro-Fuzzy Model

    PubMed Central

    Acampora, Giovanni; Brown, David; Rees, Robert C.

    2016-01-01

    The prediction of cancer staging in prostate cancer is a process for estimating the likelihood that the cancer has spread before treatment is given to the patient. Although important for determining the most suitable treatment and optimal management strategy for patients, staging continues to present significant challenges to clinicians. Clinical test results such as the pre-treatment Prostate-Specific Antigen (PSA) level, the biopsy most common tumor pattern (Primary Gleason pattern) and the second most common tumor pattern (Secondary Gleason pattern) in tissue biopsies, and the clinical T stage can be used by clinicians to predict the pathological stage of cancer. However, not every patient will return abnormal results in all tests. This significantly influences the capacity to effectively predict the stage of prostate cancer. Herein we have developed a neuro-fuzzy computational intelligence model for classifying and predicting the likelihood of a patient having Organ-Confined Disease (OCD) or Extra-Prostatic Disease (ED) using a prostate cancer patient dataset obtained from The Cancer Genome Atlas (TCGA) Research Network. The system input consisted of the following variables: Primary and Secondary Gleason biopsy patterns, PSA levels, age at diagnosis, and clinical T stage. The performance of the neuro-fuzzy system was compared to other computational intelligence based approaches, namely the Artificial Neural Network, Fuzzy C-Means, Support Vector Machine, the Naive Bayes classifiers, and also the AJCC pTNM Staging Nomogram which is commonly used by clinicians. A comparison of the optimal Receiver Operating Characteristic (ROC) points that were identified using these approaches, revealed that the neuro-fuzzy system, at its optimal point, returns the largest Area Under the ROC Curve (AUC), with a low number of false positives (FPR = 0.274, TPR = 0.789, AUC = 0.812). The proposed approach is also an improvement over the AJCC pTNM Staging Nomogram (FPR = 0.032, TPR = 0.197, AUC = 0.582). PMID:27258119

  8. Outcomes at 12 months after early magnetic resonance imaging in acute trauma patients with persistent midline cervical tenderness and negative computed tomography.

    PubMed

    Ackland, Helen M; Cameron, Peter A; Wolfe, Rory; Malham, Gregory M; Varma, Dinesh K; Fitt, Gregory J; Cooper, D James; Rosenfeld, Jeffrey V; Liew, Susan M

    2013-06-01

    A prospective observational cohort study of alert, neurologically intact trauma patients presenting to the emergency department with midline cervical tenderness. Screening cervical magnetic resonance imaging (MRI) had been conducted after negative computed tomography (CT) when tenderness was persistent. To determine the association of acute findings and demographic characteristics with any long-term neck disability, and with time to return to work in such patients. The relationship between acute findings and outcomes in these patients is unknown, and we hypothesized that outcomes at 12 months would correlate with acute clinical signs and symptoms, MRI findings, and mechanisms of injury. Patients at a Level 1 trauma center with persistent midline cervical tenderness in the absence of evidence of intoxication, painful distracting injury, persistently abnormal neurology, or acute CT findings, who underwent early cervical MRI under the institutional protocol, were reviewed in the outpatient spine clinic after discharge. In addition, the factors associated with neck disability and time to return to work were examined at follow-up at 12 months after presentation. There were 162 of 178 patients available for follow-up at 12 months (91%). Of these, 46% had MRI-identified cervical spine injury at their initial examination, and 22% had required clinical management, including 2.5% with operative stabilization. Neck disability was present in 43% of patients and was associated with depressive symptoms, workers' compensation, and low annual income. Delay in return to work was associated with the presence of minor limb/other fractures and depressive symptoms, whereas patients on high annual incomes were found to return to work more quickly. Surprisingly in these acute trauma patients, MRI-detected injury, clinical factors, and injury mechanism were not found to be associated with long-term patient outcomes. As a result, a trial of a more targeted, individual return to work plan, including strategies aimed at improving physical and psychological function, may now be justified to optimize long-term recovery, reduce health resource costs, and maximize economic productivity through early return to work.

  9. Changes in autonomic nervous system activity, body weight, and percentage fat mass in the first year postpartum and factors regulating the return to pre-pregnancy weight.

    PubMed

    Izumi, Mie; Manabe, Emiko; Uematsu, Sayo; Watanabe, Ayako; Moritani, Toshio

    2016-10-27

    Many women become obese during pregnancy and the postpartum period. Weight gain and obesity in the general population are often attributed to abnormalities of autonomic nervous system (ANS) activity. The aim of this study was to clarify change in ANS activity, body weight, percentage fat mass (%FM), and body mass index (BMI) and the factors regulating the return to the pre-pregnancy weight in the first year postpartum. This study was conducted from 2012 to 2016 at the University Hospital of the Kyoto Prefectural University of Medicine and a nearby obstetrics and gynecology clinic in Japan. Body weight and %FM were measured in 51 women using a dual-frequency body composition measuring device. Heart rate variability and R-R spectral transformation were used as indicators of ANS activity. All parameters were calculated at three postpartum time points. Repeated measure analysis of variance was used for comparisons between measurement times. A multivariable Cox proportional hazards model was conducted to determine factors associated with the return to pre-pregnancy weight. Mean body weight, %FM, and BMI decreased significantly over time after delivery (P < 0.001, P < 0.001, P < 0.001). However, ANS activity did not differ among subjects in the three time points. 25.5 % of subjects had still not returned to their pre-pregnancy body weight by 150-270 days postpartum, and 19.6 % had not by 270-360 days postpartum. Normal-weight obesity (NWO; BMI of 18.5-25 kg/m 2 and %FM of ≥30 %) was observed in several subjects at each measurement. The results of analysis using a multivariable Cox proportional hazards model suggest that ANS activity had no significant correlation with the return to pre-pregnancy weight. The management of body weight and %FM after delivery is considered important. These findings suggest that ANS activity is not associated with the return to pre-pregnancy weight, albeit that sample size was small.

  10. Ametropia, retinal anatomy, and OCT abnormality patterns in glaucoma. 2. Impacts of optic nerve head parameters

    NASA Astrophysics Data System (ADS)

    Baniasadi, Neda; Wang, Mengyu; Wang, Hui; Jin, Qingying; Elze, Tobias

    2017-12-01

    Clinicians use retinal nerve fiber layer thickness (RNFLT) measured by optical coherence tomography (OCT) as an adjunct to glaucoma diagnosis. Ametropia is accompanied by changes to the optic nerve head (ONH), which may affect how OCT machines mark RNFLT measurements as abnormal. These changes in abnormality patterns may bias glaucoma diagnosis. Here, we investigate the relationship between OCT abnormality patterns and the following ONH-related and ametropia-associated parameters on 421 eyes of glaucoma patients: optic disc tilt and torsion, central retinal vessel trunk location (CRVTL), and nasal and temporal retinal curvature adjacent to ONH, quantified as nasal/temporal slopes of the inner limiting membrane. We applied multivariate logistic regression with abnormality marks as regressands to 40,401 locations of the peripapillary region and generated spatial maps of locations of false positive/negative abnormality marks independent of glaucoma severity. Effects of torsion and temporal slope were negligible. The effect of tilt could be explained by covariation with ametropia. For CRVTL/nasal slope, abnormality pattern shifts at 7.2%/23.5% of the peripapillary region were detected, respectively, independent of glaucoma severity and ametropia. Therefore, CRVTL and nasal curvature should be included in OCT RNFLT norms. Our spatial location maps may aid clinicians to improve diagnostic accuracy.

  11. Characteristics of the somatotropic axis in insulin dependent diabetes mellitus.

    PubMed

    Mercado, M; Baumann, G

    1995-01-01

    Growth hormone (GH) plays an important role in glucose homeostasis in both healthy subjects and patients with diabetes. Patients with poorly controlled insulin-dependent diabetes mellitus (IDDM) have high basal and integrated serum GH concentrations, as well as an enhanced GH response to several secretagogues. Yet, these patients have impaired generation of insulin-like growth factor-I (IGF-I). These abnormalities tend to return to normal as an adequate metabolic control is achieved. In view of this hormonal profile, IDDM has been considered a state of relative GH resistance. Studies in experimental animals with streptozotocin-induced diabetes have shown a decreased binding of radiolabeled GH to liver membranes. More recently, adults and children with IDDM have been found to have low levels of the high affinity growth hormone binding protein (GHBP), which represents the extracellular portion of the GH receptor, and is thought to reflect GH receptor tissue concentrations. The abnormalities in the GH/IGF-I axis have been implicated in the worsening of metabolic control that occurs in some patients, as well as in the development of microvascular complications, particularly retinopathy.

  12. Progressive brain atrophy in patients with chronic neuropsychiatric symptoms after mild traumatic brain injury: a preliminary study.

    PubMed

    Ross, David E; Ochs, Alfred L; Seabaugh, Jan M; Demark, Michael F; Shrader, Carole R; Marwitz, Jennifer H; Havranek, Michael D

    2012-01-01

    NeuroQuant® is a recently developed, FDA-approved software program for measuring brain MRI volume in clinical settings. The aims of this study were as follows: (1) to examine the test-retest reliability of NeuroQuant®; (2) to test the hypothesis that patients with mild traumatic brain injury (TBI) would have abnormally rapid progressive brain atrophy; and (3) to test the hypothesis that progressive brain atrophy in patients with mild TBI would be associated with vocational outcome. Sixteen patients with mild TBI were compared to 20 normal controls. Vocational outcome was assessed with the Glasgow Outcome Scale-Extended (GOSE) and Disability Rating Scale (DRS). NeuroQuant® showed high test-re-test reliability. Patients had abnormally rapid progressive atrophy in several brain regions and the rate of atrophy was associated with inability to return to work. NeuroQuant®, is a reliable and valid method for assessing the anatomic effects of TBI. Progression of atrophy may continue for years after injury, even in patients with mild TBI.

  13. Some interesting examples of binormal degeneracy and analysis using a contaminated binormal ROC model

    NASA Astrophysics Data System (ADS)

    Berbaum, Kevin S.; Dorfman, Donald D.

    2001-06-01

    Receiver operating characteristic (ROC) data with false positive fractions of zero are often difficult to fit with standard ROC methodology, and are sometimes discarded. Some extreme examples of such data were analyzed. A new ROC model is proposed that assumes that for a proportion of abnormalities, no signal information is captured and that those abnormalities have the same distribution as noise along the latent decision axis. Rating reports of fracture for single view ankle radiographs were also analyzed with the binormal ROC model and two proper ROC models. The conventional models gave ROC area close to one, implying a true positive fraction close to one. The data contained no such fractions. When all false positive fractions were zero, conventional ROC areas gave little or no hint of unmistakable differences in true positive fractions. In contrast, the new model can fit ROC data in which some or all of the ROC points have false positive fractions of zero and true positive fractions less than one without concluding perfect performance. These data challenge the validity and robustness of conventional ROC models, but the contaminated binormal model accounts for these data. This research has been published for a different audience.

  14. Flow cytometry application in the assessment of sperm DNA integrity of men with asthenozoospermia.

    PubMed

    Piasecka, M; Gaczarzewicz, D; Laszczyńska, M; Starczewski, A; Brodowska, A

    2007-01-01

    Sperm genomic integrity and ultrastructural features of ejaculated spermatozoa contributing to the assessment of gamete fertility potential in patients with asthenozoospermia are discussed. The proportion of TUNEL-positive cells was significantly higher in the semen of patients with low sperm motility (n=40; p<0.01) as compared to men with normal sperm motility (n=54). Sperm DNA fragmentation negatively correlated (n=94) with sperm motility, sperm concentration, and integrity of the sperm cellular membrane (HOS-test). Two categories of patients were distinguished: (1) patients (23 out of 94 subjects) with < or = 4% of TUNEL-positive cells and (2) patients (71 subjects) with 4% of TUNEL-positive cells. A significant difference was noted in the sperm motility and HOS-test results between patients from both groups. Large numbers of immature spermatozoa with extensive cytoplasmic retention, ultrastructural chromatin and midpiece abnormalities, and conglomerates containing sperm fragments were present more frequently in the semen of asthenozoospermic subjects with >4% of TUNEL-positive sperm cells. Low sperm motility seems to be accompanied by serious defects of gamete chromatin expressed as diminished sperm genomic integrity and abnormal DNA condensation and by defects of sperm midpiece. These abnormalities may reflect developmental failure during the spermatogenic remodeling process. The DNA fragmentation test may be considered as an additional assay for the evaluation of spermatozoa beside standard analysis and taken together with electron microscopy may help to determine the actual number of "healthy" spermatozoa thereby playing an important role during diagnosis and treatment of male infertility.

  15. Pregnant women in the workplace: distinguishing between normal and abnormal physiologic changes.

    PubMed

    Draper, London

    2006-05-01

    The Bureau of Labor Statistics reported in 2001 that 51% of married women return to the work force before their children are 1 year old (Rojjanasrirat, 2004). Women's roles in the United States are rapidly changing, and the workplace environment is also changing to meet the added demands of women in the work force. Many women assimilate the multiple roles of wife, mother, and working professional into a cohesive unit; however, this is often difficult. Occupational health nurses play a vital role advocating for women in the work force. A critical area of advocacy (and education) focuses on providing necessary support to pregnant employees.

  16. KSC-97PC1349

    NASA Image and Video Library

    1997-09-07

    Workers in the Payload Hazardous Servicing Facility (PHSF) begin to remove a protective cover from the Cassini spacecraft with its attached Huygens probe. Damage to thermal insulation was discovered inside Huygens from an abnormally high flow of conditioned air. Further internal inspection, insulation repair and a cleaning of the probe are now required. Mission managers are targeting a mid-October launch date after Cassini returns to the pad and is once again placed atop its Titan IVB expendable launch vehicle at Launch Pad 40 at Cape Canaveral Air Station. Cassini will explore the Saturnian system, including the planet’s rings, while the Huygens probe will explore the moon Titan

  17. KSC-97PC1350

    NASA Image and Video Library

    1997-09-07

    Workers in the Payload Hazardous Servicing Facility (PHSF) finish the removal of a protective cover from the Cassini spacecraft with its attached Huygens probe. Damage to thermal insulation was discovered inside Huygens from an abnormally high flow of conditioned air. Further internal inspection, insulation repair and a cleaning of the probe are now required. Mission managers are targeting a mid-October launch date after Cassini returns to the pad and is once again placed atop its Titan IVB expendable launch vehicle at Launch Pad 40 at Cape Canaveral Air Station. Cassini will explore the Saturnian system, including the planet’s rings, while the Huygens probe will explore the moon Titan

  18. A CASE OF GRANISETRON ASSOCIATED INTRAOPERATIVE CARDIAC ARREST.

    PubMed

    Al Harbi, Mohammed; Al Rifai, Derar; Al Habeeb, Hassan; Wambi, Freddie; Geldhof, Georges; Dimitriou, Vassilios

    2016-02-01

    We report a case of intraoperative severe bradycardia that resulted in asystole and cardiac arrest shortly after (<2 min) intravenous granisetron 1mg for postoperative nausea and vomiting prophylaxis, that occurred in a female patient who underwent an elective total thyroidectomy. After two cycles of cardiopulmonary resuscitation and defibrillation, spontaneous circulation and sinus rhythm returned successfully. Postoperatively, the patient was diagnosed with a drug-induced long QT syndrome. At the time of the event, granisetron was the only medication administered. Furthermore, there was no reason to suspect electrolyte abnormalities. We explore the association of the onset of severe sinus bradycardia with the intravenous administration of granisetron.

  19. [A case of transient auditory agnosia and schizophrenia].

    PubMed

    Kanzaki, Jin; Harada, Tatsuhiko; Kanzaki, Sho

    2011-03-01

    We report a case of transient functional auditory agnosia and schizophrenia and discuss their relationship. A 30-year-old woman with schizophrenia reporting bilateral hearing loss was found in history taking to be able to hear but could neither understand speech nor discriminate among environmental sounds. Audiometry clarified normal but low speech discrimination. Otoacoustic emission and auditory brainstem response were normal. Magnetic resonance imaging (MRI) elsewhere evidenced no abnormal findings. We assumed that taking care of her grandparents who had been discharged from the hospital had unduly stressed her, and her condition improved shortly after she stopped caring for them, returned home and started taking a minor tranquilizer.

  20. Rapid perceptual adaptation to high gravitoinertial force levels Evidence for context-specific adaptation

    NASA Technical Reports Server (NTRS)

    Lackner, J. R.; Graybiel, A.

    1982-01-01

    Subjects exposed to periodic variations in gravitoinertial force (2-G peak) in parabolic flight maneuvers quickly come to perceive the peak force level as having decreased in intensity. By the end of a 40-parabola flight, the decrease in apparent force is approximately 40%. On successive flight days, the apparent intensity of the force loads seems to decrease as well, indicating a cumulative adaptive effect. None of the subjects reported feeling abnormally 'light' for more than a minute or two after return to 1-G background force levels. The pattern of findings suggests a context-specific adaptation to high-force levels.

  1. Late clotted haemothorax after blunt chest trauma.

    PubMed Central

    Sinha, P; Sarkar, P

    1998-01-01

    A clotted haemothorax can develop any time after blunt chest trauma. Two cases are described in which late clotted haemothoraces developed which were treated by limited thoracotomy and evacuation of clots. Late clotted haemothorax may occur even in the absence of any abnormal initial clinical findings. Early detection and treatment is important to avoid the complications of fibrothorax and empyema with permanent pulmonary dysfunction. After blunt chest trauma patients should be advised to return to the accident and emergency department for assessment on development of any new chest symptom. Under these circumstances a chest x ray is mandatory to exclude a haemothorax. Images Figure 1 PMID:9639184

  2. Redox Abnormalities as a Vulnerability Phenotype for Autism and Related Alterations in CNS Development

    DTIC Science & Technology

    2010-10-14

    number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1 . REPORT DATE (DD-MM-YYYY) 10/14/2010 2 . REPORT TYPE Annual 3. DATES COVERED (From...predictive of subsequent development of autism . In Aim 2 , we will determine whether immune cells from autistic children are associated with altered...7 Appendices…………………………………………………………………………… 7 1 0 1 2 3 4 5 6 7 8 9 10 All Regression CONTROL to ta l G SH (µ m ol

  3. Antenatal care--antenatal screening for fetal abnormality.

    PubMed

    Baston, Helen

    2003-02-01

    JOANNA IS NOW 24 WEEKS pregnant. She is feeling very well and finding that now her energy has returned, she is really enjoying being preganant. She still proudly shows her precious scan picture to interested friends and takes the occasional glance herself during quiet moments. Joanna, has a cousin, Susan, who has Down's syndrome. Susan is a happy and loving child who has brought a lot of joy, as well as heartache, to the extended family. Although Joanna has no delusions about the hard work and continuing care that her cousin requires, she would not herself contemplate terminating a pregnancy if her baby had the condition.

  4. Java Radar Analysis Tool

    NASA Technical Reports Server (NTRS)

    Zaczek, Mariusz P.

    2005-01-01

    Java Radar Analysis Tool (JRAT) is a computer program for analyzing two-dimensional (2D) scatter plots derived from radar returns showing pieces of the disintegrating Space Shuttle Columbia. JRAT can also be applied to similar plots representing radar returns showing aviation accidents, and to scatter plots in general. The 2D scatter plots include overhead map views and side altitude views. The superposition of points in these views makes searching difficult. JRAT enables three-dimensional (3D) viewing: by use of a mouse and keyboard, the user can rotate to any desired viewing angle. The 3D view can include overlaid trajectories and search footprints to enhance situational awareness in searching for pieces. JRAT also enables playback: time-tagged radar-return data can be displayed in time order and an animated 3D model can be moved through the scene to show the locations of the Columbia (or other vehicle) at the times of the corresponding radar events. The combination of overlays and playback enables the user to correlate a radar return with a position of the vehicle to determine whether the return is valid. JRAT can optionally filter single radar returns, enabling the user to selectively hide or highlight a desired radar return.

  5. On the Empirical Importance of the Conditional Skewness Assumption in Modelling the Relationship between Risk and Return

    NASA Astrophysics Data System (ADS)

    Pipień, M.

    2008-09-01

    We present the results of an application of Bayesian inference in testing the relation between risk and return on the financial instruments. On the basis of the Intertemporal Capital Asset Pricing Model, proposed by Merton we built a general sampling distribution suitable in analysing this relationship. The most important feature of our assumptions is that the skewness of the conditional distribution of returns is used as an alternative source of relation between risk and return. This general specification relates to Skewed Generalized Autoregressive Conditionally Heteroscedastic-in-Mean model. In order to make conditional distribution of financial returns skewed we considered the unified approach based on the inverse probability integral transformation. In particular, we applied hidden truncation mechanism, inverse scale factors, order statistics concept, Beta and Bernstein distribution transformations and also a constructive method. Based on the daily excess returns on the Warsaw Stock Exchange Index we checked the empirical importance of the conditional skewness assumption on the relation between risk and return on the Warsaw Stock Market. We present posterior probabilities of all competing specifications as well as the posterior analysis of the positive sign of the tested relationship.

  6. Comparison of knee flexion isokinetic deficits between seated and prone positions after ACL reconstruction with hamstrings graft: Implications for rehabilitation and return to sports decisions.

    PubMed

    Koutras, Georgios; Bernard, Manfred; Terzidis, Ioannis P; Papadopoulos, Pericles; Georgoulis, Anastasios; Pappas, Evangelos

    2016-07-01

    Hamstrings grafts are commonly used in ACL reconstruction, however, the effect of graft harvesting on knee flexion strength has not been longitudinally evaluated in functional positions. We hypothesized that greater deficits in knee flexion strength exist in the prone compared to the seated position and these deficits remain as rehabilitation progresses. Case series. Forty-two consecutive patients who underwent ACL reconstruction with a hamstrings graft were followed prospectively for 9 months. Isokinetic knee flexion strength at a slow and a fast speed were collected at 3, 4, 6, and 9 months in two different positions: conventional (seated) and functional (0° of hip flexion). Peak torque knee flexion deficits were higher in the prone position compared to the seated position by an average of 6.5% at 60°/s and 9.1% at 180°/s (p<0.001). Measuring knee flexion strength in prone demonstrates higher deficits than in the conventional seated position. Most athletes would not be cleared to return to sports even at 9 months after surgery with this method. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  7. Knee joint position sense ability in elite athletes who have returned to international level play following ACL reconstruction: A cross-sectional study.

    PubMed

    Relph, Nicola; Herrington, Lee

    2016-12-01

    Following an ACL injury, reconstruction (ACL-R) and rehabilitation, athletes may return to play with a proprioceptive deficit. However, literature is lacking to support this hypothesis in elite athletic groups who have returned to international levels of performance. It is possible the potentially heightened proprioceptive ability evidenced in athletes may negate a deficit following injury. The purpose of this study was to consider the effects of ACL injury, reconstruction and rehabilitation on knee joint position sense (JPS) on a group of elite athletes who had returned to international performance. Using a cross-sectional design ten elite athletes with ACL-R and ten controls were evaluated. JPS was tested into knee extension and flexion using absolute error scores. Average data with 95% confidence intervals between the reconstructed, contralateral and uninjured control knees were analyzed using t-tests and effect sizes. The reconstructed knee of the injured group demonstrated significantly greater angle of error scores when compared to the contralateral and uninjured control into knee flexion (p=0.0001, r=0.98) and knee extension (p=0.0001, r=0.91). There were no significant differences between the contralateral uninjured knee of the injured group and the uninjured control group. Elite athletes who have had an ACL injury, reconstruction, rehabilitation and returned to international play demonstrate lower JPS ability compared to control groups. It is unclear if this deficiency affects long-term performance or secondary injury and re-injury problems. In the future physical therapists should monitor athletes longitudinally when they return to play. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Outcomes in revision Tommy John surgery in Major League Baseball pitchers.

    PubMed

    Liu, Joseph N; Garcia, Grant H; Conte, Stan; ElAttrache, Neal; Altchek, David W; Dines, Joshua S

    2016-01-01

    With the recent rise in the number of Tommy John surgeries, a proportionate rise in revisions is expected. However, much is unknown regarding the current revision rate of Tommy John surgery, return to play, and change in performance in Major League Baseball (MLB) pitchers. Publicly available databases were used to obtain a list of all MLB pitchers who underwent primary and revision Tommy John surgery. Pitching performance preoperatively and postoperatively for pitchers who returned to 1 or more MLB games after revision surgery was compared with controls matched for age and position. Since 1999, 235 MLB pitchers have undergone Tommy John surgeries; 31 pitchers (13.2%) underwent revision surgery, and 37% underwent revision within 3 years of the index procedure. Twenty-six revisions had more than 2 years of follow-up; 17 pitchers (65.4%) returned to pitch at least 1 major league game, whereas only 11 (42.3%) returned to pitch 10 or more games. Of those who returned to MLB competition, the average length of recovery was 20.76 months. Compared with controls matched for age and position, MLB pitchers undergoing revision surgery had a statistically shorter career after revision surgery (4.9 vs 2.6 seasons, P = .002), pitched fewer innings, and had fewer total pitches per season. The rate of revision Tommy John surgery is substantially higher than previously reported. For MLB pitchers, return to play after revision surgery is much lower than after primary reconstruction. The overall durability of MLB pitchers after revision ulnar collateral ligament reconstruction decreases significantly compared with controls matched for age and matched controls. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  9. Respiratory modulation of cardiovascular rhythms before and after short-duration human spaceflight.

    PubMed

    Verheyden, B; Beckers, F; Couckuyt, K; Liu, J; Aubert, A E

    2007-12-01

    Astronauts commonly return from space with altered short-term cardiovascular dynamics and blunted baroreflex sensitivity. Although many studies have addressed this issue, post-flight effects on the dynamic circulatory control remain incompletely understood. It is not clear how long the cardiovascular system needs to recover from spaceflight as most post-flight investigations only extended between a few days and 2 weeks. In this study, we examined the effect of short-duration spaceflight (1-2 weeks) on respiratory-mediated cardiovascular rhythms in five cosmonauts. Two paced-breathing protocols at 6 and 12 breaths min(-1) were performed in the standing and supine positions before spaceflight, and after 1 and 25 days upon return. Dynamic baroreflex function was evaluated by transfer function analysis between systolic pressure and the RR intervals. Post-flight orthostatic blood pressure control was preserved in all cosmonauts. In the standing position after spaceflight there was an increase in heart rate (HR) of approx. 20 beats min(-1) or more. Averaged for all five cosmonauts, respiratory sinus dysrhythmia and transfer gain reduced to 40% the day after landing, and had returned to pre-flight levels after 25 days. Low-frequency gain decreased from 6.6 (3.4) [mean (SD)] pre-flight to 3.9 (1.6) post-flight and returned to 5.7 (1.3) ms mmHg(-1) after 25 days upon return to Earth. Unlike alterations in the modulation of HR, blood pressure dynamics were not significantly different between pre- and post-flight sessions. Our results indicate that short-duration spaceflight reduces respiratory modulation of HR and decreases cardiac baroreflex gain without affecting post-flight arterial blood pressure dynamics. Altered respiratory modulation of human autonomic rhythms does not persist until 25 days upon return to Earth.

  10. Return to Play and Performance After Jones Fracture in National Basketball Association Athletes.

    PubMed

    Begly, John P; Guss, Michael; Ramme, Austin J; Karia, Raj; Meislin, Robert J

    2016-07-01

    Basketball players are at risk for foot injuries, including Jones fractures. It is unknown how this injury affects the future play and performance of athletes. National Basketball Association (NBA) players who sustain Jones fractures of the base of the fifth metatarsal have high rates of return to play and do not experience a decrease in performance on return to competition when compared with preinjury and with control-matched peers. Retrospective cohort study. Level 5. Data on 26 elite basketball players with Jones fractures over 19 NBA seasons (1994-1995 to 2012-2013) were obtained from injury reports, press releases, player profiles, and online public databases. Variables included age, body mass index (BMI), player position, experience, and surgical treatment. Individual season statistics pre- and postinjury were collected. Twenty-six controls were identified by matched player position, age, and performance statistics. The mean age at the time of injury was 24.8 years, mean BMI was 24.7 kg/m(2), and the mean experience prior to injury was 4.1 NBA seasons. Return to previous level of competition was achieved by 85% of athletes. There was no change in player efficiency rating (PER) when pre- and postinjury performance was compared. When compared with controls, no decline in PER measured performance was identified. The majority of NBA players sustaining a Jones fracture return to their preinjury level of competition. These elite athletes demonstrate no decrease in performance on their return to play. Jones fractures are well-studied injuries in terms of etiology, diagnosis, and management. However, the effect of these injuries on future performance of athletes is unknown. Using the findings of our study, orthopaedic surgeons may be better prepared to counsel and educate elite athletes who sustain a Jones fracture. © 2015 The Author(s).

  11. Impact of reproductive efficiency over time and mare financial value on economic returns among Thoroughbred mares in central Kentucky.

    PubMed

    Bosh, K A; Powell, D; Neibergs, J S; Shelton, B; Zent, W

    2009-12-01

    There have been no studies reporting the impact of reproductive efficiency and mare financial value on economic returns. To explore the economic consequences of differences in reproductive efficiency over time in the Thoroughbred mare. Complete production records for 1176 mares were obtained. Production history and drift in foaling date were calculated. Multiple logistic regression was used to identify factors influencing the probability of producing a registered foal in 2005. The 'net present value' and 'internal rate of return' were calculated for economic scenarios involving different initial mare financial values, levels of reproductive efficiency, and durations of investment. Among mares that did not produce a foal every year (63%), the mean time before failing to produce a registered foal was 3.4 years. The majority of mares drifted later in their foaling dates in subsequent foaling seasons. Increasing mare age, foaling after 1st April, needing to be mated multiple times during the season, and producing a lower number of foals in continuous sequence during previous years decreased the probability of producing a registered foal. Over a 7 year investment period, live foals must be produced in all but one year to yield a positive financial return. Profitability was highest among mares of greatest financial value. Mares are long-term investments due to the extended period before there is a return on the investment. Improving our understanding of mare, stallion and management factors that affect the likelihood of producing a live foal are critical to ensuring a positive financial return. Additional work is needed to test the robustness of the study's conclusions when the cost and revenue assumptions are varied. This information can assist in assessing mare profitability and developing management strategies to maximise profitability.

  12. The asymmetric reactions of mean and volatility of stock returns to domestic and international information based on a four-regime double-threshold GARCH model

    NASA Astrophysics Data System (ADS)

    Chen, Cathy W. S.; Yang, Ming Jing; Gerlach, Richard; Jim Lo, H.

    2006-07-01

    In this paper, we investigate the asymmetric reactions of mean and volatility of stock returns in five major markets to their own local news and the US information via linear and nonlinear models. We introduce a four-regime Double-Threshold GARCH (DTGARCH) model, which allows asymmetry in both the conditional mean and variance equations simultaneously by employing two threshold variables, to analyze the stock markets’ reactions to different types of information (good/bad news) generated from the domestic markets and the US stock market. By applying the four-regime DTGARCH model, this study finds that the interaction between the information of domestic and US stock markets leads to the asymmetric reactions of stock returns and their variability. In addition, this research also finds that the positive autocorrelation reported in the previous studies of financial markets may in fact be mis-specified, and actually due to the local market's positive response to the US stock market.

  13. Getting a return on investment from spending capital dollars on new beds.

    PubMed

    Hardy, Patsy A

    2004-01-01

    In assessing this bed-purchase process and the resulting return on investment, I identified the following critical success factors related to capital investments: Evaluation of capital equipment for return on investment from the expense side, particularly when looking at use of manpower for critical positions in the organization Evaluation of capital equipment for increasing nursing satisfaction, a factor in addressing the healthcare worker shortage in today's environment Involvement of a representative team to create personal ownership through individuals wanting to take care of something they are involved in purchasing Spin-off timesaving that can be realized through the adage "form follows function" The last factor was found not only in savings of nurse staff time but also in pharmacy time because the weight function on the new beds saved approximately one hour, allowing for speedier calculation of creatinine clearance in antibiotic dosing. Changing my position and perspective was rewarding. The persistence of the CNO and the involvement of the employees made the experience gratifying on a personal level as well.

  14. Analysis on the correlation between temperature and discharge characteristic of cloud-to-ground lightning discharge plasma with multiple return strokes

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

    Qu Haiyan; Chang Zhengshi; Yuan Ping

    2011-01-15

    The spectra of cloud-to-ground lightning with multiple return strokes have been obtained by using a slitless spectrograph on the Chinese Tibet plateau. Combining the spectra with synchronous electrical information, the correlation among spectral properties, channel temperatures and discharge characteristics, and thermal effects of current is discussed for the first time. The results show that the channel plasma temperature varies significantly from stroke to stroke within a given flash, and the total intensity of spectra is directly proportional to the amplitude of electric field change. Moreover, the positive correlation has been confirmed between the channel plasma temperature and the thermal effectmore » which shows the effect of the electric current accumulation. It is inferred that the total intensity of the spectra should be directly proportional to the intensity of discharge current, and channel temperature is correlated positively with the energy transmission in one return stroke.« less

  15. Treatment of Chagas' disease with itraconazole: electrocardiographic and parasitological conditions after 20 years of follow-up.

    PubMed

    Apt, Werner; Arribada, Arturo; Zulantay, Inés; Rodríguez, Jorge; Saavedra, Miguel; Muñoz, Andrea

    2013-09-01

    To evaluate cases of chronic Chagas' disease for the long-term effects of treatment with itraconazole on Trypanosoma cruzi infections and the regression or development of ECG abnormalities. In March 1992, we treated 46 patients with chronic Chagas' disease with 6 mg/kg/day of itraconazole for 120 days in a blind evaluation. The patients came from an area of Chile where the disease was endemic and were checked for ECG abnormalities and with xenodiagnosis (XD) or real-time XD-quantitative PCR (XD-qPCR) for Trypanosoma cruzi infection before treatment and once a year for 20 years. Twenty-one patients proved to be uninfected after 20 years and 15 of the patients had a normal ECG. Of the latter cases, 32.6% could be considered cured, although all of them had positive serology. Itraconazole prevents the development of ECG abnormalities, because after 20 years of treatment only 10.86% of patients developed ECG abnormalities (Z = 1.70, P = 0.046). XD-qPCR performed on 16 patients demonstrated 10 cases with <1.42 parasites/mL: eight with <1 parasite/mL, one with 1.42 parasites/mL and one with 1.01 parasites/mL. Five patients had more than 11.75 parasites/mL, all of them with a positive XD; these cases correspond to therapy failure, since re-infection was ruled out. In one case, XD-qPCR did not present amplification. Itraconazole is useful in the treatment of chronic Chagas' disease as it prevented the development of ECG abnormalities and cured 32.6% of patients.

  16. Naked-eye inspection of the cervix after acetic acid application may improve the predictive value of negative cytologic screening.

    PubMed

    Frisch, L E; Milner, F H; Ferris, D G

    1994-11-01

    The purpose of this study was to assess the predictive value of naked-eye inspection of the cervix (NIC) after acetic acid application as an adjunct to Papanicolaou (Pap) testing for cervical cancer screening. Study subjects were women attending a medical college student health clinic either for cervical cytologic screening (67%) or because of a recent atypical cytologic screening result (33%). All study participants received cytologic screening, cervicography, and NIC. Of the 95 patients, 71 (75%) had abnormal findings on NIC. Fifty-one patients underwent colposcopy with biopsy, including 48 of the 71 with an abnormal finding on NIC. The results of 40 of the biopsies were abnormal: 36 showed human papillomavirus or low-grade squamous intraepithelial lesions, 3 showed high-grade squamous intraepithelial lesions, and 1 showed invasive cervical cancer. Sixty-five percent (26) of the abnormal biopsy findings occurred in women with normal cytologic test results. NIC and cervicography both were effective in identifying patients with abnormalities, but the combination of NIC followed by cervicography referred fewer women for colposcopy than did a positive result on NIC alone (52% vs 75%). The combination of a negative Pap smear and a negative NIC result had a 91% predictive value for the absence of cervical intraepithelial neoplasia. This was a significant improvement over cytologic screening alone. In this study, the combination of cytologic screening (Pap smear) and NIC increased the screening yield as compared with a Pap smear alone but with some loss of positive predictive value. NIC significantly improved the predictive value of negative cytologic screening results.

  17. Relationship between pre-sarcopenia, sarcopenia and bone mineral density in elderly men.

    PubMed

    Pereira, Fernando Borges; Leite, André Ferreira; de Paula, Ana Patrícia

    2015-02-01

    Analyze the influence of sarcopenia in bone health of elderly men. This cross-sectional study evaluated 198 men aged over 60 years. Body composition was measured by dual energy X-ray absorptiometry. The BMD was measured at the femoral neck, total hip, lumbar spine and 33% radius. The diagnosis of abnormal BMD was defined for men who presented densitometric diagnosis of osteopenia or osteoporosis defined by T-score of femoral neck, total hip and lumbar spine. The pre-sarcopenia and sarcopenia were defined according to the European Working Group on Sarcopenia in Older People. The group diagnosed with normal BMD, compared to the group of abnormal BMD, have significantly higher body weight, body mass index, grip strength, lean mass, fat mass, and relative appendicular skeletal muscle mass (RASM). However, after multiple linear regression analysis, we found that only the RASM, lean mass, and handgrip strength in the dominant hand influenced the variability of the BMD after adjustment for age and weight. Regression analyzes showed a positive association between greater appendicular lean mass and a smaller number of elderly patients with abnormal BMD diagnostic. The regression analyzes showed that elderly men diagnosed with pre-sarcopenia and sarcopenia had more abnormal BMD than non-sarcopenic elderly men. We concluded that pre-sarcopenia and sarcopenia were associated with abnormal BMD. The lean mass, compared to fat mass, has a greater positive influence on the BMD of elderly men. This result suggests the importance of the increase in lean mass for the bone health of elderly men.

  18. Role of classic signs as diagnostic predictors for enteric fever among returned travellers: Relative bradycardia and eosinopenia.

    PubMed

    Matono, Takashi; Kutsuna, Satoshi; Kato, Yasuyuki; Katanami, Yuichi; Yamamoto, Kei; Takeshita, Nozomi; Hayakawa, Kayoko; Kanagawa, Shuzo; Kaku, Mitsuo; Ohmagari, Norio

    2017-01-01

    The lack of characteristic clinical findings and accurate diagnostic tools has made the diagnosis of enteric fever difficult. We evaluated the classic signs of relative bradycardia and eosinopenia as diagnostic predictors for enteric fever among travellers who had returned from the tropics or subtropics. This matched case-control study used data from 2006 to 2015 for culture-proven enteric fever patients as cases. Febrile patients (>38.3°C) with non-enteric fever, who had returned from the tropics or subtropics, were matched to the cases in a 1:3 ratio by age (±3 years), sex, and year of diagnosis as controls. Cunha's criteria were used for relative bradycardia. Absolute eosinopenia was defined as an eosinophilic count of 0/μL. Data from 160 patients (40 cases and 120 controls) were analysed. Cases predominantly returned from South Asia (70% versus 18%, p <0.001). Relative bradycardia (88% versus 51%, p <0.001) and absolute eosinopenia (63% versus 38%, p = 0.008) were more frequent in cases than controls. In multivariate logistic regression analysis, return from South Asia (aOR: 21.6; 95% CI: 7.17-64.9) and relative bradycardia (aOR: 11.7; 95% CI: 3.21-42.5) were independent predictors for a diagnosis of enteric fever. The positive likelihood ratio was 4.00 (95% CI: 2.58-6.20) for return from South Asia, 1.72 (95% CI: 1.39-2.13) for relative bradycardia, and 1.63 (95%CI: 1.17-2.27) for absolute eosinopenia. The negative predictive values of the three variables were notably high (83-92%);. however, positive predictive values were 35-57%. The classic signs of relative bradycardia and eosinopenia were not specific for enteric fever; however both met the criteria for being diagnostic predictors for enteric fever. Among febrile returned travellers, relative bradycardia and eosinopenia should be re-evaluated for predicting a diagnosis of enteric fever in non-endemic areas prior to obtaining blood cultures.

  19. Use of Opioid Medications for Employees in Critical Safety or Security Positions and Positions with Safety Sensitive Duties

    DTIC Science & Technology

    2017-01-30

    workers function while on the job must be thoroughly evaluated by a competent healthcare provider and fitness for duty must be determined. Treatment...performance of job functions with or without accommodation. D. Prior to recommending an employee’s return to a safety sensitive position, the healthcare

  20. Effect of colectomy on gastric emptying in idiopathic slow-transit constipation.

    PubMed

    Hemingway, D M; Finlay, I G

    2000-09-01

    Gastric emptying is delayed in patients with idiopathic slow-transit constipation (ISTC). Gastric emptying was measured before and after colectomy and ileorectal anastomosis in patients with ISTC to determine whether the abnormality persists after operation. Twelve patients undergoing colectomy for severe ISTC had solid-phase gastric emptying measured after an overnight fast. All 12 had an uncomplicated subtotal colectomy and ileorectal anastomosis; 11 had an excellent functional outcome. In ten of these patients gastric emptying was repeated within 3 months of operation. Seven patients (including the remaining two) had the study performed at 1 year. All 12 patients had severely delayed gastric emptying before operation. Gastric emptying remained delayed in the ten patients who underwent an early postoperative gastric emptying study. Six of seven patients assessed at 1 year had improved gastric emptying, of whom four had returned to normal. Functional outcome did not relate to gastric emptying. Patients with ISTC have delayed gastric emptying. In some patients this returns to normal after colectomy, but is persistent in others. This may have implications for our understanding of ISTC.

  1. Abort Options for Human Missions to Earth-Moon Halo Orbits

    NASA Technical Reports Server (NTRS)

    Jesick, Mark C.

    2013-01-01

    Abort trajectories are optimized for human halo orbit missions about the translunar libration point (L2), with an emphasis on the use of free return trajectories. Optimal transfers from outbound free returns to L2 halo orbits are numerically optimized in the four-body ephemeris model. Circumlunar free returns are used for direct transfers, and cislunar free returns are used in combination with lunar gravity assists to reduce propulsive requirements. Trends in orbit insertion cost and flight time are documented across the southern L2 halo family as a function of halo orbit position and free return flight time. It is determined that the maximum amplitude southern halo incurs the lowest orbit insertion cost for direct transfers but the maximum cost for lunar gravity assist transfers. The minimum amplitude halo is the most expensive destination for direct transfers but the least expensive for lunar gravity assist transfers. The on-orbit abort costs for three halos are computed as a function of abort time and return time. Finally, an architecture analysis is performed to determine launch and on-orbit vehicle requirements for halo orbit missions.

  2. Prognostic significance of cytogenetic abnormalities in patients with chronic myelogenous leukemia.

    PubMed

    Przepiorka, D; Thomas, E D

    1988-03-01

    The cytogenetic data for 126 patients with Ph-positive chronic myelogenous leukemia (CML) in accelerated phase or blast crisis were analysed for clonal chromosomal abnormalities in addition to the standard Ph prior to allogeneic or syngeneic bone marrow transplantation (BMT). Additional clonal abnormalities were found in 84%, and 14% had a variant Ph (VPh). In decreasing order of frequency, the most common clonal abnormalities were a second Ph, +8, i(17q), -Y and +19. A second Ph, VPh or +8 occurred more frequently in patients who relapsed following BMT than in those who survived disease-free for at least 1 1/2 years. The presence of an i(17q) alone did not correlate with relapse. The patients with a second Ph, VPh or +8 had a median time to relapse of 19 months, and the risk of relapse at 3 years was 73%. Those with other or no additional clonal abnormalities had not reached a median time to relapse and had a 3-year risk of relapse of 31% (p = 0.002). This analysis suggests that specific cytogenetic abnormalities may be useful indicators of resistance to therapy for CML and should be included in proportional hazard models to predict outcome after BMT.

  3. An analysis of the financial crisis in the KOSPI market using Hurst exponents

    NASA Astrophysics Data System (ADS)

    Yim, Kyubin; Oh, Gabjin; Kim, Seunghwan

    2014-09-01

    Recently, the study of the financial crisis has progressed to include the concept of the complex system, thereby improving the understanding of this extreme event from a neoclassical economic perspective. To determine which variables are related to the financial event caused by the 2008 US subprime crisis using temporal correlations, we investigate the diverse variables that may explain the financial system. These variables include return, volatility, trading volume and inter-trade duration data sets within the TAQ data for 27 highly capitalized individual companies listed on the KOSPI stock market. During 2008 and 2009, the Hurst exponent for the return time series over the whole period was less than 0.5, and the Hurst exponents for other variables, such as the volatility, trading volume and inter-trade duration, were greater than 0.5. Additionally, we analyze the relationships between the variation of temporal correlation and market instability based on these Hurst exponents and the degree of multifractality. We find that for the data related to trading volume, the Hurst exponents do not allow us to detect changes in market status, such as changes from normal to abnormal status, whereas other variables, including the return, volatility and weekly inter-trade duration, indicate a significant change in market status after the Lehman Brothers' bankruptcy. In addition, the multifractality and the measurement defined by subtracting the Hurst exponent of the return time series from that of the volatility time series decrease sharply after the US subprime event and recover approximately 50 days after the Lehman Brothers' collapse. Our findings suggest that the temporal features of financial quantities in the TAQ data set and the market complexity perform very well at diagnosing financial market stability.

  4. Return on investment from fuel treatments to reduce severe wildfire and erosion in a watershed investment program in Colorado.

    PubMed

    Jones, Kelly W; Cannon, Jeffery B; Saavedra, Freddy A; Kampf, Stephanie K; Addington, Robert N; Cheng, Antony S; MacDonald, Lee H; Wilson, Codie; Wolk, Brett

    2017-08-01

    A small but growing number of watershed investment programs in the western United States focus on wildfire risk reduction to municipal water supplies. This paper used return on investment (ROI) analysis to quantify how the amounts and placement of fuel treatment interventions would reduce sediment loading to the Strontia Springs Reservoir in the Upper South Platte River watershed southwest of Denver, Colorado following an extreme fire event. We simulated various extents of fuel mitigation activities under two placement strategies: (a) a strategic treatment prioritization map and (b) accessibility. Potential fire behavior was modeled under each extent and scenario to determine the impact on fire severity, and this was used to estimate expected change in post-fire erosion due to treatments. We found a positive ROI after large storm events when fire mitigation treatments were placed in priority areas with diminishing marginal returns after treating >50-80% of the forested area. While our ROI results should not be used prescriptively they do show that, conditional on severe fire occurrence and precipitation, investments in the Upper South Platte could feasibly lead to positive financial returns based on the reduced costs of dredging sediment from the reservoir. While our analysis showed positive ROI focusing only on post-fire erosion mitigation, it is important to consider multiple benefits in future ROI calculations and increase monitoring and evaluation of these benefits of wildfire fuel reduction investments for different site conditions and climates. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. A stochastic model to determine the economic value of changing diagnostic test characteristics for identification of cattle for treatment of bovine respiratory disease.

    PubMed

    Theurer, M E; White, B J; Larson, R L; Schroeder, T C

    2015-03-01

    Bovine respiratory disease is an economically important syndrome in the beef industry, and diagnostic accuracy is important for optimal disease management. The objective of this study was to determine whether improving diagnostic sensitivity or specificity was of greater economic value at varied levels of respiratory disease prevalence by using Monte Carlo simulation. Existing literature was used to populate model distributions of published sensitivity, specificity, and performance (ADG, carcass weight, yield grade, quality grade, and mortality risk) differences among calves based on clinical respiratory disease status. Data from multiple cattle feeding operations were used to generate true ranges of respiratory disease prevalence and associated mortality. Input variables were combined into a single model that calculated estimated net returns for animals by diagnostic category (true positive, false positive, false negative, and true negative) based on the prevalence, sensitivity, and specificity for each iteration. Net returns for each diagnostic category were multiplied by the proportion of animals in each diagnostic category to determine group profitability. Apparent prevalence was categorized into low (<15%) and high (≥15%) groups. For both apparent prevalence categories, increasing specificity created more rapid, positive change in net returns than increasing sensitivity. Improvement of diagnostic specificity, perhaps through a confirmatory test interpreted in series or pen-level diagnostics, can increase diagnostic value more than improving sensitivity. Mortality risk was the primary driver for net returns. The results from this study are important for determining future research priorities to analyze diagnostic techniques for bovine respiratory disease and provide a novel way for modeling diagnostic tests.

  6. Human papillomavirus prevalence, viral load and pre-cancerous lesions of the cervix in women initiating highly active antiretroviral therapy in South Africa: a cross-sectional study.

    PubMed

    Moodley, Jennifer R; Constant, Deborah; Hoffman, Margaret; Salimo, Anna; Allan, Bruce; Rybicki, Ed; Hitzeroth, Inga; Williamson, Anna-Lise

    2009-08-07

    Cervical cancer and infection with human immunodeficiency virus (HIV) are both important public health problems in South Africa (SA). The aim of this study was to determine the prevalence of cervical squamous intraepithelial lesions (SILs), high-risk human papillomavirus (HR-HPV), HPV viral load and HPV genotypes in HIV positive women initiating anti-retroviral (ARV) therapy. A cross-sectional survey was conducted at an anti-retroviral (ARV) treatment clinic in Cape Town, SA in 2007. Cervical specimens were taken for cytological analysis and HPV testing. The Digene Hybrid Capture 2 (HC2) test was used to detect HR-HPV. Relative light units (RLU) were used as a measure of HPV viral load. HPV types were determined using the Roche Linear Array HPV Genotyping test. Crude associations with abnormal cytology were tested and multiple logistic regression was used to determine independent risk factors for abnormal cytology. The median age of the 109 participants was 31 years, the median CD4 count was 125/mm3, 66.3% had an abnormal Pap smear, the HR-HPV prevalence was 78.9% (Digene), the median HPV viral load was 181.1 RLU (HC2 positive samples only) and 78.4% had multiple genotypes. Among women with abnormal smears the most prevalent HR-HPV types were HPV types 16, 58 and 51, all with a prevalence of 28.5%. On univariate analysis HR-HPV, multiple HPV types and HPV viral load were significantly associated with the presence of low and high-grade SILs (LSIL/HSIL). The multivariate logistic regression showed that HPV viral load was associated with an increased odds of LSIL/HSIL, odds ratio of 10.7 (95% CI 2.0 - 57.7) for those that were HC2 positive and had a viral load of 181.1 RLU. Women initiating ARVs have a high prevalence of abnormal Pap smears and HR-HPV. Our results underscore the need for locally relevant, rigorous screening protocols for the increasing numbers of women accessing ARV therapy so that the benefits of ARVs are not partially offset by an excess risk in cervical cancer.

  7. Different forms, reasons and motivations for return migration of persons who voluntarily decide to return to their countries of origin.

    PubMed

    Callea, S

    1986-03-01

    Although the 1973 oil crisis did not have the drastic effects on immigration which were originally feared, it did end a period of quasi-liberal immigration policy, establish intense and effective international cooperation on immigration, and arouse great interest in immigration studies and research. This paper analyzes the situations arising as a result of the petroleum shortage and focuses on the conditions relating to the return of emigrants to Southern European countries. This new research draws attention to the following fundamental aspects of the immigration problem: 1) the emigrant's return to his homeland cannot be considered a factor in development; it is a positive element in development only if the right socioeconomic conditions exist in the country of origin. 2) Concern for children's education is one of the most common reasons for return. 3) A large percentage of emigrants are satisfied with their work abroad. 4) An emigrant's return potential is wasted due to the slight use that is made of the resources he offers. 5) Returning workers most often want to set up an independent enterprise. 6) Savings are generally used to buy a house or farm. 7) Vocational level does not increase significantly between emigration and returning, though this increase becomes greater the longer the emigrant stays abroad. 8) The number of returning emigrants is too slight to bring about any change in the country of origin. 9) Incentives and subsidies to encourage return have not had a considerable impact on the decision to return. Callea recommends that officials of the country of origin posted abroad be assigned to counsel returning emigrants on finding employment, attending vocational development courses, obtaining housing, accruing interests and savings, and on the problems and perspectives of sociocultural reintegration.

  8. Long-term return behavior of Chinese whole blood donors.

    PubMed

    Guo, Nan; Wang, Jingxing; Yu, Qilu; Yang, Tonghan; Dong, Xiangdong; Wen, Guoxin; Tiemuer, Mei-hei-li; Li, Julin; He, Weilan; Lv, Yunlai; Ma, Hongli; Wen, Xiuqiong; Huang, Mei; Ness, Paul; Liu, Jing; Wright, David J; Nelson, Kenrad; Shan, Hua

    2013-09-01

    It is important to understand donor return behavior to maintain sufficient numbers of blood donors in developing countries where blood supplies are often inadequate. A total of 54,267 whole blood (WB) donors who donated between January 1 and March 31, 2008, at the five blood centers in China were followed for 2.5 years. Logistic regression was conducted to identify factors associated with their return behavior. A recurrent-event Cox proportional-hazard model was used to evaluate the overall effect of demographic variables and return behavior among first-time donors. Donors with previous donation history were more likely to return and the number of previous returns was positively associated with future return (odds ratios, 3.31, 4.82, and 8.16 for one, two to three, and more than three times compared to none). Thirty-four percent of donors (first-time donor, 21%; repeat donor, 54%) made at least one return donation, with 14% returning in the first 9 months. The multivariable logistic regression model for all WB donors and the Cox proportional hazard model for first-time donors showed consistent predictors for return: female sex, older age (≥ 25 years), larger volume (300 or 400 mL), and donating in satellite collection site. Encouraging first-time donors to make multiple donations is important for keeping adequate blood supply. The finding that first-time and repeat donors shared the same predictors for return indicates that retention strategies on repeat donors may be effective on first-time donors. Studies on motivators and barriers to return are needed, so that successful retention strategies can be tailored. © 2013 American Association of Blood Banks.

  9. Myelogenous leukemia in a bearded dragon (Acanthodraco vitticeps).

    PubMed

    Tocidlowski, M E; McNamara, P L; Wojcieszyn, J W

    2001-03-01

    A 3-yr-old bearded dragon (Acanthodraco vitticeps) presented with lethargy, a swollen right elbow joint, inability to move its rear limbs normally, and marked leukocytosis. The majority of leukocytes were an abnormal mononuclear lymphoid-type cell with a high nuclear to cytoplasmic ratio, a slightly blue cytoplasm, nuclei with coarsely granular chromatin, and some nuclear clefts. Acute leukemia of lymphoid or myeloid origin was tentatively diagnosed. The abnormal mononuclear leukocyte cell population stained positively for the myeloid cytochemical stains: peroxidase, chloroacetate esterase, and L1-calprotectin. The abnormal cell population of the peripheral blood did not stain with the lymphoid cytochemical stains: alpha-naphthyl butyrate esterase, CD3, and CD79a.

  10. Intranetwork and internetwork connectivity in patients with Alzheimer disease and the association with cerebrospinal fluid biomarker levels.

    PubMed

    Weiler, Marina; de Campos, Brunno Machado; Teixeira, Camila Vieira de Ligo; Casseb, Raphael Fernandes; Carletti-Cassani, Ana Flávia Mac Knight; Vicentini, Jéssica Elias; Magalhães, Thamires Naela Cardoso; Talib, Leda Leme; Forlenza, Orestes Vicente; Balthazar, Marcio Luiz Figueredo

    2017-11-01

    In the last decade, many studies have reported abnormal connectivity within the default mode network (DMN) in patients with Alzheimer disease. Few studies, however, have investigated other networks and their association with pathophysiological proteins obtained from cerebrospinal fluid (CSF). We performed 3 T imaging in patients with mild Alzheimer disease, patients with amnestic mild cognitive impairment (aMCI) and healthy controls, and we collected CSF samples from the patients with aMCI and mild Alzheimer disease. We analyzed 57 regions from 8 networks. Additionally, we performed correlation tests to investigate possible associations between the networks' functional connectivity and the protein levels obtained from the CSF of patients with aMCI and Alzheimer disease. Our sample included 41 patients with Alzheimer disease, 35 with aMCI and 48 controls. We found that the main connectivity abnormalities in those with Alzheimer disease occurred between the DMN and task-positive networks: these patients presented not only a decreased anticorrelation between some regions, but also an inversion of the correlation signal (positive correlation instead of anticorrelation). Those with aMCI did not present statistically different connectivity from patients with Alzheimer disease or controls. Abnormal levels of CSF proteins were associated with functional disconnectivity between several regions in both the aMCI and mild Alzheimer disease groups, extending well beyond the DMN or temporal areas. The presented data are cross-sectional in nature, and our findings are dependent on the choice of seed regions used. We found that the main functional connectivity abnormalities occur between the DMN and task-positive networks and that the pathological levels of CSF biomarkers correlate with functional connectivity disruption in patients with Alzheimer disease.

  11. Intranetwork and internetwork connectivity in patients with Alzheimer disease and the association with cerebrospinal fluid biomarker levels

    PubMed Central

    Weiler, Marina; de Campos, Brunno Machado; de Ligo Teixeira, Camila Vieira; Casseb, Raphael Fernandes; Mac Knight Carletti-Cassani, Ana Flávia; Vicentini, Jéssica Elias; Magalhães, Thamires Naela Cardoso; Talib, Leda Leme; Forlenza, Orestes Vicente; Balthazar, Marcio Luiz Figueredo

    2017-01-01

    Background In the last decade, many studies have reported abnormal connectivity within the default mode network (DMN) in patients with Alzheimer disease. Few studies, however, have investigated other networks and their association with pathophysiological proteins obtained from cerebrospinal fluid (CSF). Methods We performed 3 T imaging in patients with mild Alzheimer disease, patients with amnestic mild cognitive impairment (aMCI) and healthy controls, and we collected CSF samples from the patients with aMCI and mild Alzheimer disease. We analyzed 57 regions from 8 networks. Additionally, we performed correlation tests to investigate possible associations between the networks’ functional connectivity and the protein levels obtained from the CSF of patients with aMCI and Alzheimer disease. Results Our sample included 41 patients with Alzheimer disease, 35 with aMCI and 48 controls. We found that the main connectivity abnormalities in those with Alzheimer disease occurred between the DMN and task-positive networks: these patients presented not only a decreased anticorrelation between some regions, but also an inversion of the correlation signal (positive correlation instead of anti-correlation). Those with aMCI did not present statistically different connectivity from patients with Alzheimer disease or controls. Abnormal levels of CSF proteins were associated with functional disconnectivity between several regions in both the aMCI and mild Alzheimer disease groups, extending well beyond the DMN or temporal areas. Limitations The presented data are cross-sectional in nature, and our findings are dependent on the choice of seed regions used. Conclusion We found that the main functional connectivity abnormalities occur between the DMN and task-positive networks and that the pathological levels of CSF biomarkers correlate with functional connectivity disruption in patients with Alzheimer disease. PMID:28375076

  12. Mammography performance in Oman: Review of factors influencing cancer yield and positive predictive value.

    PubMed

    Taif, Sawsan; Tufail, Fatma; Alnuaimi, Ahmed Sameer

    2016-06-01

    The aim of this study is to assess mammography performance in Oman by estimating the breast cancer rate and the positive predictive value (PPV) with the influence of some variables. This cross-sectional study was conducted on mammograms done in one of the three main breast imaging centers in Oman between January 2008 and July 2012. Diagnostic and screening groups were identified and assessed separately. Rate of abnormal mammograms, rate of breast cancer and the PPV were estimated according to Breast Imaging Reporting and Data System (BIRADS) score, presence of breast lump and patient's age. Total of 653 mammograms were included, 254 diagnostic and 399 screening. Abnormal mammograms (BIRADS 4 and 5) form 31.9% of the diagnostic examinations compared with 6.8% of screening examinations. Breast cancer was present in 17.9% of the diagnostic compared with 1.0% of the screening group. The PPV of BIRADS 5 was 94.1%, and for BIRADS 4 was 37.1 and 26.7% for diagnostic and screening studies. Overall PPV for abnormal mammograms was 65.2% in the diagnostic and 26.7% in the screening group. Mammography PPV shows positive association with age (P = 0.039) while presence of breast lump has no significant effect on the PPV (P = 0.38). BIRADS 5 score was found to have a high cancer yield making it a strong predictor of cancer. Different results were obtained in the diagnostic compared with screening mammography with higher rates of abnormal mammograms and breast cancer. Mammography performance should be better in the older women. © 2014 Wiley Publishing Asia Pty Ltd.

  13. Compressive sensing-based electrostatic sensor array signal processing and exhausted abnormal debris detecting

    NASA Astrophysics Data System (ADS)

    Tang, Xin; Chen, Zhongsheng; Li, Yue; Yang, Yongmin

    2018-05-01

    When faults happen at gas path components of gas turbines, some sparsely-distributed and charged debris will be generated and released into the exhaust gas. The debris is called abnormal debris. Electrostatic sensors can detect the debris online and further indicate the faults. It is generally considered that, under a specific working condition, a more serious fault generates more and larger debris, and a piece of larger debris carries more charge. Therefore, the amount and charge of the abnormal debris are important indicators of the fault severity. However, because an electrostatic sensor can only detect the superposed effect on the electrostatic field of all the debris, it can hardly identify the amount and position of the debris. Moreover, because signals of electrostatic sensors depend on not only charge but also position of debris, and the position information is difficult to acquire, measuring debris charge accurately using the electrostatic detecting method is still a technical difficulty. To solve these problems, a hemisphere-shaped electrostatic sensors' circular array (HSESCA) is used, and an array signal processing method based on compressive sensing (CS) is proposed in this paper. To research in a theoretical framework of CS, the measurement model of the HSESCA is discretized into a sparse representation form by meshing. In this way, the amount and charge of the abnormal debris are described as a sparse vector. It is further reconstructed by constraining l1-norm when solving an underdetermined equation. In addition, a pre-processing method based on singular value decomposition and a result calibration method based on weighted-centroid algorithm are applied to ensure the accuracy of the reconstruction. The proposed method is validated by both numerical simulations and experiments. Reconstruction errors, characteristics of the results and some related factors are discussed.

  14. Achievements and Challenges upon the Implementation of a Program for National Control of Congenital Chagas in Bolivia: Results 2004–2009

    PubMed Central

    Alonso-Vega, Cristina; Billot, Claire; Torrico, Faustino

    2013-01-01

    Bolivia is one of the most endemic countries for Chagas disease. Data of 2005 shows that incidence is around 1.09‰ inhabitants and seroprevalence in children under 15 ranged from 10% in urban areas to 40% in rural areas. In this article, we report results obtained during the implementation of the congenital Chagas program, one of the biggest casuistry in congenital Chagas disease, led by National Program of Chagas and Belgian cooperation from 2004 to 2009. The program strategy was based on serological results during pregnancy and on the follow up of children born from positive mothers until one year old; if positive, treatment was done with Benznidazole, 10 mg/Kg/day/30 days with one post treatment control 6 months later. Throughout the length of the program, a total of 318,479 pregnant women were screened and 23.31% were detected positive. 42,538 children born from positive mothers were analyzed at birth by micromethod, of which 1.43% read positive. 10,120 children returned for their second micromethod control of which 2.29% read positive, 7,650 children returned for the serological control, of which 3.32% turned out positive. From the 1,093 positive children, 70% completed the 30 day-treatment and 122 returned for post treatment control with 96% showing a negative result. It has been seen that maternal-fetal transmission rates vary between 2% and 4%, with an average of 2.6% (about half of previously reported studies that reached 5%). In this work, we show that it is possible to implement, with limited resources, a National Congenital Chagas Program and to integrate it into the Bolivian health system. Keys of success are population awareness, health personnel motivation, and political commitment at all levels. PMID:23875039

  15. Do all the patients with gastric parietal cell antibodies have pernicious anemia?

    PubMed

    Sun, A; Wang, Y P; Lin, H P; Chia, J S; Chiang, C P

    2013-05-01

    This study evaluated whether all the patients with serum gastric parietal cell antibody (GPCA) positivity had pernicious anemia (PA). The blood hemoglobin (Hb), iron, and vitamin B12 concentrations, and mean corpuscular volume (MCV) in 124 GPCA-positive patients were measured and compared with the corresponding data in 124 age- and sex-matched healthy controls. PA was defined by World Health Organization (WHO) as having an Hb concentration < 13 g dl(-1) for men and < 12 g dl(-1) for women, an MCV ≥ 100 fl, and a serum vitamin B12 level < 200 pg ml(-1) . We found that 20, 25, and 20 GPCA-positive patients had deficiencies of Hb (men < 13 g dl(-1) , women < 12 g dl(-1) ), iron (<60 μg dl(-1) ), and vitamin B12 (<200 pg ml(-1) ), respectively. Moreover, 16 GPCA-positive patients had abnormally high MCV (≥ 100 fl). GPCA-positive patients had a significantly higher frequency of Hb, iron, or vitamin B12 deficiency and of abnormally high MCV (all P-values < 0.001) than healthy controls. However, only 12.9% of 124 GPCA-positive patients were diagnosed as having PA by the WHO definition. Only 12.9% of GPCA-positive patients are discovered to have PA by the WHO definition. © 2012 John Wiley & Sons A/S.

  16. Abnormal pap tests among women living in a Hispanic migrant farmworker community: A narrative of health literacy.

    PubMed

    Vamos, Cheryl A; Lockhart, Elizabeth; Vázquez-Otero, Coralia; Thompson, Erika L; Proctor, Sara; Wells, Kristen J; Daley, Ellen M

    2016-08-01

    This study explored narrative responses following abnormal Pap tests among Hispanic migrant farmworkers ( N = 18; ages 22-50 years) via in-depth interviews in Florida. Qualitative analyses utilized health literacy domains (obtain/process/understand/communicate) as a conceptual framework. Participants described how they (1) obtained information about getting a Pap test, (2) processed positive and negative reactions following results, (3) understood results and recommended health-promoting behaviors, and (4) communicated and received social support. Women had disparate reactions and understanding following an abnormal Pap result. Health literacy was a meaningful conceptual framework to understand assets and gaps among women receiving an abnormal Pap test result. Future interventions should incorporate health literacy domains and facilitate patient-provider communications and social support to assist women in decision-making and health-promoting behaviors, ultimately decreasing cancer disparities.

  17. Hb Molfetta [beta126(H4)Val-->Leu, GTG-->CTG]: a new, silent, neutral beta chain variant found in an Italian woman.

    PubMed

    Qualtieri, Antonio; Le, Pera Maria; Pedace, Vera; Magariello, Angela; Brancati, Carlo

    2002-02-01

    We have identified a new neutral hemoglobin variant in a pregnant Italian woman, that resulted from a GTG-->CTG replacement at codon 126 of the beta chain, corresponding to a Val-->Leu amino acid change at position beta126(H4). Thermal and isopropanol stability tests were normal and there were no abnormal clinical features. Routine electrophoretic and ion exchange chromatographic methods for hemoglobin separation failed to show this variant, but reversed phase high performance liquid chromatography revealed an abnormal peak eluting near the normal beta chain. No abnormal tryptic peptide was revealed on the high performance liquid chromatographic elution pattern of the total globin digest. The mutation was determined at the DNA level by amplification of the three beta exons by polymerase chain reaction and direct sequencing of one exon that showed an abnormal migration on single strand conformational polymorphism analysis.

  18. A description of QUALCOMM Automatic Satellite Position Reporting (QASPR(R)) for mobile communications

    NASA Technical Reports Server (NTRS)

    Ames, William G.

    1990-01-01

    Two satellite position reporting has been introduced into the OmniTRACS mobile satellite communication system. This system significantly improves position reporting reliability and accuracy while simplifying the terminal's hardware. The positioning technique uses the original OmniTRACS TDMA timing signal formats in the forward and return link directions plus an auxiliary, low power forward link signal through a second satellite to derive distance values. The distances are then converted into the mobile terminal's latitude and longitude in real time. A minor augmentation of the spread spectrum profile of the return link allowed the resolution of periodic ambiguities. The system also locates the two satellites in real time with fixed platforms in known locations using identical mobile terminal hardware. Initial accuracies of 1/4 mile have been realized uniformly throughout the USA using a satellite separation of 22 degrees and there are no dead zones, skywaves, or cycle slips as found in terrestrial systems like LORAN-C.

  19. A description of QUALCOMM Automatic Satellite Position Reporting (QASPR(R)) for mobile communications

    NASA Astrophysics Data System (ADS)

    Ames, William G.

    Two satellite position reporting has been introduced into the OmniTRACS mobile satellite communication system. This system significantly improves position reporting reliability and accuracy while simplifying the terminal's hardware. The positioning technique uses the original OmniTRACS TDMA timing signal formats in the forward and return link directions plus an auxiliary, low power forward link signal through a second satellite to derive distance values. The distances are then converted into the mobile terminal's latitude and longitude in real time. A minor augmentation of the spread spectrum profile of the return link allowed the resolution of periodic ambiguities. The system also locates the two satellites in real time with fixed platforms in known locations using identical mobile terminal hardware. Initial accuracies of 1/4 mile have been realized uniformly throughout the USA using a satellite separation of 22 degrees and there are no dead zones, skywaves, or cycle slips as found in terrestrial systems like LORAN-C.

  20. Forecasting stock return volatility: A comparison between the roles of short-term and long-term leverage effects

    NASA Astrophysics Data System (ADS)

    Pan, Zhiyuan; Liu, Li

    2018-02-01

    In this paper, we extend the GARCH-MIDAS model proposed by Engle et al. (2013) to account for the leverage effect in short-term and long-term volatility components. Our in-sample evidence suggests that both short-term and long-term negative returns can cause higher future volatility than positive returns. Out-of-sample results show that the predictive ability of GARCH-MIDAS is significantly improved after taking the leverage effect into account. The leverage effect for short-term volatility component plays more important role than the leverage effect for long-term volatility component in affecting out-of-sample forecasting performance.

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