Sample records for predict subsequent art

  1. Interruption or deferral of antiretroviral therapy reduces markers of bone turnover compared with continuous therapy: the SMART Body Composition Substudy

    PubMed Central

    Hoy, Jennifer; Grund, Birgit; Roediger, Mollie; Ensrud, Kristine E.; Brar, Indira; Colebunders, Robert; De Castro, Nathalie; Johnson, Margaret; Sharma, Anjali; Carr, Andrew

    2013-01-01

    Bone mineral density (BMD) declines significantly in HIV patients on antiretroviral therapy (ART). We compared the effects of intermittent versus continuous ART on markers of bone turnover in the Body Composition substudy of the Strategies for Management of AntiRetroviral Therapy (SMART) trial and determined whether early changes in markers predicted subsequent change in BMD. For 202 participants (median age 44 years, 17% female, 74% on ART) randomised to continuous or intermittent ART, plasma markers of inflammation and bone turnover were evaluated at baseline, months 4 and 12; BMD at the spine (dual X-ray absorptiometry [DXA] and computed tomography) and hip (DXA) was evaluated annually. Compared to the continuous ART group, mean bone-specific alkaline phosphatase (bALP), osteocalcin, procollagen type 1 N-terminal propeptide (P1NP), N-terminal cross-linking telopeptide of type 1 collagen (NTX), and C-terminal cross-linking telopeptide of type 1 collagen (βCTX) decreased significantly in the intermittent ART group, whereas RANKL and the RANKL:osteoprotegerin (OPG) ratio increased (all p≤0.002 at month 4 and month 12). Increases in bALP, osteocalcin, P1NP, NTX, and βCTX at month 4 predicted decrease in hip BMD at month 12, while increases in RANKL and the RANKL:OPG ratio at month 4 predicted increase in hip and spine BMD at month 12. This study has shown that compared with continuous ART, interruption of ART results in a reduction in markers of bone turnover and increase in BMD at hip and spine, and that early changes in markers of bone turnover predict BMD changes at 12 months. PMID:23299909

  2. Semen molecular and cellular features: these parameters can reliably predict subsequent ART outcome in a goat model

    PubMed Central

    Berlinguer, Fiammetta; Madeddu, Manuela; Pasciu, Valeria; Succu, Sara; Spezzigu, Antonio; Satta, Valentina; Mereu, Paolo; Leoni, Giovanni G; Naitana, Salvatore

    2009-01-01

    Currently, the assessment of sperm function in a raw or processed semen sample is not able to reliably predict sperm ability to withstand freezing and thawing procedures and in vivo fertility and/or assisted reproductive biotechnologies (ART) outcome. The aim of the present study was to investigate which parameters among a battery of analyses could predict subsequent spermatozoa in vitro fertilization ability and hence blastocyst output in a goat model. Ejaculates were obtained by artificial vagina from 3 adult goats (Capra hircus) aged 2 years (A, B and C). In order to assess the predictive value of viability, computer assisted sperm analyzer (CASA) motility parameters and ATP intracellular concentration before and after thawing and of DNA integrity after thawing on subsequent embryo output after an in vitro fertility test, a logistic regression analysis was used. Individual differences in semen parameters were evident for semen viability after thawing and DNA integrity. Results of IVF test showed that spermatozoa collected from A and B lead to higher cleavage rates (0 < 0.01) and blastocysts output (p < 0.05) compared with C. Logistic regression analysis model explained a deviance of 72% (p < 0.0001), directly related with the mean percentage of rapid spermatozoa in fresh semen (p < 0.01), semen viability after thawing (p < 0.01), and with two of the three comet parameters considered, i.e tail DNA percentage and comet length (p < 0.0001). DNA integrity alone had a high predictive value on IVF outcome with frozen/thawed semen (deviance explained: 57%). The model proposed here represents one of the many possible ways to explain differences found in embryo output following IVF with different semen donors and may represent a useful tool to select the most suitable donors for semen cryopreservation. PMID:19900288

  3. Mechanism of Change in Cognitive Behavioral Therapy for Body Image and Self-Care on ART Adherence Among Sexual Minority Men Living with HIV.

    PubMed

    Lamb, Kalina M; Nogg, Kelsey A; Safren, Steven A; Blashill, Aaron J

    2018-05-11

    Body image disturbance is a common problem reported among sexual minority men living with HIV, and is associated with poor antiretroviral therapy (ART) adherence. Recently, a novel integrated intervention (cognitive behavioral therapy for body image and self-care; CBT-BISC) was developed and pilot tested to simultaneously improve body image and ART adherence in this population. Although CBT-BISC has demonstrated preliminary efficacy in improving ART adherence, the mechanisms of change are unknown. Utilizing data from a two-armed randomized controlled trial (N = 44 sexual minority men living with HIV), comparing CBT-BISC to an enhanced treatment as usual (ETAU) condition, sequential process mediation via latent difference scores was assessed, with changes in body image disturbance entered as the mechanism between treatment condition and changes in ART adherence. Participants assigned to CBT-BISC reported statistically significant reductions in body image disturbance post-intervention, which subsequently predicted changes in ART adherence from post-intervention to long term follow-up (b = 20.01, SE = 9.11, t = 2.19, p = 0.028). One pathway in which CBT-BISC positively impacts ART adherence is through reductions in body image disturbance. Body image disturbance represents one, of likely several, mechanism that prospectively predicts ART adherence among sexual minority men living with HIV.

  4. Circulating metabolomic profile can predict dyslipidemia in HIV patients undergoing antiretroviral therapy.

    PubMed

    Rodríguez-Gallego, Esther; Gómez, Josep; Domingo, Pere; Ferrando-Martínez, Sara; Peraire, Joaquim; Viladés, Consuelo; Veloso, Sergi; López-Dupla, Miguel; Beltrán-Debón, Raúl; Alba, Verónica; Vargas, Montserrat; Castellano, Alfonso J; Leal, Manuel; Pacheco, Yolanda María; Ruiz-Mateos, Ezequiel; Gutiérrez, Félix; Vidal, Francesc; Rull, Anna

    2018-06-01

    Dyslipidemia in HIV-infected patients is unique and pathophysiologically associated with host factors, HIV itself and the use of antiretroviral therapy (ART). The use of nuclear magnetic resonance spectroscopy (NMR) provides additional data to conventional lipid measurements concerning the number of lipoprotein subclasses and particle sizes. To investigate the ability of lipoprotein profile, we used a circulating metabolomic approach in a cohort of 103 ART-naive HIV-infected patients, who were initiating non-nucleoside analogue transcriptase inhibitor (NNRTI)-based ART, and we subsequently followed up these patients for 36 months. Univariate and multivariate analyses were performed to evaluate the predictive power of NMR spectroscopy. VLDL-metabolism (including VLDL lipid concentrations, sizes, and particle numbers), total triglycerides and lactate levels resulted in good classifiers of dyslipidemia (AUC 0.903). Total particles/HDL-P ratio was significantly higher in ART-associated dyslipidemia compared to ART-normolipidemia (p = 0.001). Large VLDL-Ps were positively associated with both LDL-triglycerides (ρ 0.682, p < 0.001) and lactate concentrations (ρ 0.416, p < 0.001), the last one a marker of mitochondrial low oxidative capacity. Our data suggest that circulating metabolites have better predictive values for HIV/ART-related dyslipidemia onset than do the biochemical markers associated with conventional lipid measurements. NMR identifies changes in VLDL-P, lactate and LDL-TG as potential clinical markers of baseline HIV-dyslipidemia predisposition. Differences in circulating metabolomics, especially differences in particle size, are indicators of important derangements of mitochondrial function that are linked to ART-related dyslipidemia. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

  5. Metabolic and anthropometric parameters contribute to ART-mediated CD4+ T cell recovery in HIV-1-infected individuals: an observational study.

    PubMed

    Azzoni, Livio; Foulkes, Andrea S; Firnhaber, Cynthia; Yin, Xiangfan; Crowther, Nigel J; Glencross, Deborah; Lawrie, Denise; Stevens, Wendy; Papasavvas, Emmanouil; Sanne, Ian; Montaner, Luis J

    2011-07-29

    The degree of immune reconstitution achieved in response to suppressive ART is associated with baseline individual characteristics, such as pre-treatment CD4 count, levels of viral replication, cellular activation, choice of treatment regimen and gender. However, the combined effect of these variables on long-term CD4 recovery remains elusive, and no single variable predicts treatment response. We sought to determine if adiposity and molecules associated with lipid metabolism may affect the response to ART and the degree of subsequent immune reconstitution, and to assess their ability to predict CD4 recovery. We studied a cohort of 69 (48 females and 21 males) HIV-infected, treatment-naïve South African subjects initiating antiretroviral treatment (d4T, 3Tc and lopinavir/ritonavir). We collected information at baseline and six months after viral suppression, assessing anthropometric parameters, dual energy X-ray absorptiometry and magnetic resonance imaging scans, serum-based clinical laboratory tests and whole blood-based flow cytometry, and determined their role in predicting the increase in CD4 count in response to ART. We present evidence that baseline CD4+ T cell count, viral load, CD8+ T cell activation (CD95 expression) and metabolic and anthropometric parameters linked to adiposity (LDL/HDL cholesterol ratio and waist/hip ratio) significantly contribute to variability in the extent of CD4 reconstitution (ΔCD4) after six months of continuous ART. Our final model accounts for 44% of the variability in CD4+ T cell recovery in virally suppressed individuals, representing a workable predictive model of immune reconstitution.

  6. Metabolic and anthropometric parameters contribute to ART-mediated CD4+ T cell recovery in HIV-1-infected individuals: an observational study

    PubMed Central

    2011-01-01

    Background The degree of immune reconstitution achieved in response to suppressive ART is associated with baseline individual characteristics, such as pre-treatment CD4 count, levels of viral replication, cellular activation, choice of treatment regimen and gender. However, the combined effect of these variables on long-term CD4 recovery remains elusive, and no single variable predicts treatment response. We sought to determine if adiposity and molecules associated with lipid metabolism may affect the response to ART and the degree of subsequent immune reconstitution, and to assess their ability to predict CD4 recovery. Methods We studied a cohort of 69 (48 females and 21 males) HIV-infected, treatment-naïve South African subjects initiating antiretroviral treatment (d4T, 3Tc and lopinavir/ritonavir). We collected information at baseline and six months after viral suppression, assessing anthropometric parameters, dual energy X-ray absorptiometry and magnetic resonance imaging scans, serum-based clinical laboratory tests and whole blood-based flow cytometry, and determined their role in predicting the increase in CD4 count in response to ART. Results We present evidence that baseline CD4+ T cell count, viral load, CD8+ T cell activation (CD95 expression) and metabolic and anthropometric parameters linked to adiposity (LDL/HDL cholesterol ratio and waist/hip ratio) significantly contribute to variability in the extent of CD4 reconstitution (ΔCD4) after six months of continuous ART. Conclusions Our final model accounts for 44% of the variability in CD4+ T cell recovery in virally suppressed individuals, representing a workable predictive model of immune reconstitution. PMID:21801351

  7. Sexual relationship power and depression among HIV-infected women in Rural Uganda.

    PubMed

    Hatcher, Abigail M; Tsai, Alexander C; Kumbakumba, Elias; Dworkin, Shari L; Hunt, Peter W; Martin, Jeffrey N; Clark, Gina; Bangsberg, David R; Weiser, Sheri D

    2012-01-01

    Depression is associated with increased HIV transmission risk, increased morbidity, and higher risk of HIV-related death among HIV-infected women. Low sexual relationship power also contributes to HIV risk, but there is limited understanding of how it relates to mental health among HIV-infected women. Participants were 270 HIV-infected women from the Uganda AIDS Rural Treatment Outcomes study, a prospective cohort of individuals initiating antiretroviral therapy (ART) in Mbarara, Uganda. Our primary predictor was baseline sexual relationship power as measured by the Sexual Relationship Power Scale (SRPS). The primary outcome was depression severity, measured with the Hopkins Symptom Checklist (HSCL), and a secondary outcome was a functional scale for mental health status (MHS). Adjusted models controlled for socio-demographic factors, CD4 count, alcohol and tobacco use, baseline WHO stage 4 disease, social support, and duration of ART. The mean HSCL score was 1.34 and 23.7% of participants had HSCL scores consistent with probable depression (HSCL>1.75). Compared to participants with low SRPS scores, individuals with both moderate (coefficient b = -0.21; 95%CI, -0.36 to -0.07) and high power (b = -0.21; 95%CI, -0.36 to -0.06) reported decreased depressive symptomology. High SRPS scores halved the likelihood of women meeting criteria for probable depression (adjusted odds ratio = 0.44; 95%CI, 0.20 to 0.93). In lagged models, low SRPS predicted subsequent depression severity, but depression did not predict subsequent changes in SPRS. Results were similar for MHS, with lagged models showing SRPS predicts subsequent mental health, but not visa versa. Both Decision-Making Dominance and Relationship Control subscales of SRPS were associated with depression symptom severity. HIV-infected women with high sexual relationship power had lower depression and higher mental health status than women with low power. Interventions to improve equity in decision-making and control within dyadic partnerships are critical to prevent HIV transmission and to optimize mental health of HIV-infected women.

  8. Pretreatment CD4 Cell Slope and Progression to AIDS or Death in HIV-Infected Patients Initiating Antiretroviral Therapy—The CASCADE Collaboration: A Collaboration of 23 Cohort Studies

    PubMed Central

    Wolbers, Marcel; Babiker, Abdel; Sabin, Caroline; Young, Jim; Dorrucci, Maria; Chêne, Geneviève; Mussini, Cristina; Porter, Kholoud; Bucher, Heiner C.

    2010-01-01

    Background CD4 cell count is a strong predictor of the subsequent risk of AIDS or death in HIV-infected patients initiating combination antiretroviral therapy (cART). It is not known whether the rate of CD4 cell decline prior to therapy is related to prognosis and should, therefore, influence the decision on when to initiate cART. Methods and Findings We carried out survival analyses of patients from the 23 cohorts of the CASCADE (Concerted Action on SeroConversion to AIDS and Death in Europe) collaboration with a known date of HIV seroconversion and with at least two CD4 measurements prior to initiating cART. For each patient, a pre-cART CD4 slope was estimated using a linear mixed effects model. Our primary outcome was time from initiating cART to a first new AIDS event or death. We included 2,820 treatment-naïve patients initiating cART with a median (interquartile range) pre-cART CD4 cell decline of 61 (46–81) cells/µl per year; 255 patients subsequently experienced a new AIDS event or death and 125 patients died. In an analysis adjusted for established risk factors, the hazard ratio for AIDS or death was 1.01 (95% confidence interval 0.97–1.04) for each 10 cells/µl per year reduction in pre-cART CD4 cell decline. There was also no association between pre-cART CD4 cell slope and survival. Alternative estimates of CD4 cell slope gave similar results. In 1,731 AIDS-free patients with >350 CD4 cells/µl from the pre-cART era, the rate of CD4 cell decline was also not significantly associated with progression to AIDS or death (hazard ratio 0.99, 95% confidence interval 0.94–1.03, for each 10 cells/µl per year reduction in CD4 cell decline). Conclusions The CD4 cell slope does not improve the prediction of clinical outcome in patients with a CD4 cell count above 350 cells/µl. Knowledge of the current CD4 cell count is sufficient when deciding whether to initiate cART in asymptomatic patients. Please see later in the article for the Editors' Summary PMID:20186270

  9. RNA-Puzzles Round II: assessment of RNA structure prediction programs applied to three large RNA structures

    PubMed Central

    Miao, Zhichao; Adamiak, Ryszard W.; Blanchet, Marc-Frédérick; Boniecki, Michal; Bujnicki, Janusz M.; Chen, Shi-Jie; Cheng, Clarence; Chojnowski, Grzegorz; Chou, Fang-Chieh; Cordero, Pablo; Cruz, José Almeida; Ferré-D'Amaré, Adrian R.; Das, Rhiju; Ding, Feng; Dokholyan, Nikolay V.; Dunin-Horkawicz, Stanislaw; Kladwang, Wipapat; Krokhotin, Andrey; Lach, Grzegorz; Magnus, Marcin; Major, François; Mann, Thomas H.; Masquida, Benoît; Matelska, Dorota; Meyer, Mélanie; Peselis, Alla; Popenda, Mariusz; Purzycka, Katarzyna J.; Serganov, Alexander; Stasiewicz, Juliusz; Szachniuk, Marta; Tandon, Arpit; Tian, Siqi; Wang, Jian; Xiao, Yi; Xu, Xiaojun; Zhang, Jinwei; Zhao, Peinan; Zok, Tomasz; Westhof, Eric

    2015-01-01

    This paper is a report of a second round of RNA-Puzzles, a collective and blind experiment in three-dimensional (3D) RNA structure prediction. Three puzzles, Puzzles 5, 6, and 10, represented sequences of three large RNA structures with limited or no homology with previously solved RNA molecules. A lariat-capping ribozyme, as well as riboswitches complexed to adenosylcobalamin and tRNA, were predicted by seven groups using RNAComposer, ModeRNA/SimRNA, Vfold, Rosetta, DMD, MC-Fold, 3dRNA, and AMBER refinement. Some groups derived models using data from state-of-the-art chemical-mapping methods (SHAPE, DMS, CMCT, and mutate-and-map). The comparisons between the predictions and the three subsequently released crystallographic structures, solved at diffraction resolutions of 2.5–3.2 Å, were carried out automatically using various sets of quality indicators. The comparisons clearly demonstrate the state of present-day de novo prediction abilities as well as the limitations of these state-of-the-art methods. All of the best prediction models have similar topologies to the native structures, which suggests that computational methods for RNA structure prediction can already provide useful structural information for biological problems. However, the prediction accuracy for non-Watson–Crick interactions, key to proper folding of RNAs, is low and some predicted models had high Clash Scores. These two difficulties point to some of the continuing bottlenecks in RNA structure prediction. All submitted models are available for download at http://ahsoka.u-strasbg.fr/rnapuzzles/. PMID:25883046

  10. Outcome of assisted reproductive technology (ART) and subsequent self-reported life satisfaction.

    PubMed

    Kuivasaari-Pirinen, Paula; Koivumaa-Honkanen, Heli; Hippeläinen, Maritta; Raatikainen, Kaisa; Heinonen, Seppo

    2014-01-01

    To compare life satisfaction between women with successful or unsuccessful outcome after assisted reproductive treatment (ART) by taking into account the time since the last ART. Cohort study. Tertiary hospital. A total of 987 consecutive women who had undergone ART during 1996-2007 were invited and altogether 505 women participated in the study. A postal enquiry with a life satisfaction scale. Self-reported life satisfaction in respect to the time since the last ART. In general, women who achieved a live birth after ART had a significantly higher life satisfaction than those who had unsuccessful ART, especially when compared in the first three years. The difference disappeared in the time period of 6-9 years after ART. The unsuccessfully treated women who had a child by some other means before or after the unsuccessful ART had comparable life satisfaction with successfully treated women even earlier. Even if unsuccessful ART outcome is associated with subsequent lower level of life satisfaction, it does not seem to threaten the long-term wellbeing.

  11. Outcome of Assisted Reproductive Technology (ART) and Subsequent Self-Reported Life Satisfaction

    PubMed Central

    Kuivasaari-Pirinen, Paula; Koivumaa-Honkanen, Heli; Hippeläinen, Maritta; Raatikainen, Kaisa; Heinonen, Seppo

    2014-01-01

    Objective To compare life satisfaction between women with successful or unsuccessful outcome after assisted reproductive treatment (ART) by taking into account the time since the last ART. Design Cohort study. Setting Tertiary hospital. Patients A total of 987 consecutive women who had undergone ART during 1996–2007 were invited and altogether 505 women participated in the study. Interventions A postal enquiry with a life satisfaction scale. Main Outcome Measure Self-reported life satisfaction in respect to the time since the last ART. Results In general, women who achieved a live birth after ART had a significantly higher life satisfaction than those who had unsuccessful ART, especially when compared in the first three years. The difference disappeared in the time period of 6–9 years after ART. The unsuccessfully treated women who had a child by some other means before or after the unsuccessful ART had comparable life satisfaction with successfully treated women even earlier. Conclusions Even if unsuccessful ART outcome is associated with subsequent lower level of life satisfaction, it does not seem to threaten the long-term wellbeing. PMID:25393846

  12. Sexual Relationship Power and Depression among HIV-Infected Women in Rural Uganda

    PubMed Central

    Hatcher, Abigail M.; Tsai, Alexander C.; Kumbakumba, Elias; Dworkin, Shari L.; Hunt, Peter W.; Martin, Jeffrey N.; Clark, Gina; Bangsberg, David R.; Weiser, Sheri D.

    2012-01-01

    Background Depression is associated with increased HIV transmission risk, increased morbidity, and higher risk of HIV-related death among HIV-infected women. Low sexual relationship power also contributes to HIV risk, but there is limited understanding of how it relates to mental health among HIV-infected women. Methods Participants were 270 HIV-infected women from the Uganda AIDS Rural Treatment Outcomes study, a prospective cohort of individuals initiating antiretroviral therapy (ART) in Mbarara, Uganda. Our primary predictor was baseline sexual relationship power as measured by the Sexual Relationship Power Scale (SRPS). The primary outcome was depression severity, measured with the Hopkins Symptom Checklist (HSCL), and a secondary outcome was a functional scale for mental health status (MHS). Adjusted models controlled for socio-demographic factors, CD4 count, alcohol and tobacco use, baseline WHO stage 4 disease, social support, and duration of ART. Results The mean HSCL score was 1.34 and 23.7% of participants had HSCL scores consistent with probable depression (HSCL>1.75). Compared to participants with low SRPS scores, individuals with both moderate (coefficient b = −0.21; 95%CI, −0.36 to −0.07) and high power (b = −0.21; 95%CI, −0.36 to −0.06) reported decreased depressive symptomology. High SRPS scores halved the likelihood of women meeting criteria for probable depression (adjusted odds ratio = 0.44; 95%CI, 0.20 to 0.93). In lagged models, low SRPS predicted subsequent depression severity, but depression did not predict subsequent changes in SPRS. Results were similar for MHS, with lagged models showing SRPS predicts subsequent mental health, but not visa versa. Both Decision-Making Dominance and Relationship Control subscales of SRPS were associated with depression symptom severity. Conclusions HIV-infected women with high sexual relationship power had lower depression and higher mental health status than women with low power. Interventions to improve equity in decision-making and control within dyadic partnerships are critical to prevent HIV transmission and to optimize mental health of HIV-infected women. PMID:23300519

  13. Ovarian reserve and subsequent ART outcomes following methotrexate therapy for ectopic pregnancy and pregnancy of unknown location

    PubMed Central

    Hill, Micah J.; Cooper, Janelle C.; Levy, Gary; Alford, Connie; Richter, Kevin S.; DeCherney, Alan H.; Katz, Charles; Levens, Eric D.; Wolff, Erin F.

    2013-01-01

    Objective It is unclear whether the stimulated state of the ovaries as part of ART results in an increased vulnerability to the effects of methotrexate. The objective of this study was to assess ovarian reserve following methotrexate treatment for ectopic pregnancy or pregnancy of unknown location after ART. Design Retrospective cohort study. Setting Large ART practice. Patients Methotrexate or surgery following ART. Interventions None. Main Outcome Measures Follicle stimulating hormone (FSH), antral follicle count (AFC), and oocyte yield were compared between subjects treated with methotrexate and surgery. Secondary outcomes were clinical pregnancy and live birth. Results There were 153 patients in the methotrexate group and 36 patients in the surgery group. Neither group demonstrated differences in ovarian reserve or oocyte yield comparing before and after treatment values. The change in ovarian reserve and oocyte yield after treatment were similar between the two groups. The number of doses of methotrexate was not correlated with changes in ovarian reserve, indicating no dose-dependent effect. Time between treatment and repeat ART was not correlated with outcomes. Live birth in subsequent cycles was similar in the two groups. Conclusions Ovarian reserve and subsequent ART cycle outcomes were reassuring following methotrexate and surgical management of ectopic pregnancy. An adverse impact of methotrexate was not detected in this large fertility cohort as has been previously described. PMID:24269042

  14. The predictive mind and the experience of visual art work

    PubMed Central

    Kesner, Ladislav

    2014-01-01

    Among the main challenges of the predictive brain/mind concept is how to link prediction at the neural level to prediction at the cognitive-psychological level and finding conceptually robust and empirically verifiable ways to harness this theoretical framework toward explaining higher-order mental and cognitive phenomena, including the subjective experience of aesthetic and symbolic forms. Building on the tentative prediction error account of visual art, this article extends the application of the predictive coding framework to the visual arts. It does so by linking this theoretical discussion to a subjective, phenomenological account of how a work of art is experienced. In order to engage more deeply with a work of art, viewers must be able to tune or adapt their prediction mechanism to recognize art as a specific class of objects whose ontological nature defies predictability, and they must be able to sustain a productive flow of predictions from low-level sensory, recognitional to abstract semantic, conceptual, and affective inferences. The affective component of the process of predictive error optimization that occurs when a viewer enters into dialog with a painting is constituted both by activating the affective affordances within the image and by the affective consequences of prediction error minimization itself. The predictive coding framework also has implications for the problem of the culturality of vision. A person’s mindset, which determines what top–down expectations and predictions are generated, is co-constituted by culture-relative skills and knowledge, which form hyperpriors that operate in the perception of art. PMID:25566111

  15. The predictive mind and the experience of visual art work.

    PubMed

    Kesner, Ladislav

    2014-01-01

    Among the main challenges of the predictive brain/mind concept is how to link prediction at the neural level to prediction at the cognitive-psychological level and finding conceptually robust and empirically verifiable ways to harness this theoretical framework toward explaining higher-order mental and cognitive phenomena, including the subjective experience of aesthetic and symbolic forms. Building on the tentative prediction error account of visual art, this article extends the application of the predictive coding framework to the visual arts. It does so by linking this theoretical discussion to a subjective, phenomenological account of how a work of art is experienced. In order to engage more deeply with a work of art, viewers must be able to tune or adapt their prediction mechanism to recognize art as a specific class of objects whose ontological nature defies predictability, and they must be able to sustain a productive flow of predictions from low-level sensory, recognitional to abstract semantic, conceptual, and affective inferences. The affective component of the process of predictive error optimization that occurs when a viewer enters into dialog with a painting is constituted both by activating the affective affordances within the image and by the affective consequences of prediction error minimization itself. The predictive coding framework also has implications for the problem of the culturality of vision. A person's mindset, which determines what top-down expectations and predictions are generated, is co-constituted by culture-relative skills and knowledge, which form hyperpriors that operate in the perception of art.

  16. Elaboration over a Discourse Facilitates Retrieval in Sentence Processing.

    PubMed

    Troyer, Melissa; Hofmeister, Philip; Kutas, Marta

    2016-01-01

    Language comprehension requires access to stored knowledge and the ability to combine knowledge in new, meaningful ways. Previous work has shown that processing linguistically more complex expressions ('Texas cattle rancher' vs. 'rancher') leads to slow-downs in reading during initial processing, possibly reflecting effort in combining information. Conversely, when this information must subsequently be retrieved (as in filler-gap constructions), processing is facilitated for more complex expressions, possibly because more semantic cues are available during retrieval. To follow up on this hypothesis, we tested whether information distributed across a short discourse can similarly provide effective cues for retrieval. Participants read texts introducing two referents (e.g., two senators), one of whom was described in greater detail than the other (e.g., 'The Democrat had voted for one of the senators, and the Republican had voted for the other, a man from Ohio who was running for president'). The final sentence (e.g., 'The senator who the {Republican/Democrat}had voted for…') contained a relative clause picking out either the Many-Cue referent (with 'Republican') or the One-Cue referent (with 'Democrat'). We predicted facilitated retrieval (faster reading times) for the Many-Cue condition at the verb region ('had voted for'), where readers could understand that 'The senator' is the object of the verb. As predicted, this pattern was observed at the retrieval region and continued throughout the rest of the sentence. Participants also completed the Author/Magazine Recognition Tests (ART/MRT; Stanovich and West, 1989), providing a proxy for world knowledge. Since higher ART/MRT scores may index (a) greater experience accessing relevant knowledge and/or (b) richer/more highly structured representations in semantic memory, we predicted it would be positively associated with effects of elaboration on retrieval. We did not observe the predicted interaction between ART/MRT scores and Cue condition at the retrieval region, though ART/MRT interacted with Cue condition in other locations in the sentence. In sum, we found that providing more elaborative information over the course of a text can facilitate retrieval for referents, consistent with a framework in which referential elaboration over a discourse and not just local linguistic information directly impacts information retrieval during sentence processing.

  17. THE RELATIONSHIP OF CERTAIN PREDICTION AND SELF-EVALUATION DISCREPANCIES TO ART PERFORMANCE AND ART JUDGMENT.

    ERIC Educational Resources Information Center

    HARVEY, THEODORE E.

    NINTH-GRADE STUDENTS WERE SELECTED AS A SAMPLE TO STUDY THE RELATIONSHIP OF CERTAIN PREDICTION AND SELF-EVALUATION DISCREPANCIES TO ART PERFORMANCE AND ART JUDGMENT. STUDENTS WERE REQUIRED TO DEVELOP AN OIL CRAYON DRAWING, RESULTING FROM AN IMAGINARY SENTENCE SPOKEN TO AND SEEN BY ALL PARTICIPANTS. PREDICTIONS OF PERFORMANCE WERE ASKED PRIOR TO…

  18. Predicting adverse hemodynamic events in critically ill patients.

    PubMed

    Yoon, Joo H; Pinsky, Michael R

    2018-06-01

    The art of predicting future hemodynamic instability in the critically ill has rapidly become a science with the advent of advanced analytical processed based on computer-driven machine learning techniques. How these methods have progressed beyond severity scoring systems to interface with decision-support is summarized. Data mining of large multidimensional clinical time-series databases using a variety of machine learning tools has led to our ability to identify alert artifact and filter it from bedside alarms, display real-time risk stratification at the bedside to aid in clinical decision-making and predict the subsequent development of cardiorespiratory insufficiency hours before these events occur. This fast evolving filed is primarily limited by linkage of high-quality granular to physiologic rationale across heterogeneous clinical care domains. Using advanced analytic tools to glean knowledge from clinical data streams is rapidly becoming a reality whose clinical impact potential is great.

  19. Decreased clinical pregnancy and live birth rates after short interval from delivery to subsequent assisted reproductive treatment cycle.

    PubMed

    Quinn, Molly M; Rosen, Mitchell P; Allen, Isabel Elaine; Huddleston, Heather G; Cedars, Marcelle I; Fujimoto, Victor Y

    2018-06-15

    Does the interval from delivery to initiation of a subsequent ART treatment cycle impact clinical pregnancy or live birth rates? An interval from delivery to treatment start of <6 months or ≥24 months is associated with decreased likelihood of clinical pregnancy and live birth. Short interpregnancy intervals are associated with poor obstetric outcomes in the naturally conceiving population prompting birth spacing recommendations of 18-24 months from international organizations. Deferring a subsequent pregnancy attempt means a woman will age in the interval with an attendant decline in her fertility. Retrospective analysis of the Society for Assisted Reproductive Technology Clinical Outcome Reporting System (SARTCORS) cohort containing 61 686 ART cycles from 2004 to 2013. The delivery-to-cycle interval (DCI) was calculated for patients from SARTCORS with a history of live birth from ART who returned to the same clinic for a first subsequent treatment cycle. Generalized linear models were fit to determine the risk of clinical pregnancy and live birth by DCI with subsequent adjustment for factors associated with outcomes of interest. Predicted probabilities of clinical pregnancy and live birth were generated from each model. A DCI of <6 months was associated with a 5.6% reduction in probability of clinical pregnancy (40.1 ± 1.9 versus 45.7 ± 0.6%, P = 0.009) and 6.8% reduction in live birth (31.6 ± 1.7 versus 38.4 ± 0.6%, P = 0.001) per cycle start compared to a DCI of 12 to <18 months. A DCI of ≥24 months was associated with a 5.1% reduction in probability of clinical pregnancy (40.6 ± 0.5 versus 45.7 ± 0.6%, P < 0.001) and 5.7% reduction in live birth (32.7 ± 0.5 versus 38.4 ± 0.6%, P < 0.001) compared to 12 to <18 months. The SART database is reliant upon self-report of many variables of interest including live birth. It remains unclear whether poorer outcomes are a result of residual confounding from factors inherent to the population with a very short or long DCI or the interval itself. Birth spacing recommendations for naturally conceiving populations may not be generally applicable to patients with a history of infertility. Patients planning ART treatment should wait a minimum of 6 months, but not more than 24 months, from a live birth for optimization of clinical pregnancy and live birth rates. National Center for Advancing Translational Sciences, National Institutes of Health, UCSF-CTSI Grant number UL1TR001872. The authors have no competing interests.

  20. Predicting RNA-protein binding sites and motifs through combining local and global deep convolutional neural networks.

    PubMed

    Pan, Xiaoyong; Shen, Hong-Bin

    2018-05-02

    RNA-binding proteins (RBPs) take over 5∼10% of the eukaryotic proteome and play key roles in many biological processes, e.g. gene regulation. Experimental detection of RBP binding sites is still time-intensive and high-costly. Instead, computational prediction of the RBP binding sites using pattern learned from existing annotation knowledge is a fast approach. From the biological point of view, the local structure context derived from local sequences will be recognized by specific RBPs. However, in computational modeling using deep learning, to our best knowledge, only global representations of entire RNA sequences are employed. So far, the local sequence information is ignored in the deep model construction process. In this study, we present a computational method iDeepE to predict RNA-protein binding sites from RNA sequences by combining global and local convolutional neural networks (CNNs). For the global CNN, we pad the RNA sequences into the same length. For the local CNN, we split a RNA sequence into multiple overlapping fixed-length subsequences, where each subsequence is a signal channel of the whole sequence. Next, we train deep CNNs for multiple subsequences and the padded sequences to learn high-level features, respectively. Finally, the outputs from local and global CNNs are combined to improve the prediction. iDeepE demonstrates a better performance over state-of-the-art methods on two large-scale datasets derived from CLIP-seq. We also find that the local CNN run 1.8 times faster than the global CNN with comparable performance when using GPUs. Our results show that iDeepE has captured experimentally verified binding motifs. https://github.com/xypan1232/iDeepE. xypan172436@gmail.com or hbshen@sjtu.edu.cn. Supplementary data are available at Bioinformatics online.

  1. Graphic Narratives: Cognitive and Pedagogical Choices for Implementation in the English Language Arts Classroom

    ERIC Educational Resources Information Center

    Dulaney, Margaret Anne

    2012-01-01

    There is little empirical research that investigates the implementation of graphic narratives into the English language arts classroom, subsequently leading to misperceptions and misconceptions about their educative uses. Despite sequential arts' long history, graphic narratives continue to experience a marginalized existence within the…

  2. Impact of Risk Factors for Specific Causes of Death in the First and Subsequent Years of Antiretroviral Therapy Among HIV-Infected Patients

    PubMed Central

    Ingle, Suzanne M.; May, Margaret T.; Gill, M. John; Mugavero, Michael J.; Lewden, Charlotte; Abgrall, Sophie; Fätkenheuer, Gerd; Reiss, Peter; Saag, Michael S.; Manzardo, Christian; Grabar, Sophie; Bruyand, Mathias; Moore, David; Mocroft, Amanda; Sterling, Timothy R.; D'Arminio Monforte, Antonella; Hernando, Victoria; Teira, Ramon; Guest, Jodie; Cavassini, Matthias; Crane, Heidi M.; Sterne, Jonathan A. C.

    2014-01-01

    Background. Patterns of cause-specific mortality in individuals infected with human immunodeficiency virus type 1 (HIV-1) are changing dramatically in the era of antiretroviral therapy (ART). Methods. Sixteen cohorts from Europe and North America contributed data on adult patients followed from the start of ART. Procedures for coding causes of death were standardized. Estimated hazard ratios (HRs) were adjusted for transmission risk group, sex, age, year of ART initiation, baseline CD4 count, viral load, and AIDS status, before and after the first year of ART. Results. A total of 4237 of 65 121 (6.5%) patients died (median, 4.5 years follow-up). Rates of AIDS death decreased substantially with time since starting ART, but mortality from non-AIDS malignancy increased (rate ratio, 1.04 per year; 95% confidence interval [CI], 1.0–1.1). Higher mortality in men than women during the first year of ART was mostly due to non-AIDS malignancy and liver-related deaths. Associations with age were strongest for cardiovascular disease, heart/vascular, and malignancy deaths. Patients with presumed transmission through injection drug use had higher rates of all causes of death, particularly for liver-related causes (HRs compared with men who have sex with men: 18.1 [95% CI, 6.2–52.7] during the first year of ART and 9.1 [95% CI, 5.8–14.2] thereafter). There was a persistent role of CD4 count at baseline and at 12 months in predicting AIDS, non-AIDS infection, and non-AIDS malignancy deaths. Lack of viral suppression on ART was associated with AIDS, non-AIDS infection, and other causes of death. Conclusions. Better understanding of patterns of and risk factors for cause-specific mortality in the ART era can aid in development of appropriate care for HIV-infected individuals and inform guidelines for risk factor management. PMID:24771333

  3. ‘My Virtual Dream’: Collective Neurofeedback in an Immersive Art Environment

    PubMed Central

    Kovacevic, Natasha; Ritter, Petra; Tays, William; Moreno, Sylvain; McIntosh, Anthony Randal

    2015-01-01

    While human brains are specialized for complex and variable real world tasks, most neuroscience studies reduce environmental complexity, which limits the range of behaviours that can be explored. Motivated to overcome this limitation, we conducted a large-scale experiment with electroencephalography (EEG) based brain-computer interface (BCI) technology as part of an immersive multi-media science-art installation. Data from 523 participants were collected in a single night. The exploratory experiment was designed as a collective computer game where players manipulated mental states of relaxation and concentration with neurofeedback targeting modulation of relative spectral power in alpha and beta frequency ranges. Besides validating robust time-of-night effects, gender differences and distinct spectral power patterns for the two mental states, our results also show differences in neurofeedback learning outcome. The unusually large sample size allowed us to detect unprecedented speed of learning changes in the power spectrum (~ 1 min). Moreover, we found that participants' baseline brain activity predicted subsequent neurofeedback beta training, indicating state-dependent learning. Besides revealing these training effects, which are relevant for BCI applications, our results validate a novel platform engaging art and science and fostering the understanding of brains under natural conditions. PMID:26154513

  4. Benefit of interpregnancy HIV viral load suppression on subsequent maternal and infant outcomes.

    PubMed

    Stewart, Robert D; Wells, C Edward; Roberts, Scott W; Rogers, Vanessa L; McElwee, Barbara S; McIntire, Donald D; Sheffield, Jeanne S

    2014-09-01

    The objective of the study was to determine whether interpregnancy human immunodeficiency virus (HIV) viral load suppression affects outcomes in subsequent pregnancies. This is a retrospective review of all women who delivered 2 consecutive pregnancies while diagnosed with HIV from Jan. 1, 1984, until Jan. 1, 2012. Medical records were reviewed for maternal, infant, and delivery data. Pregnancies were divided into index and subsequent pregnancy and analyzed for outcomes. During the study period, 172 HIV-infected women who delivered 2 pregnancies at our institution were identified. There was no difference in median HIV viral load at presentation or delivery between the index and subsequent pregnancies. During the subsequent pregnancy, more women presented on antiretroviral therapy (ART) and more often remained compliant with ART; however, there was no difference in vertical transmission risk between the pregnancies. Of those with a viral load less than 1000 copies/mL at the end of their index pregnancy (n = 103), 57 (55%) presented for their subsequent pregnancy with a viral load still less than 1000 copies/mL. Those women who maintained the viral load suppression between pregnancies were more likely to present for their subsequent pregnancy on ART, maintained a greater viral load suppression and CD4 counts during the pregnancy, and had fewer vertical transmissions compared with those who presented with higher viral loads in their subsequent pregnancy (0% vs 9%, P = .02). Maintaining an HIV viral load suppression between pregnancies is associated with improved HIV disease status at delivery in subsequent pregnancies. Interpregnancy HIV viral load suppression is associated with less vertical transmission, emphasizing the importance of maintaining HIV disease control between pregnancies. Copyright © 2014 Mosby, Inc. All rights reserved.

  5. Mexican-Origin Youth Participation in Extracurricular Activities: Predicting Trajectories of Involvement from 7th to 12th Grade.

    PubMed

    Dawes, Nickki Pearce; Modecki, Kathryn L; Gonzales, Nancy; Dumka, Larry; Millsap, Roger

    2015-11-01

    The potential benefits of participation in extracurricular activities may be especially important for youth who are at risk for academic underachievement, such as low income Mexican-origin youth in the U.S. To advance understanding of factors that drive participation for this population, this study examined Mexican-origin youth's trajectories of participation in extracurricular activities across Grades 7-12 and tested theoretically-derived predictors of these trajectories. Participants were 178 adolescents (53.9 % Female, Mage = 12.28) and their mothers who separately completed in-home interviews. Youth reported the frequency of their participation across a range of extracurricular activities. Latent growth curve models of overall extracurricular activities participation, sports participation, and fine arts participation were individually estimated via structural equation modeling. The findings demonstrated developmental declines in overall participation and in sports participation. For fine arts, declines in participation in middle school were followed by subsequent increases during high school (a curvilinear pattern). Motivationally-salient predictors of participation trajectories included youth's traditional cultural values orientation (sports), the mothers' educational aspirations for the youth (sports, fine arts, overall activity), and youth gender (sports, fine arts). Overall, the results suggest variability in participation trajectories based on program type, and highlight the need for additional research to enhance our understanding of the impact of culturally-relevant predictors on participation over time.

  6. Out of Plato's Cave: The Role of Mathematics in the Christian Liberal Arts Curriculum

    ERIC Educational Resources Information Center

    Nelsen, Luke L.

    2014-01-01

    This article presents a historical defense of liberal arts education--a philosophy that is commonly claimed among Christian colleges and universities--in order to provide an understanding of liberal education to skeptics and subscribers alike. A subsequent discussion of the role of mathematics in the liberal arts tradition contends that…

  7. Carpe Diem: Seizing the Common Core with Visual Thinking Strategies in the Visual Arts Classroom

    ERIC Educational Resources Information Center

    Franco, Mary; Unrath, Kathleen

    2014-01-01

    This article demonstrates how Visual Thinking Strategies (VTS) art discussions and subsequent, inspired artmaking can help reach the goals of the Common Core State Standards for English Language Arts & Literacy in History/Social Studies, Science, & Technical Subjects (CCSS-ELA). The authors describe how this was achieved in a remedial…

  8. Clinical and Virologic Outcomes After Changes in First Antiretroviral Regimen at 7 Sites in the Caribbean, Central and South America Network.

    PubMed

    Wolff, Marcelo; Shepherd, Bryan E; Cortés, Claudia; Rebeiro, Peter; Cesar, Carina; Wagner Cardoso, Sandra; Pape, Jean W; Padgett, Denis; Sierra-Madero, Juan; Echevarria, Juan; McGowan, Catherine C

    2016-01-01

    HIV-infected persons in resource-limited settings may experience high rates of antiretroviral therapy (ART) change, particularly because of toxicity or other nonfailure reasons. Few reports address patient outcomes after these modifications. HIV-infected adults from the 7 Caribbean, Central and South America network clinical cohorts who modified >1 drug from the first ART regimen (ART-1) for any reason thereby starting a second regimen (ART-2) were included. We assessed cumulative incidence of, and factors associated with, death, virologic failure (VF), and regimen change after starting ART-2. Five thousand five hundred sixty-five ART-naive highly active ART initiators started ART-2 after a median of 9.8 months on ART-1; 39% changed to ART-2 because of toxicity and 11% because of failure. Median follow-up after starting ART-2 was 2.9 years; 45% subsequently modified ART-2. Cumulative incidences of death at 1, 3, and 5 years after starting ART-2 were 5.1%, 8.4%, and 10.5%, respectively. In adjusted analyses, death was associated with older age, clinical AIDS, lower CD4 at ART-2 start, earlier calendar year, and starting ART-2 because of toxicity (adjusted hazard ratio = 1.5 vs. failure, 95% confidence interval: 1.0 to 2.1). Cumulative incidences of VF after 1, 3, and 5 years were 9%, 19%, and 25%. In adjusted analyses, VF was associated with younger age, earlier calendar year, lower CD4 at the start of ART-2, and starting ART-2 because of failure (adjusted hazard ratio = 2.1 vs. toxicity, 95% confidence interval: 1.5 to 2.8). Among patients modifying the first ART regimen, risks of subsequent modifications, mortality, and virologic failure were high. Access to improved antiretrovirals in the region is needed to improve initial treatment success.

  9. Elaboration over a Discourse Facilitates Retrieval in Sentence Processing

    PubMed Central

    Troyer, Melissa; Hofmeister, Philip; Kutas, Marta

    2016-01-01

    Language comprehension requires access to stored knowledge and the ability to combine knowledge in new, meaningful ways. Previous work has shown that processing linguistically more complex expressions (‘Texas cattle rancher’ vs. ‘rancher’) leads to slow-downs in reading during initial processing, possibly reflecting effort in combining information. Conversely, when this information must subsequently be retrieved (as in filler-gap constructions), processing is facilitated for more complex expressions, possibly because more semantic cues are available during retrieval. To follow up on this hypothesis, we tested whether information distributed across a short discourse can similarly provide effective cues for retrieval. Participants read texts introducing two referents (e.g., two senators), one of whom was described in greater detail than the other (e.g., ‘The Democrat had voted for one of the senators, and the Republican had voted for the other, a man from Ohio who was running for president’). The final sentence (e.g., ‘The senator who the {Republican/Democrat}had voted for…’) contained a relative clause picking out either the Many-Cue referent (with ‘Republican’) or the One-Cue referent (with ‘Democrat’). We predicted facilitated retrieval (faster reading times) for the Many-Cue condition at the verb region (‘had voted for’), where readers could understand that ‘The senator’ is the object of the verb. As predicted, this pattern was observed at the retrieval region and continued throughout the rest of the sentence. Participants also completed the Author/Magazine Recognition Tests (ART/MRT; Stanovich and West, 1989), providing a proxy for world knowledge. Since higher ART/MRT scores may index (a) greater experience accessing relevant knowledge and/or (b) richer/more highly structured representations in semantic memory, we predicted it would be positively associated with effects of elaboration on retrieval. We did not observe the predicted interaction between ART/MRT scores and Cue condition at the retrieval region, though ART/MRT interacted with Cue condition in other locations in the sentence. In sum, we found that providing more elaborative information over the course of a text can facilitate retrieval for referents, consistent with a framework in which referential elaboration over a discourse and not just local linguistic information directly impacts information retrieval during sentence processing. PMID:27014172

  10. Early limited antiretroviral therapy is superior to deferred therapy in HIV-infected South African infants: results from the CHER (Children with HIV Early antiRetroviral) Randomized Trial

    PubMed Central

    Cotton, Mark F; Violari, Avy; Otwombe, Kennedy; Panchia, Ravindre; Dobbels, Els; Rabie, Helena; Josipovic, Deirdre; Liberty, Afaff; Lazarus, Erica; Innes, Steve; van Rensburg, Anita Janse; Pelser, Wilma; Truter, Handre; Madhi, Shabir A; Handelsman, Edward; Jean-Philippe, Patrick; McIntyre, James A; Gibb, Diana M; Babiker, Abdel G

    2014-01-01

    Background Interim results from the CHER trial showed that early antiretroviral therapy (ART) was life-saving for HIV-infected infants. Given limited options and potential for toxicity with life-long ART, CHER compared early limited ART with deferred ART. Methods CHER was an open 3-arm trial in HIV-infected asymptomatic infants aged <12 weeks with CD4% ≥25%. Infants were randomized to deferred (ART-Def) or immediate ART for 40weeks (ART-40W) or 96weeks (ART-96W), followed by interruption. Criteria for ART initiation in ART-Def and re-initiation after interruption were CD4% <25% in infancy; otherwise <20% or CDC severe stage B or stage C disease. Lopinavir-ritonavir, zidovudine, lamivudine was the first-line regimen at ART initiation and re-initiation. The primary endpoint was time-to-failure of first-line ART (immunological/clinical/virological) or death. Comparisons were by intent-to-treat, using time-to-event methods. Findings 377 infants were enrolled: median age 7.4weeks; CD4% 35% and HIV RNA log 5.7copies/ml. Median follow-up was 4.8 years; 34 (9%) were lost-to-follow-up. Median time to ART initiation in ART-Def was 20 (IQR 16–25) weeks. Time to restarting ART after interruption was 33 (26–45) weeks in ART-40W and 70 (35–109) weeks in ART-96W; at trial end 19% and 32% respectively, remained off ART. Proportions of follow-up time spent on ART were 81%, 70% and 69% in ART-Def, ART-40W and ART-96W arms. 48/125(38%), 32/126(25%) and 26/126(21%) children reached the primary endpoint; hazard ratio (95%CI), relative to ART-Def, was 0.59(0.38-0.93, p=0.02) for ART-40W and 0.47(0.27-0.76, p=0.002) for ART-96W. Seven children (3 ART-Def, 3 ART-40W, 1 ART-96W) switched to second-line ART. Interpretation Early limited ART had superior clinical/immunological outcome with no evidence of excess disease progression during subsequent interruption and less overall ART exposure than deferred ART. Longer time on primary ART permits longer subsequent interruption with marginally better outcomes. PMID:24209829

  11. Steep declines in population-level AIDS mortality following the introduction of antiretroviral therapy in Addis Ababa, Ethiopia

    PubMed Central

    Reniers, Georges; Araya, Tekebash; Davey, Gail; Nagelkerke, Nico; Berhane, Yemane; Coutinho, Roel; Sanders, Eduard J.

    2009-01-01

    Objectives Assessments of population-level effects of antiretroviral therapy (ART) programs in Africa are rare. We use data from burial sites to estimate trends in adult AIDS mortality and the mitigating effects of ART in Addis Ababa. ART has been available since 2003, and for free since 2005. Methods To substitute for deficient vital registration, we use surveillance of burials at all cemeteries. We present trends in all-cause mortality, and estimate AIDS mortality (ages 20–64) from lay reports of causes of death. These lay reports are first used as a diagnostic test for the true cause of death. As reference standard we use the cause of death established via verbal autopsy interviews conducted in 2004. The Positive Predictive Value and Sensitivity are subsequently used as anchors to estimate the number of AIDS deaths for the period 2001–2007. Estimates are compared with Spectrum projections. Results Between 2001 and 2005, the number of AIDS deaths declined by 21.9% and 9.3% for men and women, respectively. Between 2005 and 2007, the number of AIDS deaths declined by 38.2% for men and 42.9% for women. Compared to the expected number in the absence of ART, the reduction in AIDS deaths in 2007 is estimated between 56.8% and 63.3%, depending on the coverage of the burial surveillance. Conclusion Five years into the ART program, adult AIDS mortality has been reduced by more than half. Following the free provision of ART in 2005, the decline accelerated and became more gender balanced. Substantial AIDS mortality, however, persists. PMID:19169138

  12. Contemporary art in medicine: the Cleveland Clinic art collection.

    PubMed

    Finkel, Jennifer

    2011-12-01

    Fine art is good medicine. It comforts, elevates the spirit, and affirms life and hope. Art in the healthcare setting, combined with outstanding care and service, creates an environment that encourages healing and supports the work of medical professionals. As one of the world's great medical centers, Cleveland Clinic has always included the arts in its healing environment. The four founders and subsequent leadership encouraged artistic and musical expression by employees. Distinguished artworks have long hung on the walls. In 1983, an Aesthetics Committee was officially formed at Cleveland Clinic to address issues of art and design in Cleveland Clinic facilities.

  13. Outcomes of Patients Lost to Follow-up in African Antiretroviral Therapy Programs: Individual Patient Data Meta-analysis.

    PubMed

    Chammartin, Frédérique; Zürcher, Kathrin; Keiser, Olivia; Weigel, Ralf; Chu, Kathryn; Kiragga, Agnes N; Ardura-Garcia, Cristina; Anderegg, Nanina; Laurent, Christian; Cornell, Morna; Tweya, Hannock; Haas, Andreas D; Rice, Brian D; Geng, Elvin H; Fox, Matthew P; Hargreaves, James R; Egger, Matthias

    2018-06-08

    Low retention on combination antiretroviral therapy (cART) has emerged as a threat to the Joint United Nations Programme on human immunodeficiency virus (HIV)/AIDS (UNAIDS) 90-90-90 targets. We examined outcomes of patients who started cART but were subsequently lost to follow-up (LTFU) in African treatment programs. This was a systematic review and individual patient data meta-analysis of studies that traced patients who were LTFU. Outcomes were analyzed using cumulative incidence functions and proportional hazards models for the competing risks of (i) death, (ii) alive but stopped cART, (iii) silent transfer to other clinics, and (iv) retention on cART. Nine studies contributed data on 7377 patients who started cART and were subsequently LTFU in sub-Saharan Africa. The median CD4 count at the start of cART was 129 cells/μL. At 4 years after the last clinic visit, 21.8% (95% confidence interval [CI], 20.8%-22.7%) were known to have died, 22.6% (95% CI, 21.6%-23.6%) were alive but had stopped cART, 14.8% (95% CI, 14.0%-15.6%) had transferred to another clinic, 9.2% (95% CI, 8.5%-9.8%) were retained on cART, and 31.6% (95% CI, 30.6%-32.7%) could not been found. Mortality was associated with male sex, more advanced disease, and shorter cART duration; stopping cART with less advanced disease andlonger cART duration; and silent transfer with female sex and less advanced disease. Mortality in patients LTFU must be considered for unbiased assessments of program outcomes and UNAIDS targets in sub-Saharan Africa. Immediate start of cART and early tracing of patients LTFU should be priorities.

  14. Art and Archaeology.

    ERIC Educational Resources Information Center

    Wildman, Jul; Schumacher, Leni

    Organized in eight chapters, this interdisciplinary resource packet highlights the relationship between art and archaeology. Chapter 1 presents the vocabulary and several introductory activities that prepare students to participate in the subsequent chapters. These chapters focus on (2) "Lascaux Cave Paintings"; (3) "Life Along the…

  15. Fast large-scale clustering of protein structures using Gauss integrals.

    PubMed

    Harder, Tim; Borg, Mikael; Boomsma, Wouter; Røgen, Peter; Hamelryck, Thomas

    2012-02-15

    Clustering protein structures is an important task in structural bioinformatics. De novo structure prediction, for example, often involves a clustering step for finding the best prediction. Other applications include assigning proteins to fold families and analyzing molecular dynamics trajectories. We present Pleiades, a novel approach to clustering protein structures with a rigorous mathematical underpinning. The method approximates clustering based on the root mean square deviation by first mapping structures to Gauss integral vectors--which were introduced by Røgen and co-workers--and subsequently performing K-means clustering. Compared to current methods, Pleiades dramatically improves on the time needed to perform clustering, and can cluster a significantly larger number of structures, while providing state-of-the-art results. The number of low energy structures generated in a typical folding study, which is in the order of 50,000 structures, can be clustered within seconds to minutes.

  16. A review of clinical and histological parameters associated with contralateral neck metastases in oral squamous cell carcinoma

    PubMed Central

    Fan, Song; Tang, Qiong-lan; Lin, Ying-jin; Chen, Wei-liang; Li, Jin-song; Huang, Zhi-quan; Yang, Zhao-hui; Wang, You-yuan; Zhang, Da-ming; Wang, Hui-jing; Dias-Ribeiro, Eduardo; Cai, Qiang; Wang, Lei

    2011-01-01

    Oral squamous cell carcinoma (OSCC) has a high incidence of cervical micrometastases and sometimes metastasizes contralaterally because of the rich lymphatic intercommunications relative to submucosal plexus of oral cavity that freely communicate across the midline, and it can facilitate the spread of neoplastic cells to any area of the neck consequently. Clinical and histopathologic factors continue to provide predictive information to contralateral neck metastases (CLNM) in OSCC, which determine prophylactic and adjuvant treatments for an individual patient. This review describes the predictive value of clinical-histopathologic factors, which relate to primary tumor and cervical lymph nodes, and surgical dissection and adjuvant treatments. In addition, the indications for elective contralateral neck dissection and adjuvant radiotherapy (aRT) and strategies for follow-up are offered, which is strongly focused by clinicians to prevent later CLNM and poor prognosis subsequently. PMID:22010576

  17. Contemporary art in medicine: the Cleveland Clinic art collection

    PubMed Central

    2011-01-01

    Fine art is good medicine. It comforts, elevates the spirit, and affirms life and hope. Art in the healthcare setting, combined with outstanding care and service, creates an environment that encourages healing and supports the work of medical professionals. As one of the world’s great medical centers, Cleveland Clinic has always included the arts in its healing environment. The four founders and subsequent leadership encouraged artistic and musical expression by employees. Distinguished artworks have long hung on the walls. In 1983, an Aesthetics Committee was officially formed at Cleveland Clinic to address issues of art and design in Cleveland Clinic facilities. PMID:24282686

  18. Italian Advisory Board: sFlt-1/PlGF ratio and preeclampsia, state of the art and developments in diagnostic, therapeutic and clinical management.

    PubMed

    Di Martino, Daniela; Cetin, Irene; Frusca, Tiziana; Ferrazzi, Enrico; Fuse', Federica; Gervasi, Maria Teresa; Plebani, Mario; Todros, Tullia

    2016-11-01

    Extensive research has been published, showing the usefulness of angiogenic markers in both diagnosis and subsequent prediction and management of preeclampsia and placenta-related disorders. Recent evidence provides a helpful cut off for the Elecsys ratio sFlt-1 to PlGF, that predicts preeclampsia development in women with sign and symptoms, before its clinical onset in the short term. In Europe, no accordance exists for the use of such kind of test in clinical practice; only German guidelines have recently taken it into account, as a diagnostic aid for preeclampsia, in conjunction with other clinical findings. This panel of Italian experts recently met, in order to review the literature and to promote the evaluation of the clinical utility of sFlt-1/PlGF ratio at the Italian country level, as regards: prediction of preeclampsia during the first trimester, prediction or exclusion of new onset or recurrence in patients with risk factors for preeclampsia, triage of patients suffering from gestational hypertension, evaluation of disease severity, prediction of adverse maternal and fetal outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. The combined effect of age and basal follicle-stimulating hormone on the cost of a live birth at assisted reproductive technology.

    PubMed

    Henne, Melinda B; Stegmann, Barbara J; Neithardt, Adrienne B; Catherino, William H; Armstrong, Alicia Y; Kao, Tzu-Cheg; Segars, James H

    2008-01-01

    To predict the cost of a delivery following assisted reproductive technologies (ART). Cost analysis based on retrospective chart analysis. University-based ART program. Women aged >or=26 and

  20. Task value profiles across subjects and aspirations to physical and IT-related sciences in the United States and Finland.

    PubMed

    Chow, Angela; Eccles, Jacquelynne S; Salmela-Aro, Katariina

    2012-11-01

    Two independent studies were conducted to extend previous research by examining the associations between task value priority patterns across school subjects and aspirations toward the physical and information technology- (IT-) related sciences. Study 1 measured task values of a sample of 10th graders in the United States (N = 249) across (a) physics and chemistry, (b) math, and (c) English. Study 2 measured task values of a sample of students in the second year of high school in Finland (N = 351) across (a) math and science, (b) Finnish, and (c) the arts and physical education. In both studies, students were classified into groups according to how they ranked math and science in relation to the other subjects. Regression analyses indicated that task value group membership significantly predicted subsequent aspirations toward physical and IT-related sciences measured 1-2 years later. The task value groups who placed the highest priority on math and science were significantly more likely to aspire to physical and IT-related sciences than were the other groups. These findings provide support for the theoretical assumption regarding the predictive role of intraindividual hierarchical patterns of task values for subsequent preferences and choices suggested by the Eccles [Parsons] (1983) expectancy-value model.

  1. Previous antiretroviral therapy for prevention of mother-to-child transmission of HIV does not hamper the initial response to PI-based multitherapy during subsequent pregnancy.

    PubMed

    Briand, Nelly; Mandelbrot, Laurent; Blanche, Stéphane; Tubiana, Roland; Faye, Albert; Dollfus, Catherine; Le Chenadec, Jérôme; Benhammou, Valérie; Rouzioux, Christine; Warszawski, Josiane

    2011-06-01

    Few data are available on the possible long-term negative effects of a short exposure to antiretroviral therapy (ART) for prevention of mother-to-child transmission (PMTCT). To determine whether ART for PMTCT, discontinued after delivery, affects the virological response to highly active antiretroviral therapy (HAART) administered during subsequent pregnancies. All current pregnancies of HIV-1-infected women enrolled in the French Perinatal Cohort (ANRS CO-01 EPF) between 2005 and 2009 and not receiving ART at the time of conception were eligible. We studied the association between history of exposure to ART during a previous pregnancy and detectable viral load (VL) under multitherapy at current delivery (VL ≥ 50 copies/mL). Among 1116 eligible women, 869 were ART naive and 247 had received PMTCT during a previous pregnancy. Previous ART was protease inhibitor (PI)-based HAART in 48%, non-PI-based HAART in 4%, nucleoside reverse transcriptase inhibitor bitherapy in 19% and zidovudine monotherapy in 29% of the women. At current pregnancy, women with or without prior exposure to ART had similar CD4 cell counts and VL before ART initiation. PI-based HAART was initiated in 90% of the women. VL was undetectable (<50 copies/mL) at delivery in 65% of previously ART-naive women, 72% of women previously exposed to HAART, 62% previously exposed to bitherapy, and 67% previously exposed to monotherapy for prophylaxis (P = 0.42). Detectable VL was not associated with previous exposure in multivariate analysis (adjusted OR for previous versus no previous exposure to ART: 0.92; 0.95% confidence interval: 0.59 to 1.44). Efficacy of PI-based combinations is not decreased in women previously exposed to various regimens of antiretroviral PMTCT.

  2. "A Prophecy for the Arts" in Higher Education

    ERIC Educational Resources Information Center

    Merrion, Margaret

    2009-01-01

    This article presents a Delphi study that captured a myriad of predictions that represent the best thinking of a panel of creative minds, experts in a variety of arts and with many years of experience as arts leaders. Predictions provide a set of interlinked challenges and opportunities. In this study, the experts forecast changes in students that…

  3. External validation of the endometriosis fertility index (EFI) staging system for predicting non-ART pregnancy after endometriosis surgery.

    PubMed

    Tomassetti, C; Geysenbergh, B; Meuleman, C; Timmerman, D; Fieuws, S; D'Hooghe, T

    2013-05-01

    Can the ability of the endometriosis fertility index (EFI) to predict non-assisted reproductive technology (ART) pregnancy after endometriosis surgery be confirmed by an external validation study? The significant relationship between the EFI score and the time to non-ART pregnancy observed in our study represents an external validation of this scoring system. The EFI was previously developed and tested prospectively in a single center, but up to now no external validation has been published. Our data provide validation of the EFI in an external fertility unit on a robust scientific basis, to identify couples with a good prognosis for spontaneous conception who can therefore defer ART treatment, regardless of their revised American Fertility Society (rAFS) endometriosis staging. Retrospective cohort study where the EFI was calculated based on history and detailed surgical findings, and related to pregnancy outcome in 233 women attempting non-ART conception immediately after surgery; all data used for EFI calculation and analysis of reproductive outcome had been collected prospectively as part of another study. The EFI score was calculated (score 0-10) for 233 women with all rAFS endometriosis stages (minimal-mild, n = 75; moderate-severe, n = 158) after endometriosis surgery (1 September 2006-30 September 2010) in a university hospital-based reproductive medicine unit with combined expertise in reproductive surgery and medically assisted reproduction. All participants attempted non-ART conception immediately after surgery by natural intercourse, ovulation induction with timed intercourse or intrauterine insemination (with or without ovulation induction or controlled ovarian stimulation). All analyses were performed for three different definitions of pregnancy [overall (any HCG >25 IU/l), clinical and ongoing >20 weeks]. Six groups were distinguished (EFI scores 1-3, 4, 5, 6, 7+8, 9+10), and Kaplan-Meier (K-M) estimates for cumulative pregnancy rate were calculated. Subjects were censored when they were lost to follow-up, had subsequent surgery for endometriosis, started ovarian suppression or underwent ART. As K-M estimates might overestimate the actual event rate, cumulative incidence estimates treating ART as competing event were also calculated. Cox regression analysis was used to assess the performance of EFI and constituting variables. Performance of the score (prediction, discrimination) was quantified with the following methods: mean squared error of prediction (Brier score), areas under the receiver-operating curve and global concordance index C(τ). There was a highly significant relationship between the EFI and the time to non-ART pregnancy (cumulative overall pregnancy rate, P = 0.0004), with the K-M estimate of cumulative overall pregnancy rate at 12 months after surgery equal to 45.5% [95% confidence interval (CI) 39.47-49.87]-ranging from 16.67% (95% CI 5.01-47.65) for EFI scores 0-3, to 62.55% (95% CI 55.18-69.94) for EFI scores 9-10. For each increase of 1 point in the EFI score, the relative risk of becoming pregnant increased by 31% (95% CI 16-47%; i.e. hazard ratio 1.31). The 'least function score'-which assesses the tubal/ovarian function at conclusion of surgery-was found to be the most important contributor to the total EFI score among all the other variables (age, duration of infertility, prior pregnancy, AFS endometriosis lesion and total score). The EFI score had a moderate performance in the prediction of the pregnancy rate. Indeed, the decrease in prediction error was rather small, as shown by the decrease in Brier score from 0.213 to 0.198, and low estimates for R² (13%) and C(τ) (0.629). As the EFI was validated externally in our own European population after initial testing by Adamson and Pasta (Endometriosis fertility index: the new, validated endometriosis staging system. Fertil Steril 2010;94:1609-1615) in an American population, it appears that the EFI can be used clinically to counsel infertile endometriosis patients receiving reproductive surgery in specialized centers about their post-operative conception options. This research was supported by funds obtained via the Clinical Research Fund of the University Hospitals Leuven, Belgium, via the Ferring Chair in Reproductive Medicine and Surgery, and the Serono Chair in Reproductive Medicine granted to the Leuven University Fertility Center. The authors have no conflicts of interest to declare.

  4. Back from the Brink of Extinction.

    ERIC Educational Resources Information Center

    Macneil, William

    1999-01-01

    New Mexico's Institute of American Indian and Alaska Native Culture and Arts Development has survived major loss of federal funding and subsequent retrenchment, watched enrollment rise, and begun construction of a new campus. The institute is dedicated to study, creative application, preservation, and care of Indian arts and culture, and houses…

  5. Putting reward in art: A tentative prediction error account of visual art

    PubMed Central

    Van de Cruys, Sander; Wagemans, Johan

    2011-01-01

    The predictive coding model is increasingly and fruitfully used to explain a wide range of findings in perception. Here we discuss the potential of this model in explaining the mechanisms underlying aesthetic experiences. Traditionally art appreciation has been associated with concepts such as harmony, perceptual fluency, and the so-called good Gestalt. We observe that more often than not great artworks blatantly violate these characteristics. Using the concept of prediction error from the predictive coding approach, we attempt to resolve this contradiction. We argue that artists often destroy predictions that they have first carefully built up in their viewers, and thus highlight the importance of negative affect in aesthetic experience. However, the viewer often succeeds in recovering the predictable pattern, sometimes on a different level. The ensuing rewarding effect is derived from this transition from a state of uncertainty to a state of increased predictability. We illustrate our account with several example paintings and with a discussion of art movements and individual differences in preference. On a more fundamental level, our theorizing leads us to consider the affective implications of prediction confirmation and violation. We compare our proposal to other influential theories on aesthetics and explore its advantages and limitations. PMID:23145260

  6. Predictive Utility of Brief Alcohol Use Disorders Identification Test (AUDIT) for human immunodeficiency virus antiretroviral medication nonadherence.

    PubMed

    Broyles, Lauren Matukaitis; Gordon, Adam J; Sereika, Susan M; Ryan, Christopher M; Erlen, Judith A

    2011-10-01

    Alcohol use negatively affects adherence to antiretroviral therapy (ART), thus human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) care providers need accurate, efficient assessments of alcohol use. Using existing data from an efficacy trial of 2 cognitive-behavioral ART adherence interventions, the authors sought to determine if results on 2 common alcohol screening tests (Alcohol Use Disorders Identification Test--Consumption [AUDIT-C] and its binge-related question [AUDIT-3]) predict ART nonadherence. Twenty-seven percent of the sample (n = 308) were positive on the AUDIT-C and 34% were positive on the AUDIT-3. In multivariate analyses, AUDIT-C-positive status predicted ART nonadherence after controlling for race, age, conscientiousness, and self-efficacy (P = .036). Although AUDIT-3-positive status was associated with ART nonadherence in unadjusted analyses, this relationship was not maintained in the final multivariate model. The AUDIT-C shows potential as an indirect screening tool for both at-risk drinking and ART nonadherence, underscoring the relationship between alcohol and chronic disease management.

  7. Predictive Utility of Brief AUDIT for HIV Antiretroviral Medication Nonadherence

    PubMed Central

    Broyles, Lauren Matukaitis; Gordon, Adam J.; Sereika, Susan M.; Ryan, Christopher M.; Erlen, Judith A.

    2012-01-01

    Alcohol use negatively affects adherence to antiretroviral therapy (ART), thus HIV/AIDS providers need accurate, efficient assessments of alcohol use. Using existing data from an efficacy trial of two cognitive-behavioral ART adherence interventions, we sought to determine if results on two common alcohol screening tests (Alcohol Use Disorders Identification Test—Consumption (AUDIT-C) and its binge-related question (AUDIT-3)) predict ART nonadherence. Twenty seven percent of the sample (n=308) were positive on the AUDIT-C and 34% were positive on the AUDIT-3. In multivariate analyses, AUDIT-C positive status predicted ART nonadherence after controlling for race, age, conscientiousness, and self-efficacy (p=.036). While AUDIT-3 positive status was associated with ART nonadherence in unadjusted analyses, this relationship was not maintained in the final multivariate model. The AUDIT-C shows potential as an indirect screening tool for both at-risk drinking and ART nonadherence, underscoring the relationship between alcohol and chronic disease management. PMID:22014256

  8. Development of an Electronic Medical Record Based Alert for Risk of HIV Treatment Failure in a Low-Resource Setting

    PubMed Central

    Puttkammer, Nancy; Zeliadt, Steven; Balan, Jean Gabriel; Baseman, Janet; Destiné, Rodney; Domerçant, Jean Wysler; France, Garilus; Hyppolite, Nathaelf; Pelletier, Valérie; Raphael, Nernst Atwood; Sherr, Kenneth; Yuhas, Krista; Barnhart, Scott

    2014-01-01

    Background The adoption of electronic medical record systems in resource-limited settings can help clinicians monitor patients' adherence to HIV antiretroviral therapy (ART) and identify patients at risk of future ART failure, allowing resources to be targeted to those most at risk. Methods Among adult patients enrolled on ART from 2005–2013 at two large, public-sector hospitals in Haiti, ART failure was assessed after 6–12 months on treatment, based on the World Health Organization's immunologic and clinical criteria. We identified models for predicting ART failure based on ART adherence measures and other patient characteristics. We assessed performance of candidate models using area under the receiver operating curve, and validated results using a randomly-split data sample. The selected prediction model was used to generate a risk score, and its ability to differentiate ART failure risk over a 42-month follow-up period was tested using stratified Kaplan Meier survival curves. Results Among 923 patients with CD4 results available during the period 6–12 months after ART initiation, 196 (21.2%) met ART failure criteria. The pharmacy-based proportion of days covered (PDC) measure performed best among five possible ART adherence measures at predicting ART failure. Average PDC during the first 6 months on ART was 79.0% among cases of ART failure and 88.6% among cases of non-failure (p<0.01). When additional information including sex, baseline CD4, and duration of enrollment in HIV care prior to ART initiation were added to PDC, the risk score differentiated between those who did and did not meet failure criteria over 42 months following ART initiation. Conclusions Pharmacy data are most useful for new ART adherence alerts within iSanté. Such alerts offer potential to help clinicians identify patients at high risk of ART failure so that they can be targeted with adherence support interventions, before ART failure occurs. PMID:25390044

  9. Development of an electronic medical record based alert for risk of HIV treatment failure in a low-resource setting.

    PubMed

    Puttkammer, Nancy; Zeliadt, Steven; Balan, Jean Gabriel; Baseman, Janet; Destiné, Rodney; Domerçant, Jean Wysler; France, Garilus; Hyppolite, Nathaelf; Pelletier, Valérie; Raphael, Nernst Atwood; Sherr, Kenneth; Yuhas, Krista; Barnhart, Scott

    2014-01-01

    The adoption of electronic medical record systems in resource-limited settings can help clinicians monitor patients' adherence to HIV antiretroviral therapy (ART) and identify patients at risk of future ART failure, allowing resources to be targeted to those most at risk. Among adult patients enrolled on ART from 2005-2013 at two large, public-sector hospitals in Haiti, ART failure was assessed after 6-12 months on treatment, based on the World Health Organization's immunologic and clinical criteria. We identified models for predicting ART failure based on ART adherence measures and other patient characteristics. We assessed performance of candidate models using area under the receiver operating curve, and validated results using a randomly-split data sample. The selected prediction model was used to generate a risk score, and its ability to differentiate ART failure risk over a 42-month follow-up period was tested using stratified Kaplan Meier survival curves. Among 923 patients with CD4 results available during the period 6-12 months after ART initiation, 196 (21.2%) met ART failure criteria. The pharmacy-based proportion of days covered (PDC) measure performed best among five possible ART adherence measures at predicting ART failure. Average PDC during the first 6 months on ART was 79.0% among cases of ART failure and 88.6% among cases of non-failure (p<0.01). When additional information including sex, baseline CD4, and duration of enrollment in HIV care prior to ART initiation were added to PDC, the risk score differentiated between those who did and did not meet failure criteria over 42 months following ART initiation. Pharmacy data are most useful for new ART adherence alerts within iSanté. Such alerts offer potential to help clinicians identify patients at high risk of ART failure so that they can be targeted with adherence support interventions, before ART failure occurs.

  10. Eye Movements During Everyday Behavior Predict Personality Traits.

    PubMed

    Hoppe, Sabrina; Loetscher, Tobias; Morey, Stephanie A; Bulling, Andreas

    2018-01-01

    Besides allowing us to perceive our surroundings, eye movements are also a window into our mind and a rich source of information on who we are, how we feel, and what we do. Here we show that eye movements during an everyday task predict aspects of our personality. We tracked eye movements of 42 participants while they ran an errand on a university campus and subsequently assessed their personality traits using well-established questionnaires. Using a state-of-the-art machine learning method and a rich set of features encoding different eye movement characteristics, we were able to reliably predict four of the Big Five personality traits (neuroticism, extraversion, agreeableness, conscientiousness) as well as perceptual curiosity only from eye movements. Further analysis revealed new relations between previously neglected eye movement characteristics and personality. Our findings demonstrate a considerable influence of personality on everyday eye movement control, thereby complementing earlier studies in laboratory settings. Improving automatic recognition and interpretation of human social signals is an important endeavor, enabling innovative design of human-computer systems capable of sensing spontaneous natural user behavior to facilitate efficient interaction and personalization.

  11. Eye Movements During Everyday Behavior Predict Personality Traits

    PubMed Central

    Hoppe, Sabrina; Loetscher, Tobias; Morey, Stephanie A.; Bulling, Andreas

    2018-01-01

    Besides allowing us to perceive our surroundings, eye movements are also a window into our mind and a rich source of information on who we are, how we feel, and what we do. Here we show that eye movements during an everyday task predict aspects of our personality. We tracked eye movements of 42 participants while they ran an errand on a university campus and subsequently assessed their personality traits using well-established questionnaires. Using a state-of-the-art machine learning method and a rich set of features encoding different eye movement characteristics, we were able to reliably predict four of the Big Five personality traits (neuroticism, extraversion, agreeableness, conscientiousness) as well as perceptual curiosity only from eye movements. Further analysis revealed new relations between previously neglected eye movement characteristics and personality. Our findings demonstrate a considerable influence of personality on everyday eye movement control, thereby complementing earlier studies in laboratory settings. Improving automatic recognition and interpretation of human social signals is an important endeavor, enabling innovative design of human–computer systems capable of sensing spontaneous natural user behavior to facilitate efficient interaction and personalization. PMID:29713270

  12. Analysis of the Performance of a Laser Scanner for Predictive Automotive Applications

    NASA Astrophysics Data System (ADS)

    Zeisler, J.; Maas, H.-G.

    2015-08-01

    In this paper we evaluate the use of a laser scanner for future advanced driver assistance systems. We focus on the important task of predicting the target vehicle for longitudinal ego vehicle control. Our motivation is to decrease the reaction time of existing systems during cut-in maneuvers of other traffic participants. A state-of-the-art laser scanner, the Ibeo Scala B2 R , is presented, providing its sensing characteristics and the subsequent high level object data output. We evaluate the performance of the scanner towards object tracking with the help of a GPS real time kinematics system on a test track. Two designed scenarios show phases with constant distance and velocity as well as dynamic motion of the vehicles. We provide the results for the error in position and velocity of the scanner and furthermore, review our algorithm for target vehicle prediction. Finally we show the potential of the laser scanner with the estimated error, that leads to a decrease of up to 40% in reaction time with best conditions.

  13. Video quality assessment using motion-compensated temporal filtering and manifold feature similarity

    PubMed Central

    Yu, Mei; Jiang, Gangyi; Shao, Feng; Peng, Zongju

    2017-01-01

    Well-performed Video quality assessment (VQA) method should be consistent with human visual systems for better prediction accuracy. In this paper, we propose a VQA method using motion-compensated temporal filtering (MCTF) and manifold feature similarity. To be more specific, a group of frames (GoF) is first decomposed into a temporal high-pass component (HPC) and a temporal low-pass component (LPC) by MCTF. Following this, manifold feature learning (MFL) and phase congruency (PC) are used to predict the quality of temporal LPC and temporal HPC respectively. The quality measures of the LPC and the HPC are then combined as GoF quality. A temporal pooling strategy is subsequently used to integrate GoF qualities into an overall video quality. The proposed VQA method appropriately processes temporal information in video by MCTF and temporal pooling strategy, and simulate human visual perception by MFL. Experiments on publicly available video quality database showed that in comparison with several state-of-the-art VQA methods, the proposed VQA method achieves better consistency with subjective video quality and can predict video quality more accurately. PMID:28445489

  14. Patterns and Predictors of Early Biochemical Recurrence After Radical Prostatectomy and Adjuvant Radiation Therapy in Men With pT{sub 3}N{sub 0} Prostate Cancer: Implications for Multimodal Therapies

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

    Briganti, Alberto, E-mail: briganti.alberto@hsr.it; Joniau, Steven; Gandaglia, Giorgio

    Purpose: The aim of our study was to evaluate patterns and predictors of early biochemical recurrence (eBCR) after radical prostatectomy (RP) and adjuvant radiation therapy (aRT) in order to identify which individuals might benefit from additional treatments. Methods and Materials: We evaluated 390 patients with pT{sub 3}N{sub 0} prostate cancer (PCa) receiving RP and aRT at 6 European centers between 1993 and 2006. Patients who were free from BCR at <2 years' follow-up were excluded. This resulted in 374 assessable patients. Early BCR was defined as 2 consecutive prostate-specific antigen (PSA) test values >0.2 ng/mL within 2 or 3 yearsmore » after aRT. Uni- and multivariable Cox regression analyses predicting overall and eBCR after aRT were fitted. Covariates consisted of preoperative PSA results, surgical margins, pathological stage, Gleason score, and aRT dose. Results: Overall, 5- and 8-year BCR-free survival rates were 77.1% and 70.8%, respectively. At a median follow-up of 86 months after aRT, 33 (8.8%) and 55 (14.6%) men experienced BCR within 2 or 3 years after aRT, respectively. In multivariable analyses, Gleason scores of 8 to 10 represented the only independent predictor of eBCR after aRT (all, P≤.01). The risk of BCR was significantly higher in patients with a Gleason score of 8 to 10 disease than in those with Gleason 2 to 6 within 24 months after treatment, after adjusting for all covariates (all, P≤.04). However, given a 24-month BCR free period, the risk of subsequent BCR for men with poorly differentiated disease was equal to that of men with less aggressive disease (all, P≥.3). Conclusions: High Gleason score represents the only predictor of eBCR after RP and aRT in patients affected by pT{sub 3}N{sub 0} PCa. Given the association between early PSA recurrence, clinical progression, and mortality, these patients might be considered candidates for adjuvant medical therapy and/or prophylactic whole-pelvis radiation therapy in addition to aRT, delivered to the prostatic bed.« less

  15. Immunological biomarkers predict HIV-1 viral rebound after treatment interruption

    PubMed Central

    Hurst, Jacob; Hoffmann, Matthias; Pace, Matthew; Williams, James P.; Thornhill, John; Hamlyn, Elizabeth; Meyerowitz, Jodi; Willberg, Chris; Koelsch, Kersten K.; Robinson, Nicola; Brown, Helen; Fisher, Martin; Kinloch, Sabine; Cooper, David A.; Schechter, Mauro; Tambussi, Giuseppe; Fidler, Sarah; Babiker, Abdel; Weber, Jonathan; Kelleher, Anthony D.; Phillips, Rodney E.; Frater, John

    2015-01-01

    Treatment of HIV-1 infection with antiretroviral therapy (ART) in the weeks following transmission may induce a state of ‘post-treatment control' (PTC) in some patients, in whom viraemia remains undetectable when ART is stopped. Explaining PTC could help our understanding of the processes that maintain viral persistence. Here we show that immunological biomarkers can predict time to viral rebound after stopping ART by analysing data from a randomized study of primary HIV-1 infection incorporating a treatment interruption (TI) after 48 weeks of ART (the SPARTAC trial). T-cell exhaustion markers PD-1, Tim-3 and Lag-3 measured prior to ART strongly predict time to the return of viraemia. These data indicate that T-cell exhaustion markers may identify those latently infected cells with a higher proclivity to viral transcription. Our results may open new avenues for understanding the mechanisms underlying PTC, and eventually HIV-1 eradication. PMID:26449164

  16. Modeling Neurocognitive Decline and Recovery During Repeated Cycles of Extended Sleep and Chronic Sleep Deficiency.

    PubMed

    St Hilaire, Melissa A; Rüger, Melanie; Fratelli, Federico; Hull, Joseph T; Phillips, Andrew J K; Lockley, Steven W

    2017-01-01

    Intraindividual night-to-night sleep duration is often insufficient and variable. Here we report the effects of such chronic variable sleep deficiency on neurobehavioral performance and the ability of state-of-the-art models to predict these changes. Eight healthy males (mean age ± SD: 23.9 ± 2.4 years) studied at our inpatient intensive physiologic monitoring unit completed an 11-day protocol with a baseline 10-hour sleep opportunity and three cycles of two 3-hour time-in-bed (TIB) and one 10-hour TIB sleep opportunities. Participants received one of three polychromatic white light interventions (200 lux 4100K, 200 or 400 lux 17000K) for 3.5 hours on the morning following the second 3-hour TIB opportunity each cycle. Neurocognitive performance was assessed using the psychomotor vigilance test (PVT) administered every 1-2 hours. PVT data were compared to predictions of five group-average mathematical models that incorporate chronic sleep loss functions. While PVT performance deteriorated cumulatively following each cycle of two 3-hour sleep opportunities, and improved following each 10-hour sleep opportunity, performance declined cumulatively throughout the protocol at a more accelerated rate than predicted by state-of-the-art group-average mathematical models. Subjective sleepiness did not reflect performance. The light interventions had minimal effect. Despite apparent recovery following each extended sleep opportunity, residual performance impairment remained and deteriorated rapidly when rechallenged with subsequent sleep loss. None of the group-average models were capable of predicting both the build-up in impairment and recovery profile of performance observed at the group or individual level, raising concerns regarding their use in real-world settings to predict performance and improve safety. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  17. Finite element prediction on the chassis design of UniART4 racing car

    NASA Astrophysics Data System (ADS)

    Zaman, Z. I.; Basaruddin, K. S.; Basha, M. H.; Rahman, M. T. Abd; Daud, R.

    2017-09-01

    This paper presents the analysis and evaluation of the chassis design for University Automotive Racing Team No. 4 (UniART4) car based on finite element analysis. The existing UniART4 car chassis was measured and modelled geometrically using Solidwork before analysed in FEA software (ANSYS). Four types of static structural analysis were used to predict the chassis design capability under four different loading conditions; vertical bending, lateral bending, lateral torsion and horizontal lozenging. The results showed the chassis subjected to the highest stress and strain under horizontal lozenging, whereas the minimum stress and strain response was obtained under lateral bending. The present analysis result could provide valuable information in predicting the sustainability of the current UniART car chassis design.

  18. Under Your Skin

    ERIC Educational Resources Information Center

    Corsino, Janet

    2012-01-01

    A traditional understanding in art is that, in order to draw the human figure, the artist must first understand its structure and inner workings. This project was first developed for middle-school art students in an attempt to help them better understand figure drawing. In subsequent years, it has been amended and adapted to integrate with other…

  19. The Rose Art Museum Crisis

    ERIC Educational Resources Information Center

    Dillon, Paul

    2010-01-01

    On January 26, 2009, the Brandeis University Board of Trustees voted unanimously to close the Rose Art Museum (Waltham, Massachusetts). The proceeds from the subsequent auction were to be reinvested in the university to ensure its long-term financial health. The reaction to the decision by campus constituencies provides a case study to show the…

  20. Photographing Teaching Artists at Work: A Photo Essay and Commentary

    ERIC Educational Resources Information Center

    Talner, Lee

    2010-01-01

    Like so many other doctors, the author loves the arts deeply. Playing a musical instrument and making photographs have been joyful pursuits throughout his schooling, training, and subsequent forty-five-year career as a medical school professor and practitioner of diagnostic radiology. Despite stretches when his healing art pushed aside his visual…

  1. Noise normalization and windowing functions for VALIDAR in wind parameter estimation

    NASA Astrophysics Data System (ADS)

    Beyon, Jeffrey Y.; Koch, Grady J.; Li, Zhiwen

    2006-05-01

    The wind parameter estimates from a state-of-the-art 2-μm coherent lidar system located at NASA Langley, Virginia, named VALIDAR (validation lidar), were compared after normalizing the noise by its estimated power spectra via the periodogram and the linear predictive coding (LPC) scheme. The power spectra and the Doppler shift estimates were the main parameter estimates for comparison. Different types of windowing functions were implemented in VALIDAR data processing algorithm and their impact on the wind parameter estimates was observed. Time and frequency independent windowing functions such as Rectangular, Hanning, and Kaiser-Bessel and time and frequency dependent apodized windowing function were compared. The briefing of current nonlinear algorithm development for Doppler shift correction subsequently follows.

  2. Cycle 1 as predictor of assisted reproductive technology treatment outcome over multiple cycles: an analysis of linked cycles from the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System online database.

    PubMed

    Stern, Judy E; Brown, Morton B; Luke, Barbara; Wantman, Ethan; Lederman, Avi; Hornstein, Mark D

    2011-02-01

    To determine whether the first cycle of assisted reproductive technology (ART) predicts treatment course and outcome. Retrospective study of linked cycles. Society for Assisted Reproductive Technology Clinic Outcome Reporting System database. A total of 6,352 ART patients residing or treated in Massachusetts with first treatment cycle in 2004-2005 using fresh, autologous oocytes and no prior ART. Women were categorized by first cycle as follows: Group I, no retrieval; Group II, retrieval, no transfer; Group III, transfer, no embryo cryopreservation; Group IV, transfer plus cryopreservation; and Group V, all embryos cryopreserved. None. Cumulative live-birth delivery per woman, use of donor eggs, intracytoplasmic sperm injection (ICSI), or frozen embryo transfers (FET). Groups differed in age, baseline FSH level, prior gravidity, diagnosis, and failure to return for Cycle 2. Live-birth delivery per woman for groups I through V for women with no delivery in Cycle I were 32.1%, 35.9%, 40.1%, 53.4%, and 51.3%, respectively. Groups I and II were more likely to subsequently use donor eggs (14.5% and 10.9%). Group II had the highest use of ICSI (73.3%); Group III had the lowest use of FET (8.9%). Course of treatment in the first ART cycle is related to different cumulative live-birth delivery rates and eventual use of donor egg, ICSI, and FET. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  3. Predicting survival of men with recurrent prostate cancer after radical prostatectomy.

    PubMed

    Dell'Oglio, Paolo; Suardi, Nazareno; Boorjian, Stephen A; Fossati, Nicola; Gandaglia, Giorgio; Tian, Zhe; Moschini, Marco; Capitanio, Umberto; Karakiewicz, Pierre I; Montorsi, Francesco; Karnes, R Jeffrey; Briganti, Alberto

    2016-02-01

    To develop and externally validate a novel nomogram aimed at predicting cancer-specific mortality (CSM) after biochemical recurrence (BCR) among prostate cancer (PCa) patients treated with radical prostatectomy (RP) with or without adjuvant external beam radiotherapy (aRT) and/or hormonal therapy (aHT). The development cohort included 689 consecutive PCa patients treated with RP between 1987 and 2011 with subsequent BCR, defined as two subsequent prostate-specific antigen values >0.2 ng/ml. Multivariable competing-risks regression analyses tested the predictors of CSM after BCR for the purpose of 5-year CSM nomogram development. Validation (2000 bootstrap resamples) was internally tested. External validation was performed into a population of 6734 PCa patients with BCR after treatment with RP at the Mayo Clinic from 1987 to 2011. The predictive accuracy (PA) was quantified using the receiver operating characteristic-derived area under the curve and the calibration plot method. The 5-year CSM-free survival rate was 83.6% (confidence interval [CI]: 79.6-87.2). In multivariable analyses, pathologic stage T3b or more (hazard ratio [HR]: 7.42; p = 0.008), pathologic Gleason score 8-10 (HR: 2.19; p = 0.003), lymph node invasion (HR: 3.57; p = 0.001), time to BCR (HR: 0.99; p = 0.03) and age at BCR (HR: 1.04; p = 0.04), were each significantly associated with the risk of CSM after BCR. The bootstrap-corrected PA was 87.4% (bootstrap 95% CI: 82.0-91.7%). External validation of our nomogram showed a good PA at 83.2%. We developed and externally validated the first nomogram predicting 5-year CSM applicable to contemporary patients with BCR after RP with or without adjuvant treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Re-Viewing an Arts-in-Health Process: "For the Best"

    ERIC Educational Resources Information Center

    Walsh, Aylwyn; Ledgard, Anna

    2013-01-01

    This paper focuses on several images and metaphors from an artist residency at the Evelina Children's Hospital and subsequent production at the Unicorn Theatre, "For the Best." The intention is to consider how reflecting on an arts-based process with children on dialysis, and their school-mates can provide new ways of viewing performance…

  5. Will the Liberal Arts Survive the Bronze Age of American Academe?

    ERIC Educational Resources Information Center

    Kimball, Bruce A.

    2015-01-01

    Kimball begins this essay by comparing the start of the "golden age" of liberal arts education as the period between about 1950 and 1975 when American higher education's revenue and enrollments of colleges and universities grew enormously. During the subsequent silver age of academe, ending in the Great Recession of 2008-2009,…

  6. Mine Burial Assessment State-of the Art in Prediction and Modeling Workshop and Initiation of Technical Program

    DTIC Science & Technology

    2000-09-30

    Burial Assessment State-of-the Art Science , Technology, and Modeling. A Review of Coastal Research, Modeling, and Naval Operational Needs in Shallow Water...the ONR Mine Burial Prediction Program are summarized below. 1) Completed comprehensive technical reports: a. Mine Burial Assessment, State-of-the Art ... Science , Technology, and Modeling. A review of Coastal Research, Modeling, and Naval Operational Needs in Shallow Water Environments with

  7. The Condition of Art Education: Critical Visual Art Education [CVAE] Club, Winter 2010

    ERIC Educational Resources Information Center

    Hausman, Jerome; Ploof, John; Duignan, James; Brown, W. Keith; Hostert, Nicholas

    2010-01-01

    Artist Ad Reinhardt's 1991 prediction of the "Future of Art" can be interpreted as the condition of art education in 2010. He writes, "The next revolution will see the emancipation of the university academy of art from its market-place fantasies and its emergence as a center of consciousness and conscience." The focus in the fields of art and art…

  8. Openness to Experience and Intellect differentially predict creative achievement in the arts and sciences

    PubMed Central

    Kaufman, Scott Barry; Quilty, Lena C.; Grazioplene, Rachael G.; Hirsh, Jacob B.; Gray, Jeremy R.; Peterson, Jordan B.; DeYoung, Colin G.

    2014-01-01

    Objective The Big Five personality dimension Openness/Intellect is the trait most closely associated with creativity and creative achievement. Little is known, however, regarding the discriminant validity of its two aspects— Openness to Experience (reflecting cognitive engagement with perception, fantasy, aesthetics, and emotions) and Intellect (reflecting cognitive engagement with abstract and semantic information, primarily through reasoning)— in relation to creativity. Method In four demographically diverse samples totaling 1035 participants, we investigated the independent predictive validity of Openness and Intellect by assessing the relations among cognitive ability, divergent thinking, personality, and creative achievement across the arts and sciences. Results and Conclusions We confirmed the hypothesis that whereas Openness predicts creative achievement in the arts, Intellect predicts creative achievement in the sciences. Inclusion of performance measures of general cognitive ability and divergent thinking indicated that the relation of Intellect to scientific creativity may be due at least in part to these abilities. Lastly, we found that Extraversion additionally predicted creative achievement in the arts, independently of Openness. Results are discussed in the context of dual-process theory. PMID:25487993

  9. Long terms trends in CD4+ cell counts, CD8+ cell counts, and the CD4+ : CD8+ ratio

    PubMed Central

    Hughes, Rachael A.; May, Margaret T.; Tilling, Kate; Taylor, Ninon; Wittkop, Linda; Reiss, Peter; Gill, John; Schommers, Philipp; Costagliola, Dominique; Guest, Jodie L.; Lima, Viviane D.; d’Arminio Monforte, Antonella; Smith, Colette; Cavassini, Matthias; Saag, Michael; Castilho, Jessica L.; Sterne, Jonathan A.C.

    2018-01-01

    Objective: Model trajectories of CD4+ and CD8+ cell counts after starting combination antiretroviral therapy (ART) and use the model to predict trends in these counts and the CD4+ : CD8+ ratio. Design: Cohort study of antiretroviral-naïve HIV-positive adults who started ART after 1997 (ART Cohort Collaboration) with more than 6 months of follow-up data. Methods: We jointly estimated CD4+ and CD8+ cell count trends and their correlation using a bivariate random effects model, with linear splines describing their population trends, and predicted the CD4+ : CD8+ ratio trend from this model. We assessed whether CD4+ and CD8+ cell count trends and the CD4+ : CD8+ ratio trend varied according to CD4+ cell count at start of ART (baseline), and, whether these trends differed in patients with and without virological failure more than 6 months after starting ART. Results: A total of 39 979 patients were included (median follow-up was 53 months). Among patients with baseline CD4+ cell count at least 50 cells/μl, predicted mean CD8+ cell counts continued to decrease between 3 and 15 years post-ART, partly driving increases in the predicted mean CD4+ : CD8+ ratio. During 15 years of follow-up, normalization of the predicted mean CD4+ : CD8+ ratio (to >1) was only observed among patients with baseline CD4+ cell count at least 200 cells/μl. A higher baseline CD4+ cell count predicted a shorter time to normalization. Conclusion: Declines in CD8+ cell count and increases in CD4+ : CD8+ ratio occurred up to 15 years after starting ART. The likelihood of normalization of the CD4+ : CD8+ ratio is strongly related to baseline CD4+ cell count. PMID:29851663

  10. HIV-1 DNA predicts disease progression and post-treatment virological control

    PubMed Central

    Williams, James P; Hurst, Jacob; Stöhr, Wolfgang; Robinson, Nicola; Brown, Helen; Fisher, Martin; Kinloch, Sabine; Cooper, David; Schechter, Mauro; Tambussi, Giuseppe; Fidler, Sarah; Carrington, Mary; Babiker, Abdel; Weber, Jonathan

    2014-01-01

    In HIV-1 infection, a population of latently infected cells facilitates viral persistence despite antiretroviral therapy (ART). With the aim of identifying individuals in whom ART might induce a period of viraemic control on stopping therapy, we hypothesised that quantification of the pool of latently infected cells in primary HIV-1 infection (PHI) would predict clinical progression and viral replication following ART. We measured HIV-1 DNA in a highly characterised randomised population of individuals with PHI. We explored associations between HIV-1 DNA and immunological and virological markers of clinical progression, including viral rebound in those interrupting therapy. In multivariable analyses, HIV-1 DNA was more predictive of disease progression than plasma viral load and, at treatment interruption, predicted time to plasma virus rebound. HIV-1 DNA may help identify individuals who could safely interrupt ART in future HIV-1 eradication trials. Clinical trial registration: ISRCTN76742797 and EudraCT2004-000446-20 DOI: http://dx.doi.org/10.7554/eLife.03821.001 PMID:25217531

  11. Early loss to follow-up of recently diagnosed HIV-infected adults from routine pre-ART care in a rural district hospital in Kenya: a cohort study.

    PubMed

    Hassan, Amin S; Fielding, Katherine L; Thuo, Nahashon M; Nabwera, Helen M; Sanders, Eduard J; Berkley, James A

    2012-01-01

    To determine the rate and predictors of early loss to follow-up (LTFU) for recently diagnosed HIV-infected, antiretroviral therapy (ART)-ineligible adults in rural Kenya. Prospective cohort study. Clients registering for HIV care between July 2008 and August 2009 were followed up for 6 months. Baseline data were used to assess predictors of pre-ART LTFU (not returning for care within 2 months of a scheduled appointment), LTFU before the second visit and LTFU after the second visit. Logistic regression was used to determine factors associated with LTFU before the second visit, while Cox regression was used to assess predictors of time to LTFU and LTFU after the second visit. Of 530 eligible clients, 178 (33.6%) were LTFU from pre-ART care (11.1/100 person-months). Of these, 96 (53.9%) were LTFU before the second visit. Distance (>5 km vs. <1 km: adjusted hazard ratio 2.6 [1.9-3.7], P < 0.01) and marital status (married vs. single: 0.5 [0.3-0.6], P < 0.01) independently predicted pre-ART LTFU. Distance and marital status were independently associated with LTFU before the second visit, while distance, education status and seasonality showed weak evidence of predicting LTFU after the second visit. HIV disease severity did not predict pre-ART LTFU. A third of recently diagnosed HIV-infected, ART-ineligible clients were LTFU within 6 months of registration. Predictors of LTFU among ART-ineligible clients are different from those among clients on ART. These findings warrant consideration of an enhanced pre-ART care package aimed at improving retention and timely ART initiation. © 2011 Blackwell Publishing Ltd.

  12. Behavioral and autonomic responses to real and digital reproductions of works of art.

    PubMed

    Siri, Francesca; Ferroni, Francesca; Ardizzi, Martina; Kolesnikova, Anna; Beccaria, Marcella; Rocci, Barbara; Christov-Bakargiev, Carolyn; Gallese, Vittorio

    2018-01-01

    Nowadays, works of art can be enjoyed in both their original and reproduced format. The aim of this study was to investigate whether the format of a work of art could influence physiological and cognitive responses in beholders. Two abstract works of art and their digital reproductions were selected as experimental stimuli and displayed for 2min to 60 participants in a museum. HRV, HR, and RMSSD were recorded, while participants observed the works of art. Subsequently, participants provided behavioral ratings of color intensity, emotional intensity, aesthetic evaluation, perceived movement, and desire to touch the works of art. Results demonstrated that the faithful high-quality digital reproduction of works of art could be as arousing as the original works of art, but at the same time, they cannot replace the experience of standing in front of an authentic work of art in terms of explicit hedonic attributed values. Furthermore, specific interactions between individual inclinations to identify with fictional characters and acquired art competences in the context of aesthetic experience were found. © 2018 Elsevier B.V. All rights reserved.

  13. The Moons of Jupiter / Journey to the Stars

    NASA Astrophysics Data System (ADS)

    Litwak, J.; Chatzichristou, E.

    2017-09-01

    The Moons of Jupiter/ Journey to the Stars uses the arts, most particularly theatre arts to inspire curiosity about science education. Using characters which include famous scientists as well as mythological figures, the project provokes thought and offers opportunity for discovery. The play and the subsequent creative teaching tools are accessible to scientists, artists and lay people in an out of the classroom.

  14. State-of-the-Art Review : Prediction and Control of Groundborne Noise and Vibration from Rail Transit Trains

    DOT National Transportation Integrated Search

    1983-12-01

    This report provides a comprehensive review of the state-of-the-art in the prediction and control of groundborne noise and vibration. Various types of impact criteria are reviewed for groundborne noise and vibration, building damage, and soil settlem...

  15. Role of aerosols on the Indian Summer Monsoon variability, as simulated by state-of-the-art global climate models

    NASA Astrophysics Data System (ADS)

    Cagnazzo, Chiara; Biondi, Riccardo; D'Errico, Miriam; Cherchi, Annalisa; Fierli, Federico; Lau, William K. M.

    2016-04-01

    Recent observational and modeling analyses have explored the interaction between aerosols and the Indian summer monsoon precipitation on seasonal-to-interannual time scales. By using global scale climate model simulations, we show that when increased aerosol loading is found on the Himalayas slopes in the premonsoon period (April-May), intensification of early monsoon rainfall over India and increased low-level westerly flow follow, in agreement with the elevated-heat-pump (EHP) mechanism. The increase in rainfall during the early monsoon season has a cooling effect on the land surface that may also be amplified through solar dimming (SD) by more cloudiness and aerosol loading with subsequent reduction in monsoon rainfall over India. We extend this analyses to a subset of CMIP5 climate model simulations. Our results suggest that 1) absorbing aerosols, by influencing the seasonal variability of the Indian summer monsoon with the discussed time-lag, may act as a source of predictability for the Indian Summer Monsoon and 2) if the EHP and SD effects are operating also in a number of state-of-the-art climate models, their inclusion could potentially improve seasonal forecasts.

  16. Computational predictive models for P-glycoprotein inhibition of in-house chalcone derivatives and drug-bank compounds.

    PubMed

    Ngo, Trieu-Du; Tran, Thanh-Dao; Le, Minh-Tri; Thai, Khac-Minh

    2016-11-01

    The human P-glycoprotein (P-gp) efflux pump is of great interest for medicinal chemists because of its important role in multidrug resistance (MDR). Because of the high polyspecificity as well as the unavailability of high-resolution X-ray crystal structures of this transmembrane protein, ligand-based, and structure-based approaches which were machine learning, homology modeling, and molecular docking were combined for this study. In ligand-based approach, individual two-dimensional quantitative structure-activity relationship models were developed using different machine learning algorithms and subsequently combined into the Ensemble model which showed good performance on both the diverse training set and the validation sets. The applicability domain and the prediction quality of the developed models were also judged using the state-of-the-art methods and tools. In our structure-based approach, the P-gp structure and its binding region were predicted for a docking study to determine possible interactions between the ligands and the receptor. Based on these in silico tools, hit compounds for reversing MDR were discovered from the in-house and DrugBank databases through virtual screening using prediction models and molecular docking in an attempt to restore cancer cell sensitivity to cytotoxic drugs.

  17. Proposed clinical case definition for cytomegalovirus-immune recovery retinitis.

    PubMed

    Ruiz-Cruz, Matilde; Alvarado-de la Barrera, Claudia; Ablanedo-Terrazas, Yuria; Reyes-Terán, Gustavo

    2014-07-15

    Cytomegalovirus (CMV) retinitis has been extensively described in patients with advanced or late human immunodeficiency virus (HIV) disease under ineffective treatment of opportunistic infection and antiretroviral therapy (ART) failure. However, there is limited information about patients who develop active cytomegalovirus retinitis as an immune reconstitution inflammatory syndrome (IRIS) after successful initiation of ART. Therefore, a case definition of cytomegalovirus-immune recovery retinitis (CMV-IRR) is proposed here. We reviewed medical records of 116 HIV-infected patients with CMV retinitis attending our institution during January 2003-June 2012. We retrospectively studied HIV-infected patients who had CMV retinitis on ART initiation or during the subsequent 6 months. Clinical and immunological characteristics of patients with active CMV retinitis were described. Of the 75 patients under successful ART included in the study, 20 had improvement of CMV retinitis. The remaining 55 patients experienced CMV-IRR; 35 of those developed CMV-IRR after ART initiation (unmasking CMV-IRR) and 20 experienced paradoxical clinical worsening of retinitis (paradoxical CMV-IRR). Nineteen patients with CMV-IRR had a CD4 count of ≥50 cells/µL. Six patients with CMV-IRR subsequently developed immune recovery uveitis. There is no case definition for CMV-IRR, although this condition is likely to occur after successful initiation of ART, even in patients with high CD4 T-cell counts. By consequence, we propose the case definitions for paradoxical and unmasking CMV-IRR. We recommend close follow-up of HIV-infected patients following ART initiation. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  18. Embracing the Burden of Proof: New Strategies for Determining Predictive Links between Arts Integration Teacher Professional Development, Student Arts Learning, and Student Academic Achievement Outcomes

    ERIC Educational Resources Information Center

    Scripp, Lawrence; Paradis, Laura

    2014-01-01

    This article provides a window into Chicago Arts Partnerships in Education's (CAPE) Partnerships in Arts Integration Research (PAIR) project conducted in Chicago public schools (CPS) (pairresults.org), which statistically demonstrates how a three-year arts integration project can impact treatment versus control students in both academic and arts…

  19. Comprehensive comparative analysis and identification of RNA-binding protein domains: multi-class classification and feature selection.

    PubMed

    Jahandideh, Samad; Srinivasasainagendra, Vinodh; Zhi, Degui

    2012-11-07

    RNA-protein interaction plays an important role in various cellular processes, such as protein synthesis, gene regulation, post-transcriptional gene regulation, alternative splicing, and infections by RNA viruses. In this study, using Gene Ontology Annotated (GOA) and Structural Classification of Proteins (SCOP) databases an automatic procedure was designed to capture structurally solved RNA-binding protein domains in different subclasses. Subsequently, we applied tuned multi-class SVM (TMCSVM), Random Forest (RF), and multi-class ℓ1/ℓq-regularized logistic regression (MCRLR) for analysis and classifying RNA-binding protein domains based on a comprehensive set of sequence and structural features. In this study, we compared prediction accuracy of three different state-of-the-art predictor methods. From our results, TMCSVM outperforms the other methods and suggests the potential of TMCSVM as a useful tool for facilitating the multi-class prediction of RNA-binding protein domains. On the other hand, MCRLR by elucidating importance of features for their contribution in predictive accuracy of RNA-binding protein domains subclasses, helps us to provide some biological insights into the roles of sequences and structures in protein-RNA interactions.

  20. Optimal timing of viral load monitoring during pregnancy to predict viraemia at delivery in HIV-infected women initiating ART in South Africa: a simulation study.

    PubMed

    Lesosky, Maia; Glass, Tracy; Mukonda, Elton; Hsiao, Nei-Yuan; Abrams, Elaine J; Myer, Landon

    2017-11-01

    HIV viral load (VL) monitoring is a central tool to evaluate ART effectiveness and transmission risk. There is a global movement to expand VL monitoring following recent recommendations from the World Health Organization (WHO), but there has been little research into VL monitoring in pregnant women. We investigated one important question in this area: when and how frequently VL should be monitored in women initiating ART during pregnancy to predict VL at the time of delivery in a simulated South African population. We developed a mathematical model simulating VL from conception through delivery using VL data from the Maternal and Child Health - Antiretroviral Therapy (MCH-ART) cohort. VL was modelled based on three major compartments: pre-ART VL, viral decay immediately after ART initiation and viral maintenance (including viral suppression and viraemic episodes). Using this simulation, we examined the performance of various VL monitoring schema in predicting elevated VL at delivery. If WHO guidelines for non-pregnant adults were used, the majority of HIV-infected pregnant women (69%) would not receive a VL test during pregnancy. Most models that based VL monitoring in pregnancy on the time elapsed since ART initiation (regardless of gestation) performed poorly (sensitivity <50%); models that based VL measures in pregnancy on the woman's gestation (regardless of time on ART) appeared to perform better overall (sensitivity >60%). Across all permutations, inclusion of pre-ART VL values had a negligible impact on predictive performance (improving test sensitivity and specificity <6%). Performance of VL monitoring in predicting VL at delivery generally improved at later gestations, with the best performing option a single VL measure at 36 weeks' gestation. Development and evaluation of a novel simulation model suggests that strategies to measure VL relative to gestational age may be more useful than strategies relative to duration on ART, in women initiating ART during pregnancy, supporting better integration of maternal and HIV health services. Testing turnaround times require careful consideration, and point-of-care VL testing may be the best approach for measuring VL at delivery. Broadening the scope of this simulation model in the light of current scale up of VL monitoring in high burden countries is important. © 2017 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

  1. Performance of immunological response in predicting virological failure.

    PubMed

    Ingole, Nayana; Mehta, Preeti; Pazare, Amar; Paranjpe, Supriya; Sarkate, Purva

    2013-03-01

    In HIV-infected individuals on antiretroviral therapy (ART), the decision on when to switch from first-line to second-line therapy is dictated by treatment failure, and this can be measured in three ways: clinically, immunologically, and virologically. While viral load (VL) decreases and CD4 cell increases typically occur together after starting ART, discordant responses may be seen. Hence the current study was designed to determine the immunological and virological response to ART and to evaluate the utility of immunological response to predict virological failure. All treatment-naive HIV-positive individuals aged >18 years who were eligible for ART were enrolled and assessed at baseline, 6 months, and 12 months clinically and by CD4 cell count and viral load estimations. The patients were categorized as showing concordant favorable (CF), immunological only (IO), virological only (VO), and concordant unfavorable responses (CU). The efficiency of immunological failure to predict virological failure was analyzed across various levels of virological failure (VL>50, >500, and >5,000 copies/ml). At 6 months, 87(79.81%), 7(5.5%), 13 (11.92%), and 2 (1.83%) patients and at 12 months 61(69.3%), 9(10.2%), 16 (18.2%), and 2 (2.3%) patients had CF, IO, VO, and CU responses, respectively. Immunological failure criteria had a very low sensitivity (11.1-40%) and positive predictive value (8.3-25%) to predict virological failure. Immunological criteria do not accurately predict virological failure resulting in significant misclassification of therapeutic responses. There is an urgent need for inclusion of viral load testing in the initiation and monitoring of ART.

  2. Aging and the Arts Online: Lessons Learned From Course Development and Implementation.

    PubMed

    Eaton, Jacqueline

    2016-01-01

    With the recent move toward competency-based gerontology education, incorporating humanities and arts will be necessary for accreditation. This article describes the pedagogical approaches and lessons learned during 5 years of development and implementation of an asynchronous online course in Aging and the Arts. Fifty graduate and undergraduate students participated in the course over five semesters. Discipline diversity increased subsequent to designation as a fine arts general education course. Students expressed appreciation for multimedia resources, an initial fear of creating a wiki, and online redundancy was reduced through increased community engagement that also augmented application in real-world settings. The visual nature of arts and aging lends itself to a compelling and interactive online course experience that can be adapted to synchronous, hybrid, and face-to-face formats. Opportunities for community engaged learning will increase as art programs for older adults become more prevalent.

  3. State-of-the-Art Review Prediction and Control of Groundborne Noise and Vibration from Rail Transit Trains : Annotated Bibliography

    DOT National Transportation Integrated Search

    1982-02-01

    This interim report presents an annotated bibliography that has been compiled as part of a comprehensive review of the state-of-the-art in the prediction and control of groundborne noise and vibration created by rail transit operations. Included in t...

  4. ‘Side effects’ are ‘central effects’ that challenge retention in HIV treatment programmes in six sub-Saharan African countries: a multicountry qualitative study

    PubMed Central

    McLean, Estelle; Ddaaki, William; Odongo, Fred; Bukenya, Dominic; Wamoyi, Joyce; Bonnington, Oliver; Seeley, Janet; Zaba, Basia; Wringe, Alison

    2017-01-01

    Objectives To explore the bodily and relational experience of taking antiretroviral therapy (ART) and the subsequent effect on retention in HIV care in six sub-Saharan African countries. Methods In-depth interviews were conducted with 130 people living with HIV (PLHIV) who had initiated ART, 38 PLHIV who were lost to follow-up and 53 healthcare workers (HCWs) in Kenya, Uganda, Tanzania, Malawi, Zimbabwe and South Africa. PLHIV were purposely selected to include a range of HIV treatment histories. Deductive and inductive analysis was guided by aspects of practice theory; retention in HIV care following ART initiation was the practice of interest. Results PLHIV who were engaged in HIV care took ART every day, attended clinic appointments and ate as well as possible. For PLHIV, biomedical markers acted as reassurance for their positive treatment progression. However, many described ART side effects ranging from dizziness to conditions severe enough to prevent them from leaving home or caring for themselves or others. In all settings, the primary concern of HCW was ensuring patients achieved viral suppression, with management of side effects seen as a lower priority. Where PLHIV tolerated side effects, they were deemed the lesser of two evils compared with their pre-ART illnesses. Participants who reported feeling well prior to starting ART were often less able to tolerate side effects, and in many cases these events triggered their disengagement from HIV care. Conclusions Retention in ART care is rarely an outcome of rational decision-making, but the consequence of bodily and relational experiences. Initiatives to improve retention should consider how bodily experiences of PLHIV relate to the rest of their lives and how this can be respected and supported by service providers to subsequently improve retention in care. PMID:28736390

  5. Which adherence measure - self-report, clinician recorded or pharmacy refill - is best able to predict detectable viral load in a public ART programme without routine plasma viral load monitoring?

    PubMed

    Mekuria, Legese A; Prins, Jan M; Yalew, Alemayehu W; Sprangers, Mirjam A G; Nieuwkerk, Pythia T

    2016-07-01

    Combination antiretroviral therapy (cART) suppresses viral replication to an undetectable level if a sufficiently high level of adherence is achieved. We investigated which adherence measurement best distinguishes between patients with and without detectable viral load in a public ART programme without routine plasma viral load monitoring. We randomly selected 870 patients who started cART between May 2009 and April 2012 in 10 healthcare facilities in Addis Ababa, Ethiopia. Six hundred and sixty-four (76.3%) patients who were retained in HIV care and were receiving cART for at least 6 months were included and 642 had their plasma HIV-1 RNA concentration measured. Patients' adherence to cART was assessed according to self-report, clinician recorded and pharmacy refill measures. Multivariate logistic regression model was fitted to identify the predictors of detectable viremia. Model accuracy was evaluated by computing the area under the receiver operating characteristic (ROC) curve. A total of 9.2% and 5.5% of the 642 patients had a detectable viral load of ≥40 and ≥400 RNA copies/ml, respectively. In the multivariate analyses, younger age, lower CD4 cell count at cART initiation, being illiterate and widowed, and each of the adherence measures were significantly and independently predictive of having ≥400 RNA copies/ml. The ROC curve showed that these variables altogether had a likelihood of more than 80% to distinguish patients with a plasma viral load of ≥400 RNA copies/ml from those without. Adherence to cART was remarkably high. Self-report, clinician recorded and pharmacy refill non-adherence were all significantly predictive of detectable viremia. The choice for one of these methods to detect non-adherence and predict a detectable viral load can therefore be based on what is most practical in a particular setting. © 2016 John Wiley & Sons Ltd.

  6. Influence of model assumptions about HIV disease progression after initiating or stopping treatment on estimates of infections and deaths averted by scaling up antiretroviral therapy

    PubMed Central

    Sucharitakul, Kanes; Boily, Marie-Claude; Dimitrov, Dobromir

    2018-01-01

    Background Many mathematical models have investigated the population-level impact of expanding antiretroviral therapy (ART), using different assumptions about HIV disease progression on ART and among ART dropouts. We evaluated the influence of these assumptions on model projections of the number of infections and deaths prevented by expanded ART. Methods A new dynamic model of HIV transmission among men who have sex with men (MSM) was developed, which incorporated each of four alternative assumptions about disease progression used in previous models: (A) ART slows disease progression; (B) ART halts disease progression; (C) ART reverses disease progression by increasing CD4 count; (D) ART reverses disease progression, but disease progresses rapidly once treatment is stopped. The model was independently calibrated to HIV prevalence and ART coverage data from the United States under each progression assumption in turn. New HIV infections and HIV-related deaths averted over 10 years were compared for fixed ART coverage increases. Results Little absolute difference (<7 percentage points (pp)) in HIV infections averted over 10 years was seen between progression assumptions for the same increases in ART coverage (varied between 33% and 90%) if ART dropouts reinitiated ART at the same rate as ART-naïve MSM. Larger differences in the predicted fraction of HIV-related deaths averted were observed (up to 15pp). However, if ART dropouts could only reinitiate ART at CD4<200 cells/μl, assumption C predicted substantially larger fractions of HIV infections and deaths averted than other assumptions (up to 20pp and 37pp larger, respectively). Conclusion Different disease progression assumptions on and post-ART interruption did not affect the fraction of HIV infections averted with expanded ART, unless ART dropouts only re-initiated ART at low CD4 counts. Different disease progression assumptions had a larger influence on the fraction of HIV-related deaths averted with expanded ART. PMID:29554136

  7. Science Art: Projects and Activities That Teach Science Concepts and Develop Process Skills. Grades 2-4.

    ERIC Educational Resources Information Center

    Schecter, Deborah

    The activities in this collection are designed to help teachers bring the worlds of science and art into the classroom. Each activity is both a hands-on science investigation and an art experience. As students create satisfying art projects, they utilize science skills such as observing, predicting, investigating, and communicating. The projects…

  8. Viral blips during suppressive antiretroviral treatment are associated with high baseline HIV-1 RNA levels.

    PubMed

    Sörstedt, Erik; Nilsson, Staffan; Blaxhult, Anders; Gisslén, Magnus; Flamholc, Leo; Sönnerborg, Anders; Yilmaz, Aylin

    2016-06-21

    Many HIV-1-infected patients on suppressive antiretroviral therapy (ART) have transiently elevated HIV RNA levels. The clinical significance of these viral blips is uncertain. We have determined the incidence of blips and investigated important associations in the Swedish HIV-cohort. HIV-1-infected ART naïve adults who commenced ART 2007-2013 were retrospectively included. Viral blips were defined as a transient viral load between 50 and 500 copies/mL Subjects not suppressed after six months on ART were excluded. Viral blips were found in 76/735 included subjects (10.3 %) and in 90/4449 samples (2.0 %). Median blip viral load was 76 copies/mL (range 56-138). Median follow-up time was 170 weeks (range 97-240). Baseline viral load was higher in subjects with viral blips (median log10 4.85 copies/mL) compared with subjects without blips (median log10 4.55 copies/mL) (p < 0.01). There was a significant association between viral blips and risk for subsequent virological failure (p < 0.001). The Swedish national HIV-cohort has a low incidence of viral blips (10 %). Blips were associated with high baseline viral load and an increased risk of subsequent virological failure.

  9. Impact of Nursing Students' Free-Clinic Experiences on Subsequent Professional Nursing Practice

    ERIC Educational Resources Information Center

    Bell, Christina Lynn

    2017-01-01

    Bachelors of Science Nursing students at a small liberal arts college in the upper Midwest volunteer with an instructor at a free clinic as part of their curriculum. This study's purpose was to identify the impact of nursing students' free-clinic experiences on their subsequent professional nursing practice and their ability to attend to: (a)…

  10. The effect of nutritional supplementation on quality of life in people living with HIV: a randomised controlled trial.

    PubMed

    Tesfaye, Markos; Kaestel, Pernille; Olsen, Mette Frahm; Girma, Tsinuel; Yilma, Daniel; Abdissa, Alemseged; Ritz, Christian; Michaelsen, Kim F; Hanlon, Charlotte; Friis, Henrik

    2016-06-01

    To determine the effects of lipid-based nutrient supplements (LNS) on the quality of life of people living with HIV (PLHIV) during the first 3 months of antiretroviral treatment (ART) and to investigate the effects of timing of supplementation by comparing with supplementation during the subsequent 3 months. A randomised controlled trial was conducted in three ART clinics within public health facilities in Jimma, Ethiopia. Participants were PLHIV eligible to start ART with body mass index >17 kg/m(2) and given daily supplements of 200 g of LNS containing whey or soya either during the first 3 months or the subsequent months of ART. The outcome was measured in terms of total quality-of-life scores on the adapted version of the WHOQOL-HIV-BREF assessed at baseline, three and six months. Of the 282 participants, 186 (66.0%) were women. The mean age (SD) was 32.8 (±9.0) years, and the mean (SD) total quality-of-life score was 82.0 (±14.8) at baseline assessment. At 3 months, participants who received LNS showed better quality of life than those who only received ART without LNS (β = 6.2, 95% CI: 2.9: 9.6). At 6 months, there was no difference in total quality-of-life score between the early and delayed supplementation groups (β = 3.0, 95% CI: -0.4: 6.4). However, the early supplementation group showed higher scores on the social and spirituality domains than the delayed group. LNS given during the first three months of ART improves the quality of life of PLHIV. © 2016 John Wiley & Sons Ltd.

  11. Artistic misunderstandings: The emotional significance of historical learning in the arts.

    PubMed

    Bullot, Nicolas J; Reber, Rolf

    2017-01-01

    The Distancing-Embracing model does not have the conceptual resources to explain artistic misunderstandings and the emotional consequences of historical learning in the arts. Specifically, it suggests implausible predictions about emotional distancing caused by art schemata (e.g., misunderstandings of artistic intentions and contexts). These problems show the need for further inquiries into how historical contextualization modulates negative emotions in the arts.

  12. What Predicts Pre-Service Teacher Use of Arts-Based Pedagogies in the Classroom? An Analysis of the Beliefs, Values, and Attitudes of Pre-Service Teachers

    ERIC Educational Resources Information Center

    Lee, Bridget; Cawthon, Stephanie

    2015-01-01

    Arts-based pedagogies have a positive, significant impact on various student academic-related outcomes. University teacher preparation programs may want to consider "pre-service" teacher beliefs, values, and attitudes toward arts-based pedagogies in order to better support teacher growth in using these arts-based approaches. In this…

  13. Prediction of higher cost of antiretroviral therapy (ART) according to clinical complexity. A validated clinical index.

    PubMed

    Velasco, Cesar; Pérez, Inaki; Podzamczer, Daniel; Llibre, Josep Maria; Domingo, Pere; González-García, Juan; Puig, Inma; Ayala, Pilar; Martín, Mayte; Trilla, Antoni; Lázaro, Pablo; Gatell, Josep Maria

    2016-03-01

    The financing of antiretroviral therapy (ART) is generally determined by the cost incurred in the previous year, the number of patients on treatment, and the evidence-based recommendations, but not the clinical characteristics of the population. To establish a score relating the cost of ART and patient clinical complexity in order to understand the costing differences between hospitals in the region that could be explained by the clinical complexity of their population. Retrospective analysis of patients receiving ART in a tertiary hospital between 2009 and 2011. Factors potentially associated with a higher cost of ART were assessed by bivariate and multivariate analysis. Two predictive models of "high-cost" were developed. The normalized estimated (adjusted for the complexity scores) costs were calculated and compared with the normalized real costs. In the Hospital Index, 631 (16.8%) of the 3758 patients receiving ART were responsible for a "high-cost" subgroup, defined as the highest 25% of spending on ART. Baseline variables that were significant predictors of high cost in the Clinic-B model in the multivariate analysis were: route of transmission of HIV, AIDS criteria, Spanish nationality, year of initiation of ART, CD4+ lymphocyte count nadir, and number of hospital admissions. The Clinic-B score ranged from 0 to 13, and the mean value (5.97) was lower than the overall mean value of the four hospitals (6.16). The clinical complexity of the HIV patient influences the cost of ART. The Clinic-B and Clinic-BF scores predicted patients with high cost of ART and could be used to compare and allocate costs corrected for the patient clinical complexity. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  14. The Predictive Validity of the Torrance Figural Test (Form B) of Creative Thinking in the College of Fine and Applied Arts.

    ERIC Educational Resources Information Center

    Stallings, William M.

    In an effort to improve the predictability of course grades in the College of Fine and Applied Arts the Torrance Figural Test (Form B) of Creative Thinking was administered to entering 1968 freshmen. Four figural creativity variables (Fluency, Flexibility, Originality, and Elaboration) were correlated with course grades, American College Testing…

  15. Ethical Issues in School Art Therapy

    ERIC Educational Resources Information Center

    Moriya, Dafna

    2006-01-01

    School art therapists face numerous ethical dilemmas, from referrals to therapy, through privacy, safety and predictability in the art therapy room, to the need to balance cooperation with the educational staff and its expectations of shared information with loyalty to the patient. Breach of confidentiality also has legal implications. The…

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

    Zawisza, I; Yan, H; Yin, F

    Purpose: To assure that tumor motion is within the radiation field during high-dose and high-precision radiosurgery, real-time imaging and surrogate monitoring are employed. These methods are useful in providing real-time tumor/surrogate motion but no future information is available. In order to anticipate future tumor/surrogate motion and track target location precisely, an algorithm is developed and investigated for estimating surrogate motion multiple-steps ahead. Methods: The study utilized a one-dimensional surrogate motion signal divided into three components: (a) training component containing the primary data including the first frame to the beginning of the input subsequence; (b) input subsequence component of the surrogatemore » signal used as input to the prediction algorithm: (c) output subsequence component is the remaining signal used as the known output of the prediction algorithm for validation. The prediction algorithm consists of three major steps: (1) extracting subsequences from training component which best-match the input subsequence according to given criterion; (2) calculating weighting factors from these best-matched subsequence; (3) collecting the proceeding parts of the subsequences and combining them together with assigned weighting factors to form output. The prediction algorithm was examined for several patients, and its performance is assessed based on the correlation between prediction and known output. Results: Respiratory motion data was collected for 20 patients using the RPM system. The output subsequence is the last 50 samples (∼2 seconds) of a surrogate signal, and the input subsequence was 100 (∼3 seconds) frames prior to the output subsequence. Based on the analysis of correlation coefficient between predicted and known output subsequence, the average correlation is 0.9644±0.0394 and 0.9789±0.0239 for equal-weighting and relative-weighting strategies, respectively. Conclusion: Preliminary results indicate that the prediction algorithm is effective in estimating surrogate motion multiple-steps in advance. Relative-weighting method shows better prediction accuracy than equal-weighting method. More parameters of this algorithm are under investigation.« less

  17. Trends in detectable viral load by calendar year in the Australian HIV observational database.

    PubMed

    Law, Matthew G; Woolley, Ian; Templeton, David J; Roth, Norm; Chuah, John; Mulhall, Brian; Canavan, Peter; McManus, Hamish; Cooper, David A; Petoumenos, Kathy

    2011-02-23

    Recent papers have suggested that expanded combination antiretroviral treatment (cART) through lower viral load may be a strategy to reduce HIV transmission at a population level. We assessed calendar trends in detectable viral load in patients recruited to the Australian HIV Observational Database who were receiving cART. Patients were included in analyses if they had started cART (defined as three or more antiretrovirals) and had at least one viral load assessment after 1 January 1997. We analyzed detectable viral load (>400 copies/ml) in the first and second six months of each calendar year while receiving cART. Repeated measures logistic regression methods were used to account for within and between patient variability. Rates of detectable viral load were predicted allowing for patients lost to follow up. Analyses were based on 2439 patients and 31,339 viral load assessments between 1 January 1997 and 31 March 2009. Observed detectable viral load in patients receiving cART declined to 5.3% in the first half of 2009. Predicted detectable viral load based on multivariate models, allowing for patient loss to follow up, also declined over time, but at higher levels, to 13.8% in 2009. Predicted detectable viral load in Australian HIV Observational Database patients receiving cART declined over calendar time, albeit at higher levels than observed. However, over this period, HIV diagnoses and estimated HIV incidence increased in Australia.

  18. Looking is not seeing: using art to improve observational skills.

    PubMed

    Pellico, Linda Honan; Friedlaender, Linda; Fennie, Kristopher P

    2009-11-01

    This project evaluated the effects of an art museum experience on the observational skills of nursing students. Half of a class of non-nurse college graduates entering an accelerated master's degree program (n = 34) were assigned to a museum experience, whereas the other half (n = 32) received traditional teaching methods. Using original works of art, students participated in focused observational experiences to visually itemize everything noted in the art piece, discriminate visual qualities, recognize patterns, and cluster observations. After organizing observed information, they drew conclusions to construct the object's meaning. Participants visiting the museum subsequently wrote more about what they saw, resulting in significantly more objective clinical findings when viewing patient photographs. In addition, participants demonstrated significantly more fluidity in their differential diagnosis by offering more alternative diagnoses than did the control group. The study supports the notion that focused viewing of works of art enhances observational skills. Copyright 2009, SLACK Incorporated.

  19. Response to antiretroviral therapy (ART): comparing women with previous use of zidovudine monotherapy (ZDVm) in pregnancy with ART naïve women.

    PubMed

    Huntington, Susie; Thorne, Claire; Anderson, Jane; Newell, Marie-Louise; Taylor, Graham P; Pillay, Deenan; Hill, Teresa; Tookey, Pat; Sabin, Caroline

    2014-03-04

    Short-term zidovudine monotherapy (ZDVm) remains an option for some pregnant HIV-positive women not requiring treatment for their own health but may affect treatment responses once antiretroviral therapy (ART) is subsequently started. Data were obtained by linking two UK studies: the UK Collaborative HIV Cohort (UK CHIC) study and the National Study of HIV in Pregnancy and Childhood (NSHPC). Treatment responses were assessed for 2028 women initiating ART at least one year after HIV-diagnosis. Outcomes were compared using logistic regression, proportional hazards regression or linear regression. In adjusted analyses, ART-naïve (n = 1937) and ZDVm-experienced (n = 91) women had similar increases in CD4 count and a similar proportion achieving virological suppression; both groups had a low risk of AIDS. In this setting, antenatal ZDVm exposure did not adversely impact on outcomes once ART was initiated for the woman's health.

  20. Insulin resistance change and antiretroviral therapy exposure in HIV-infected and uninfected Rwandan women: a longitudinal analysis.

    PubMed

    Mutimura, Eugene; Hoover, Donald R; Shi, Qiuhu; Dusingize, Jean Claude; Sinayobye, Jean D'Amour; Cohen, Mardge; Anastos, Kathryn

    2015-01-01

    We longitudinally assessed predictors of insulin resistance (IR) change among HIV-uninfected and HIV-infected (ART-initiators and ART-non-initiators) Rwandan women. HIV-infected (HIV+) and uninfected (HIV-) women provided demographic and clinical measures: age, body mass index (BMI) in Kg/(height in meters)2, Fat-Mass (FMI) and Fat-Free-Mass (FFMI) index, fasting serum glucose and insulin. Homeostasis Model Assessment (HOMA) was calculated to estimate IR change over time in log10 transformed HOMA measured at study enrollment or prior to ART initiation in 3 groups: HIV- (n = 194), HIV+ ART-non-initiators (n=95) and HIV+ ART-initiators (n=371). ANCOVA linear regression models of change in log10-HOMA were fit with all models included the first log10 HOMA as a predictor. Mean±SD log10-HOMA was -0.18±0.39 at the 1st and -0.21±0.41 at the 2nd measure, with mean change of 0.03±0.44. In the final model (all women) BMI at 1st HOMA measure (0.014; 95% CI=0.006-0.021 per kg/m2; p<0.001) and change in BMI from 1st to 2nd measure (0.024; 95% CI=0.013-0.035 per kg/m2; p<0.001) predicted HOMA change. When restricted to subjects with FMI measures, FMI at 1st HOMA measure (0.020; 95% CI=0.010-0.030 per kg/m2; p<0.001) and change in FMI from 1st to 2nd measure (0.032; 95% CI=0.020-0.043 per kg/m2; p<0.0001) predicted change in HOMA. While ART use did not predict change in log10-HOMA, untreated HIV+ women had a significant decline in IR over time. Use or duration of AZT, d4T and EFV was not associated with HOMA change in HIV+ women. Baseline BMI and change in BMI, and in particular fat mass and change in fat mass predicted insulin resistance change over ~3 years in HIV-infected and uninfected Rwandan women. Exposure to specific ART (d4T, AZT, EFV) did not predict insulin resistance change in ART-treated HIV-infected Rwandan women.

  1. An Expert System For Multispectral Threat Assessment And Response

    NASA Astrophysics Data System (ADS)

    Steinberg, Alan N.

    1987-05-01

    A concept has been defined for an automatic system to manage the self-defense of a combat aircraft. Distinctive new features of this concept include: a. the flexible prioritization of tasks and coordinated use of sensor, countermeasures, flight systems and weapons assets by means of an automated planning function; b. the integration of state-of-the-art data fusion algorithms with event prediction processing; c. the use of advanced Artificial Intelligence tools to emulate the decision processes of tactical EW experts. Threat Assessment functions (a) estimate threat identity, lethality and intent on the basis of multi-spectral sensor data, and (b) predict the time to critical events in threat engagements (e.g., target acquisition, tracking, weapon launch, impact). Response Management functions (a) select candidate responses to reported threat situations; (b) estimate the effects of candidate actions on survival; and (c) coordinate the assignment of sensors, weapons and countermeasures with the flight plan. The system employs Finite State Models to represent current engagements and to predict subsequent events. Each state in a model is associated with a set of observable features, allowing interpretation of sensor data and adaptive use of sensor assets. Defined conditions on state transitions allow prediction of times to critical future states and are used in planning self-defensive responses, which are designed either to impede a particular state transition or to force a transition to a lower threat state.

  2. Potential Seasonal Predictability for Winter Storms over Europe

    NASA Astrophysics Data System (ADS)

    Wild, Simon; Befort, Daniel J.; Leckebusch, Gregor C.

    2017-04-01

    Reliable seasonal forecasts of strong extra-tropical cyclones and windstorms would have great social and economical benefits, as these events are the most costly natural hazards over Europe. In a previous study we have shown good agreement of spatial climatological distributions of extra-tropical cyclones and wind storms in state-of-the-art multi-member seasonal prediction systems with reanalysis. We also found significant seasonal prediction skill of extra-tropical cyclones and windstorms affecting numerous European countries. We continue this research by investigating the mechanisms and precursor conditions (primarily over the North Atlantic) on a seasonal time scale leading to enhanced extra-tropical cyclone activity and winter storm frequency over Europe. Our results regarding mechanisms show that an increased surface temperature gradient at the western edge of the North Atlantic can be related to enhanced winter storm frequency further downstream causing for example a greater number of storms over the British Isles, as observed in winter 2013-14.The so-called "Horseshoe Index", a SST tripole anomaly pattern over the North Atlantic in the summer months can also cause a higher number of winter storms over Europe in the subsequent winter. We will show results of AMIP-type sensitivity experiments using an AGCM (ECHAM5), supporting this hypothesis. Finally we will analyse whether existing seasonal forecast systems are able to capture these identified mechanisms and precursor conditions affecting the models' seasonal prediction skill.

  3. Progress and challenges in the development of physically-based numerical models for prediction of flow and contaminant dispersion in the urban environment

    NASA Astrophysics Data System (ADS)

    Lien, F. S.; Yee, E.; Ji, H.; Keats, A.; Hsieh, K. J.

    2006-06-01

    The release of chemical, biological, radiological, or nuclear (CBRN) agents by terrorists or rogue states in a North American city (densely populated urban centre) and the subsequent exposure, deposition and contamination are emerging threats in an uncertain world. The modeling of the transport, dispersion, deposition and fate of a CBRN agent released in an urban environment is an extremely complex problem that encompasses potentially multiple space and time scales. The availability of high-fidelity, time-dependent models for the prediction of a CBRN agent's movement and fate in a complex urban environment can provide the strongest technical and scientific foundation for support of Canada's more broadly based effort at advancing counter-terrorism planning and operational capabilities.The objective of this paper is to report the progress of developing and validating an integrated, state-of-the-art, high-fidelity multi-scale, multi-physics modeling system for the accurate and efficient prediction of urban flow and dispersion of CBRN (and other toxic) materials discharged into these flows. Development of this proposed multi-scale modeling system will provide the real-time modeling and simulation tool required to predict injuries, casualties and contamination and to make relevant decisions (based on the strongest technical and scientific foundations) in order to minimize the consequences of a CBRN incident in a populated centre.

  4. The differences between medical trust and mistrust and their respective influences on medication beliefs and ART adherence among African-Americans living with HIV.

    PubMed

    Pellowski, Jennifer A; Price, Devon M; Allen, Aerielle M; Eaton, Lisa A; Kalichman, Seth C

    2017-09-01

    The purpose of this study was to examine the relationships between medical mistrust and trust and to determine if these measures differentially predict antiretroviral therapy (ART) medication adherence for African-American adults living with HIV. A total of 458 HIV positive African-Americans completed a cross-sectional survey. Self-reported ART adherence was collected using the visual-analog scale. The Beliefs About Medicines Questionnaire was used to assess medication necessity and concern beliefs. All measures of medical mistrust and trust were significantly negatively correlated, ranging from r = -.339 to -.504. Race-based medical mistrust significantly predicted medication necessity and concern beliefs, whereas general medical mistrust only significantly predicted medication concerns. Both measures of trust significantly predicted medication necessity beliefs and medication concerns. Higher levels of race-based medical mistrust predicted lower medication adherence, whereas, neither trust in own physician nor trust in health care provider significantly predicted medication adherence. However, trust in own physician significantly predicted medication necessity beliefs, which predicted medication adherence. Trust and mistrust are not simply opposites of one another. These findings provide evidence for the complexity of understanding the relationship between health care trust, mistrust and patient-related health beliefs and behaviours.

  5. High precision in protein contact prediction using fully convolutional neural networks and minimal sequence features.

    PubMed

    Jones, David T; Kandathil, Shaun M

    2018-04-26

    In addition to substitution frequency data from protein sequence alignments, many state-of-the-art methods for contact prediction rely on additional sources of information, or features, of protein sequences in order to predict residue-residue contacts, such as solvent accessibility, predicted secondary structure, and scores from other contact prediction methods. It is unclear how much of this information is needed to achieve state-of-the-art results. Here, we show that using deep neural network models, simple alignment statistics contain sufficient information to achieve state-of-the-art precision. Our prediction method, DeepCov, uses fully convolutional neural networks operating on amino-acid pair frequency or covariance data derived directly from sequence alignments, without using global statistical methods such as sparse inverse covariance or pseudolikelihood estimation. Comparisons against CCMpred and MetaPSICOV2 show that using pairwise covariance data calculated from raw alignments as input allows us to match or exceed the performance of both of these methods. Almost all of the achieved precision is obtained when considering relatively local windows (around 15 residues) around any member of a given residue pairing; larger window sizes have comparable performance. Assessment on a set of shallow sequence alignments (fewer than 160 effective sequences) indicates that the new method is substantially more precise than CCMpred and MetaPSICOV2 in this regime, suggesting that improved precision is attainable on smaller sequence families. Overall, the performance of DeepCov is competitive with the state of the art, and our results demonstrate that global models, which employ features from all parts of the input alignment when predicting individual contacts, are not strictly needed in order to attain precise contact predictions. DeepCov is freely available at https://github.com/psipred/DeepCov. d.t.jones@ucl.ac.uk.

  6. A Review of Subsequence Time Series Clustering

    PubMed Central

    Teh, Ying Wah

    2014-01-01

    Clustering of subsequence time series remains an open issue in time series clustering. Subsequence time series clustering is used in different fields, such as e-commerce, outlier detection, speech recognition, biological systems, DNA recognition, and text mining. One of the useful fields in the domain of subsequence time series clustering is pattern recognition. To improve this field, a sequence of time series data is used. This paper reviews some definitions and backgrounds related to subsequence time series clustering. The categorization of the literature reviews is divided into three groups: preproof, interproof, and postproof period. Moreover, various state-of-the-art approaches in performing subsequence time series clustering are discussed under each of the following categories. The strengths and weaknesses of the employed methods are evaluated as potential issues for future studies. PMID:25140332

  7. A review of subsequence time series clustering.

    PubMed

    Zolhavarieh, Seyedjamal; Aghabozorgi, Saeed; Teh, Ying Wah

    2014-01-01

    Clustering of subsequence time series remains an open issue in time series clustering. Subsequence time series clustering is used in different fields, such as e-commerce, outlier detection, speech recognition, biological systems, DNA recognition, and text mining. One of the useful fields in the domain of subsequence time series clustering is pattern recognition. To improve this field, a sequence of time series data is used. This paper reviews some definitions and backgrounds related to subsequence time series clustering. The categorization of the literature reviews is divided into three groups: preproof, interproof, and postproof period. Moreover, various state-of-the-art approaches in performing subsequence time series clustering are discussed under each of the following categories. The strengths and weaknesses of the employed methods are evaluated as potential issues for future studies.

  8. A Note on Some Characteristics and Correlates of the Meier Art Test of Aesthetic Perception.

    ERIC Educational Resources Information Center

    Stallings, William M.; Anderson, Frances E.

    The reliability and the predictive and concurrent validity of the MATAP were investigated with the implicit goal of improving the prediction of course grades in the College of Fine and Applied Arts. It was found that reliability and validity coefficients were low, and it was suggested that the scoring system was a source of error variance. (MS)

  9. The Predictive Influence of Family and Community Demographic Variables on Grade 7 Student Achievement in Language Arts and Mathematics

    ERIC Educational Resources Information Center

    Wolfe, Adam

    2016-01-01

    This correlational, explanatory, longitudinal study sought to determine the combination of community and family-level demographic variables found in the 2010 U.S. Census data that most accurately predicted a New Jersey school district's percentage of students scoring proficient or above on the 2010, 2011, and 2012 NJ ASK 7 in Language Arts and…

  10. Predicting CD4 count changes among patients on antiretroviral treatment: Application of data mining techniques.

    PubMed

    Kebede, Mihiretu; Zegeye, Desalegn Tigabu; Zeleke, Berihun Megabiaw

    2017-12-01

    To monitor the progress of therapy and disease progression, periodic CD4 counts are required throughout the course of HIV/AIDS care and support. The demand for CD4 count measurement is increasing as ART programs expand over the last decade. This study aimed to predict CD4 count changes and to identify the predictors of CD4 count changes among patients on ART. A cross-sectional study was conducted at the University of Gondar Hospital from 3,104 adult patients on ART with CD4 counts measured at least twice (baseline and most recent). Data were retrieved from the HIV care clinic electronic database and patients` charts. Descriptive data were analyzed by SPSS version 20. Cross-Industry Standard Process for Data Mining (CRISP-DM) methodology was followed to undertake the study. WEKA version 3.8 was used to conduct a predictive data mining. Before building the predictive data mining models, information gain values and correlation-based Feature Selection methods were used for attribute selection. Variables were ranked according to their relevance based on their information gain values. J48, Neural Network, and Random Forest algorithms were experimented to assess model accuracies. The median duration of ART was 191.5 weeks. The mean CD4 count change was 243 (SD 191.14) cells per microliter. Overall, 2427 (78.2%) patients had their CD4 counts increased by at least 100 cells per microliter, while 4% had a decline from the baseline CD4 value. Baseline variables including age, educational status, CD8 count, ART regimen, and hemoglobin levels predicted CD4 count changes with predictive accuracies of J48, Neural Network, and Random Forest being 87.1%, 83.5%, and 99.8%, respectively. Random Forest algorithm had a superior performance accuracy level than both J48 and Artificial Neural Network. The precision, sensitivity and recall values of Random Forest were also more than 99%. Nearly accurate prediction results were obtained using Random Forest algorithm. This algorithm could be used in a low-resource setting to build a web-based prediction model for CD4 count changes. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Successful treatment algorithm for evaluation of early pregnancy after in vitro fertilization.

    PubMed

    Cookingham, Lisa Marii; Goossen, Rachel P; Sparks, Amy E T; Van Voorhis, Bradley J; Duran, Eyup Hakan

    2015-10-01

    To evaluate a prospectively implemented clinical algorithm for early identification of ectopic pregnancy (EP) and heterotopic pregnancy (HP) after assisted reproductive technology (ART). Analysis of prospectively collected data. Academic medical center. All ART-conceived pregnancies between January 1995 and June 2013. Early pregnancy monitoring via clinical algorithm with all pregnancies screened using human chorionic gonadotropin (hCG) levels and reported symptoms, with subsequent early ultrasound evaluation if hCG levels were abnormal or if the patient reported pain or vaginal bleeding. Algorithmic efficiency for diagnosis of EP and HP and their subsequent clinical outcomes using a binary forward stepwise logistic regression model built to determine predictors of early pregnancy failure. Of the 3,904 pregnancies included, the incidence of EP and HP was 0.77% and 0.46%, respectively. The algorithm selected 96.7% and 83.3% of pregnancies diagnosed with EP and HP, respectively, for early ultrasound evaluation, leading to earlier treatment and resolution. Logistic regression revealed that first hCG, second hCG, hCG slope, age, pain, and vaginal bleeding were all independent predictors of early pregnancy failure after ART. Our clinical algorithm for early pregnancy evaluation after ART is effective for identification and prompt intervention of EP and HP without significant over- or misdiagnosis, and avoids the potential catastrophic morbidity associated with delayed diagnosis. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  12. CaMELS: In silico prediction of calmodulin binding proteins and their binding sites.

    PubMed

    Abbasi, Wajid Arshad; Asif, Amina; Andleeb, Saiqa; Minhas, Fayyaz Ul Amir Afsar

    2017-09-01

    Due to Ca 2+ -dependent binding and the sequence diversity of Calmodulin (CaM) binding proteins, identifying CaM interactions and binding sites in the wet-lab is tedious and costly. Therefore, computational methods for this purpose are crucial to the design of such wet-lab experiments. We present an algorithm suite called CaMELS (CalModulin intEraction Learning System) for predicting proteins that interact with CaM as well as their binding sites using sequence information alone. CaMELS offers state of the art accuracy for both CaM interaction and binding site prediction and can aid biologists in studying CaM binding proteins. For CaM interaction prediction, CaMELS uses protein sequence features coupled with a large-margin classifier. CaMELS models the binding site prediction problem using multiple instance machine learning with a custom optimization algorithm which allows more effective learning over imprecisely annotated CaM-binding sites during training. CaMELS has been extensively benchmarked using a variety of data sets, mutagenic studies, proteome-wide Gene Ontology enrichment analyses and protein structures. Our experiments indicate that CaMELS outperforms simple motif-based search and other existing methods for interaction and binding site prediction. We have also found that the whole sequence of a protein, rather than just its binding site, is important for predicting its interaction with CaM. Using the machine learning model in CaMELS, we have identified important features of protein sequences for CaM interaction prediction as well as characteristic amino acid sub-sequences and their relative position for identifying CaM binding sites. Python code for training and evaluating CaMELS together with a webserver implementation is available at the URL: http://faculty.pieas.edu.pk/fayyaz/software.html#camels. © 2017 Wiley Periodicals, Inc.

  13. The analogy between dreams and the ancient art of memory is tempting but superficial.

    PubMed

    Axmacher, Nikolai; Fell, Juergen

    2013-12-01

    Although the analogy between dreams and ancient mnemotechniques is tempting because they share several phenomenological characteristics, this analogy is superficial at a closer look. Unlike mneomotechnically encoded material, rapid eye movement (REM) dreams are inherently difficult to remember, do not usually allow conscious subsequent retrieval of all interconnected elements, and have been found to support subsequent episodic memory in only rare cases.

  14. Art engagement and mental health: experiences of service users of a community-based arts programme at Tate Modern, London.

    PubMed

    McKeown, Eamonn; Weir, Hannele; Berridge, Emma-Jane; Ellis, Liz; Kyratsis, Yiannis

    2016-01-01

    To examine the experiences of mental health service users who took part in an arts-based programme at Tate Modern, a major London art gallery. Exploratory qualitative design. Data were collected using in-depth semi-structured interviews with 10 mental health service users who had taken part in a community-based programme at Tate Modern. Additionally, six art educators from Tate Modern were interviewed. Concepts that emerged from the text were identified using thematic analysis. All participants valued the gallery-based programme. The three overarching thematic areas were: the symbolic and physical context in which the programme workshops were located; the relational and social context of the programme workshops; and reflections on the relationship between the arts-based programme and subsequent mental health. Art galleries are increasingly seen to function as vehicles for popular education with mental health service users. This study adds to the growing body of evidence related to how mental health service users experience and reflect on arts-related programmes targeted at them. This study indicates that emphasis on how users experience gallery-based programmes may contribute to a more nuanced understanding of the relationship between art and mental health. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  15. Predictability of the summer East Asian upper-tropospheric westerly jet in ENSEMBLES multi-model forecasts

    NASA Astrophysics Data System (ADS)

    Li, Chaofan; Lin, Zhongda

    2015-12-01

    The interannual variation of the East Asian upper-tropospheric westerly jet (EAJ) significantly affects East Asian climate in summer. Identifying its performance in model prediction may provide us another viewpoint, from the perspective of upper-tropospheric circulation, to understand the predictability of summer climate anomalies in East Asia. This study presents a comprehensive assessment of year-to-year variability of the EAJ based on retrospective seasonal forecasts, initiated from 1 May, in the five state-of-the-art coupled models from ENSEMBLES during 1960-2005. It is found that the coupled models show certain capability in describing the interannual meridional displacement of the EAJ, which reflects the models' performance in the first leading empirical orthogonal function (EOF) mode. This capability is mainly shown over the region south of the EAJ axis. Additionally, the models generally capture well the main features of atmospheric circulation and SST anomalies related to the interannual meridional displacement of the EAJ. Further analysis suggests that the predicted warm SST anomalies in the concurrent summer over the tropical eastern Pacific and northern Indian Ocean are the two main sources of the potential prediction skill of the southward shift of the EAJ. In contrast, the models are powerless in describing the variation over the region north of the EAJ axis, associated with the meridional displacement, and interannual intensity change of the EAJ, the second leading EOF mode, meaning it still remains a challenge to better predict the EAJ and, subsequently, summer climate in East Asia, using current coupled models.

  16. On the role of crossmodal prediction in audiovisual emotion perception.

    PubMed

    Jessen, Sarah; Kotz, Sonja A

    2013-01-01

    Humans rely on multiple sensory modalities to determine the emotional state of others. In fact, such multisensory perception may be one of the mechanisms explaining the ease and efficiency by which others' emotions are recognized. But how and when exactly do the different modalities interact? One aspect in multisensory perception that has received increasing interest in recent years is the concept of cross-modal prediction. In emotion perception, as in most other settings, visual information precedes the auditory information. Thereby, leading in visual information can facilitate subsequent auditory processing. While this mechanism has often been described in audiovisual speech perception, so far it has not been addressed in audiovisual emotion perception. Based on the current state of the art in (a) cross-modal prediction and (b) multisensory emotion perception research, we propose that it is essential to consider the former in order to fully understand the latter. Focusing on electroencephalographic (EEG) and magnetoencephalographic (MEG) studies, we provide a brief overview of the current research in both fields. In discussing these findings, we suggest that emotional visual information may allow more reliable predicting of auditory information compared to non-emotional visual information. In support of this hypothesis, we present a re-analysis of a previous data set that shows an inverse correlation between the N1 EEG response and the duration of visual emotional, but not non-emotional information. If the assumption that emotional content allows more reliable predicting can be corroborated in future studies, cross-modal prediction is a crucial factor in our understanding of multisensory emotion perception.

  17. Embryo banking among women diagnosed with cancer: a pilot population-based study in New York, Texas, and Illinois.

    PubMed

    Luke, Barbara; Brown, Morton B; Spector, Logan G; Stern, Judy E; Smith, Yolanda R; Williams, Melanie; Koch, Lori; Schymura, Maria J

    2016-05-01

    The purpose of the present study is to estimate the proportion of women with cancer who return to use the embryos that they have banked and to compare this proportion to that of women without cancer who bank embryos. This is a cohort study of three groups of women from New York, Texas, and Illinois who used embryo banking in their first assisted reproductive technology (ART) treatment cycle: two groups with cancer (222 women without an infertility diagnosis and 48 women with an infertility diagnosis) and a control group without cancer (68 women with the infertility diagnosis of male factor only). Women were included only if their first ART cycle reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) occurred between 2004 and 2009. Cancer cases were identified from each State Cancer Registry from 5 years prior to initiation of ART treatment to 6 months post-initiation; mean follow-up after the first ART cycle was 2.0 years. Women with cancer without an infertility diagnosis returned for a subsequent ART cycle at a lower rate (10.8 %) than those with an infertility diagnosis (31.3 %, p = 0.0010) or the control group (85.3 %, p < 0.0001). Among those who returned for a subsequent cycle, women with cancer waited a longer time to return (14.3 months without an infertility diagnosis and 8.3 months with an infertility diagnosis, p = 0.13) compared to the control group (2.8 months, p = 0.0007). The live birth rate among women who did not utilize embryo banking in their second cycle did not differ significantly across the three study groups, ranging from 25.0 and 42.9 % for women with cancer with and without an infertility diagnosis, respectively, to 36.2 % for women in the control group. Women with cancer without an infertility diagnosis are either less likely to return for subsequent treatment or will wait a longer time to return than women with an infertility diagnosis or those that do not have cancer. A longer-term study is necessary to assess whether these women return to use their frozen embryos after cancer treatment or are able to spontaneously conceive and if those subsequent pregnancies are adversely affected by the cancer diagnosis or therapy.

  18. Computer-Assisted Interactive Documentary and Performance Arts in Illimitable Space

    NASA Astrophysics Data System (ADS)

    Sheridan, William Michael

    Winter can bring significant snow storm systems or nor'easters to New England. Understanding each factor which can affect nor'easters will allow forecasters to better predict the subsequent weather conditions. One important parameter is the sea surface temperature (SST) of the Atlantic Ocean, where many of these systems strengthen and gain much of their structure. The Weather Research and Forecasting (WRF) model was used to simulate four different nor'easters (Mar 2007, Dec 2007, Jan 2008, Dec 2010) using both observed and warmed SSTs. For the wanner SST simulations, the SSTs over the model domain were increased by 1°C. This change increased the total surface heat fluxes in all of the storms, and the resulting simulated storms were all more intense. The influence on the amount of snowfall over land was highly variable, depending on how close to the coastline the storms were and temperatures across the region.

  19. Hyperspectral fluorescence imaging system for biomedical diagnostics

    NASA Astrophysics Data System (ADS)

    Martin, Matthew E.; Wabuyele, Musundi B.; Panjehpour, Masoud; Phan, Mary N.; Overholt, Bergein F.; Vo-Dinh, Tuan

    2006-02-01

    An advanced hyper-spectral imaging (HSI) system has been developed for use in medical diagnostics. One such diagnostic, esophageal cancer is diagnosed currently through biopsy and subsequent pathology. The end goal of this research is to develop an optical-based technique to assist or replace biopsy. In this paper, we demonstrate an instrument that has the capability to optically diagnose cancer in laboratory mice. We have developed a real-time HSI system based on state-of-the-art liquid crystal tunable filter (LCTF) technology coupled to an endoscope. This unique HSI technology is being developed to obtain spatially resolved images of the slight differences in luminescent properties of normal versus tumorous tissues. In this report, an in-vivo mouse study is shown. A predictive measure of cancer for the mice studied is developed and shown. It is hoped that the results of this study will lead to advances in the optical diagnosis of esophageal cancer in humans.

  20. Fluid mechanics of directional solidification at reduced gravity

    NASA Technical Reports Server (NTRS)

    Chen, C. F.

    1992-01-01

    The primary objective of the proposed research is to provide additional groundbased support for the flight experiment 'Casting and Solidification Technology' (CAST). This experiment is to be performed in the International Microgravity Laboratory-1 (IML-1) scheduled to be flown on a space shuttle mission scheduled for 1992. In particular, we will provide data on the convective motion and freckle formation during directional solidification of NH4Cl from its aqueous solution at simulated parameter ranges equivalent to reducing the gravity from the sea-level value down to 0.1 g or lower. The secondary objectives of the proposed research are to examine the stability phenomena associated with the onset of freckles and the mechanisms for their subsequent growth and decline (to eventual demise of some) by state-of-the-art imaging techniques and to formulate mathematical models for the prediction of the observed phenomena.

  1. Recommended procedures for measuring aircraft noise and associated parameters

    NASA Technical Reports Server (NTRS)

    Marsh, A. H.

    1977-01-01

    Procedures are recommended for obtaining experimental values of aircraft flyover noise levels (and associated parameters). Specific recommendations are made for test criteria, instrumentation performance requirements, data-acquisition procedures, and test operations. The recommendations are based on state-of-the-art measurement capabilities available in 1976 and are consistent with the measurement objectives of the NASA Aircraft Noise Prediction Program. The recommendations are applicable to measurements of the noise produced by an airplane flying subsonically over (or past) microphones located near the surface of the ground. Aircraft types covered by the recommendations are fixed-wing airplanes powered by turbojet or turbofan engines and using conventional aerodynamic means for takeoff and landing. Various assumptions with respect to subsequent data processing and analysis were made (and are described) and the recommended measurement procedures are compatible with the assumptions. Some areas where additional research is needed relative to aircraft flyover noise measurement techniques are also discussed.

  2. Association between prescription cost sharing and adherence to initial combination antiretroviral therapy in commercially insured antiretroviral-naïve patients with HIV.

    PubMed

    Johnston, Stephen S; Juday, Timothy; Seekins, Daniel; Espindle, Derek; Chu, Bong-Chul

    2012-03-01

    In treatment of human immunodeficiency virus (HIV), high levels of adherence to combination antiretroviral therapy (cART) are required to prevent failure of virologic suppression, development of drug resistance, and permanent loss of therapeutic options. No published research has assessed the association between cART prescription cost sharing and adherence to cART. To analyze the association between cART prescription cost sharing and adherence to initial cART in commercially insured antiretroviral (ARV)-naïve patients with HIV. This retrospective observational cohort study used 2002-2008 data from a large U.S. claims database of more than 56 million commercially insured individuals. Study subjects were patients aged 18 years or older who initiated cART during the period January 1, 2003, to December 31, 2007, had no ARV claims during the 6-month period prior to the initiation date, and had at least 1 ICD-9-CM diagnosis code for HIV infection (042, 795.71, V08) from 12 months before to 12 months after cART initiation. A minimum 12-month period of continuous enrollment after cART initiation was used to construct a patient-quarter repeated measures panel dataset in which each quarter of data that a patient contributed represented an observation. The evaluation period extended from cART initiation until the occurrence of 1 of the following events: addition of an ARV that was not part of the initial cART regimen, 30-day gap in possession of an ARV within the initiated cART regimen, hospitalization of 30 or more days, loss to follow-up due to study end (December 31, 2008), or disenrollment. The study's outcome was quarterly adherence to cART, defined as the number of days within the quarter that a patient possessed all components of the initial cART regimen. Each patient's cART cost-sharing amount was calculated per 30-day supply of the entire cART regimen. Adherence was dichotomized for analysis at the clinically meaningful thresholds of 95% and 78%. The dichotomized adherence outcomes were separately modeled using population-averaged generalized estimating equations (GEEs) with time-varying and time-constant covariates and an exchangeable working correlation structure. Independent variables included cost-sharing amount; sequential quarter number after cART initiation; interaction between cost-sharing amount and sequential quarter number (to capture any changes in the association of cost sharing with adherence that may occur over time after initiation of cART); and patient demographic, clinical, and insurance characteristics. For each sequential quarter after cART initiation, the GEE models were used to generate average predicted probabilities of adherence reaching each threshold (95% and 78%) at cost-sharing levels of $25, $75, and $144, which represented the 25th, 75th, and 90th percentiles of the cost-sharing distribution, respectively. The study sample included 19,199 patient-quarters and 3,731 patients: mean age 41.1 years; 83.2% male; mean (SD) duration of post-index period 5.1 (4.2) quarters; mean (SD) daily cART pill count 3.2 (2.2); mean (median) cost sharing per 30-day supply of the entire cART regimen $67 ($40). In the unadjusted analyses of patient-quarters, mean adherence ranged from 97.2% for cost-sharing levels within the 0-20th percentiles (from $0 to $20 per 30-day cART supply) to 94.0% for cost-sharing levels exceeding the 80th percentile (from $84 to $3,832 per 30-day cART supply). In the adjusted analyses for the second quarter (25th percentile of follow-up duration, n = 3,117 cases still under observation) at the cost-sharing levels of $25, $75, and $144, the predicted probabilities of at least 95% adherence were 0.782, 0.770, and 0.752, respectively, and the predicted probabilities of at least 78% adherence were 0.936, 0.931, and 0.924, respectively. The differences in the predicted probabilities of adherence grew over time. By the seventh quarter (the 75th percentile of follow-up duration, n = 1,096 cases still under observation), the predicted probabilities were 0.773, 0.746, and 0.707 for 95% adherence and 0.933, 0.922, and 0.904 for 78% adherence at cost-sharing levels of $25, $75, and $144, respectively. Increasing cART prescription cost sharing was associated with modestly decreased probability of maintaining clinically meaningful levels of cART adherence.

  3. Managing HIV-infected children in a low-resource, public clinic: a comparison of nurse vs. clinical officer practices in ART refill, calculation of adherence and subsequent appointments.

    PubMed

    Weigel, Ralf; Feldacker, Caryl; Tweya, Hannock; Gondwe, Chimwemwe; Chiwoko, Jane; Gumulira, Joe; Kalulu, Mike; Phiri, Sam

    2012-01-01

    In Malawi, as in other sub-Saharan African countries, nurses manage patients of all ages on antiretroviral treatment(ART). Nurse management of children is rarely studied.We compare ART prescribing between nurses and clinical officers during routine clinic visits at an urban, public clinic to inform policy in paediatric ART management. Caregivers of children on first-line ART provided information about visit dates, pill counts, ART dosage and formulation to a nurse and, subsequently, to a clinical officer. Nurses and clinical officers independently calculated adherence, dosage based on body weight, and set next appointment date. Clinical officers, but not nurses, accessed an electronic data system that made the calculations for them based on information from prior visits, actual and expected pill consumption, and standard drug supplies. Nurses calculated with pen and paper. For numerical variables, Bland-Altman graphs plot differences of each nurse clinical officer pair against the mean, show the 95% limits of agreement (LoA), and also show the mean difference across all reviews. Kappa statistics assess agreement for categorical variables. A total of 704 matched nurse clinical officer reviews of 367 children attending the ART clinics between March and July 2010 were analyzed. Eight nurses and 18 clinical officers were involved; two nurses and five clinical officers managed 100 visits or more. Overall, there was a good agreement between the two cadres. Differences between nurses and clinical officers were within narrow LoA and mean differences showed little deviation from zero, indicating little skewing towards one cadre. LoA of adherence and morning and evening ART dosages varied from -24% to 24%, -0.4 to 0.4 and -0.41 to 0.40 tablets,respectively, with mean differences (95% CI) of 0.003 (-0.9, 0.91), -0.005 (-0.02, 0.01) and -0.009 (-0.02, 0.01). Next appointment calculations differed more between cadres with LoA from -40 to 42 days [mean difference: 0.96 days (95%CI:-0.6 to 2.5)], but agreement in the ART formulation prescribed was very good (kappa 0.93). Nurses' ART prescribing practices and calculations of adherence and next appointments are similar to clinical officers, although clinical officers used an electronic system. Our findings support the decision of Malawi's health officials to utilize nurses to manage paediatric ART patients.

  4. A novel Acute Retroviral Syndrome Severity Score predicts the key surrogate markers for HIV-1 disease progression.

    PubMed

    Braun, Dominique L; Kouyos, Roger; Oberle, Corinna; Grube, Christina; Joos, Beda; Fellay, Jacques; McLaren, Paul J; Kuster, Herbert; Günthard, Huldrych F

    2014-01-01

    Best long-term practice in primary HIV-1 infection (PHI) remains unknown for the individual. A risk-based scoring system associated with surrogate markers of HIV-1 disease progression could be helpful to stratify patients with PHI at highest risk for HIV-1 disease progression. We prospectively enrolled 290 individuals with well-documented PHI in the Zurich Primary HIV-1 Infection Study, an open-label, non-randomized, observational, single-center study. Patients could choose to undergo early antiretroviral treatment (eART) and stop it after one year of undetectable viremia, to go on with treatment indefinitely, or to defer treatment. For each patient we calculated an a priori defined "Acute Retroviral Syndrome Severity Score" (ARSSS), consisting of clinical and basic laboratory variables, ranging from zero to ten points. We used linear regression models to assess the association between ARSSS and log baseline viral load (VL), baseline CD4+ cell count, and log viral setpoint (sVL) (i.e. VL measured ≥90 days after infection or treatment interruption). Mean ARSSS was 2.89. CD4+ cell count at baseline was negatively correlated with ARSSS (p = 0.03, n = 289), whereas HIV-RNA levels at baseline showed a strong positive correlation with ARSSS (p<0.001, n = 290). In the regression models, a 1-point increase in the score corresponded to a 0.10 log increase in baseline VL and a CD4+ cell count decline of 12/µl, respectively. In patients with PHI and not undergoing eART, higher ARSSS were significantly associated with higher sVL (p = 0.029, n = 64). In contrast, in patients undergoing eART with subsequent structured treatment interruption, no correlation was found between sVL and ARSSS (p = 0.28, n = 40). The ARSSS is a simple clinical score that correlates with the best-validated surrogate markers of HIV-1 disease progression. In regions where ART is not universally available and eART is not standard this score may help identifying patients who will profit the most from early antiretroviral therapy.

  5. Antiretroviral Therapy Optimisation without Genotype Resistance Testing: A Perspective on Treatment History Based Models

    PubMed Central

    Prosperi, Mattia C. F.; Rosen-Zvi, Michal; Altmann, André; Zazzi, Maurizio; Di Giambenedetto, Simona; Kaiser, Rolf; Schülter, Eugen; Struck, Daniel; Sloot, Peter; van de Vijver, David A.; Vandamme, Anne-Mieke; Sönnerborg, Anders

    2010-01-01

    Background Although genotypic resistance testing (GRT) is recommended to guide combination antiretroviral therapy (cART), funding and/or facilities to perform GRT may not be available in low to middle income countries. Since treatment history (TH) impacts response to subsequent therapy, we investigated a set of statistical learning models to optimise cART in the absence of GRT information. Methods and Findings The EuResist database was used to extract 8-week and 24-week treatment change episodes (TCE) with GRT and additional clinical, demographic and TH information. Random Forest (RF) classification was used to predict 8- and 24-week success, defined as undetectable HIV-1 RNA, comparing nested models including (i) GRT+TH and (ii) TH without GRT, using multiple cross-validation and area under the receiver operating characteristic curve (AUC). Virological success was achieved in 68.2% and 68.0% of TCE at 8- and 24-weeks (n = 2,831 and 2,579), respectively. RF (i) and (ii) showed comparable performances, with an average (st.dev.) AUC 0.77 (0.031) vs. 0.757 (0.035) at 8-weeks, 0.834 (0.027) vs. 0.821 (0.025) at 24-weeks. Sensitivity analyses, carried out on a data subset that included antiretroviral regimens commonly used in low to middle income countries, confirmed our findings. Training on subtype B and validation on non-B isolates resulted in a decline of performance for models (i) and (ii). Conclusions Treatment history-based RF prediction models are comparable to GRT-based for classification of virological outcome. These results may be relevant for therapy optimisation in areas where availability of GRT is limited. Further investigations are required in order to account for different demographics, subtypes and different therapy switching strategies. PMID:21060792

  6. Distributed Learning, Recognition, and Prediction by ART and ARTMAP Neural Networks.

    PubMed

    Carpenter, Gail A.

    1997-11-01

    A class of adaptive resonance theory (ART) models for learning, recognition, and prediction with arbitrarily distributed code representations is introduced. Distributed ART neural networks combine the stable fast learning capabilities of winner-take-all ART systems with the noise tolerance and code compression capabilities of multilayer perceptrons. With a winner-take-all code, the unsupervised model dART reduces to fuzzy ART and the supervised model dARTMAP reduces to fuzzy ARTMAP. With a distributed code, these networks automatically apportion learned changes according to the degree of activation of each coding node, which permits fast as well as slow learning without catastrophic forgetting. Distributed ART models replace the traditional neural network path weight with a dynamic weight equal to the rectified difference between coding node activation and an adaptive threshold. Thresholds increase monotonically during learning according to a principle of atrophy due to disuse. However, monotonic change at the synaptic level manifests itself as bidirectional change at the dynamic level, where the result of adaptation resembles long-term potentiation (LTP) for single-pulse or low frequency test inputs but can resemble long-term depression (LTD) for higher frequency test inputs. This paradoxical behavior is traced to dual computational properties of phasic and tonic coding signal components. A parallel distributed match-reset-search process also helps stabilize memory. Without the match-reset-search system, dART becomes a type of distributed competitive learning network.

  7. Screening for Cryptococcal Antigenaemia in Patients Accessing an Antiretroviral Treatment Program in South Africa

    PubMed Central

    Jarvis, Joseph N; Lawn, Stephen D; Vogt, Monica; Bangani, Nonzwakazi; Wood, Robin; Harrison, Thomas S

    2009-01-01

    Background Cryptococcal meningitis is a leading cause of death in AIDS patients and contributes substantially to the high early mortality in antiretroviral treatment (ART) programs in low-resource settings. Screening for cryptococcal antigen (CRAG) in patients enrolling in ART programs may identify those at risk of cryptococcal meningitis and permit targeted use of pre-emptive therapy. Methods In this retrospective study, CRAG was measured in stored plasma samples obtained from patients as they enrolled in a well characterised ART cohort in South Africa. The predictive value of screening for CRAG prior to ART for development of microbiologically confirmed cryptococcal meningitis or death during the first year of follow-up was determined. Results Of 707 participants with a baseline median CD4 count of 97 (IQR 46-157) cells/μL, 46 (7%) had a positive CRAG. Antigenaemia was 100% sensitive for predicting development of cryptococcal meningitis during the first year of ART and in multivariate analysis was an independent predictor of mortality (AHR 3.2, 95%CI 1.5-6.6). Most (92%) cases of cryptococcal meningitis developed in patients with a CD4 count ≤100 cells/μL. In this sub-set of patients, a CRAG titre ≥1 in 8 was 100% sensitive and 96% specific for predicting incident cryptococcal meningitis during the first year of ART in those with no previous history of the disease. Conclusions CRAG screening prior to commencing ART in patients with a CD4 count ≤100 cells/μL is highly effective at identifying those at risk of cryptococcal meningitis and death and might permit implementation of a targeted pre-emptive treatment strategy. PMID:19222372

  8. Admissibility of Evidence from Compelled Mental Examinations: MRE 302 and Beyond

    DTIC Science & Technology

    1988-04-01

    antisocial and paranoid personality disorder. He was subsequently apprehended for possession of marihuana and another assault. He was again referred to the...acts. Mental disease or defect does not otherwise constitute a defense. Uniform Code of Military Justice art . 50a, 10 U.S.C.A. § 859a (1987 Supp...UCMJ art . 5a (bW. 4 RCM 716k (3)(A). 5 "No problem in the drafting of a penal code presents larger intrinsic difficulties than that of determining when

  9. Summer music and arts festivals as hot spots for measles transmission: experience from England and Wales, June to October 2016

    PubMed Central

    le Polain de Waroux, Olivier; Saliba, Vanessa; Cottrell, Simon; Young, Nick; Perry, Malorie; Bukasa, Antoaneta; Ramsay, Mary; Brown, Kevin; Amirthalingam, Gayatri

    2016-01-01

    We report 52 cases of measles linked to music and arts festivals in England and Wales, between mid-June and mid-October 2016. Nearly half were aged 15 to 19 years. Several individuals who acquired measles at one festival subsequently attended another festival while infectious, resulting in multiple interlinked outbreaks. Transmission within festivals resulted in a geographical spread of cases nationally as well as internationally, which presents particular challenges for measles control. PMID:27881230

  10. Race-Based Medical Mistrust, Medication Beliefs and HIV Treatment Adherence: Test of a Mediation Model in People Living with HIV/AIDS

    PubMed Central

    Kalichman, Seth C.; Eaton, Lisa; Kalichman, Moira O.; Grebler, Tama; Merely, Cynthia; Welles, Brandi

    2016-01-01

    Race-based medical mistrust significantly predicts non-adherence to antiretroviral therapy (ART) in people living with HIV. The current study builds on previous research that shows beliefs about medication necessity (i.e., “My medicines protect me from becoming worse”) and concerns (i.e., Having to take my medicines worries me) mediate the association between race-based medical mistrust and medication adherence. Racial and ethnic minority men and women living with HIV and receiving ART (N=178) in a southern US city completed computerized measures of demographic and health characteristics, telephone interviews of race-based medical mistrust and medication beliefs, and unannounced phone-based pill counts for ART adherence. Multiple mediation modeling showed that medical mistrust is related to medication necessity and concerns beliefs and ART adherence. Furthermore, medication necessity beliefs predicted ART adherence. The indirect effect of medical mistrust on adherence through medication necessity beliefs was also significant. Results confirm that medication necessity beliefs, although not concerns beliefs, mediate the association between medical mistrust and ART adherence. Medication necessity beliefs offer a viable target for interventions to improve ART adherence in the context of mistrust that patients may have for medical providers and health care systems. PMID:27392477

  11. Adaptation effects to attractiveness of face photographs and art portraits are domain-specific

    PubMed Central

    Hayn-Leichsenring, Gregor U.; Kloth, Nadine; Schweinberger, Stefan R.; Redies, Christoph

    2013-01-01

    We studied the neural coding of facial attractiveness by investigating effects of adaptation to attractive and unattractive human faces on the perceived attractiveness of veridical human face pictures (Experiment 1) and art portraits (Experiment 2). Experiment 1 revealed a clear pattern of contrastive aftereffects. Relative to a pre-adaptation baseline, the perceived attractiveness of faces was increased after adaptation to unattractive faces, and was decreased after adaptation to attractive faces. Experiment 2 revealed similar aftereffects when art portraits rather than face photographs were used as adaptors and test stimuli, suggesting that effects of adaptation to attractiveness are not restricted to facial photographs. Additionally, we found similar aftereffects in art portraits for beauty, another aesthetic feature that, unlike attractiveness, relates to the properties of the image (rather than to the face displayed). Importantly, Experiment 3 showed that aftereffects were abolished when adaptors were art portraits and face photographs were test stimuli. These results suggest that adaptation to facial attractiveness elicits aftereffects in the perception of subsequently presented faces, for both face photographs and art portraits, and that these effects do not cross image domains. PMID:24349690

  12. BRAKER1: Unsupervised RNA-Seq-Based Genome Annotation with GeneMark-ET and AUGUSTUS.

    PubMed

    Hoff, Katharina J; Lange, Simone; Lomsadze, Alexandre; Borodovsky, Mark; Stanke, Mario

    2016-03-01

    Gene finding in eukaryotic genomes is notoriously difficult to automate. The task is to design a work flow with a minimal set of tools that would reach state-of-the-art performance across a wide range of species. GeneMark-ET is a gene prediction tool that incorporates RNA-Seq data into unsupervised training and subsequently generates ab initio gene predictions. AUGUSTUS is a gene finder that usually requires supervised training and uses information from RNA-Seq reads in the prediction step. Complementary strengths of GeneMark-ET and AUGUSTUS provided motivation for designing a new combined tool for automatic gene prediction. We present BRAKER1, a pipeline for unsupervised RNA-Seq-based genome annotation that combines the advantages of GeneMark-ET and AUGUSTUS. As input, BRAKER1 requires a genome assembly file and a file in bam-format with spliced alignments of RNA-Seq reads to the genome. First, GeneMark-ET performs iterative training and generates initial gene structures. Second, AUGUSTUS uses predicted genes for training and then integrates RNA-Seq read information into final gene predictions. In our experiments, we observed that BRAKER1 was more accurate than MAKER2 when it is using RNA-Seq as sole source for training and prediction. BRAKER1 does not require pre-trained parameters or a separate expert-prepared training step. BRAKER1 is available for download at http://bioinf.uni-greifswald.de/bioinf/braker/ and http://exon.gatech.edu/GeneMark/ katharina.hoff@uni-greifswald.de or borodovsky@gatech.edu Supplementary data are available at Bioinformatics online. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  13. Arts Involvement Predicts Academic Achievement Only When the Child Has a Musical Instrument

    ERIC Educational Resources Information Center

    Young, Laura N.; Cordes, Sara; Winner, Ellen

    2014-01-01

    We examined the associations between academic achievement and arts involvement (access to a musical instrument for the child at home, participation in unspecified after-school arts activities) in a sample of 2339 11-12-year-olds surveyed in the USA between 1998 and 2008. We compared the contributions of these variables to other kinds of cognitive…

  14. Brief Report: Prevalence of Posttreatment Controller Phenotype Is Rare in HIV-Infected Persons After Stopping Antiretroviral Therapy.

    PubMed

    Perkins, Matthew J; Bradley, William P; Lalani, Tahaniyat; Agan, Brian K; Whitman, Timothy J; Ferguson, Tomas M; Okulicz, Jason F; Ganesan, Anuradha

    2017-07-01

    Posttreatment control of HIV infection is a rare phenomenon primarily described among those initiating treatment with antiretroviral therapy (ART) during early/acute HIV infection. We examined a large, well-characterized cohort of HIV-infected Department of Defense beneficiaries for the presence of posttreatment controllers (PTCs) whom we defined as individuals with sustained viral suppression for ≥6 months after discontinuation of ART. We defined those who became viremic within 6 months of discontinuing ART as rapid viremics (RVs) and compared demographic and clinical characteristics, CD4 counts, and viral loads prior, during, and after ART discontinuation between the 2 groups. From a cohort of 6070 patients, we identified 95 who had been treated with ART for 2 years or more who subsequently discontinued ART and had viral load assessments available after discontinuation. Four (4.2%) of these 95 met our definition of PTC. The duration of viral suppression off of ART ranged from 267 to 1058 days with 1 of the 4 restarting ART without having redeveloped a significant viremia. All 4 patients initiated ART during chronic HIV infection. Demographic and clinical characteristics of PTCs were similar to RVs. While posttreatment control has predominantly been described among individuals who initiated ART in early/acute HIV infection, we identified 4 PTCs who started ART during chronic infection suggesting that posttreatment control also occurs among such patients. The rarity of PTCs identified in our cohort is consistent with reports from previous studies.

  15. Maraviroc Observational Study: The Impact of Expanded Resistance Testing and Clinical Considerations for Antiretroviral Regimen Selection in Treatment-Experienced Patients

    PubMed Central

    Wilkins, Sara-Anne; Tamhane, Ashutosh; Nevin, Christa R.; Mugavero, Michael J.; Raper, James L.; Napolitano, Laura A.; Saag, Michael S.

    2013-01-01

    Abstract Maraviroc (MVC) use has trailed that of other post-2006 antiretroviral therapy (ART) options for treatment-experienced patients. We explored the impact of free tropism testing on MVC utilization in our cohort and explored barriers to MVC utilization. The Maraviroc Outcomes Study (MOS) is an investigator-initiated industry-sponsored trial where consecutive ART-experienced patients receiving routine care with viral loads ≥1,000 copies/ml, and whose provider requested resistance testing and received standardized resistance testing (SRT; phenotype, genotype, coreceptor/tropism). Sociodemographic, clinical, and ART characteristics of those receiving SRT were compared to a historical cohort (HC). Subsequently, providers were surveyed regarding factors influencing selection of salvage ART therapy. The HC (n=165) had resistance testing 7/08–9/09, while prospective SRT (n=83) patients were enrolled 9/09–8/10. In the HC, 92% had genotypes, 2% had tropism assays, and 62% (n=102) changed ART after resistance testing (raltegravir 37%, etravirine 25%, darunavir 24%, MVC 1%). In the SRT cohort, 57% (n=48) changed regimens after standardized resistance testing (darunavir 48%, raltegravir 40%, and etravirine 19%). CCR5-tropic virus was identified in 43% of the SRT group, and MVC was used in 10% [or 20% of R5 tropic patients who underwent a subsequent regimen change (n=25)], a statistically significant (p=0.01) increase in utilization. The factors most strongly influencing utilization were unique patient circumstances (60%), clinical experience (55%), and potential side effects (40%). The addition of routine tropism testing to genotypic/phenotypic testing was associated with increased MVC utilization, raising the possibility that tropism testing may present a barrier to MVC use; however, additional barriers exist, and merit further evaluation. PMID:22881368

  16. Predicting the Functional Impact of CDH1 Missense Mutations in Hereditary Diffuse Gastric Cancer

    PubMed Central

    Melo, Soraia; Fernandes, Maria Sofia; Gonçalves, Margarida; Morais-de-Sá, Eurico; Sanches, João Miguel; Seruca, Raquel

    2017-01-01

    The role of E-cadherin in Hereditary Diffuse Gastric Cancer (HDGC) is unequivocal. Germline alterations in its encoding gene (CDH1) are causative of HDGC and occur in about 40% of patients. Importantly, while in most cases CDH1 alterations result in the complete loss of E-cadherin associated with a well-established clinical impact, in about 20% of cases the mutations are of the missense type. The latter are of particular concern in terms of genetic counselling and clinical management, as the effect of the sequence variants in E-cadherin function is not predictable. If a deleterious variant is identified, prophylactic surgery could be recommended. Therefore, over the last few years, intensive research has focused on evaluating the functional consequences of CDH1 missense variants and in assessing E-cadherin pathogenicity. In that context, our group has contributed to better characterize CDH1 germline missense variants and is now considered a worldwide reference centre. In this review, we highlight the state of the art methodologies to categorize CDH1 variants, as neutral or deleterious. This information is subsequently integrated with clinical data for genetic counseling and management of CDH1 variant carriers. PMID:29231860

  17. Length of training, hostility and the martial arts: a comparison with other sporting groups.

    PubMed Central

    Daniels, K; Thornton, E

    1992-01-01

    Previous research has indicated that training in the martial arts leads to a reduction in levels of hostility. However, such research has only compared hostility within martial arts groups. The present research compares two martial arts groups and two other sporting groups on levels of assaultive, verbal and indirect hostility. Moderated multiple regression analyses revealed a significant interaction between length of training in the respondent's stated sport and whether that sport was a martial art in predicting assaultive and verbal hostility. The form of the interaction suggests that participation in the martial arts is associated, over time, with decreased feelings of assaultive and verbal hostility. PMID:1422642

  18. Types and predictors of partner reactions to HIV status disclosure among HIV-infected adult Nigerians in a tertiary hospital in the Niger Delta.

    PubMed

    Ogoina, Dimie; Ikuabe, Peter; Ebuenyi, Ikenna; Harry, Tubonye; Inatimi, Otonyo; Chukwueke, Ogechi

    2015-03-01

    Our aim was to describe the types and determinants of partner reactions to HIV-status disclosure among adults attending an antiretroviral therapy-(ART) clinic in the Bayelsa State, Nigeria. A cross-sectional study was undertaken between January and March 2013 among consecutive adult patients who had disclosed their HIV-status to their current sexual partner. Sociodemograhic data and types of initial and subsequent partner reactions to disclosure were obtained using interviewer-administered standardized-questionnaire. Independent determinants of reactions to disclosure were ascertained by unconditional logistic regression. Out of 123 study participants, 57.7% were females, 92% were receiving ART and 86.1% were currently married. Majority of the participants reported predominant positive or supportive initial (72.4%) and subsequent (89.5%) partner reactions to disclosure, with significant increase in positive reactions over time. Positive initial partner reactions were independently associated with prior post-test counselling-(Odds ratio [OR]-6.5, 95% Confidence interval [CI]-1.3-31.6-p=0.02), age>35 years-(OR-5.8, 95% CI-1.6-20.9-p=0.008) and being healthy at time of disclosure-(OR-7.8, 95% CI-1.7-35.4-p=0.008). Subsequent positive partner reactions were significantly associated with receiving antiretroviral therapy and having only one lifetime sexual partner. Our results indicate that partner reactions to HIV-status disclosure are predominantly supportive. Disclosure counselling and early initiation of ART may be effective in improving HIV-status disclosure in Nigeria.

  19. Overview of the Aeroelastic Prediction Workshop

    NASA Technical Reports Server (NTRS)

    Heeg, Jennifer; Chwalowski, Pawel; Schuster, David M.; Dalenbring, Mats

    2013-01-01

    The AIAA Aeroelastic Prediction Workshop (AePW) was held in April, 2012, bringing together communities of aeroelasticians and computational fluid dynamicists. The objective in conducting this workshop on aeroelastic prediction was to assess state-of-the-art computational aeroelasticity methods as practical tools for the prediction of static and dynamic aeroelastic phenomena. No comprehensive aeroelastic benchmarking validation standard currently exists, greatly hindering validation and state-of-the-art assessment objectives. The workshop was a step towards assessing the state of the art in computational aeroelasticity. This was an opportunity to discuss and evaluate the effectiveness of existing computer codes and modeling techniques for unsteady flow, and to identify computational and experimental areas needing additional research and development. Three configurations served as the basis for the workshop, providing different levels of geometric and flow field complexity. All cases considered involved supercritical airfoils at transonic conditions. The flow fields contained oscillating shocks and in some cases, regions of separation. The computational tools principally employed Reynolds-Averaged Navier Stokes solutions. The successes and failures of the computations and the experiments are examined in this paper.

  20. Validating neural-network refinements of nuclear mass models

    NASA Astrophysics Data System (ADS)

    Utama, R.; Piekarewicz, J.

    2018-01-01

    Background: Nuclear astrophysics centers on the role of nuclear physics in the cosmos. In particular, nuclear masses at the limits of stability are critical in the development of stellar structure and the origin of the elements. Purpose: We aim to test and validate the predictions of recently refined nuclear mass models against the newly published AME2016 compilation. Methods: The basic paradigm underlining the recently refined nuclear mass models is based on existing state-of-the-art models that are subsequently refined through the training of an artificial neural network. Bayesian inference is used to determine the parameters of the neural network so that statistical uncertainties are provided for all model predictions. Results: We observe a significant improvement in the Bayesian neural network (BNN) predictions relative to the corresponding "bare" models when compared to the nearly 50 new masses reported in the AME2016 compilation. Further, AME2016 estimates for the handful of impactful isotopes in the determination of r -process abundances are found to be in fairly good agreement with our theoretical predictions. Indeed, the BNN-improved Duflo-Zuker model predicts a root-mean-square deviation relative to experiment of σrms≃400 keV. Conclusions: Given the excellent performance of the BNN refinement in confronting the recently published AME2016 compilation, we are confident of its critical role in our quest for mass models of the highest quality. Moreover, as uncertainty quantification is at the core of the BNN approach, the improved mass models are in a unique position to identify those nuclei that will have the strongest impact in resolving some of the outstanding questions in nuclear astrophysics.

  1. Comparing the PPAT Drawings of Boys with AD/HD and Age-Matched Controls Using the Formal Elements Art Therapy Scale.

    ERIC Educational Resources Information Center

    Munley, Maripat

    2002-01-01

    Explores whether children with AD/HD respond differently to a specific art directive. Using the Formal Elements Art Therapy Scale to evaluate the drawings, results indicate three elements that would most accurately predict the artists into the AD/HD group: color prominence, details of objects and environments, and line quality. (Contains 29…

  2. Art in Time and Space: Context Modulates the Relation between Art Experience and Viewing Time

    PubMed Central

    Brieber, David; Nadal, Marcos; Leder, Helmut; Rosenberg, Raphael

    2014-01-01

    The experience of art emerges from the interaction of various cognitive and affective processes. The unfolding of these processes in time and their relation with viewing behavior, however, is still poorly understood. Here we examined the effect of context on the relation between the experience of art and viewing time, the most basic indicator of viewing behavior. Two groups of participants viewed an art exhibition in one of two contexts: one in the museum, the other in the laboratory. In both cases viewing time was recorded with a mobile eye tracking system. After freely viewing the exhibition, participants rated each artwork on liking, interest, understanding, and ambiguity scales. Our results show that participants in the museum context liked artworks more, found them more interesting, and viewed them longer than those in the laboratory. Analyses with mixed effects models revealed that aesthetic appreciation (compounding liking and interest), understanding, and ambiguity predicted viewing time for artworks and for their corresponding labels. The effect of aesthetic appreciation and ambiguity on viewing time was modulated by context: Whereas art appreciation tended to predict viewing time better in the laboratory than in museum context, the relation between ambiguity and viewing time was positive in the museum and negative in the laboratory context. Our results suggest that art museums foster an enduring and focused aesthetic experience and demonstrate that context modulates the relation between art experience and viewing behavior. PMID:24892829

  3. Art in time and space: context modulates the relation between art experience and viewing time.

    PubMed

    Brieber, David; Nadal, Marcos; Leder, Helmut; Rosenberg, Raphael

    2014-01-01

    The experience of art emerges from the interaction of various cognitive and affective processes. The unfolding of these processes in time and their relation with viewing behavior, however, is still poorly understood. Here we examined the effect of context on the relation between the experience of art and viewing time, the most basic indicator of viewing behavior. Two groups of participants viewed an art exhibition in one of two contexts: one in the museum, the other in the laboratory. In both cases viewing time was recorded with a mobile eye tracking system. After freely viewing the exhibition, participants rated each artwork on liking, interest, understanding, and ambiguity scales. Our results show that participants in the museum context liked artworks more, found them more interesting, and viewed them longer than those in the laboratory. Analyses with mixed effects models revealed that aesthetic appreciation (compounding liking and interest), understanding, and ambiguity predicted viewing time for artworks and for their corresponding labels. The effect of aesthetic appreciation and ambiguity on viewing time was modulated by context: Whereas art appreciation tended to predict viewing time better in the laboratory than in museum context, the relation between ambiguity and viewing time was positive in the museum and negative in the laboratory context. Our results suggest that art museums foster an enduring and focused aesthetic experience and demonstrate that context modulates the relation between art experience and viewing behavior.

  4. The ability of pulse pressure variations obtained with CNAP™ device to predict fluid responsiveness in the operating room.

    PubMed

    Biais, Matthieu; Stecken, Laurent; Ottolenghi, Laetitia; Roullet, Stéphanie; Quinart, Alice; Masson, Françoise; Sztark, François

    2011-09-01

    Respiratory-induced pulse pressure variations obtained with an arterial line (ΔPP(ART)) indicate fluid responsiveness in mechanically ventilated patients. The Infinity® CNAP™ SmartPod® (Dräger Medical AG & Co. KG, Lübeck, Germany) provides noninvasive continuous beat-to-beat arterial blood pressure measurements and a near real-time pressure waveform. We hypothesized that respiratory-induced pulse pressure variations obtained with the CNAP system (ΔPP(CNAP)) predict fluid responsiveness as well as ΔPP(ART) predicts fluid responsiveness in mechanically ventilated patients during general anesthesia. Thirty-five patients undergoing vascular surgery were studied after induction of general anesthesia. Stroke volume (SV) measured with the Vigileo™/FloTrac™ (Edwards Lifesciences, Irvine, CA), ΔPP(ART), and ΔPP(CNAP) were recorded before and after intravascular volume expansion (VE) (500 mL of 6% hydroxyethyl starch 130/0.4). Subjects were defined as responders if SV increased by ≥15% after VE. Twenty patients responded to VE and 15 did not. The correlation coefficient between ΔPP(ART) and ΔPP(CNAP) before VE was r = 0.90 (95% confidence interval [CI] = 0.84-0.96; P < 0.0001). Before VE, ΔPP(ART) and ΔPP(CNAP) were significantly higher in responders than in nonresponders (P < 0.0001). The values of ΔPP(ART) and ΔPP(CNAP) before VE were significantly correlated with the percent increase in SV induced by VE (respectively, r(2) = 0.50; P < 0.0001 and r(2) = 0.57; P < 0.0001). Before VE, a ΔPP(ART) >10% discriminated between responders and nonresponders with a sensitivity of 90% (95% CI = 69%-99%) and a specificity of 87% (95% CI = 60%-98%). The area under the receiver operating characteristic (ROC) curve was 0.957 ± 0.035 for ΔPP(ART). Before VE, a ΔPP(CNAP) >11% discriminated between responders and nonresponders with a sensitivity of 85% (95% CI = 62%-97%) and a specificity of 100% (95% CI = 78%-100%). The area under the ROC curve was 0.942 ± 0.040 for ΔPP(CNAP). There was no significant difference between the area under the ROC curve for ΔPP(ART) and ΔPP(CNAP). A value of ΔPP(CNAP) >11% has a sensitivity of at least 62% in predicting preload-dependent responders to VE in mechanically ventilated patients during general anesthesia.

  5. Diffusion measures indicate fight exposure-related damage to cerebral white matter in boxers and mixed martial arts fighters.

    PubMed

    Shin, W; Mahmoud, S Y; Sakaie, K; Banks, S J; Lowe, M J; Phillips, M; Modic, M T; Bernick, C

    2014-02-01

    Traumatic brain injury is common in fighting athletes such as boxers, given the frequency of blows to the head. Because DTI is sensitive to microstructural changes in white matter, this technique is often used to investigate white matter integrity in patients with traumatic brain injury. We hypothesized that previous fight exposure would predict DTI abnormalities in fighting athletes after controlling for individual variation. A total of 74 boxers and 81 mixed martial arts fighters were included in the analysis and scanned by use of DTI. Individual information and data on fight exposures, including number of fights and knockouts, were collected. A multiple hierarchical linear regression model was used in region-of-interest analysis to test the hypothesis that fight-related exposure could predict DTI values separately in boxers and mixed martial arts fighters. Age, weight, and years of education were controlled to ensure that these factors would not account for the hypothesized effects. We found that the number of knockouts among boxers predicted increased longitudinal diffusivity and transversal diffusivity in white matter and subcortical gray matter regions, including corpus callosum, isthmus cingulate, pericalcarine, precuneus, and amygdala, leading to increased mean diffusivity and decreased fractional anisotropy in the corresponding regions. The mixed martial arts fighters had increased transversal diffusivity in the posterior cingulate. The number of fights did not predict any DTI measures in either group. These findings suggest that the history of fight exposure in a fighter population can be used to predict microstructural brain damage.

  6. Androgen responses to reproductive competition of males pursuing either fixed or plastic alternative reproductive tactics.

    PubMed

    von Kuerthy, Corinna; Ros, Albert F H; Taborsky, Michael

    2016-11-15

    Alternative reproductive tactics (ARTs), which can be plastic or fixed for life, may be characterized by distinct hormonal profiles. The relative plasticity hypothesis predicts flexible androgen regulation for adult males pursuing plastic tactics, but a less flexible regulation for males using a fixed tactic throughout life. Furthermore, androgen profiles may respond to changes in the social environment, as predicted by the social reciprocity models of hormone/behaviour interactions. The cichlid fish Lamprologus callipterus provides a rare opportunity to study the roles of androgens for male ARTs within a single species, because fixed and plastic ARTs coexist. We experimentally exposed males to competitors pursuing either the same or different tactics to test predictions of the relative plasticity and the social reciprocity models. Androgen profiles of different male types partly comply with predictions derived from the relative plasticity hypothesis: males of the plastic bourgeois/sneaker male trajectory showed different 11-ketotestosterone (11-KT) levels when pursuing either bourgeois or parasitic sneaker male behaviours. Surprisingly, males pursuing the fixed dwarf male tactic showed the highest free and conjugated 11-KT and testosterone (T) levels. Our experimental social challenges significantly affected the free 11-KT levels of bourgeois males, but the androgen responses did not differ between challenges involving different types of competitors. Furthermore, the free T-responses of the bourgeois males correlated with their aggressive behaviour exhibited against competitors. Our results provide new insights into the endocrine responsiveness of fixed and plastic ARTs, confirming and refuting some predictions of both the relative plasticity and the social reciprocity models. © 2016. Published by The Company of Biologists Ltd.

  7. The art and science of prognostication in early university medicine.

    PubMed

    Demaitre, Luke

    2003-01-01

    Prognosis occupied a more prominent place in the medieval curriculum than it does at the modern university. Scholastic discussions were rooted in the Hippocratic Aphorisms and shaped by Galen's treatises On Crisis and On Critical Days. Medical prediction, as an art dependent on personal skills such as memory and conjecture, was taught with the aid of the liberal arts of rhetoric and logic. Scientific predictability was sought in branches of mathematics, moving from periodicity and numerology to astronomy. The search for certitude contributed to the cultivation of astrology; even at its peak, however, astrological medicine did not dominate the teaching on prognostication. The ultimate concern, which awaits further discussion, was not even with forecasting as such, but with the physician and, indeed, the patient.

  8. Combined online and offline adaptive radiation therapy: a dosimetric feasibility study.

    PubMed

    Yang, Chengliang; Liu, Feng; Ahunbay, Ergun; Chang, Yu-Wen; Lawton, Colleen; Schultz, Christopher; Wang, Dian; Firat, Selim; Erickson, Beth; Li, X Allen

    2014-01-01

    The purpose of this work is to explore a new adaptive radiation therapy (ART) strategy, combined "online and offline" ART, that can fully account for interfraction variations similar to the existing online ART but with substantially reduced online effort. The concept for the combined ART is to perform online ART only for the fractions with obvious interfraction variations and to deliver the ART plan for that online fraction as well as the subsequent fractions until the next online fraction needs to be adapted. To demonstrate the idea, the daily computed tomographic (CT) data acquired during image guided radiation therapy (IGRT) with an in-room CT (CTVision, Siemens Healthcare, Amarillo, TX) for 6 representative patients (including 2 prostate, 1 head-and-neck, and 1 pancreatic cancer, 1 adrenal carcinoma, and 1 craniopharyngioma patients) were analyzed. Three types of plans were generated based on the following selected daily CTs: (1) IGRT repositioning plan, generated by applying the repositioning shifts to the original plan (representing the current IGRT practice); (2) Re-Opt plan, generated with full-scope optimization; and (3) ART plan, either online ART plan generated with an online ART tool (RealArt, Prowess Inc, Concord, CA) or offline ART plan generated with shifts from the online ART plan. Various dose-volume parameters were compared with measure dosimetric benefits of the ART plans based on daily dose distributions and the cumulative dose maps obtained with deformable image registration. In general, for all the cases studied, the ART (with 3-5 online ART) and Re-Opt plans provide comparable plan quality and offer significantly better target coverage and normal tissue sparing when compared with the repositioning plans. This improvement is statistically significant. The combined online and offline ART is dosimetrically equivalent to the online ART but with substantially reduced online effort, and enables immediate delivery of the adaptive plan when an obvious anatomic change is observed. Copyright © 2014 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  9. Impact of active controls technology on structural integrity

    NASA Technical Reports Server (NTRS)

    Noll, Thomas; Austin, Edward; Donley, Shawn; Graham, George; Harris, Terry

    1991-01-01

    This paper summarizes the findings of The Technical Cooperation Program to assess the impact of active controls technology on the structural integrity of aeronautical vehicles and to evaluate the present state-of-the-art for predicting the loads caused by a flight-control system modification and the resulting change in the fatigue life of the flight vehicle. The potential for active controls to adversely affect structural integrity is described, and load predictions obtained using two state-of-the-art analytical methods are given.

  10. Impact of isotropic constitutive descriptions on the predicted peak wall stress in abdominal aortic aneurysms.

    PubMed

    Man, V; Polzer, S; Gasser, T C; Novotny, T; Bursa, J

    2018-03-01

    Biomechanics-based assessment of Abdominal Aortic Aneurysm (AAA) rupture risk has gained considerable scientific and clinical momentum. However, computation of peak wall stress (PWS) using state-of-the-art finite element models is time demanding. This study investigates which features of the constitutive description of AAA wall are decisive for achieving acceptable stress predictions in it. Influence of five different isotropic constitutive descriptions of AAA wall is tested; models reflect realistic non-linear, artificially stiff non-linear, or artificially stiff pseudo-linear constitutive descriptions of AAA wall. Influence of the AAA wall model is tested on idealized (n=4) and patient-specific (n=16) AAA geometries. Wall stress computations consider a (hypothetical) load-free configuration and include residual stresses homogenizing the stresses across the wall. Wall stress differences amongst the different descriptions were statistically analyzed. When the qualitatively similar non-linear response of the AAA wall with low initial stiffness and subsequent strain stiffening was taken into consideration, wall stress (and PWS) predictions did not change significantly. Keeping this non-linear feature when using an artificially stiff wall can save up to 30% of the computational time, without significant change in PWS. In contrast, a stiff pseudo-linear elastic model may underestimate the PWS and is not reliable for AAA wall stress computations. Copyright © 2018 IPEM. Published by Elsevier Ltd. All rights reserved.

  11. Linking rainfall-induced landslides with debris flows runout patterns towards catchment scale hazard assessment

    NASA Astrophysics Data System (ADS)

    Fan, Linfeng; Lehmann, Peter; McArdell, Brian; Or, Dani

    2017-03-01

    Debris flows and landslides induced by heavy rainfall represent an ubiquitous and destructive natural hazard in steep mountainous regions. For debris flows initiated by shallow landslides, the prediction of the resulting pathways and associated hazard is often hindered by uncertainty in determining initiation locations, volumes and mechanical state of the mobilized debris (and by model parameterization). We propose a framework for linking a simplified physically-based debris flow runout model with a novel Landslide Hydro-mechanical Triggering (LHT) model to obtain a coupled landslide-debris flow susceptibility and hazard assessment. We first compared the simplified debris flow model of Perla (1980) with a state-of-the art continuum-based model (RAMMS) and with an empirical model of Rickenmann (1999) at the catchment scale. The results indicate that predicted runout distances by the Perla model are in reasonable agreement with inventory measurements and with the other models. Predictions of localized shallow landslides by LHT model provides information on water content of released mass. To incorporate effects of water content and flow viscosity as provided by LHT on debris flow runout, we adapted the Perla model. The proposed integral link between landslide triggering susceptibility quantified by LHT and subsequent debris flow runout hazard calculation using the adapted Perla model provides a spatially and temporally resolved framework for real-time hazard assessment at the catchment scale or along critical infrastructure (roads, railroad lines).

  12. [Robotics].

    PubMed

    Bier, J

    2000-05-01

    Content of this paper is the current state of the art of robots in surgery and the ongoing work on the field of surgical robotics at the Clinic for Maxillofacial Surgery at the Charité. Robots in surgery allows the surgeon to transform the accuracy of the imaging systems directly during the intervention and to plan an intervention beforehand. In this paper firstly the state of the art is described. Subsequently the scientific work at the clinic is described in detail. The paper closes with a outlook for future applications of robotics systems in maxillofacial surgery.

  13. Prediction algorithms for urban traffic control

    DOT National Transportation Integrated Search

    1979-02-01

    The objectives of this study are to 1) review and assess the state-of-the-art of prediction algorithms for urban traffic control in terms of their accuracy and application, and 2) determine the prediction accuracy obtainable by examining the performa...

  14. Exploring the Effects of Low Power Schemas in Mothers.

    ERIC Educational Resources Information Center

    Mills, Rosemary S. L.

    1999-01-01

    Assessed whether low perceived maternal power and temperamentally fearful preschool-aged daughters predicted subsequent maternal overcontrol and internalizing symptoms in daughters 2 years later. Found that low perceived maternal power predicted subsequent maternal overcontrol with initially fearful daughters but did not predict subsequent…

  15. Arts on prescription in Scandinavia: a review of current practice and future possibilities.

    PubMed

    Jensen, Anita; Stickley, Theodore; Torrissen, Wenche; Stigmar, Kjerstin

    2017-09-01

    This article reviews current practice relating to arts and culture on prescription in Sweden, Norway, Denmark and in the United Kingdom. It considers future possibilities and also each of the Scandinavian countries from a culture and health policy and research perspective. The United Kingdom perhaps leads the field of Arts on Prescription practice, and subsequent research is described in order to help identify what the Scandinavian countries might learn from the UK research. The method adopted for the literature search was a rapid review which included peer-reviewed and grey literature in English and the respective languages of Scandinavia. The discussion considers the evidence to support social prescription and the potential obstacles of the implementation of Arts on Prescription in Scandinavian countries. The article concludes that of the Scandinavian countries, Sweden is ahead in terms of Arts on Prescription and has embraced the use of culture for health benefits on a different scale compared to Norway and Denmark. Denmark, in particular, is behind in recognising ways in which art and culture can benefit patients and for wider public health promotion. All three countries may benefit from the evidence provided by UK researchers.

  16. Subsequent Vertebral Fractures Post Cement Augmentation of the Thoracolumbar Spine: Does it Correlate With Level-specific Bone Mineral Density Scores?

    PubMed

    Hey, Hwee Weng Dennis; Hwee Weng, Dennis Hey; Tan, Jun Hao; Jun, Hao Tan; Tan, Chuen Seng; Chuen, Seng Tan; Tan, Hsi Ming Bryan; Ming, Bryan Tan Hsi; Lau, Puang Huh Bernard; Huh, Bernard Lau Puang; Hee, Hwan Tak; Hwan, Tak Hee

    2015-12-01

    A case-control study. In this study, we investigated the correlation between level-specific preoperative bone mineral density and subsequent vertebral fractures. We also identified factors associated with subsequent vertebral fractures. Complications of cement augmentation of the spine include subsequent vertebral fractures, leading to unnecessary morbidity and more treatment. Ability to predict at-risk vertebra will help guide management. We studied all patients with osteoporotic compression fractures who underwent cement augmentation in a single institution from November 2001 to December 2010 by a single surgeon. Association between level-specific bone mineral density T-scores and subsequent fractures was assessed. Multivariable analysis was performed to identify significant factors associated with subsequent vertebral fractures. 93 patients followed up for a mean duration of 25.1 months (12-96) had a mean age of 76.8 years (47-99). Vertebroplasty was performed in 58 patients (62.4%) on 68 levels and kyphoplasty in 35 patients (37.6%) on 44 levels. Refracture was seen in 16 patients (17.2%). The time to subsequent fracture post cement augmentation was 20.5 months (2-90). For refracture cases, 43.8% (7/16) fractured in the adjacent vertebrae. Subsequently fractured vertebra had a mean T-score of -2.860 (95% confidence interval -3.268 to -2.452) and nonfractured vertebra had a mean T-score of -2.180 (95% confidence interval -2.373 to -1.986). A T-score of -2.2 or lower is predictive of refracture at that vertebra (P = 0.047). Odds ratio increases with decreasing T-scores from -2.2 or lower to -2.6 or lower. A T-score of -2.6 or lower gives no additional predictive advantage. After multivariable analysis, age (P = 0.049) and loss of preoperative anterior vertebral height (P = 0.017) are associated with refracture. Level-specific T-scores are predictive of subsequent fractures and the odds ratio increases with lower T-scores from -2.2 or less to -2.6 or less. They have a low positive predictive value, but a high negative predictive value for subsequent fractures. Other significant associations with subsequent refractures include age and anterior vertebral height. 4.

  17. PMTCT Option B+ Does Not Increase Preterm Birth Risk and May Prevent Extreme Prematurity: A Retrospective Cohort Study in Malawi.

    PubMed

    Chagomerana, Maganizo B; Miller, William C; Pence, Brian W; Hosseinipour, Mina C; Hoffman, Irving F; Flick, Robert J; Tweya, Hannock; Mumba, Soyapi; Chimbwandira, Frank; Powers, Kimberly A

    2017-04-01

    To estimate preterm birth risk among infants of HIV-infected women in Lilongwe, Malawi, according to maternal antiretroviral therapy (ART) status and initiation time under Option B+. A retrospective cohort study of HIV-infected women delivering at ≥27 weeks of gestation, April 2012 to November 2015. Among women on ART at delivery, we restricted our analysis to those who initiated ART before 27 weeks of gestation. We defined preterm birth as a singleton live birth at ≥27 and <37 weeks of gestation, with births at <32 weeks classified as extremely to very preterm. We used log-binomial models to estimate risk ratios and 95% confidence intervals for the association between ART and preterm birth. Among 3074 women included in our analyses, 731 preterm deliveries were observed (24%). Overall preterm birth risk was similar in women who had initiated ART at any point before 27 weeks and those who never initiated ART (risk ratio = 1.14; 95% confidence interval: 0.84 to 1.55), but risk of extremely to very preterm birth was 2.33 (1.39 to 3.92) times as great in those who never initiated ART compared with those who did at any point before 27 weeks. Among women on ART before delivery, ART initiation before conception was associated with the lowest preterm birth risk. ART during pregnancy was not associated with preterm birth, and it may in fact be protective against severe adverse outcomes accompanying extremely to very preterm birth. As preconception ART initiation appears especially protective, long-term retention on ART should be a priority to minimize preterm birth in subsequent pregnancies.

  18. Heartfelt images: learning cardiac science artistically.

    PubMed

    Courneya, Carol Ann

    2018-03-01

    There are limited curricular options for medical students to engage in art-making during their training. Yet, it is known that art-making confers a variety of benefits related to learning. This qualitative study utilises a visual methodology to explore students' art-making in the context of the cardiovascular sciences. The existence of a multiyear repository of medical/dental student generated, cardiac-inspired art, collected over 6 years, provided the opportunity to explore the nature of the art made. The aim was to categorise the art produced, as well as the depth and breadth of understanding required to produce the art. The data set included a wide variety of titled art (paintings, photographs, sketches, sculptures, collages, poetry and music/dance). Systematic curation of the collection, across all media, yielded three main categories: anatomical renderings, physiology/pathophysiology renderings and kinesthetic creations (music/dance/tactile). Overall (medical and dental) student-generated art suggested a high level of content/process understanding, as illustrated by attention to scientific detail, integration of form and function as well as the sophisticated use of visual metaphor and word play. Dental students preferentially expressed their understanding of anatomy and physiology kinesthetically, creating art that required manual dexterity as well as through choreography and dance. Combining art-making with basic science curricular learning invited the medical and dentistry students to link their understanding to different modes of expression and a non-biomedical way of knowing. Subsequent incorporation of the student-generated cardiac art into lectures exposed the entire class to creative pictorial expressions of anatomy, physiology and pathophysiology. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Childhood and/or Adolescent Sexual Experiences: Predicting Variability in Subsequent Adjustment.

    ERIC Educational Resources Information Center

    Seidner, Andrea L.; And Others

    There is considerable debate regarding the effects of childhood sexual abuse on an individual's subsequent adjustment. To determine which variables are most useful in predicting subsequent adjustment of individuals who were involved in sexual experiences as children or adolescents, 59 female and 17 male undergraduates who reported having had a…

  20. Scalable Joint Models for Reliable Uncertainty-Aware Event Prediction.

    PubMed

    Soleimani, Hossein; Hensman, James; Saria, Suchi

    2017-08-21

    Missing data and noisy observations pose significant challenges for reliably predicting events from irregularly sampled multivariate time series (longitudinal) data. Imputation methods, which are typically used for completing the data prior to event prediction, lack a principled mechanism to account for the uncertainty due to missingness. Alternatively, state-of-the-art joint modeling techniques can be used for jointly modeling the longitudinal and event data and compute event probabilities conditioned on the longitudinal observations. These approaches, however, make strong parametric assumptions and do not easily scale to multivariate signals with many observations. Our proposed approach consists of several key innovations. First, we develop a flexible and scalable joint model based upon sparse multiple-output Gaussian processes. Unlike state-of-the-art joint models, the proposed model can explain highly challenging structure including non-Gaussian noise while scaling to large data. Second, we derive an optimal policy for predicting events using the distribution of the event occurrence estimated by the joint model. The derived policy trades-off the cost of a delayed detection versus incorrect assessments and abstains from making decisions when the estimated event probability does not satisfy the derived confidence criteria. Experiments on a large dataset show that the proposed framework significantly outperforms state-of-the-art techniques in event prediction.

  1. Assessment of NASA's Aircraft Noise Prediction Capability

    NASA Technical Reports Server (NTRS)

    Dahl, Milo D. (Editor)

    2012-01-01

    A goal of NASA s Fundamental Aeronautics Program is the improvement of aircraft noise prediction. This document provides an assessment, conducted from 2006 to 2009, on the current state of the art for aircraft noise prediction by carefully analyzing the results from prediction tools and from the experimental databases to determine errors and uncertainties and compare results to validate the predictions. The error analysis is included for both the predictions and the experimental data and helps identify where improvements are required. This study is restricted to prediction methods and databases developed or sponsored by NASA, although in many cases they represent the current state of the art for industry. The present document begins with an introduction giving a general background for and a discussion on the process of this assessment followed by eight chapters covering topics at both the system and the component levels. The topic areas, each with multiple contributors, are aircraft system noise, engine system noise, airframe noise, fan noise, liner physics, duct acoustics, jet noise, and propulsion airframe aeroacoustics.

  2. A Tonsillar PolyICLC/AT-2 SIV Therapeutic Vaccine Maintains Low Viremia Following Antiretroviral Therapy Cessation

    PubMed Central

    Vagenas, Panagiotis; Aravantinou, Meropi; Williams, Vennansha G.; Jasny, Edith; Piatak, Michael; Lifson, Jeffrey D.; Salazar, Andres M.; Blanchard, James L.; Gettie, Agegnehu; Robbiani, Melissa

    2010-01-01

    Background HIV-infected individuals rely on antiretroviral therapy (ART) to control viral replication. Despite abundant demonstrable benefits, the multiple limitations of ART point to the potential advantages of therapeutic vaccination approaches that could provide sustained host control of viral replication after discontinuation of ART. We provide evidence from a non-human primate model that a therapeutic vaccine applied to the tonsils can maintain low viral loads after cessation of ART. Methodology/Principal Findings Animals received 40 weeks of ART initiated 9 weeks after rectal SIVmac239 infection. During ART, animals were vaccinated (or not) with AT-2 inactivated SIVmac239 using CpG-C ISS-ODN (C274) or polyICLC as adjuvants. PolyICLC/AT-2 SIV vaccinated animals maintained viral loads <3×103 copies/ml for up to 16 weeks post-ART, whereas the C274/AT-2 SIV vaccinated and non-vaccinated animals' viremia ranged between 1×104–4×105 copies/ml (p<0.03). Neutralizing Ab activity in plasma was increased by polyICLC/AT-2 tonsillar vaccination under ART, compared to controls (p<0.03). Subsequent vaccination of all animals with polyICLC/AT-2 SIV in the absence of ART did not alter viral loads. Other immune parameters measured in blood and tissues were comparable between groups. Conclusions/Significance These results provide support for the potential benefit of mucosally delivered vaccines in therapeutic immunization strategies for control of AIDS virus infection. PMID:20877632

  3. ROTONET Primer

    NASA Technical Reports Server (NTRS)

    Prichard, Devon S.

    1996-01-01

    This document provides a brief overview of use of the ROTONET rotorcraft system noise prediction capability within the Aircraft Noise Program (ANOPP). Reviews are given on rotorcraft noise, the state-of-the-art of system noise prediction, and methods for using the various ROTONET prediction modules.

  4. In-Situ Analysis Of Metal(loid)s In Plants: State Of The Art And Artefacts

    EPA Science Inventory

    Metals and metalloids play important roles in plant function and metabolism. Likewise, plants subsequently introduce vital dietary nutrition to people and animals. Understanding the transport, localisation and speciation of these elements is critical for understanding availabil...

  5. Multilevel regulation of an α-arrestin by glucose depletion controls hexose transporter endocytosis.

    PubMed

    Hovsepian, Junie; Defenouillère, Quentin; Albanèse, Véronique; Váchová, Libuše; Garcia, Camille; Palková, Zdena; Léon, Sébastien

    2017-06-05

    Nutrient availability controls the landscape of nutrient transporters present at the plasma membrane, notably by regulating their ubiquitylation and subsequent endocytosis. In yeast, this involves the Nedd4 ubiquitin ligase Rsp5 and arrestin-related trafficking adaptors (ARTs). ARTs are targeted by signaling pathways and warrant that cargo ubiquitylation and endocytosis appropriately respond to nutritional inputs. Here, we show that glucose deprivation regulates the ART protein Csr2/Art8 at multiple levels to trigger high-affinity glucose transporter endocytosis. Csr2 is transcriptionally induced in these conditions through the AMPK orthologue Snf1 and downstream transcriptional repressors. Upon synthesis, Csr2 becomes activated by ubiquitylation. In contrast, glucose replenishment induces CSR2 transcriptional shutdown and switches Csr2 to an inactive, deubiquitylated form. This glucose-induced deubiquitylation of Csr2 correlates with its phospho-dependent association with 14-3-3 proteins and involves protein kinase A. Thus, two glucose signaling pathways converge onto Csr2 to regulate hexose transporter endocytosis by glucose availability. These data illustrate novel mechanisms by which nutrients modulate ART activity and endocytosis. © 2017 Hovsepian et al.

  6. Multilevel regulation of an α-arrestin by glucose depletion controls hexose transporter endocytosis

    PubMed Central

    Hovsepian, Junie; Váchová, Libuše; Garcia, Camille; Palková, Zdena

    2017-01-01

    Nutrient availability controls the landscape of nutrient transporters present at the plasma membrane, notably by regulating their ubiquitylation and subsequent endocytosis. In yeast, this involves the Nedd4 ubiquitin ligase Rsp5 and arrestin-related trafficking adaptors (ARTs). ARTs are targeted by signaling pathways and warrant that cargo ubiquitylation and endocytosis appropriately respond to nutritional inputs. Here, we show that glucose deprivation regulates the ART protein Csr2/Art8 at multiple levels to trigger high-affinity glucose transporter endocytosis. Csr2 is transcriptionally induced in these conditions through the AMPK orthologue Snf1 and downstream transcriptional repressors. Upon synthesis, Csr2 becomes activated by ubiquitylation. In contrast, glucose replenishment induces CSR2 transcriptional shutdown and switches Csr2 to an inactive, deubiquitylated form. This glucose-induced deubiquitylation of Csr2 correlates with its phospho-dependent association with 14-3-3 proteins and involves protein kinase A. Thus, two glucose signaling pathways converge onto Csr2 to regulate hexose transporter endocytosis by glucose availability. These data illustrate novel mechanisms by which nutrients modulate ART activity and endocytosis. PMID:28468835

  7. Predicting beauty: fractal dimension and visual complexity in art.

    PubMed

    Forsythe, A; Nadal, M; Sheehy, N; Cela-Conde, C J; Sawey, M

    2011-02-01

    Visual complexity has been known to be a significant predictor of preference for artistic works for some time. The first study reported here examines the extent to which perceived visual complexity in art can be successfully predicted using automated measures of complexity. Contrary to previous findings the most successful predictor of visual complexity was Gif compression. The second study examined the extent to which fractal dimension could account for judgments of perceived beauty. The fractal dimension measure accounts for more of the variance in judgments of perceived beauty in visual art than measures of visual complexity alone, particularly for abstract and natural images. Results also suggest that when colour is removed from an artistic image observers are unable to make meaningful judgments as to its beauty. ©2010 The British Psychological Society.

  8. MADRS symptom subtypes in ECT-treated depressed patients: relationship to response and subsequent ECT.

    PubMed

    Spashett, Renee; Fernie, Gordon; Reid, Ian C; Cameron, Isobel M

    2014-09-01

    This study aimed to explore the relationship of Montgomery-Åsberg Depression Rating Scale (MADRS) symptom subtypes with response to electroconvulsive therapy (ECT) and subsequent ECT treatment within 12 months. A consecutive sample of 414 patients with depression receiving ECT in the North East of Scotland was assessed by retrospective chart review. Response rate was defined as greater than or equal to 50% decrease in pretreatment total MADRS score or a posttreatment total MADRS less than or equal to 10. Principal component analyses were conducted on a sample with psychotic features (n = 124) and a sample without psychotic features (n = 290). Scores on extracted factor subscales, clinical and demographic characteristics were assessed for association with response and subsequent ECT treatment within 12 months. Where more than 1 variable was associated with response or subsequent ECT, logistic regression analysis was applied. MADRS symptom subtypes formed 3 separate factors in both samples. Logistic regression revealed older age and high "Despondency" subscale score predicted response in the nonpsychotic group. Older age alone predicted response in the group with psychotic features. Nonpsychotic patients subsequently re-treated with ECT were older than those not prescribed subsequent ECT. No association of variables emerged with subsequent ECT treatment in the group with psychotic features. Being of older age and the presence of psychotic features predicted response. Presence of psychotic features alone predicted subsequent retreatment. Subscale scores of the MADRS are of limited use in predicting which patients with depression will respond to ECT, with the exception of "Despondency" subscale scores in patients without psychotic features.

  9. Predictive validity of the classroom strategies scale-observer form on statewide testing scores: an initial investigation.

    PubMed

    Reddy, Linda A; Fabiano, Gregory A; Dudek, Christopher M; Hsu, Louis

    2013-12-01

    The present study examined the validity of a teacher observation measure, the Classroom Strategies Scale--Observer Form (CSS), as a predictor of student performance on statewide tests of mathematics and English language arts. The CSS is a teacher practice observational measure that assesses evidence-based instructional and behavioral management practices in elementary school. A series of two-level hierarchical generalized linear models were fitted to data of a sample of 662 third- through fifth-grade students to assess whether CSS Part 2 Instructional Strategy and Behavioral Management Strategy scale discrepancy scores (i.e., ∑ |recommended frequency--frequency ratings|) predicted statewide mathematics and English language arts proficiency scores when percentage of minority students in schools was controlled. Results indicated that the Instructional Strategy scale discrepancy scores significantly predicted mathematics and English language arts proficiency scores: Relatively larger discrepancies on observer ratings of what teachers did versus what should have been done were associated with lower proficiency scores. Results offer initial evidence of the predictive validity of the CSS Part 2 Instructional Strategy discrepancy scores on student academic outcomes. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  10. Short Communication: Hyperthyroidism in Human Immunodeficiency Virus Patients on Combined Antiretroviral Therapy: Case Series and Literature Review.

    PubMed

    Hsu, Emory; Phadke, Varun K; Nguyen, Minh Ly T

    2016-06-01

    We describe an HIV-infected patient initiated on combined antiretroviral therapy (cART) who subsequently developed immune restoration disease (IRD) hyperthyroidism-this case represents one of five such patients seen at our center within the past year. Similar to previous reports of hyperthyroidism due to IRD, all of our patients experienced a rapid early recovery in total CD4 count, but developed symptoms of hyperthyroidism on average 3 years (38 months) after beginning cART, which represents a longer time frame than previously reported. Awareness and recognition of this potential complication of cART, which may occur years after treatment initiation, will allow patients with immune restorative hyperthyroidism to receive timely therapy and avoid the long-term complications associated with undiagnosed thyroid disease.

  11. Sustained virologic control in SIV+ macaques after antiretroviral and α4β7 antibody therapy

    PubMed Central

    Byrareddy, Siddappa N.; Arthos, James; Cicala, Claudia; Villinger, Francois; Ortiz, Kristina T.; Little, Dawn; Sidell, Neil; Kane, Maureen A.; Yu, Jianshi; Jones, Jace W.; Santangelo, Philip J.; Zurla, Chiara; McKinnon, Lyle R.; Arnold, Kelly B.; Woody, Caroline E.; Walter, Lutz; Roos, Christian; Noll, Angela; Van Ryk, Donald; Jelicic, Katija; Cimbro, Raffaello; Gumber, Sanjeev; Reid, Michelle D.; Adsay, Volkan; Amancha, Praveen K.; Mayne, Ann E.; Parslow, Tristram G.; Fauci, Anthony S.; Ansari, Aftab A.

    2017-01-01

    Antiretroviral drug therapy (ART) effectively suppresses replication of both the immunodeficiency viruses, human (HIV) and simian (SIV); however, virus rebounds soon after ART is withdrawn. SIV-infected monkeys were treated with a 90-day course of ART initiated at 5 weeks post infection followed at 9 weeks post infection by infusions of a primatized monoclonal antibody against the α4β7 integrin administered every 3 weeks until week 32. These animals subsequently maintained low to undetectable viral loads and normal CD4+ T cell counts in plasma and gastrointestinal tissues for more than 9 months, even after all treatment was withdrawn. This combination therapy allows macaques to effectively control viremia and reconstitute their immune systems without a need for further therapy. PMID:27738167

  12. Predictors of dropout from care among HIV-infected patients initiating antiretroviral therapy at a public sector HIV treatment clinic in sub-Saharan Africa.

    PubMed

    Asiimwe, Stephen B; Kanyesigye, Michael; Bwana, Bosco; Okello, Samson; Muyindike, Winnie

    2016-02-01

    In sub-Saharan Africa (SSA), antiretroviral therapy (ART) can prolong life for HIV-infected patients. However, patients initiating ART, especially in routine treatment programs, commonly dropout from care either due to death or loss to follow-up. In a cohort of HIV-infected patients initiating ART at a public sector clinic in Uganda, we assessed predictors of dropout from care (a composite outcome combining death and loss to follow-up). From a large set of socio-demographic, clinical, and laboratory variables routinely collected at ART initiation, we selected those predicting dropout at P <0.1 in unadjusted analyses for inclusion into a multivariable proportional hazards regression model. We then used a stepwise backward selection procedure to identify variables which independently predicted dropout at P <0.05. Data from 5,057 patients were analyzed. The median age was 33 years (IQR 28 to 40) and 27.4% had CD4+ T-cell counts <100 cells/μL at ART initiation. The median duration of follow-up was 24 months (IQR = 14 to 42, maximum follow-up = 64 months). Overall dropout was 26.9% (established cumulative mortality = 2.3%, loss to follow-up = 24.6%), 5.6% were transferred to other service providers, and 67.5% were retained in care. A diagnosis of Kaposi's sarcoma (hazard ratio (HR) = 3.3, 95% CI 2.5 to 4.5); HIV-associated dementia (HR = 2.6, 95% CI 1.5 to 4.6); history of cryptococcosis (HR = 2.2, 95% CI 1.4 to 3.3); and reduced hemoglobin concentration (<11 g/dl versus ≥13.8 g/dl (HR = 1.9, 95% CI 1.6 to 2.2) were strong predictors of dropout. Other independent predictors of dropout were: year of ART initiation; weight loss ≥10%; reduced total lymphocyte count; chronic diarrhea; male sex; young age (≤28 years); and marital status. Among HIV-infected patients initiating ART at a public sector clinic in SSA, biological factors that usually predict death were especially predictive of dropout. As most of the dropouts were lost to follow-up, this observation suggests that many losses to follow-up may have died. Future studies are needed to identify appropriate interventions that may improve both individual-level patient outcomes and outcome ascertainment among HIV-infected ART initiators in this setting.

  13. A novel method for landslide displacement prediction by integrating advanced computational intelligence algorithms.

    PubMed

    Zhou, Chao; Yin, Kunlong; Cao, Ying; Ahmed, Bayes; Fu, Xiaolin

    2018-05-08

    Landslide displacement prediction is considered as an essential component for developing early warning systems. The modelling of conventional forecast methods requires enormous monitoring data that limit its application. To conduct accurate displacement prediction with limited data, a novel method is proposed and applied by integrating three computational intelligence algorithms namely: the wavelet transform (WT), the artificial bees colony (ABC), and the kernel-based extreme learning machine (KELM). At first, the total displacement was decomposed into several sub-sequences with different frequencies using the WT. Next each sub-sequence was predicted separately by the KELM whose parameters were optimized by the ABC. Finally the predicted total displacement was obtained by adding all the predicted sub-sequences. The Shuping landslide in the Three Gorges Reservoir area in China was taken as a case study. The performance of the new method was compared with the WT-ELM, ABC-KELM, ELM, and the support vector machine (SVM) methods. Results show that the prediction accuracy can be improved by decomposing the total displacement into sub-sequences with various frequencies and by predicting them separately. The ABC-KELM algorithm shows the highest prediction capacity followed by the ELM and SVM. Overall, the proposed method achieved excellent performance both in terms of accuracy and stability.

  14. Cohort Profile: Antiretroviral Therapy Cohort Collaboration (ART-CC)

    PubMed Central

    May, Margaret T; Ingle, Suzanne M; Costagliola, Dominique; Justice, Amy C; de Wolf, Frank; Cavassini, Matthias; D’Arminio Monforte, Antonella; Casabona, Jordi; Hogg, Robert S; Mocroft, Amanda; Lampe, Fiona C; Dabis, François; Fätkenheuer, Gerd; Sterling, Timothy R; del Amo, Julia; Gill, M John; Crane, Heidi M; Saag, Michael S; Guest, Jodie; Brodt, Hans-Reinhard; Sterne, Jonathan AC

    2014-01-01

    The advent of effective combination antiretroviral therapy (ART) in 1996 resulted in fewer patients experiencing clinical events, so that some prognostic analyses of individual cohort studies of human immunodeficiency virus-infected individuals had low statistical power. Because of this, the Antiretroviral Therapy Cohort Collaboration (ART-CC) of HIV cohort studies in Europe and North America was established in 2000, with the aim of studying the prognosis for clinical events in acquired immune deficiency syndrome (AIDS) and the mortality of adult patients treated for HIV-1 infection. In 2002, the ART-CC collected data on more than 12,000 patients in 13 cohorts who had begun combination ART between 1995 and 2001. Subsequent updates took place in 2004, 2006, 2008, and 2010. The ART-CC data base now includes data on more than 70 000 patients participating in 19 cohorts who began treatment before the end of 2009. Data are collected on patient demographics (e.g. sex, age, assumed transmission group, race/ethnicity, geographical origin), HIV biomarkers (e.g. CD4 cell count, plasma viral load of HIV-1), ART regimen, dates and types of AIDS events, and dates and causes of death. In recent years, additional data on co-infections such as hepatitis C; risk factors such as smoking, alcohol and drug use; non-HIV biomarkers such as haemoglobin and liver enzymes; and adherence to ART have been collected whenever available. The data remain the property of the contributing cohorts, whose representatives manage the ART-CC via the steering committee of the Collaboration. External collaboration is welcomed. Details of contacts are given on the ART-CC website (www.art-cohort-collaboration.org). PMID:23599235

  15. Cohort profile: Antiretroviral Therapy Cohort Collaboration (ART-CC).

    PubMed

    May, Margaret T; Ingle, Suzanne M; Costagliola, Dominique; Justice, Amy C; de Wolf, Frank; Cavassini, Matthias; D'Arminio Monforte, Antonella; Casabona, Jordi; Hogg, Robert S; Mocroft, Amanda; Lampe, Fiona C; Dabis, François; Fätkenheuer, Gerd; Sterling, Timothy R; del Amo, Julia; Gill, M John; Crane, Heidi M; Saag, Michael S; Guest, Jodie; Brodt, Hans-Reinhard; Sterne, Jonathan A C

    2014-06-01

    The advent of effective combination antiretroviral therapy (ART) in 1996 resulted in fewer patients experiencing clinical events, so that some prognostic analyses of individual cohort studies of human immunodeficiency virus-infected individuals had low statistical power. Because of this, the Antiretroviral Therapy Cohort Collaboration (ART-CC) of HIV cohort studies in Europe and North America was established in 2000, with the aim of studying the prognosis for clinical events in acquired immune deficiency syndrome (AIDS) and the mortality of adult patients treated for HIV-1 infection. In 2002, the ART-CC collected data on more than 12,000 patients in 13 cohorts who had begun combination ART between 1995 and 2001. Subsequent updates took place in 2004, 2006, 2008, and 2010. The ART-CC data base now includes data on more than 70,000 patients participating in 19 cohorts who began treatment before the end of 2009. Data are collected on patient demographics (e.g. sex, age, assumed transmission group, race/ethnicity, geographical origin), HIV biomarkers (e.g. CD4 cell count, plasma viral load of HIV-1), ART regimen, dates and types of AIDS events, and dates and causes of death. In recent years, additional data on co-infections such as hepatitis C; risk factors such as smoking, alcohol and drug use; non-HIV biomarkers such as haemoglobin and liver enzymes; and adherence to ART have been collected whenever available. The data remain the property of the contributing cohorts, whose representatives manage the ART-CC via the steering committee of the Collaboration. External collaboration is welcomed. Details of contacts are given on the ART-CC website (www.art-cohort-collaboration.org). Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2013; all rights reserved.

  16. Teaching Artistry Full Circle: Formally Incarcerated Students as Co-Teachers

    ERIC Educational Resources Information Center

    Smithner, Nancy

    2017-01-01

    Through reflection on a longitudinal teaching, devising, and directing experience in a regional prison, as well as subsequent opportunities for collaboration with formerly incarcerated students, this article posits improvisation as a powerful vehicle for inclusivity, pluralism, and humanistic exchange in applied arts settings.

  17. A Model of Effective Teaching in Arts, Humanities, and Social Sciences

    ERIC Educational Resources Information Center

    Tahir, Khazima; Ikram, Hamid; Economos, Jennifer; Morote, Elsa-Sophia; Inserra, Albert

    2017-01-01

    The purpose of this study was to examine how graduate students with undergraduate majors in arts, humanities, and social sciences perceived individualized consideration, Student-Professor Engagement in Learning (SPEL), intellectual stimulation, and student deep learning, and how these variables predict effective teaching. A sample of 251 graduate…

  18. Externalizing Problems in Childhood and Adolescence Predict Subsequent Educational Achievement but for Different Genetic and Environmental Reasons

    ERIC Educational Resources Information Center

    Lewis, Gary J.; Asbury, Kathryn; Plomin, Robert

    2017-01-01

    Background: Childhood behavior problems predict subsequent educational achievement; however, little research has examined the etiology of these links using a longitudinal twin design. Moreover, it is unknown whether genetic and environmental innovations provide incremental prediction for educational achievement from childhood to adolescence.…

  19. Wideband acoustic reflex test in a test battery to predict middle-ear dysfunction

    PubMed Central

    Keefe, Douglas H.; Fitzpatrick, Denis; Liu, Yi-Wen; Sanford, Chris A.; Gorga, Michael P.

    2013-01-01

    A wideband (WB) aural acoustical test battery of middle-ear status, including acoustic-reflex thresholds (ARTs) and acoustic-transfer functions (ATFs, i.e., absorbance and admittance) was hypothesized to be more accurate than 1-kHz tympanometry in classifying ears that pass or refer on a newborn hearing screening (NHS) protocol based on otoacoustic emissions. Assessment of middle-ear status may improve NHS programs by identifying conductive dysfunction and cases in which auditory neuropathy exists. Ipsilateral ARTs were assessed with a stimulus including four broadband-noise or tonal activator pulses alternating with five clicks presented before, between and after the pulses. The reflex shift was defined as the difference between final and initial click responses. ARTs were measured using maximum likelihood both at low frequencies (0.8–2.8 kHz) and high (2.8–8 kHz). The median low-frequency ART was elevated by 24 dB in NHS refers compared to passes. An optimal combination of ATF and ART tests performed better than either test alone in predicting NHS outcomes, and WB tests performed better than 1-kHz tympanometry. Medial olivocochlear efferent shifts in cochlear function may influence ARs, but their presence would also be consistent with normal conductive function. Baseline clinical and WB ARTs were also compared in ipsilateral and contralateral measurements in adults. PMID:19772907

  20. Perception, memory and aesthetics of indeterminate art.

    PubMed

    Ishai, Alumit; Fairhall, Scott L; Pepperell, Robert

    2007-07-12

    Indeterminate art, in which familiar objects are only suggestive, invokes a perceptual conundrum as apparently detailed and vivid images resist identification. We hypothesized that compared with paintings that depict meaningful content, object recognition in indeterminate images would be delayed, and tested whether aesthetic affect depends on meaningful content. Subjects performed object recognition and judgment of aesthetic affect tasks. Response latencies were significantly longer for indeterminate images and subjects perceived recognizable objects in 24% of these paintings. Although the aesthetic affect rating of all paintings was similar, judgement latencies for the indeterminate paintings were significantly longer. A surprise memory test revealed that more representational than indeterminate paintings were remembered and that affective strength increased the probability of subsequent recall. Our results suggest that perception and memory of art depend on semantic aspects, whereas, aesthetic affect depends on formal visual features. The longer latencies associated with indeterminate paintings reflect the underlying cognitive processes that mediate object resolution. Indeterminate art works therefore comprise a rich set of stimuli with which the neural correlates of visual perception can be investigated.

  1. Deep Learning and Its Applications in Biomedicine.

    PubMed

    Cao, Chensi; Liu, Feng; Tan, Hai; Song, Deshou; Shu, Wenjie; Li, Weizhong; Zhou, Yiming; Bo, Xiaochen; Xie, Zhi

    2018-02-01

    Advances in biological and medical technologies have been providing us explosive volumes of biological and physiological data, such as medical images, electroencephalography, genomic and protein sequences. Learning from these data facilitates the understanding of human health and disease. Developed from artificial neural networks, deep learning-based algorithms show great promise in extracting features and learning patterns from complex data. The aim of this paper is to provide an overview of deep learning techniques and some of the state-of-the-art applications in the biomedical field. We first introduce the development of artificial neural network and deep learning. We then describe two main components of deep learning, i.e., deep learning architectures and model optimization. Subsequently, some examples are demonstrated for deep learning applications, including medical image classification, genomic sequence analysis, as well as protein structure classification and prediction. Finally, we offer our perspectives for the future directions in the field of deep learning. Copyright © 2018. Production and hosting by Elsevier B.V.

  2. The "sweet science" of reducing periorbital lacerations in mixed martial arts.

    PubMed

    Bastidas, Nicholas; Levine, Jamie P; Stile, Frank L

    2012-01-01

    The popularity of mixed martial arts competitions and televised events has grown exponentially since its inception, and with the growth of the sport, unique facial injury patterns have surfaced. In particular, upper eyelid and brow lacerations are common and are especially troublesome given the effect of hemorrhage from these areas on the fighter's vision and thus ability to continue. We propose that the convexity of the underlying supraorbital rim is responsible for the high frequency of lacerations in this region after blunt trauma and offer a method of reducing subsequent injury by reducing its prominence.

  3. Act local, think global: how the Malawi experience of scaling up antiretroviral treatment has informed global policy.

    PubMed

    Harries, Anthony D; Ford, Nathan; Jahn, Andreas; Schouten, Erik J; Libamba, Edwin; Chimbwandira, Frank; Maher, Dermot

    2016-09-06

    The scale-up of antiretroviral therapy (ART) in Malawi was based on a public health approach adapted to its resource-poor setting, with principles and practices borrowed from the successful tuberculosis control framework. From 2004 to 2015, the number of new patients started on ART increased from about 3000 to over 820,000. Despite being a small country, Malawi has made a significant contribution to the 15 million people globally on ART and has also contributed policy and service delivery innovations that have supported international guidelines and scale up in other countries. The first set of global guidelines for scaling up ART released by the World Health Organization (WHO) in 2002 focused on providing clinical guidance. In Malawi, the ART guidelines adopted from the outset a more operational and programmatic approach with recommendations on health systems and services that were needed to deliver HIV treatment to affected populations. Seven years after the start of national scale-up, Malawi launched a new strategy offering all HIV-infected pregnant women lifelong ART regardless of the CD4-cell count, named Option B+. This strategy was subsequently incorporated into a WHO programmatic guide in 2012 and WHO ART guidelines in 2013, and has since then been adopted by the majority of countries worldwide. In conclusion, the Malawi experience of ART scale-up has become a blueprint for a public health response to HIV and has informed international efforts to end the AIDS epidemic by 2030.

  4. Methamphetamine use and neuropsychiatric factors are associated with antiretroviral nonadherence

    PubMed Central

    Moore, David J.; Blackstone, Kaitlin; Woods, Steven Paul; Ellis, Ronald J.; Atkinson, J. Hampton; Heaton, Robert K.; Grant, Igor

    2012-01-01

    The present study assesses the impact of methamphetamine (METH) on antiretroviral (ART) adherence among HIV+ persons, as well as examines the contribution of neurocognitive impairment and other neuropsychiatric factors (i.e., major depressive disorder (MDD), Antisocial Personality Disorder (ASPD), and Attention Deficit Disorder (ADHD)) for ART nonadherence. We examined HIV+ persons with DSM-IV-diagnosed lifetime history of METH abuse/dependence (HIV+/METH+; n = 67) as compared to HIV+ participants with no history of METH abuse/dependence (HIV+/METH−; n = 50). Ancillary analyses compared these groups with a small group of HIV+/METH+ persons with current METH abuse/dependence (HIV+/CU METH+; n = 8). Nonadherence was defined as self-report of any skipped ART dose in the last four days. Neurocognitive functioning was assessed with a comprehensive battery, covering seven neuropsychological domains. Lifetime METH diagnosis was associated with higher rates of detectable levels of plasma and CSF HIV RNA. When combing groups (i.e., METH+ and METH− participants), univariate analyses indicated co-occurring ADHD, ASPD, and MDD predicted ART nonadherence (p’s<0.10; not lifetime METH status or neurocognitive impairment). A significant multivariable model including these variables indicated that only MDD uniquely predicted ART nonadherence after controlling for the other variables (p<0.05). Ancillary analyses indicated that current METH users (use within 30 days) were significantly less adherent (50% prevalence of nonadherence) than lifetime METH+ users and HIV+/METH-participants, and that neurocognitive impairment was associated with nonadherence (p’s<0.05). METH use disorders are associated with worse HIV disease outcomes and ART medication nonadherence. Interventions often target substance use behaviors alone to enhance antiretroviral treatment outcomes; however, in addition to targeting substance use behaviors, interventions to improve ART adherence may also need to address coexisting neuropsychiatric factors and cognitive impairment to improve ART medication taking. PMID:22530794

  5. Depression longitudinally mediates the association of appearance concerns to ART non-adherence in HIV-infected individuals with a history of injection drug use.

    PubMed

    Blashill, Aaron J; Gordon, Janna R; Safren, Steven A

    2014-02-01

    Appearance concerns are common among HIV-infected individuals, and previous cross-sectional and longitudinal data indicate that these concerns are associated with antiretroviral therapy (ART) non-adherence. However, to date, no known prospective data have explored the mechanism behind this relationship. Thus, the aim of the current study was to test depression severity as a prospective mediator of the relationship between appearance concerns and ART non-adherence in HIV-infected individuals with a history of injection drug use (IDU). Participants were 89 HIV-infected individuals with a history of IDU who participated in a prospective, randomized controlled trial of cognitive behavioral therapy for depression and medication adherence. Clinician-administered measures of depression severity and appearance concerns, along with electronic monitoring of ART non-adherence were included. Data were analyzed using longitudinal linear mixed-level modeling, and mediation was tested via the Monte Carlo Method of Assessing Mediation. Appearance concerns were predictive of depression severity, γ = .31, SE = .076, 95 % CI [.16, .46], t = 4.1, p = .0001, and depression severity was predictive of ART non-adherence, γ = 3.3, SE = 1.3, 95 % CI [.8, 5.8], t = 2.6, p = .01. The effect of appearance concerns on ART non-adherence, however, was significantly mediated by depression severity, γ = 1.02, 95 % CI [.21, 2.1]. Appearance concerns are associated with depression severity, which in turn is associated with ART non-adherence. Integrative interventions addressing appearance concerns, depression and ART adherence are needed, as this is one potential pathway towards worse health outcomes in HIV-infected individuals.

  6. 77 FR 58175 - Resale Royalty Right

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-19

    ... practices of groups or individuals involved in the creation, licensing, sale, exhibition, dissemination, and... artists or authors rights to control the subsequent use of the original work.\\2\\ Rather, the first sale... Citizens Benefit from the Resale Royalty Right as of June 2007], Societe des Auteurs dans les Arts...

  7. Conceptions of agency and constraint for HIV-positive patients and healthcare workers to support long-term engagement with antiretroviral therapy care in Khayelitsha, South Africa

    PubMed Central

    Stern, Erin; Colvin, Christopher; Gxabagxaba, Nobom; Schutz, Charlotte; Burton, Rosie; Meintjes, Graeme

    2017-01-01

    In the context of the optimism around antiretroviral therapy (ART) as prevention of HIV/AIDS, addressing the barriers to long-term ART adherence is critical. This is particularly important given the tendency to individualise or use a blame discourse when exploring why HIV-infected patients “fail” to adequately adhere to ART, and not sufficiently exploring contextual reasons for poor adherence that may require varying solutions. This study took place at three clinics and one hospital in Khayelitsha, South Africa, to document the contextual factors that challenged ART adherence in this community. Interviews were conducted with 20 HIV-infected patients who had defaulted on their ART and were subsequently admitted to Khayelitsha hospital for clinical complications, and 9 ART service providers including doctors, nurses and HIV counsellors. Interviews assessed the reasons patients defaulted on ART and explored ways this could be prevented. Data from both groups were analysed collectively using thematic analysis. While the interviews revealed a landscape of environmental risks threatening adherence to ART, all patients managed to overcome the identified barriers at some point in their treatment phase, indicating the fluidity of patients’ needs and decision making. Patients reported that distrustful relationships with service providers could inhibit their understanding of ART and/or interrupt their follow-up at clinics. Patients described their rationale and agency underlying non-adherence, such as testing their bodies’ physical limits without ART medication. The study speaks to the need to appreciate contextual social and structural barriers related to ART adherence, and how these are negotiated differently by specific sub-groups, to support an appropriate response. It is imperative to not solely emphasise loss to follow-up but also assess patients’ subjective trajectory of their ART journey, decision making and agency with adhering to ART, their relations with healthcare workers, and how these dynamics are intertwined with broader constraints in health systems. PMID:28367748

  8. Attrition from HIV Testing to Antiretroviral Therapy Initiation among Patients Newly Diagnosed with HIV in Haiti

    PubMed Central

    NOEL, Edva; ESPERANCE, Morgan; MCLAUGHLIN, Megan; BERTRAND, Rachel; DEVIEUX, Jessy; SEVERE, Patrice; MARCELIN, Abdias; NICOTERA, Janet; DELCHER, Chris; GRISWOLD, Mark; MEREDITH, Genevive; PAPE, Jean William; KOENIG, Serena P

    2013-01-01

    Objective We report rates and risk factors for attrition in the first cohort of patients followed through all stages from HIV testing to ART initiation. Design Cohort study of all patients diagnosed with HIV between January and June, 2009. Methods We calculated the proportion of patients who completed CD4 cell counts and initiated ART or remained in pre-ART care during two years of follow-up, and assessed predictors of attrition. Results Of 1,427 patients newly diagnosed with HIV, 680 (48%) either initiated ART or were retained in pre-ART care for the subsequent two years. One thousand eighty-three patients (76%) received a CD4 cell count and 973 (90%) returned for result; 297 (31%) had CD4 cell count < 200 cells/μl and of these, 256 (86%) initiated ART. Among 429 patients with CD4 > 350 cells/μl, 215 (50%) started ART or were retained in pre-ART care. Active TB was associated with lower odds of attrition prior to CD4 cell count (OR: 0.08; 95% CI: 0.03–0.25) but also higher odds of attrition prior to ART initiation (OR: 2.46; 95% CI: 1.29–4.71). Lower annual income (≤ $US125) was associated with higher odds of attrition prior to CD4 cell count (OR 1.65; 95% CI: 1.25–2.19), and prior to ART initiation among those with CD4 cell count > 350 cells/μl (OR: 1.74; 95% CI: 1.20–2.52). After tracking patients through a national database, the retention rate increased to only 57%. Conclusion Fewer than half of patients newly diagnosed with HIV initiate ART or remain in pre-ART care for two years in a clinic providing comprehensive services. Additional efforts to improve retention in pre-ART are critically needed. PMID:23254154

  9. Geomechanical Analysis of Underground Coal Gasification Reactor Cool Down for Subsequent CO2 Storage

    NASA Astrophysics Data System (ADS)

    Sarhosis, Vasilis; Yang, Dongmin; Kempka, Thomas; Sheng, Yong

    2013-04-01

    Underground coal gasification (UCG) is an efficient method for the conversion of conventionally unmineable coal resources into energy and feedstock. If the UCG process is combined with the subsequent storage of process CO2 in the former UCG reactors, a near-zero carbon emission energy source can be realised. This study aims to present the development of a computational model to simulate the cooling process of UCG reactors in abandonment to decrease the initial high temperature of more than 400 °C to a level where extensive CO2 volume expansion due to temperature changes can be significantly reduced during the time of CO2 injection. Furthermore, we predict the cool down temperature conditions with and without water flushing. A state of the art coupled thermal-mechanical model was developed using the finite element software ABAQUS to predict the cavity growth and the resulting surface subsidence. In addition, the multi-physics computational software COMSOL was employed to simulate the cavity cool down process which is of uttermost relevance for CO2 storage in the former UCG reactors. For that purpose, we simulated fluid flow, thermal conduction as well as thermal convection processes between fluid (water and CO2) and solid represented by coal and surrounding rocks. Material properties for rocks and coal were obtained from extant literature sources and geomechanical testings which were carried out on samples derived from a prospective demonstration site in Bulgaria. The analysis of results showed that the numerical models developed allowed for the determination of the UCG reactor growth, roof spalling, surface subsidence and heat propagation during the UCG process and the subsequent CO2 storage. It is anticipated that the results of this study can support optimisation of the preparation procedure for CO2 storage in former UCG reactors. The proposed scheme was discussed so far, but not validated by a coupled numerical analysis and if proved to be applicable it could provide a significant optimisation of the UCG process by means of CO2 storage efficiency. The proposed coupled UCG-CCS scheme allows for meeting EU targets for greenhouse gas emissions and increases the coal yield otherwise impossible to exploit.

  10. [Art-chance and art-experience in classical Greece].

    PubMed

    Ban, Deokjin

    2011-06-30

    In Classical Greece, works defining the nature of art appeared in the various disciplines like medicine, rhetoric, dietetics, architecture and painting. Hippocratic authors tried to show that an art of medicine existed indeed. They contrasted the concept of art with that of chance, not experience that Plato and Aristotle distinguished from art. In fact there are similarities and discrepancies between Hippocratic epistemology and Platoic epistemology. Hippocratic authors maintained that the products of chance were not captured by art. They distinguished the domain of art charactered by explanatory knowledge and prediction from the domain of chance ruled by the unexplained and the unforeseeable. They minimized the role of luck and believed the role of art. Hippocratic authors thought that professional ability contained both knowledge and experience. In Hippocratic corpus, experience is a synonym of competence and usually has a positive meaning. But Plato gave empirical knowledge the disdainful sense and decided a ranking between two types of knowledge. Both Hippocratic authors and Plato held that a genuine art had connection with explanatory knowledge of the nature of its subject matter. A common theme that goes through arguments about art-chance and art-chance is the connection between art and nature. Hippocratic authors and Plato regarded art as a highly systematic process. Art provides us with general and explanatory knowledge of human nature. Art and nature is a mutual relationship. The systematic understanding of nature helps us gain the exactness of art and an exact art helps us understand nature well.

  11. The impact of stress and psychosocial interventions on assisted reproductive technology outcome.

    PubMed

    Morreale, Mary; Balon, Richard; Tancer, Manuel; Diamond, Michael

    2011-01-01

    In natural cycles of attempted conception, stress has been shown to predict lower conception rates. The objective of this article is to determine whether stress affects the outcome of assisted reproductive technology (ART) as well. In addition, this article analyzes the effect that psychosocial interventions targeting the reduction of stress have on ART outcomes. This review examined available PubMed articles published in the past 15 years, and 28 articles were included. Looking specifically at numbers of women studied, stress appears to negatively affect ART outcome; interventions targeting stress reduction appear beneficial. Because stress appears to negatively affect ART outcome, and psychosocial interventions do not have detrimental effects, screening for stress should occur and some type of intervention considered during the ART process.

  12. The Chinese free antiretroviral treatment program: challenges and responses.

    PubMed

    Zhang, Fujie; Haberer, Jessica E; Wang, Yu; Zhao, Yan; Ma, Ye; Zhao, Decai; Yu, Lan; Goosby, Eric P

    2007-12-01

    To respond to the HIV/AIDS epidemic in China, the National Center for AIDS/STD Control and Prevention established the Division of Treatment and Care in late 2001. The pilot for the National Free ART Program began in Henan Province in 2002, and the program fully began in 2003. Treatment efforts initially focused on patients infected through illicit blood and plasma donation in the mid-1990s and subsequently expanded to include HIV-infected injection drug users, commercial sex workers, pregnant women, and children. The National Free ART Database was established in late 2004, and includes data on current patients and those treated before 2004. Over 31 000 adult and pediatric patients have been treated thus far. Challenges for the program include integration of drug treatment services with ART, an under-resourced health care system, co-infections, stigma, discrimination, drug resistance, and procurement of second-line ART. The merging of national treatment and care, epidemiologic, and drug resistance databases will be critical for a better understanding of the epidemic, for earlier identification of patients requiring ART, and for improved patient follow-up. The Free ART Program has made considerable progress in providing the necessary care and treatment for HIV-infected people in China and has strong government support for continued improvement and expansion.

  13. Atraumatic restorative treatment (ART): a three-year clinical study in Malawi--comparison of conventional amalgam and ART restorations.

    PubMed

    Kalf-Scholte, Sonja M; van Amerongen, Willem E; Smith, Albert J E; van Haastrecht, Harry J A

    2003-01-01

    This study compares the quality of class I restorations made with the atraumatic restorative treatment (ART) technique and conventional class I amalgam restorations. The study was carried out among secondary school students in Mzuzu, Malawi. First-year students in 1987 who needed at least two class I restorations were selected. Based on a split-mouth design, each participant received both ART and conventional restorations. The 89 pairs of class I cavities were divided randomly into two groups, since two different cermet ionomer cement (CIC) filling materials were used. Impressions of the restorations and subsequent models were made shortly after restoration, after six months, one year, two years, and three years. The quality of the restorations was determined on the models following the US Public Health Service criteria. Bulk fracture, contour, marginal integrity, and surface texture of the restorations were recorded and evaluated separately. Survival rates were determined by the resultant score of all criteria. Though conventional amalgam restorations performed better on all criteria, this difference was significant only for the contour criterion. The survival rates of ART restorations after three years (81.0%) were lower than those of amalgam restorations (90.4%) (P=.067). The quality of ART class I restorations is competitive with that of conventional amalgam restorations.

  14. Success Stories in Control: Nonlinear Dynamic Inversion Control

    NASA Technical Reports Server (NTRS)

    Bosworth, John T.

    2010-01-01

    NASA plays an important role in advancing the state of the art in flight control systems. In the case of Nonlinear Dynamic Inversion (NDI) NASA supported initial implementation of the theory in an aircraft and demonstration in a space vehicle. Dr. Dale Enns of Honeywell Aerospace Advanced Technology performed this work in cooperation with NASA and under NASA contract. Honeywell and Lockheed Martin were subsequently contracted by AFRL to create "Design Guidelines for Multivariable Control Theory". This foundational work directly contributed to the advancement of the technology and the credibility of the control law as a design option. As a result Honeywell collaborated with Lockheed Martin to produce a Nonlinear Dynamic Inversion controller for the X-35 and subsequently Lockheed Martin did the same for the production Lockheed Martin F-35 vehicle. The theory behind NDI is to use a systematic generalized approach to controlling a vehicle. Using general aircraft nonlinear equations of motion and onboard aerodynamic, mass properties, and engine models specific to the vehicle, a relationship between control effectors and desired aircraft motion can be formulated. Using this formulation a control combination is used that provides a predictable response to commanded motion. Control loops around this formulation shape the response as desired and provide robustness to modeling errors. Once the control law is designed it can be used on a similar class of vehicle with only an update to the vehicle specific onboard models.

  15. Sensitivity of El Niño intensity and timing to preceding subsurface heat magnitude

    PubMed Central

    Ballester, Joan; Petrova, Desislava; Bordoni, Simona; Ben Cash; García-Díez, Markel; Rodó, Xavier

    2016-01-01

    Despite extensive ongoing efforts on improving the long-term prediction of El Niño-Southern Oscillation, the predictability in state-of-the-art operational schemes remains limited by factors such as the spring barrier and the influence of atmospheric winds. Recent research suggests that the 2014/15 El Niño (EN) event was stalled as a result of an unusually strong basin-wide easterly wind burst in June, which led to the discharge of a large fraction of the subsurface ocean heat. Here we use observational records and numerical experiments to explore the sensitivity of EN to the magnitude of the heat buildup occurring in the ocean subsurface 21 months in advance. Our simulations suggest that a large increase in heat content during this phase can lead to basin-wide uniform warm conditions in the equatorial Pacific the winter before the occurrence of a very strong EN event. In our model configuration, the system compensates any initial decrease in heat content and naturally evolves towards a new recharge, resulting in a delay of up to one year in the occurrence of an EN event. Both scenarios substantiate the non-linear dependency between the intensity of the subsurface heat buildup and the magnitude and timing of subsequent EN episodes. PMID:27808279

  16. Sensitivity of El Niño intensity and timing to preceding subsurface heat magnitude.

    PubMed

    Ballester, Joan; Petrova, Desislava; Bordoni, Simona; Ben Cash; García-Díez, Markel; Rodó, Xavier

    2016-11-03

    Despite extensive ongoing efforts on improving the long-term prediction of El Niño-Southern Oscillation, the predictability in state-of-the-art operational schemes remains limited by factors such as the spring barrier and the influence of atmospheric winds. Recent research suggests that the 2014/15 El Niño (EN) event was stalled as a result of an unusually strong basin-wide easterly wind burst in June, which led to the discharge of a large fraction of the subsurface ocean heat. Here we use observational records and numerical experiments to explore the sensitivity of EN to the magnitude of the heat buildup occurring in the ocean subsurface 21 months in advance. Our simulations suggest that a large increase in heat content during this phase can lead to basin-wide uniform warm conditions in the equatorial Pacific the winter before the occurrence of a very strong EN event. In our model configuration, the system compensates any initial decrease in heat content and naturally evolves towards a new recharge, resulting in a delay of up to one year in the occurrence of an EN event. Both scenarios substantiate the non-linear dependency between the intensity of the subsurface heat buildup and the magnitude and timing of subsequent EN episodes.

  17. The Predictive Accuracy of Verbal, Quantitative, and Nonverbal Reasoning Tests: Consequences for Talent Identification and Program Diversity

    ERIC Educational Resources Information Center

    Lakin, Joni M.; Lohman, David F.

    2011-01-01

    Effective talent-identification procedures minimize the proportion of students whose subsequent performance indicates that they were mistakenly included in or excluded from the program. Classification errors occur when students who were predicted to excel subsequently do not excel or when students who were not predicted to excel do. Using a…

  18. Disentangling the Predictive Validity of High School Grades for Academic Success in University

    ERIC Educational Resources Information Center

    Vulperhorst, Jonne; Lutz, Christel; de Kleijn, Renske; van Tartwijk, Jan

    2018-01-01

    To refine selective admission models, we investigate which measure of prior achievement has the best predictive validity for academic success in university. We compare the predictive validity of three core high school subjects to the predictive validity of high school grade point average (GPA) for academic achievement in a liberal arts university…

  19. WITHDRAWN: Post-tonsillectomy haemorrhage-Do coagulation tests and coagulopathy history have predictive value?

    PubMed

    Zagólski, Olaf

    2010-03-16

    El editor lamenta que este artículo es un duplicado accidental del artículo publicado, doi:10.1016/j.otorri.2010.01.017. Por este motivo, el artículo duplicado ha sido retirado The Publisher regrets that this article is an accidental duplication of an article that has already been published, doi:10.1016/j.otorri.2010.01.017. The duplicate article has therefore been withdrawn. Copyright © 2009. Published by Elsevier Espana.. All rights reserved.

  20. Grid Quality and Resolution Issues from the Drag Prediction Workshop Series

    NASA Technical Reports Server (NTRS)

    Mavriplis, Dimitri J.; Vassberg, John C.; Tinoco, Edward N.; Mani, Mori; Brodersen, Olaf P.; Eisfeld, Bernhard; Wahls, Richard A.; Morrison, Joseph H.; Zickuhr, Tom; Levy, David; hide

    2008-01-01

    The drag prediction workshop series (DPW), held over the last six years, and sponsored by the AIAA Applied Aerodynamics Committee, has been extremely useful in providing an assessment of the state-of-the-art in computationally based aerodynamic drag prediction. An emerging consensus from the three workshop series has been the identification of spatial discretization errors as a dominant error source in absolute as well as incremental drag prediction. This paper provides an overview of the collective experience from the workshop series regarding the effect of grid-related issues on overall drag prediction accuracy. Examples based on workshop results are used to illustrate the effect of grid resolution and grid quality on drag prediction, and grid convergence behavior is examined in detail. For fully attached flows, various accurate and successful workshop results are demonstrated, while anomalous behavior is identified for a number of cases involving substantial regions of separated flow. Based on collective workshop experiences, recommendations for improvements in mesh generation technology which have the potential to impact the state-of-the-art of aerodynamic drag prediction are given.

  1. Urinary type IV collagen excretion predicts subsequent declining renal function in type 2 diabetic patients with proteinuria.

    PubMed

    Katavetin, Pisut; Katavetin, Paravee; Susantitaphong, Paweena; Townamchai, Natavudh; Tiranathanagul, Khajohn; Tungsanga, Kriang; Eiam-Ong, Somchai

    2010-08-01

    Baseline urinary type IV collagen excretion was negatively correlated with the subsequent GFR change (r(s)=-0.39, p=0.04) in our cohort of 30 type 2 diabetic patients with proteinuria. Therefore, it could be used to predict subsequent declining renal function in type 2 diabetic patients with proteinuria. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  2. Systemic methotrexate to treat ectopic pregnancy does not affect ovarian reserve.

    PubMed

    Oriol, Bárbara; Barrio, Ana; Pacheco, Alberto; Serna, José; Zuzuarregui, José Luis; Garcia-Velasco, Juan A

    2008-11-01

    To evaluate whether methotrexate (MTX) compromises ovarian reserve and future reproductive outcome in women undergoing assisted reproductive technology (ART), when it is used as first-line treatment for ectopic pregnancy (EP). Prospective, observational study. University-affiliated private IVF unit. Twenty-five women undergoing IVF-ICSI who were treated with MTX (1 mg/kg IM) for an EP after ART. Evaluation of reproductive outcome and serum anti-Müllerian hormone (AMH) levels. Serum AMH was evaluated before administering MTX and >or=1 week after the resolution of the EP. Reproductive outcome was evaluated by comparing subsequent IVF-ICSI cycles after EP resolution. Serum AMH levels, cycle length, gonadotropin dose required, peak serum E(2) level, oocytes collected, and embryos obtained. Serum AMH levels before MTX were not statistically significantly different from those after treatment (3.7 +/- 0.3 ng/mL vs. 3.9 +/- 0.3 ng/mL). Patients undergoing a subsequent cycle after systemic treatment for EP had similar cycle durations (10.3 vs. 10.8 d), gonadotropin requirements (2,775 vs. 2,630.3 IU), peak E(2) levels (1,884.3 vs. 1,523.6 pg/mL), number of oocytes retrieved (12.1 vs. 10.5), and total number of embryos obtained (7.1 vs. 6.5). Single-dose MTX is a safe first-treatment choice that does not compromise future reproductive outcomes in women who are diagnosed with EP after ART.

  3. Why Women Contribute Less to the Arts, Sciences, and Humanities.

    ERIC Educational Resources Information Center

    Farmer, Helen S.

    Women do not contribute to the arts, sciences, and humanities commensurate with their talents and potential nor in proportion to the opportunities available to them. This study investigated variables or combinations of variables which best predict lower achievement and career motivation in women: self-esteem, fear of success, vicarious achievement…

  4. Uncomfortable images in art and nature.

    PubMed

    Fernandez, Dominic; Wilkins, Arnold J

    2008-01-01

    The ratings of discomfort from a wide variety of images can be predicted from the energy at different spatial scales in the image, as measured by the Fourier amplitude spectrum of the luminance. Whereas comfortable images show the regression of Fourier amplitude against spatial frequency common in natural scenes, uncomfortable images show a regression with disproportionately greater amplitude at spatial frequencies within two octaves of 3 cycles deg(-1). In six studies, the amplitude in this spatial frequency range relative to that elsewhere in the spectrum explains variance in judgments of discomfort from art, from images constructed from filtered noise, and from art in which the phase or amplitude spectra have been altered. Striped patterns with spatial frequency within the above range are known to be uncomfortable and capable of provoking headaches and seizures in susceptible persons. The present findings show for the first time that, even in more complex images, the energy in this spatial-frequency range is associated with aversion. We propose a simple measurement that can predict aversion to those works of art that have reached the national media because of negative public reaction.

  5. Uncomfortable images in art and nature

    PubMed Central

    Fernandez, Dominic; Wilkins, Arnold J.

    2008-01-01

    We find that the ratings of discomfort from a wide variety of images can be predicted from the energy at different spatial scales in the image, as measured by the Fourier amplitude spectrum of the luminance. Whereas comfortable images show the regression of Fourier amplitude against spatial frequency common in natural scenes, uncomfortable images show a regression with disproportionately greater amplitude at spatial frequencies within two octaves of 3 cycles per degree. In six studies, the amplitude at this spatial frequency relative to that 3 octaves below explains variance in judgments of discomfort from art, from images constructed from filtered noise and from art in which the phase or amplitude spectra have been altered. Striped patterns with spatial frequency within the above range are known to be uncomfortable and capable of provoking headaches and seizures in susceptible persons. The present findings show for the first time that even in more complex images the energy in this spatial frequency range is associated with aversion. We propose a simple measurement that can predict aversion to those works of art that have reached the national media because of negative public reaction. PMID:18773732

  6. Silviculture research: The intersection of science and art across generations

    Treesearch

    Theresa B. Jain

    2013-01-01

    A research silviculturist's work is firmly grounded in the scientific method to acquire knowledge on forest dynamics. They also integrate information from numerous sources to produce new knowledge not readily identified by single studies. Results and interpretation subsequently provide the scientific foundation for developing management decisions and strategies....

  7. The Invisible Hand: Designing Curriculum in the Afterward

    ERIC Educational Resources Information Center

    McKnight, Lucinda; Rousell, David; Charteris, Jennifer; Thomas, Kat; Burke, Geraldine

    2017-01-01

    This paper diffracts a curriculum design workshop via online collaboration of a collective emerging from that event. Through the workshop, involving theory, conceptual art, writing, photography and curriculum planning, and the subsequent sharing of words and images, we move beyond interrogating designs for future subjects to asking how the…

  8. Theaters and Auditoriums. Second Edition.

    ERIC Educational Resources Information Center

    Burris-Meyer, Harold; Cole, Edward C.

    Facilities for the performing arts are examined as to associated problems and possible design solutions. Also included are auditoriums which may not be directly related to theater functions but have similar problems and needs. Existing facilities serve as a basis for the subsequent critical analysis of certain areas and development of optimal…

  9. "If You Cannot Say It, Point to It"

    ERIC Educational Resources Information Center

    Crews, Sarah

    2014-01-01

    Practice as research and performance as research are methods that have developed significantly over the past decade and have subsequently caused debate within the creative arts industry and in university culture. During a research seminar at Goldsmiths University in 2011, Professor Dan Rebellato proposed the question: "What if there is no…

  10. Views of Ancient Egypt. Teacher's Guide. School Arts: Looking/Learning.

    ERIC Educational Resources Information Center

    Downs, Linda; Brenner, Carla

    This teaching guide discusses ancient Egyptian culture, the lithographs made by Napoleon's scientists in 1798-99 to study and record every aspect of Egypt, the world's subsequent fascination with Egypt, ancient Egyptian architecture, Egyptian writing, and archeologists' illustrations of Egypt. The guide suggests activities for elementary school,…

  11. Optimal antiretroviral therapy adherence as evaluated by CASE index score tool is associated with virological suppression in HIV-infected adults in Dakar, Senegal.

    PubMed

    Byabene, A K; Fortes-Déguénonvo, L; Niang, K; Manga, M N; Bulabula, A N H; Nachega, J B; Seydi, M

    2017-06-01

    To determine the prevalence and factors associated with optimal antiretroviral therapy (ART) adherence and virological failure (VLF) among HIV-infected adults enrolled in the national ART programme at the teaching hospital of Fann, Dakar, Senegal. Cross-sectional study from 1 September 2013 to 30 January 2014. (1) optimal ART adherence by the Center for Adherence Support Evaluation (CASE) Index Score (>10) and (2) VLF (HIV RNA > 1000 copies/ml). Diagnostic accuracy of CASE Index Score assessed using sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) and corresponding 95% confidence intervals (CIs). Multivariate logistic regression analysis was performed to identify independent factors associated with optimal adherence and VLF. Of 98 HIV-infected patients on ART, 68% were female. The median (IQR) age was 42 (20-50) years. A total of 57 of 98 (60%) were on ART more than 3 years, and majority (88%) were on NNRTI-based first-line ART regimen. A total of 79 of 98 (80%) patients reported optimal ART adherence, and only five of 84 (5.9%) had documented VLF. Patients with VLF were significantly more likely to have suboptimal ART adherence (17.7% vs. 2.9%; P = 0.02). CASE Index Score showed the best trade-off in Se (78.9%, 95% CI: 54.4-93.9%), Sp (20.0%, 95% CI: 11.1-31.7), PPV (22.4, 95% CI: 13.1-34.2%) and NPV (76.5%, 95% CI: 50.1-93.2), when used VLF threshold of HIV RNA >50 copies/ml. Factors independently associated with VLF were CASE Index Score <10 ([aOR] = 13.0, 95% CI: 1.1-147.9; P = 0.04) and being a boosted PI-based ART regimen ([aOR] = 27.0, 95% CI: 2.4-309.4; P = 0.008). Optimal ART adherence is achievable in a high proportion of HIV-infected adults in this study population. CASE Index Score was independently associated with virological outcomes, supporting usefulness of this low-cost ART adherence monitoring tool in this setting. © 2017 John Wiley & Sons Ltd.

  12. Ensemble-based prediction of RNA secondary structures.

    PubMed

    Aghaeepour, Nima; Hoos, Holger H

    2013-04-24

    Accurate structure prediction methods play an important role for the understanding of RNA function. Energy-based, pseudoknot-free secondary structure prediction is one of the most widely used and versatile approaches, and improved methods for this task have received much attention over the past five years. Despite the impressive progress that as been achieved in this area, existing evaluations of the prediction accuracy achieved by various algorithms do not provide a comprehensive, statistically sound assessment. Furthermore, while there is increasing evidence that no prediction algorithm consistently outperforms all others, no work has been done to exploit the complementary strengths of multiple approaches. In this work, we present two contributions to the area of RNA secondary structure prediction. Firstly, we use state-of-the-art, resampling-based statistical methods together with a previously published and increasingly widely used dataset of high-quality RNA structures to conduct a comprehensive evaluation of existing RNA secondary structure prediction procedures. The results from this evaluation clarify the performance relationship between ten well-known existing energy-based pseudoknot-free RNA secondary structure prediction methods and clearly demonstrate the progress that has been achieved in recent years. Secondly, we introduce AveRNA, a generic and powerful method for combining a set of existing secondary structure prediction procedures into an ensemble-based method that achieves significantly higher prediction accuracies than obtained from any of its component procedures. Our new, ensemble-based method, AveRNA, improves the state of the art for energy-based, pseudoknot-free RNA secondary structure prediction by exploiting the complementary strengths of multiple existing prediction procedures, as demonstrated using a state-of-the-art statistical resampling approach. In addition, AveRNA allows an intuitive and effective control of the trade-off between false negative and false positive base pair predictions. Finally, AveRNA can make use of arbitrary sets of secondary structure prediction procedures and can therefore be used to leverage improvements in prediction accuracy offered by algorithms and energy models developed in the future. Our data, MATLAB software and a web-based version of AveRNA are publicly available at http://www.cs.ubc.ca/labs/beta/Software/AveRNA.

  13. The Impact of ART on the Economic Outcomes of People Living with HIV/AIDS.

    PubMed

    Nannungi, Annet; Wagner, Glenn; Ghosh-Dastidar, Bonnie

    2013-01-01

    Background. Clinical benefits of ART are well documented, but less is known about its effects on economic outcomes such as work status and income in sub-Saharan Africa. Methods. Data were examined from 482 adult clients entering HIV care (257 starting ART; 225 not yet eligible for ART) in Kampala, Uganda. Self-reported data on work status and income were assessed at baseline, months 6 and 12. Multivariate analysis examined the effects of ART over time, controlling for change in physical health functioning and baseline covariates. Results. Fewer ART patients worked at baseline compared to non-ART patients (25.5% versus 34.2%); 48.8% of those not working at baseline were now working at month 6, and 50% at month 12, with similar improvement in both the ART and non-ART groups. However, multivariate analysis revealed that the ART group experienced greater improvement over time. Average weekly income did not differ between the groups at baseline nor change significantly over time, among those who were working; being male gender and having any secondary education were predictive of higher income. Conclusions. ART was associated with greater improvement in work status, even after controlling for change in physical health functioning, suggesting other factors associated with ART may influence work.

  14. The colour of creation: Gertrude Jekyll and the art of flowers.

    PubMed

    Bisgrove, Richard

    2013-12-01

    Flowers were central to the life and work of Gertrude Jekyll (1843-1932), one of the 20th century's most influential garden designers. Born of parents with interests across a broad range of the art-science spectrum, Miss Jekyll developed an early interest in many arts and crafts, including painting and gardening in particular. During her course at the Central School of Design in Kensington she studied closely the work of JMW Turner. Many of the compositional elements of Turner's paintings, especially his use of colour, can be seen in Miss Jekyll's subsequent designs for c. 250 gardens. The use of blue and yellow flowers to create a sense of light, and the contrast of cool blue flowers and grey foliage with vivid reds and oranges are recurrent themes in her planting schemes, but many other aspects of her designs also reflect her broad interest in the art, craft, and science of plant cultivation. She encouraged others to seek the satisfaction offered by gardening as an art, convinced that a life spent seeking perfection would gradually yield 'the power of intelligent combination, the nearest thing we can know to the mighty force of creation'.

  15. Using visual art and collaborative reflection to explore medical attitudes toward vulnerable persons

    PubMed Central

    Kidd, Monica; Nixon, Lara; Rosenal, Tom; Jackson, Roberta; Pereles, Laurie; Mitchell, Ian; Bendiak, Glenda; Hughes, Lisa

    2016-01-01

    Background Vulnerable persons often face stigma-related barriers while seeking health care. Innovative education and professional development methods are needed to help change this. Method We describe an interdisciplinary group workshop designed around a discomfiting oil portrait, intended to trigger provocative conversations among health care students and practitioners, and we present our mixed methods analysis of participant reflections. Results After the workshop, participants were significantly more likely to endorse the statements that the observation and interpretive skills involved in viewing visual art are relevant to patient care and that visual art should be used in medical education to improve students’ observational skills, narrative skills, and empathy with their patients. Subsequent to the workshop, significantly more participants agreed that art interpretation should be required curriculum for health care students. Qualitative comments from two groups from two different education and professional contexts were examined for themes; conversations focused on issues of power, body image/self-esteem, and lessons for clinical practice. Conclusions We argue that difficult conversations about affective responses to vulnerable persons are possible in a collaborative context using well-chosen works of visual art that can stand in for a patient. PMID:27103949

  16. Using visual art and collaborative reflection to explore medical attitudes toward vulnerable persons.

    PubMed

    Kidd, Monica; Nixon, Lara; Rosenal, Tom; Jackson, Roberta; Pereles, Laurie; Mitchell, Ian; Bendiak, Glenda; Hughes, Lisa

    2016-01-01

    Vulnerable persons often face stigma-related barriers while seeking health care. Innovative education and professional development methods are needed to help change this. We describe an interdisciplinary group workshop designed around a discomfiting oil portrait, intended to trigger provocative conversations among health care students and practitioners, and we present our mixed methods analysis of participant reflections. After the workshop, participants were significantly more likely to endorse the statements that the observation and interpretive skills involved in viewing visual art are relevant to patient care and that visual art should be used in medical education to improve students' observational skills, narrative skills, and empathy with their patients. Subsequent to the workshop, significantly more participants agreed that art interpretation should be required curriculum for health care students. Qualitative comments from two groups from two different education and professional contexts were examined for themes; conversations focused on issues of power, body image/self-esteem, and lessons for clinical practice. We argue that difficult conversations about affective responses to vulnerable persons are possible in a collaborative context using well-chosen works of visual art that can stand in for a patient.

  17. Long-term effectiveness of initiating non-nucleoside reverse transcriptase inhibitor- versus ritonavir-boosted protease inhibitor-based antiretroviral therapy: implications for first-line therapy choice in resource-limited settings

    PubMed Central

    Lima, Viviane D; Hull, Mark; McVea, David; Chau, William; Harrigan, P Richard; Montaner, Julio SG

    2016-01-01

    Introduction In many resource-limited settings, combination antiretroviral therapy (cART) failure is diagnosed clinically or immunologically. As such, there is a high likelihood that patients may stay on a virologically failing regimen for a substantial period of time. Here, we compared the long-term impact of initiating non-nucleoside reverse transcriptase inhibitor (NNRTI)- versus boosted protease inhibitor (bPI)-based cART in British Columbia (BC), Canada. Methods We followed prospectively 3925 ART-naïve patients who started NNRTIs (N=1963, 50%) or bPIs (N=1962; 50%) from 1 January 2000 until 30 June 2013 in BC. At six months, we assessed whether patients virologically failed therapy (a plasma viral load (pVL) >50 copies/mL), and we stratified them based on the pVL at the time of failure ≤500 versus >500 copies/mL. We then followed these patients for another six months and calculated their probability of achieving subsequent viral suppression (pVL <50 copies/mL twice consecutively) and of developing drug resistance. These probabilities were adjusted for fixed and time-varying factors, including cART adherence. Results At six months, virologic failure rates were 9.5 and 14.3 cases per 100 person-months for NNRTI and bPI initiators, respectively. NNRTI initiators who failed with a pVL ≤500 copies/mL had a 16% higher probability of achieving subsequent suppression at 12 months than bPI initiators (0.81 (25th–75th percentile 0.75–0.83) vs. 0.72 (0.61–0.75)). However, if failing NNRTI initiators had a pVL >500 copies/mL, they had a 20% lower probability of suppressing at 12 months than pVL-matched bPI initiators (0.37 (0.29–0.45) vs. 0.46 (0.38–0.54)). In terms of evolving HIV drug resistance, those who failed on NNRTI performed worse than bPI in all scenarios, especially if they failed with a viral load >500 copies/mL. Conclusions Our results show that patients who virologically failed at six months on NNRTI and continued on the same regimen had a lower probability of subsequently achieving viral suppression and a higher chance of evolving HIV drug resistance. These results suggest that improving access to regular virologic monitoring is critically important, especially if NNRTI-based cART is to remain a preferred choice for first-line therapy in resource-limited settings. PMID:27499064

  18. Predicting Moves-on-Stills for Comic Art Using Viewer Gaze Data.

    PubMed

    Jain, Eakta; Sheikh, Yaser; Hodgins, Jessica

    2016-01-01

    Comic art consists of a sequence of panels of different shapes and sizes that visually communicate the narrative to the reader. The move-on-stills technique allows such still images to be retargeted for digital displays via camera moves. Today, moves-on-stills can be created by software applications given user-provided parameters for each desired camera move. The proposed algorithm uses viewer gaze as input to computationally predict camera move parameters. The authors demonstrate their algorithm on various comic book panels and evaluate its performance by comparing their results with a professional DVD.

  19. Validation of Clinical Scoring Systems ART and ABCR after Transarterial Chemoembolization of Hepatocellular Carcinoma.

    PubMed

    Kloeckner, Roman; Pitton, Michael B; Dueber, Christoph; Schmidtmann, Irene; Galle, Peter R; Koch, Sandra; Wörns, Marcus A; Weinmann, Arndt

    2017-01-01

    To perform an external validation of the Assessment for Retreatment with Transarterial Chemoembolization (ART) and α-fetoprotein (AFP), Barcelona Clinic Liver Cancer (BCLC), Child-Pugh, and response (ABCR) scores and to compare them in terms of prognostic power. From 2000 to 2015, 871 patients with hepatocellular carcinoma underwent transarterial chemoembolization at a tertiary referral hospital, and 176 met all inclusion and exclusion criteria for both scores and were analyzed. Nineteen percent (n = 34) had BCLC stage A disease and 81% had stage B disease. Thirty-nine patients (22%) presented with elevated AFP levels. Overall survival was calculated. Scores were validated and compared with a Harrell C-index, integrated Brier score (IBS), and prediction error curves. Before the second chemoembolization procedure, 22 patients (12%) showed an increase of 1 point in Child-Pugh score and 51 patients (22%) had an increase of ≥ 2 points. Thirty-one patients (23%) showed a > 25% increase in aspartate aminotransferase level, and 114 (65%) showed a response to treatment. Consequently, 127 patients (72%) had a low ART score and 49 (28%) had a high ART score. One hundred fifty-eight patients (90%) had a low ABCR score, whereas 18 (10%) had a high ABCR score. Low and high ART score groups had median survival durations of 20.8 and 15.3 mo, respectively. Harrell C-indexes were 0.572 and 0.608, and IBSs were 0.135 and 0.128, for ART and ABCR, respectively. For both scores, an increase in Child-Pugh score ≥ 2 points and a radiologic response were significantly associated with survival. Both scores were of limited predictive value, and neither was sufficient to support clear-cut clinical decisions. Further effort is necessary to determine criteria for making valid clinical predictions. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

  20. Brief Report: Lopinavir Hair Concentrations Are the Strongest Predictor of Viremia in HIV-Infected Asian Children and Adolescents on Second-Line Antiretroviral Therapy.

    PubMed

    Pintye, Jillian; Bacchetti, Peter; Teeraananchai, Sirinya; Kerr, Stephen; Prasitsuebsai, Wasana; Singtoroj, Thida; Kuncze, Karen; Louie, Alexander; Koss, Catherine A; Jin, Chengshi; Phung, Nhi; Horng, Howard; Sohn, Annette H; Gandhi, Monica

    2017-12-01

    Children/adolescents display suboptimal antiretroviral therapy (ART) adherence and outcomes versus adults. Hair ART concentrations are objective adherence measures that predict viremia in adults but longitudinal data on hair levels in pediatric populations is limited. We assessed the predictive utility of hair lopinavir (LPV) levels on viremia among youth on second-line ART. We examined predictors of viremia (HIV-1 RNA >400 and >1000 copies/mL) at least 24 weeks after switch to LPV-based second-line ART in a cohort of HIV-infected Asian children followed between 2011 and 2014. Small hair samples, HIV-1 RNA, and self-reported adherence were collected biannually. Hair concentrations of LPV were measured through liquid chromatography/tandem mass spectrometry using validated methods. Time-to-first viremia was examined using discrete-time Cox models. Overall, 244 children met the inclusion criteria for the present analysis. Approximately half (55%) were boys and the median age 10 years [interquartile range (IQR) 7-13]; 40% were older than 11 years. At switch to second-line ART, median CD4 count was 300 (IQR 146-547) cells/mm and median HIV-RNA level was 5.0 (IQR 4.3-5.6) log10/mL. Median time of study follow-up was 48 weeks and a median of 3 (range 1-5) hair samples were collected from each participant. Adjusting for age, sex, country, self-reported adherence, CD4, and HIV-RNA, higher LPV hair concentrations were the strongest predictor of lower odds of viremia (HIV-RNA >400 copies/mL adjusted odds ratio = 0.41 per doubling in hair concentration, 95% confidence interval: 0.29 to 0.58, P < 0.001; HIV-RNA >1000 copies/mL, adjusted odds ratio = 0.54, 95% confidence interval: 0.45 to 0.65, P < 0.001). Hair concentrations predict viremia among children with HIV on second-line ART and could guide clinical decisions for this population.

  1. Predicting Market Impact Costs Using Nonparametric Machine Learning Models.

    PubMed

    Park, Saerom; Lee, Jaewook; Son, Youngdoo

    2016-01-01

    Market impact cost is the most significant portion of implicit transaction costs that can reduce the overall transaction cost, although it cannot be measured directly. In this paper, we employed the state-of-the-art nonparametric machine learning models: neural networks, Bayesian neural network, Gaussian process, and support vector regression, to predict market impact cost accurately and to provide the predictive model that is versatile in the number of variables. We collected a large amount of real single transaction data of US stock market from Bloomberg Terminal and generated three independent input variables. As a result, most nonparametric machine learning models outperformed a-state-of-the-art benchmark parametric model such as I-star model in four error measures. Although these models encounter certain difficulties in separating the permanent and temporary cost directly, nonparametric machine learning models can be good alternatives in reducing transaction costs by considerably improving in prediction performance.

  2. Interpretable Deep Models for ICU Outcome Prediction

    PubMed Central

    Che, Zhengping; Purushotham, Sanjay; Khemani, Robinder; Liu, Yan

    2016-01-01

    Exponential surge in health care data, such as longitudinal data from electronic health records (EHR), sensor data from intensive care unit (ICU), etc., is providing new opportunities to discover meaningful data-driven characteristics and patterns ofdiseases. Recently, deep learning models have been employedfor many computational phenotyping and healthcare prediction tasks to achieve state-of-the-art performance. However, deep models lack interpretability which is crucial for wide adoption in medical research and clinical decision-making. In this paper, we introduce a simple yet powerful knowledge-distillation approach called interpretable mimic learning, which uses gradient boosting trees to learn interpretable models and at the same time achieves strong prediction performance as deep learning models. Experiment results on Pediatric ICU dataset for acute lung injury (ALI) show that our proposed method not only outperforms state-of-the-art approaches for morality and ventilator free days prediction tasks but can also provide interpretable models to clinicians. PMID:28269832

  3. Predicting Market Impact Costs Using Nonparametric Machine Learning Models

    PubMed Central

    Park, Saerom; Lee, Jaewook; Son, Youngdoo

    2016-01-01

    Market impact cost is the most significant portion of implicit transaction costs that can reduce the overall transaction cost, although it cannot be measured directly. In this paper, we employed the state-of-the-art nonparametric machine learning models: neural networks, Bayesian neural network, Gaussian process, and support vector regression, to predict market impact cost accurately and to provide the predictive model that is versatile in the number of variables. We collected a large amount of real single transaction data of US stock market from Bloomberg Terminal and generated three independent input variables. As a result, most nonparametric machine learning models outperformed a-state-of-the-art benchmark parametric model such as I-star model in four error measures. Although these models encounter certain difficulties in separating the permanent and temporary cost directly, nonparametric machine learning models can be good alternatives in reducing transaction costs by considerably improving in prediction performance. PMID:26926235

  4. Manual for the prediction of blast and fragment loadings on structures

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

    Not Available

    1980-11-01

    The purpose of this manual is to provide Architect-Engineer (AE) firms guidance for the prediction of air blast, ground shock and fragment loadings on structures as a result of accidental explosions in or near these structures. Information in this manual is the result of an extensive literature survey and data gathering effort, supplemented by some original analytical studies on various aspects of blast phenomena. Many prediction equations and graphs are presented, accompanied by numerous example problems illustrating their use. The manual is complementary to existing structural design manuals and is intended to reflect the current state-of-the-art in prediction of blastmore » and fragment loads for accidental explosions of high explosives at the Pantex Plant. In some instances, particularly for explosions within blast-resistant structures of complex geometry, rational estimation of these loads is beyond the current state-of-the-art.« less

  5. Within-person Changes in Individual Symptoms of Depression Predict Subsequent Depressive Episodes in Adolescents: A Prospective Study

    PubMed Central

    Kouros, Chrystyna D.; Morris, Matthew C.; Garber, Judy

    2015-01-01

    The current longitudinal study examined which individual symptoms of depression uniquely predicted a subsequent Major Depressive Episode (MDE) in adolescents, and whether these relations differed by sex. Adolescents (N=240) were first interviewed in grade 6 (M=11.86 years old; SD = 0.56; 54% female; 81.5% Caucasian) and then annually through grade 12 regarding their individual symptoms of depression as well as the occurrence of MDEs. Individual symptoms of depression were assessed with the Children’s Depression Rating Scale-Revised (CDRS-R) and depressive episodes were assessed with the Longitudinal Interval Follow-up Evaluation (LIFE). Results showed that within-person changes in sleep problems and low self-esteem/excessive guilt positively predicted an increased likelihood of an MDE for both boys and girls. Significant sex differences also were found. Within-person changes in anhedonia predicted an increased likelihood of a subsequent MDE among boys, whereas irritability predicted a decreased likelihood of a future MDE among boys, and concentration difficulties predicted a decreased likelihood of an MDE in girls. These results identified individual depressive symptoms that predicted subsequent depressive episodes in male and female adolescents, and may be used to guide the early detection, treatment, and prevention of depressive disorders in youth. PMID:26105209

  6. Cost-effectiveness of public-health policy options in the presence of pretreatment NNRTI drug resistance in sub-Saharan Africa: a modelling study.

    PubMed

    Phillips, Andrew N; Cambiano, Valentina; Nakagawa, Fumiyo; Revill, Paul; Jordan, Michael R; Hallett, Timothy B; Doherty, Meg; De Luca, Andrea; Lundgren, Jens D; Mhangara, Mutsa; Apollo, Tsitsi; Mellors, John; Nichols, Brooke; Parikh, Urvi; Pillay, Deenan; Rinke de Wit, Tobias; Sigaloff, Kim; Havlir, Diane; Kuritzkes, Daniel R; Pozniak, Anton; van de Vijver, David; Vitoria, Marco; Wainberg, Mark A; Raizes, Elliot; Bertagnolio, Silvia

    2018-03-01

    There is concern over increasing prevalence of non-nucleoside reverse-transcriptase inhibitor (NNRTI) resistance in people initiating antiretroviral therapy (ART) in low-income and middle-income countries. We assessed the effectiveness and cost-effectiveness of alternative public health responses in countries in sub-Saharan Africa where the prevalence of pretreatment drug resistance to NNRTIs is high. The HIV Synthesis Model is an individual-based simulation model of sexual HIV transmission, progression, and the effect of ART in adults, which is based on extensive published data sources and considers specific drugs and resistance mutations. We used this model to generate multiple setting scenarios mimicking those in sub-Saharan Africa and considered the prevalence of pretreatment NNRTI drug resistance in 2017. We then compared effectiveness and cost-effectiveness of alternative policy options. We took a 20 year time horizon, used a cost effectiveness threshold of US$500 per DALY averted, and discounted DALYs and costs at 3% per year. A transition to use of a dolutegravir as a first-line regimen in all new ART initiators is the option predicted to produce the most health benefits, resulting in a reduction of about 1 death per year per 100 people on ART over the next 20 years in a situation in which more than 10% of ART initiators have NNRTI resistance. The negative effect on population health of postponing the transition to dolutegravir increases substantially with higher prevalence of HIV drug resistance to NNRTI in ART initiators. Because of the reduced risk of resistance acquisition with dolutegravir-based regimens and reduced use of expensive second-line boosted protease inhibitor regimens, this policy option is also predicted to lead to a reduction of overall programme cost. A future transition from first-line regimens containing efavirenz to regimens containing dolutegravir formulations in adult ART initiators is predicted to be effective and cost-effective in low-income settings in sub-Saharan Africa at any prevalence of pre-ART NNRTI resistance. The urgency of the transition will depend largely on the country-specific prevalence of NNRTI resistance. Bill & Melinda Gates Foundation, World Health Organization. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY IGO 3.0 licence. Published by Elsevier Ltd.. All rights reserved.

  7. State-of-the-art of high-speed propeller noise prediction - A multidisciplinary approach and comparison with measured data

    NASA Technical Reports Server (NTRS)

    Dunn, Mark H.; Farassat, F.

    1990-01-01

    The results of NASA's Propeller Test Assessment program involving extensive flight tests of a large-scale advanced propeller are presented. This has provided the opportunity to evaluate the current capability of advanced propeller noise prediction utilizing principally the exterior acoustic measurements for the prediction of exterior noise. The principal object of this study was to evaluate the state-of-the-art of noise prediction for advanced propellers utilizing the best available codes of the disciplines involved. The effects of blade deformation on the aerodynamics and noise of advanced propellers were also studied. It is concluded that blade deformation can appreciably influence propeller noise and aerodynamics, and that, in general, centrifugal and blade forces must both be included in the calculation of blade forces. It is noted that the present capability for free-field noise prediction of the first three harmonics for advanced propellers is fairly good. Detailed data and diagrams of the test results are presented.

  8. Slug sizing/slug volume prediction, state of the art review and simulation

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

    Burke, N.E.; Kashou, S.F.

    1995-12-01

    Slug flow is a flow pattern commonly encountered in offshore multiphase flowlines. It is characterized by an alternate flow of liquid slugs and gas pockets, resulting in an unsteady hydrodynamic behavior. All important design variables, such as slug length and slug frequency, liquid holdup, and pressure drop, vary with time and this makes the prediction of slug flow characteristics both difficult and challenging. This paper reviews the state of the art methods in slug catcher sizing and slug volume predictions. In addition, history matching of measured slug flow data is performed using the OLGA transient simulator. This paper reviews themore » design factors that impact slug catcher sizing during steady state, during transient, during pigging, and during operations under a process control system. The slug tracking option of the OLGA simulator is applied to predict the slug length and the slug volume during a field operation. This paper will also comment on the performance of common empirical slug prediction correlations.« less

  9. Slug-sizing/slug-volume prediction: State of the art review and simulation

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

    Burke, N.E.; Kashou, S.F.

    1996-08-01

    Slug flow is a flow pattern commonly encountered in offshore multiphase flowlines. It is characterized by an alternate flow of liquid slugs and gas pockets, resulting in an unsteady hydrodynamic behavior. All important design variables, such as slug length and slug frequency, liquid holdup, and pressure drop, vary with time and this makes the prediction of slug flow characteristics both difficult and challenging. This paper reviews the state of the art methods in slug-catcher sizing and slug-volume predictions. In addition, history matching of measured slug flow data is performed using the OLGA transient simulator. This paper reviews the design factorsmore » that impact slug-catcher sizing during steady state, during transient, during pigging, and during operations under a process-control system. The slug-tracking option of the simulator is applied to predict the slug length and the slug volume during a field operation. This paper will also comment on the performance of common empirical slug-prediction correlations.« less

  10. Mechanisms for the Negative Effects of Internalized HIV-Related Stigma on Antiretroviral Therapy Adherence in Women: The Mediating Roles of Social Isolation and Depression.

    PubMed

    Turan, Bulent; Smith, Whitney; Cohen, Mardge H; Wilson, Tracey E; Adimora, Adaora A; Merenstein, Daniel; Adedimeji, Adebola; Wentz, Eryka L; Foster, Antonina G; Metsch, Lisa; Tien, Phyllis C; Weiser, Sheri D; Turan, Janet M

    2016-06-01

    Internalization of HIV-related stigma may inhibit a person's ability to manage HIV disease through adherence to treatment regimens. Studies, mainly with white men, have suggested an association between internalized stigma and suboptimal adherence to antiretroviral therapy (ART). However, there is a scarcity of research with women of different racial/ethnic backgrounds and on mediating mechanisms in the association between internalized stigma and ART adherence. The Women's Interagency HIV Study (WIHS) is a multicenter cohort study. Women living with HIV complete interviewer-administered questionnaires semiannually. Cross-sectional analyses for the current article included 1168 women on ART for whom data on medication adherence were available from their last study visit between April 2013 and March 2014, when the internalized stigma measure was initially introduced. The association between internalized stigma and self-reported suboptimal ART adherence was significant for those in racial/ethnic minority groups (AOR = 0.69, P = 0.009, 95% CI: 0.52 to 0.91), but not for non-Hispanic whites (AOR = 2.15, P = 0.19, 95% CI: 0.69 to 6.73). Depressive symptoms, loneliness, and low perceived social support mediated the association between internalized stigma and suboptimal adherence in the whole sample, as well as in the subsample of minority participants. In serial mediation models, internalized stigma predicted less-perceived social support (or higher loneliness), which in turn predicted more depressive symptoms, which in turn predicted suboptimal medication adherence. Findings suggest that interconnected psychosocial mechanisms affect ART adherence, and that improvements in adherence may require multifaceted interventions addressing both mental health and interpersonal factors, especially for minority women.

  11. Mechanisms for the Negative Effects of Internalized HIV-Related Stigma on Antiretroviral Therapy Adherence in Women: The Mediating Roles of Social Isolation and Depression

    PubMed Central

    Smith, Whitney; Cohen, Mardge H.; Wilson, Tracey E.; Adimora, Adaora A.; Merenstein, Daniel; Adedimeji, Adebola; Wentz, Eryka L.; Foster, Antonina G.; Metsch, Lisa; Tien, Phyllis C.; Weiser, Sheri D.; Turan, Janet M.

    2016-01-01

    Background: Internalization of HIV-related stigma may inhibit a person's ability to manage HIV disease through adherence to treatment regimens. Studies, mainly with white men, have suggested an association between internalized stigma and suboptimal adherence to antiretroviral therapy (ART). However, there is a scarcity of research with women of different racial/ethnic backgrounds and on mediating mechanisms in the association between internalized stigma and ART adherence. Methods: The Women's Interagency HIV Study (WIHS) is a multicenter cohort study. Women living with HIV complete interviewer-administered questionnaires semiannually. Cross-sectional analyses for the current article included 1168 women on ART for whom data on medication adherence were available from their last study visit between April 2013 and March 2014, when the internalized stigma measure was initially introduced. Results: The association between internalized stigma and self-reported suboptimal ART adherence was significant for those in racial/ethnic minority groups (AOR = 0.69, P = 0.009, 95% CI: 0.52 to 0.91), but not for non-Hispanic whites (AOR = 2.15, P = 0.19, 95% CI: 0.69 to 6.73). Depressive symptoms, loneliness, and low perceived social support mediated the association between internalized stigma and suboptimal adherence in the whole sample, as well as in the subsample of minority participants. In serial mediation models, internalized stigma predicted less-perceived social support (or higher loneliness), which in turn predicted more depressive symptoms, which in turn predicted suboptimal medication adherence. Conclusions: Findings suggest that interconnected psychosocial mechanisms affect ART adherence, and that improvements in adherence may require multifaceted interventions addressing both mental health and interpersonal factors, especially for minority women. PMID:26885803

  12. Medication-Taking Practices of Patients on Antiretroviral HIV Therapy: Control, Power, and Intentionality

    PubMed Central

    Panter, Abigail T.; Mouw, Mary S.; Amola, Kemi; Stein, Kathryn E.; Murphy, Joseph S.; Maiese, Eric M.; Wohl, David A.

    2015-01-01

    Abstract Among people living with HIV (PLWH), adherence to antiretroviral therapy (ART) is crucial for health, but patients face numerous challenges achieving sustained lifetime adherence. We conducted six focus groups with 56 PLWH regarding ART adherence barriers and collected sociodemographics and ART histories. Participants were recruited through clinics and AIDS service organizations in North Carolina. Dedoose software was used to support thematic analysis. Participants were 59% male, 77% black, aged 23–67 years, and living with HIV 4–20 years. Discussions reflected the fluid, complex nature of ART adherence. Maintaining adherence required participants to indefinitely assert consistent control across multiple areas including: their HIV disease, their own bodies, health care providers, and social systems (e.g., criminal justice, hospitals, drug assistance programs). Participants described limited control over treatment options, ART's impact on their body, and inconsistent access to ART and subsequent inability to take ART as prescribed. When participants felt they had more decision-making power, intentionally choosing whether and how to take ART was not exclusively a decision about best treating HIV. Instead, through these decisions, participants tried to regain some amount of power and control in their lives. Supportive provider relationships assuaged these struggles, while perceived side-effects and multiple co-morbidities further complicated adherence. Adherence interventions need to better convey adherence as a continuous, changing process, not a fixed state. A perspective shift among care providers could also help address negative consequences of the perceived power struggles and pressures that may drive patients to exert control via intentional medication taking practices. PMID:26505969

  13. Medication-Taking Practices of Patients on Antiretroviral HIV Therapy: Control, Power, and Intentionality.

    PubMed

    Muessig, Kathryn E; Panter, Abigail T; Mouw, Mary S; Amola, Kemi; Stein, Kathryn E; Murphy, Joseph S; Maiese, Eric M; Wohl, David A

    2015-11-01

    Among people living with HIV (PLWH), adherence to antiretroviral therapy (ART) is crucial for health, but patients face numerous challenges achieving sustained lifetime adherence. We conducted six focus groups with 56 PLWH regarding ART adherence barriers and collected sociodemographics and ART histories. Participants were recruited through clinics and AIDS service organizations in North Carolina. Dedoose software was used to support thematic analysis. Participants were 59% male, 77% black, aged 23-67 years, and living with HIV 4-20 years. Discussions reflected the fluid, complex nature of ART adherence. Maintaining adherence required participants to indefinitely assert consistent control across multiple areas including: their HIV disease, their own bodies, health care providers, and social systems (e.g., criminal justice, hospitals, drug assistance programs). Participants described limited control over treatment options, ART's impact on their body, and inconsistent access to ART and subsequent inability to take ART as prescribed. When participants felt they had more decision-making power, intentionally choosing whether and how to take ART was not exclusively a decision about best treating HIV. Instead, through these decisions, participants tried to regain some amount of power and control in their lives. Supportive provider relationships assuaged these struggles, while perceived side-effects and multiple co-morbidities further complicated adherence. Adherence interventions need to better convey adherence as a continuous, changing process, not a fixed state. A perspective shift among care providers could also help address negative consequences of the perceived power struggles and pressures that may drive patients to exert control via intentional medication taking practices.

  14. Role of HIV Infection Duration and CD4 Cell Level at Initiation of Combination Anti-Retroviral Therapy on Risk of Failure

    PubMed Central

    Lodi, Sara; Phillips, Andrew; Fidler, Sarah; Hawkins, David; Gilson, Richard; McLean, Ken; Fisher, Martin; Post, Frank; Johnson, Anne M.; Walker-Nthenda, Louise; Dunn, David; Porter, Kholoud

    2013-01-01

    Background The development of HIV drug resistance and subsequent virological failure are often cited as potential disadvantages of early cART initiation. However, their long-term probability is not known, and neither is the role of duration of infection at the time of initiation. Methods Patients enrolled in the UK Register of HIV seroconverters were followed-up from cART initiation to last HIV-RNA measurement. Through survival analysis we examined predictors of virologic failure (2HIV-RNA ≥400 c/l while on cART) including CD4 count and HIV duration at initiation. We also estimated the cumulative probabilities of failure and drug resistance (from the available HIV nucleotide sequences) for early initiators (cART within 12 months of seroconversion). Results Of 1075 starting cART at a median (IQR) CD4 count 272 (190,370) cells/mm3 and HIV duration 3 (1,6) years, virological failure occurred in 163 (15%). Higher CD4 count at initiation, but not HIV infection duration at cART initiation, was independently associated with lower risk of failure (p=0.033 and 0.592 respectively). Among 230 patients initiating cART early, 97 (42%) discontinued it after a median of 7 months; cumulative probabilities of resistance and failure by 8 years were 7% (95% CI 4,11) and 19% (13,25), respectively. Conclusion Although the rate of discontinuation of early cART in our cohort was high, the long-term rate of virological failure was low. Our data do not support early cART initiation being associated with increased risk of failure and drug resistance. PMID:24086588

  15. Growth Patterns of HIV Infected Indian Children in Response to ART: A Clinic Based Cohort Study.

    PubMed

    Parchure, Ritu S; Kulkarni, Vinay V; Darak, Trupti S; Mhaskar, Rahul; Miladinovic, Branko; Emmanuel, Patricia J

    2015-06-01

    To describe catch-up growth after antiretroviral therapy (ART) initiation among children living with human immunodeficiency virus (CLHIV), attending a private clinic in India. This is a retrospective analysis of data of CLHIV attending Prayas clinic, Pune, India. Height and weight z scores (HAZ, WAZ) were calculated using WHO growth charts. Catch-up growth post-ART was assessed using a mixed method model in cases where baseline and at least one subsequent follow-up HAZ/WAZ were available. STATA 12 was used for statistical analysis. During 1998 to 2011, 466 children were enrolled (201 girls and 265 boys; median age = 7 y). A total of 302 children were ever started on ART; of which 73 and 76 children were included for analysis for catch up growth in WAZ and HAZ respectively. Median WAZ and HAZ increased from -2.14 to -1.34 (p = 0.007) and -2.42 to -1.94 (p = 0.34), respectively, 3 y post ART. Multivariable analysis using mixed model (adjusted for gender, guardianship, baseline age, baseline WAZ/HAZ, baseline and time varying WHO clinical stage) showed gains in WAZ (coef = 0.2, 95 % CI: -0.06 to 0.46) and HAZ (coef = 0.49, 95 % CI: 0.21 to 0.77) with time on ART. Lower baseline WAZ/HAZ and older age were associated with impaired catch-up growth. Children staying in institutions and with baseline advanced clinical stage showed higher gain in WAZ. The prevalence of stunting and underweight was high at ART initiation. Sustained catch-up growth was seen with ART. The study highlights the benefit of early ART in achieving normal growth in CLHIV.

  16. Sleeve Gastrectomy in Morbidly Obese HIV Patients: Focus on Anti-retroviral Treatment Absorption After Surgery.

    PubMed

    Amouyal, Chloé; Buyse, Marion; Lucas-Martini, Lea; Hirt, Déborah; Genser, Laurent; Torcivia, Adriana; Bouillot, Jean-Luc; Oppert, Jean-Michel; Aron-Wisnewsky, Judith

    2018-05-20

    Anti-retroviral therapy (ART) dramatically reduced AIDS development, thus enabling patients to live as long as the general population. New challenges have emerged particularly cardiometabolic diseases and weight gain, with some HIV patients seeking bariatric surgery (BS). However, BS outcomes during HIV remain poorly described, with scarce data on ART pharmacokinetic post-BS. Describing sleeve gastrectomy (SG) results in HIV patients in terms of ART pharmacokinetic, HIV control, weight loss, and metabolic outcomes. Prospective study of HIV patients undergoing SG in a referral academic center, with at least 6 months follow-up. Clinical and biological parameters, HIV medical history, and ART pharmacokinetics were gathered before and post-SG. Seventeen patients (mean BMI = 44.2 ± 5.7 kg m -2 ) and major obesity-related diseases (47% type-2 diabetes, 64% obstructive sleep apnea, 70% hypertension) underwent SG during a mean 2 years of follow-up. They displayed an average of 20% reduction of initial BMI and improved body composition, similarly to obese non-HIV patients. SG improved metabolic status. All patients had undetectable viral load before BS. Upon HIV follow-up, 12 patients had undetectable viral load with correct ART kinetic parameters (3 and 6 months); 4 displayed detectable viral load along with significant decrease in raltegravir and atazanavir treatment exposure, leading to ART change with subsequent undetectable viral load; and 1 had persistent detectable viral load despite ART change. SG seems effective and safe in obese HIV patients. However, ART treatment should be monitored post-SG to control HIV infection. We suggest that some ART should be adapted before SG conjoints with infectious disease specialists.

  17. Brief Report: Stigma and HIV Care Continuum Outcomes Among Ethiopian Adults Initiating ART.

    PubMed

    Hoffman, Susie; Tymejczyk, Olga; Kulkarni, Sarah; Lahuerta, Maria; Gadisa, Tsigereda; Remien, Robert H; Melaku, Zenebe; Nash, Denis; Elul, Batya

    2017-12-01

    Stigma harms the mental health of HIV-positive individuals and reduces adherence to antiretroviral therapy (ART), but less is known about stigma and other outcomes across the HIV care continuum. Among 1180 Ethiopian adults initiating ART at 6 urban HIV clinics, we examined the relationship of internalized, anticipated, and enacted stigma to HIV care-related outcomes ascertained by interview (repeat HIV-positive testing, provider vs. self-referred testing, missed clinic visit before ART initiation, eagerness to begin ART), and by abstraction of routinely collected clinical data (late ART initiation, 3-month gap in care following ART initiation). Logistic regression was used to assess the association of each type of stigma with each outcome, adjusting for potential confounders. Scoring higher on each stigma domain was associated with 50%-90% higher odds of repeat HIV-positive testing. High internalized stigma was associated with higher odds of provider vs. self-referred test [adjusted odds ratio (aOR)high vs. low: 1.7; 95% confidence interval (CI): 1.3 to 2.2]. Higher anticipated stigma was associated with lower eagerness to begin ART (aORhigh vs. low: 0.55; 0.35-0.87; aORmedium vs. low: 0.45; 95% CI: 0.30 to 0.69). Any enacted stigma was associated with higher odds of a missed visit (aORany vs. none 1.8; 1.2-2.8). Stigma was not associated with late ART-initiation or with a subsequent gap in care. These findings provide further evidence of the importance of measuring and addressing stigma across the entire care continuum. Future work should test hypotheses about specific stigma domains and outcomes in prospective intervention or observational studies.

  18. Dendritic cell immunotherapy followed by cART interruption during HIV-1 infection induces plasma protein markers of cellular immunity and neutrophil recruitment

    PubMed Central

    Cooper, Jason D.; Tomasik, Jakub; Bahn, Sabine; Aerts, Joeri L.; Osterhaus, Albert D. M. E.; Gruters, Rob A.; Andeweg, Arno C.

    2018-01-01

    Objectives To characterize the host response to dendritic cell-based immunotherapy and subsequent combined antiretroviral therapy (cART) interruption in HIV-1-infected individuals at the plasma protein level. Design An autologous dendritic cell (DC) therapeutic vaccine was administered to HIV-infected individuals, stable on cART. The effect of vaccination was evaluated at the plasma protein level during the period preceding cART interruption, during analytical therapy interruption and at viral reactivation. Healthy controls and post-exposure prophylactically treated healthy individuals were included as controls. Methods Plasma marker (‘analyte’) levels including cytokines, chemokines, growth factors, and hormones were measured in trial participants and control plasma samples using a multiplex immunoassay. Analyte levels were analysed using principle component analysis, cluster analysis and limma. Blood neutrophil counts were analysed using linear regression. Results Plasma analyte levels of HIV-infected individuals are markedly different from those of healthy controls and HIV-negative individuals receiving post-exposure prophylaxis. Viral reactivation following cART interruption also affects multiple analytes, but cART interruption itself only has only a minor effect. We find that Thyroxine-Binding Globulin (TBG) levels and late-stage neutrophil numbers correlate with the time off cART after DC vaccination. Furthermore, analysis shows that cART alters several regulators of blood glucose levels, including C-peptide, chromogranin-A and leptin. HIV reactivation is associated with the upregulation of CXCR3 ligands. Conclusions Chronic HIV infection leads to a change in multiple plasma analyte levels, as does virus reactivation after cART interruption. Furthermore, we find evidence for the involvement of TBG and neutrophils in the response to DC-vaccination in the setting of HIV-infection. PMID:29389978

  19. The impact of HIV and ART on recurrent tuberculosis in a sub-Saharan setting.

    PubMed

    Houben, Rein M G J; Glynn, Judith R; Mboma, Sebastian; Mzemba, Themba; Mwaungulu, Nimrod J; Mwaungulu, Lorren; Mwenibabu, Michael; Mpunga, James; French, Neil; Crampin, Amelia C

    2012-11-13

    To estimate the impact of antiretroviral therapy (ART) on the incidence of recurrent tuberculosis (TB) in an African population. A long-term population cohort in Karonga District, northern Malawi. Patients who had completed treatment for laboratory-confirmed TB diagnosed since 1996 were visited annually to record vital status, ART use and screen for TB. Survival analysis estimated the effect of HIV/ART status at completion of treatment on mortality and recurrence. Analyses were stratified by time since treatment completion to estimate the effects on relapse (predominates during first year) and reinfection disease (predominates later). Among 1133 index TB cases contributing 4353 person-years of follow-up, there were 307 deaths and 103 laboratory-confirmed recurrences (recurrence rate 4.6 per 100 person-years). Half the recurrences occurred in the first year since completing treatment. HIV infection increased the recurrence rate [rate ratio adjusted for age, sex, period and TB type 2.69, 95% confidence interval (CI) 1.69-4.26], but with less effect in the first year (adjusted rate ratio 1.71, 95% CI 0.87-3.35) than subsequently (adjusted rate ratio 4.2, 95% CI 2.16-8.15). Recurrence rates on ART were intermediate between those of HIV-negative individuals and HIV-positive individuals without ART. Compared with HIV-positive individuals without ART, the adjusted rate ratio was 0.74 (95% CI 0.27-2.06) in the first year, and 0.43 (95% CI 0.11-1.73) later. The increased incidence of TB recurrence observed in HIV-positive patients appeared to be reduced by ART. The effects are mostly on later (likely reinfection) disease so the impact of ART on reducing recurrence will be highest in high TB incidence settings.

  20. Dendritic cell immunotherapy followed by cART interruption during HIV-1 infection induces plasma protein markers of cellular immunity and neutrophil recruitment.

    PubMed

    van den Ham, Henk-Jan; Cooper, Jason D; Tomasik, Jakub; Bahn, Sabine; Aerts, Joeri L; Osterhaus, Albert D M E; Gruters, Rob A; Andeweg, Arno C

    2018-01-01

    To characterize the host response to dendritic cell-based immunotherapy and subsequent combined antiretroviral therapy (cART) interruption in HIV-1-infected individuals at the plasma protein level. An autologous dendritic cell (DC) therapeutic vaccine was administered to HIV-infected individuals, stable on cART. The effect of vaccination was evaluated at the plasma protein level during the period preceding cART interruption, during analytical therapy interruption and at viral reactivation. Healthy controls and post-exposure prophylactically treated healthy individuals were included as controls. Plasma marker ('analyte') levels including cytokines, chemokines, growth factors, and hormones were measured in trial participants and control plasma samples using a multiplex immunoassay. Analyte levels were analysed using principle component analysis, cluster analysis and limma. Blood neutrophil counts were analysed using linear regression. Plasma analyte levels of HIV-infected individuals are markedly different from those of healthy controls and HIV-negative individuals receiving post-exposure prophylaxis. Viral reactivation following cART interruption also affects multiple analytes, but cART interruption itself only has only a minor effect. We find that Thyroxine-Binding Globulin (TBG) levels and late-stage neutrophil numbers correlate with the time off cART after DC vaccination. Furthermore, analysis shows that cART alters several regulators of blood glucose levels, including C-peptide, chromogranin-A and leptin. HIV reactivation is associated with the upregulation of CXCR3 ligands. Chronic HIV infection leads to a change in multiple plasma analyte levels, as does virus reactivation after cART interruption. Furthermore, we find evidence for the involvement of TBG and neutrophils in the response to DC-vaccination in the setting of HIV-infection.

  1. Modeling Preferential Admissions at Elite Liberal Arts Colleges

    ERIC Educational Resources Information Center

    Cockburn, Sally; Hewitt, Gordon; Kelly, Timothy

    2013-01-01

    This paper presents the results of a model that simulates the effects of varying preferential admissions policies on the academic profile of a set of 35 small liberal arts colleges. An underlying assumption is that all schools in the set use the same ratio of preferential to non-preferential admissions. The model predicts that even drastic changes…

  2. Predicting New Jersey High School Proficiency Test Results in Mathematics and Language Arts Using Community Demographic Data

    ERIC Educational Resources Information Center

    Lynch, Christopher D.

    2015-01-01

    This study examined the relationship between the 2013 New Jersey High School Proficiency Assessment (HSPA) Language Arts and Mathematics scores and school level data related to family human capital and community social capital found in the extant literature to influence student achievement on high-stakes standardized assessments. School level data…

  3. Complete Report: Kodak Graphic Arts Industry Manpower Study.

    ERIC Educational Resources Information Center

    Eastman Kodak Co., Rochester, NY.

    This report is believed to be the first nationwide attempt in more than three centuries of printing in America to define graphic arts manpower needs. The objectives of this study were to determine the current status of industry manpower and to predict manpower needs for the 1970's. To carry out these objectives two questionnaires were developed, a…

  4. Developing Integrated Arts Curriculum in Hong Kong: Chaos Theory at Work?

    ERIC Educational Resources Information Center

    Wong, Marina

    2013-01-01

    This article reports the development of integrated arts curriculum in two Hong Kong secondary schools over a 9-year period. Initial findings display a range of individual responses to educational change that are both non-predictable and non-linear. Chaos theory is used to explain these varied responses in terms of bifurcations. The findings of…

  5. Identification and preparation of sperm for ART.

    PubMed

    Mehta, Akanksha; Sigman, Mark

    2014-02-01

    State-of-the-art techniques attempt to select sperm with the best functional capacity to produce pregnancy and, subsequently, healthy offspring. A variety of approaches are now being evaluated. Future approaches may allow for selection of sperm based on sperm DNA integrity, degree of aneuploidy, or apoptosis. Other approaches involve attempting to improve the in vitro function of sperm with exposure to compounds such as pentoxifylline or platelet activating factor. In the future, we are likely to see significant improvements in the ability to select the best sperm for assisted-reproductive-technology procedures and the use of these procedures in routine clinical practice. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Evolutionary Dynamic Multiobjective Optimization Via Kalman Filter Prediction.

    PubMed

    Muruganantham, Arrchana; Tan, Kay Chen; Vadakkepat, Prahlad

    2016-12-01

    Evolutionary algorithms are effective in solving static multiobjective optimization problems resulting in the emergence of a number of state-of-the-art multiobjective evolutionary algorithms (MOEAs). Nevertheless, the interest in applying them to solve dynamic multiobjective optimization problems has only been tepid. Benchmark problems, appropriate performance metrics, as well as efficient algorithms are required to further the research in this field. One or more objectives may change with time in dynamic optimization problems. The optimization algorithm must be able to track the moving optima efficiently. A prediction model can learn the patterns from past experience and predict future changes. In this paper, a new dynamic MOEA using Kalman filter (KF) predictions in decision space is proposed to solve the aforementioned problems. The predictions help to guide the search toward the changed optima, thereby accelerating convergence. A scoring scheme is devised to hybridize the KF prediction with a random reinitialization method. Experimental results and performance comparisons with other state-of-the-art algorithms demonstrate that the proposed algorithm is capable of significantly improving the dynamic optimization performance.

  7. Accessibility of antiretroviral therapy in Ghana: convenience of access.

    PubMed

    Addo-Atuah, Joyce; Gourley, Dick; Gourley, Greta; White-Means, Shelley I; Womeodu, Robin J; Faris, Richard J; Addo, Nii Akwei

    2012-01-01

    The convenience of accessing antiretroviral therapy (ART) is important for initial access to care and subsequent adherence to ART. We conducted a qualitative study of people living with HIV/AIDS (PLWHA) and ART healthcare providers in Ghana in 2005. The objective of this study was to explore the participants' perceived convenience of accessing ART by PLWHA in Ghana. The convenience of accessing ART was evaluated from the reported travel and waiting times to receive care, the availability, or otherwise, of special considerations, with respect to the waiting time to receive care, for those PLWHA who were in active employment in the formal sector, the frequency of clinic visits before and after initiating ART, and whether the PLWHA saw the same or different providers at each clinic visit (continuity of care). This qualitative study used in-depth interviews based on Yin's case-study research design to collect data from 20 PLWHA and 24 ART healthcare providers as study participants. • Reported travel time to receive ART services ranged from 2 to 12 h for 30% of the PLWHA. • Waiting time to receive care was from 4 to 9 h. • While known government workers, such as teachers, were attended to earlier in some of the centres, this was not a consistent practice in all the four ART centres studied. • The PLWHA corroborated the providers' description of the procedure for initiating and monitoring ART in Ghana. • PLWHA did not see the same provider every time, but they were assured that this did not compromise the continuity of their care. Our study suggests that convenience of accessing ART is important to both PLWHA and ART healthcare providers, but the participants alluded to other factors, including open provider-patient communication, which might explain the PLWHA's understanding of the constraints under which they were receiving care. The current nation-wide coverage of the ART programme in Ghana, however, calls for the replication of this study to identify possible perception changes over time that may need attention. Our study findings can inform interventions to promote access to ART, especially in Africa.

  8. Same day HIV diagnosis and antiretroviral therapy initiation affects retention in Option B+ prevention of mother-to-child transmission services at antenatal care in Zomba District, Malawi.

    PubMed

    Chan, Adrienne K; Kanike, Emmanuel; Bedell, Richard; Mayuni, Isabel; Manyera, Ruth; Mlotha, William; Harries, Anthony D; van Oosterhout, Joep J; van Lettow, Monique

    2016-01-01

    Data from the Option B+ prevention of mother-to-child transmission (PMTCT) program in Malawi show considerable variation between health facilities in retention on antiretroviral therapy (ART). In a programmatic setting, we studied whether the "model of care," based on the degree of integration of antenatal care (ANC), HIV testing and counselling (HTC) and ART service provision-influenced uptake of and retention on ART. We conducted a retrospective cohort study of pregnant women seeking ANC at rural primary health facilities in Zomba District, Malawi. Data were extracted from standardized national ANC registers, ART registers and ART master cards. The "model of care" of Option B+ service delivery was determined at each health facility, based on the degree of integration of ANC, HTC and ART. Full integration (Model 1) of HTC and ART initiation at ANC was compared with integration of HTC only into ANC services (Model 2) with subsequent referral to an existing ART clinic for treatment initiation. A total of 10,528 women were newly registered at ANC between October 2011 and March 2012 in 23 rural health facilities (12 were Model 1 and 11 Model 2). HIV status was ascertained in 8,572 (81%) women. Among 914/8,572 (9%) HIV-positive women enrolling at ANC, 101/914 (11%) were already on ART; of those not on treatment, 456/813 (56%) were started on ART. There was significantly higher ART uptake in Model 1 compared with Model 2 sites (63% vs. 51%; p=0.001), but significantly lower ART retention in Model 1 compared with Model 2 sites (79% vs. 87%; p=0.02). Multivariable analysis showed that initiation of ART on the same day as HIV diagnosis, but not model of care, was independently associated with reduced retention in the first six months (adjusted odds ratio 2.27; 95% CI: 1.34-3.85; p=0.002). HIV diagnosis and treatment on the same day was associated with reduced retention on ART, independent of the level of PMTCT service integration at ANC.

  9. Predictive value of impaired evacuation at proctography in diagnosing anismus.

    PubMed

    Halligan, S; Malouf, A; Bartram, C I; Marshall, M; Hollings, N; Kamm, M A

    2001-09-01

    We aimed to determine the positive predictive value of impaired evacuation during evacuation proctography for the subsequent diagnosis of anismus. Thirty-one adults with signs of impaired evacuation (defined as the inability to evacuate two thirds of a 120 mL contrast enema within 30 sec) during evacuation proctography underwent subsequent anorectal physiologic testing for anismus. A physiologic diagnosis of anismus was based on a typical clinical history of the condition combined with impaired rectal balloon expulsion or abnormal surface electromyogram. Twenty-eight (90%) of the 31 patients with impaired proctographic evacuation were found to have anismus at subsequent physiologic testing. Among the 28 were all 10 patients who evacuated no contrast medium and all 11 patients with inadequate pelvic floor descent, giving evacuation proctography a positive predictive value of 90% for the diagnosis of anismus. A prominent puborectal impression was seen in only three subjects during proctography, one of whom subsequently showed no physiologic sign of anismus. Impaired evacuation during evacuation proctography is highly predictive for diagnosis of anismus.

  10. Predictors of unstructured antiretroviral treatment interruption and resumption among HIV-positive individuals in Canada.

    PubMed

    Samji, H; Taha, T E; Moore, D; Burchell, A N; Cescon, A; Cooper, C; Raboud, J M; Klein, M B; Loutfy, M R; Machouf, N; Tsoukas, C M; Montaner, J S G; Hogg, R S

    2015-02-01

    Sustained optimal use of combination antiretroviral therapy (cART) has been shown to decrease morbidity, mortality and HIV transmission. However, incomplete adherence and treatment interruption (TI) remain challenges to the full realization of the promise of cART. We estimated trends and predictors of treatment interruption and resumption among individuals in the Canadian Observational Cohort (CANOC) collaboration. cART-naïve individuals ≥ 18 years of age who initiated cART between 2000 and 2011 were included in the study. We defined TIs as ≥ 90 consecutive days off cART. We used descriptive analyses to study TI trends over time and Cox regression to identify factors predicting time to first TI and time to treatment resumption after a first TI. A total of 7633 participants were eligible for inclusion in the study, of whom 1860 (24.5%) experienced a TI. The prevalence of TI in the first calendar year of cART decreased by half over the study period. Our analyses highlighted a higher risk of TI among women [adjusted hazard ratio (aHR) 1.59; 95% confidence interval (CI) 1.33-1.92], younger individuals (aHR 1.27; 95% CI 1.15-1.37 per decade increase), earlier treatment initiators (CD4 count ≥ 350 vs. <200 cells/μL: aHR 1.46; 95% CI 1.17-1.81), Aboriginal participants (aHR 1.67; 95% CI 1.27-2.20), injecting drug users (aHR 1.43; 95% CI 1.09-1.89) and users of zidovudine vs. tenofovir in the initial cART regimen (aHR 2.47; 95% CI 1.92-3.20). Conversely, factors predicting treatment resumption were male sex, older age, and a CD4 cell count <200 cells/μL at cART initiation. Despite significant improvements in cART since its advent, our results demonstrate that TIs remain relatively prevalent. Strategies to support continuous HIV treatment are needed to maximize the benefits of cART. © 2014 British HIV Association.

  11. Adherence to antiretroviral therapy (ART) during the early months of treatment in rural Zambia: influence of demographic characteristics and social surroundings of patients

    PubMed Central

    2012-01-01

    Background Around 70% of those living with HIV in need of treatment accessed antiretroviral therapy (ART) in Zambia by 2009. However, sustaining high levels of adherence to ART is a challenge. This study aimed to identify the predictive factors associated with ART adherence during the early months of treatment in rural Zambia. Methods This is a field based observational longitudinal study in Mumbwa district, which is located 150 km west of Lusaka, the capital of Zambia. Treatment naive patients aged over 15 years, who initiated treatment during September-November 2010, were enrolled. Patients were interviewed at the initiation and six weeks later. The treatment adherence was measured according to self-reporting by the patients. Multiple logistic regression analysis was performed to identify the predictive factors associated with the adherence. Results Of 157 patients, 59.9% were fully adherent to the treatment six weeks after starting ART. According to the multivariable analysis, full adherence was associated with being female [Adjusted Odds Ratio (AOR), 3.3; 95% Confidence interval (CI), 1.2-8.9], having a spouse who were also on ART (AOR, 4.4; 95% CI, 1.5-13.1), and experience of food insufficiency in the previous 30 days (AOR, 5.0; 95% CI, 1.8-13.8). Some of the most common reasons for missed doses were long distance to health facilities (n = 21, 53.8%), food insufficiency (n = 20, 51.3%), and being busy with other activities such as work (n = 15, 38.5%). Conclusions The treatment adherence continues to be a significant challenge in rural Zambia. Social supports from spouses and people on ART could facilitate their treatment adherence. This is likely to require attention by ART services in the future, focusing on different social influences on male and female in rural Zambia. In addition, poverty reduction strategies may help to reinforce adherence to ART and could mitigate the influence of HIV infection for poor patients and those who fall into poverty after starting ART. PMID:23270312

  12. Aesthetics at the Impasse: The Unresolved Property of Dale Farm

    ERIC Educational Resources Information Center

    McCarthy, Lynne

    2015-01-01

    "Soil Depositions" was an art activist project that responded to the 2011 Irish Traveller eviction at Dale Farm in Essex when three resident women donated small amounts of soil from the site of their former home. The soil was subsequently deposited, framed and documented in various national and international locations. This article…

  13. Pop Culture in America.

    ERIC Educational Resources Information Center

    White, David Manning, Ed.

    The nature of today's popular culture, its place in American life, and its merit or lack of it are the themes of these essays from "The New York Times Magazine." Introductory essays discuss the use of leisure time, paying the cost of the arts, and whether American society can be considered "cultured." Subsequent essays discuss the nature of radio…

  14. Exploring the Artwork of Young Students' Multimodal Compositions

    ERIC Educational Resources Information Center

    Pantaleo, Sylvia

    2017-01-01

    The data featured in this article were collected during a classroom-based study with seven- and eight-year-old children in British Columbia, Canada. The multiple purposes of the research included exploring how the development of the students' understanding of elements of visual art and design would affect their subsequent application of these same…

  15. Preparing Students to Take SOA/CAS Exam FM/2

    ERIC Educational Resources Information Center

    Marchand, Richard J.

    2014-01-01

    This paper provides suggestions for preparing students to take the actuarial examination on financial mathematics, SOA/CAS Exam FM/2. It is based on current practices employed at Slippery Rock University, a small public liberal arts university. Detailed descriptions of our Theory of Interest course and subsequent Exam FM/2 prep course are provided…

  16. A Matter of Choice.

    ERIC Educational Resources Information Center

    Dance, Frank E. X.

    The intent of a liberal education is to enhance the student's freedom, the faculty of intentional choice. The capacity of humans to step outside of themselves, which allows development of self-concept and subsequently self-esteem, is potentiated by the humans' unique sign, the symbol. Each of the liberal arts is concerned with the development and…

  17. Do fertility intentions predict subsequent behavior? Evidence from Peninsular Malaysia.

    PubMed

    Tan, P C; Tey, N P

    1994-01-01

    Data from the 1984 Malaysian Population and Family Survey were matched with birth registration records for 1985-87 to determine the accuracy of statements regarding desired family size that were reported in a household survey in predicting subsequent reproductive behavior. The findings of this study were that stated fertility intention provides fairly accurate forecasts of fertility behavior in the subsequent period. In other words, whether a woman has another child is predicted closely by whether she wanted an additional child. Informational, educational, and motivational activities of family planning programs would, therefore, have greater success in reducing family size if fertility intentions were taken into account.

  18. The Science of Optics; The History of Art

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

    Falco, Charles

    2006-06-28

    Recently, renowned artist David Hockney observed that certain drawings and paintings from as early as the Renaissance seemed almost 'photographic' in detail. Following an extensive visual investigation of western art of the past 1000 years, he made the revolutionary claim that artists even of the prominence of van Eyck and Bellini must have used optical aids. However, many art historians insisted there was no supporting evidence for such a remarkable assertion. In this talk I show a wealth of optical evidence for his claim that Hockney and I subsequently discovered during an unusual, and remarkably-productive, collaboration between an artist andmore » a scientist. I also discuss the unique properties of the 'mirror lens,' and some of the implications this work has for the history of science as well as the history of art (and the modern fields of machine vision and computerized image analysis). These discoveries convincingly demonstrate optical instruments were in use - by artists, not scientists - nearly 200 years earlier than previously even thought possible, and account for the remarkable transformation in the reality of portraits that occurred early in the 15th century.« less

  19. The Science of Optics; The History of Art

    ScienceCinema

    Falco, Charles

    2018-05-21

    Recently, renowned artist David Hockney observed that certain drawings and paintings from as early as the Renaissance seemed almost 'photographic' in detail. Following an extensive visual investigation of western art of the past 1000 years, he made the revolutionary claim that artists even of the prominence of van Eyck and Bellini must have used optical aids. However, many art historians insisted there was no supporting evidence for such a remarkable assertion. In this talk I show a wealth of optical evidence for his claim that Hockney and I subsequently discovered during an unusual, and remarkably-productive, collaboration between an artist and a scientist. I also discuss the unique properties of the 'mirror lens,' and some of the implications this work has for the history of science as well as the history of art (and the modern fields of machine vision and computerized image analysis). These discoveries convincingly demonstrate optical instruments were in use - by artists, not scientists - nearly 200 years earlier than previously even thought possible, and account for the remarkable transformation in the reality of portraits that occurred early in the 15th century.

  20. BEHAVE: fire behavior prediction and fuel modeling system--FUEL subsystem

    Treesearch

    Robert E. Burgan; Richard C. Rothermel

    1984-01-01

    This manual documents the fuel modeling procedures of BEHAVE--a state-of-the-art wildland fire behavior prediction system. Described are procedures for collecting fuel data, using the data with the program, and testing and adjusting the fuel model.

  1. Neural networks for learning and prediction with applications to remote sensing and speech perception

    NASA Astrophysics Data System (ADS)

    Gjaja, Marin N.

    1997-11-01

    Neural networks for supervised and unsupervised learning are developed and applied to problems in remote sensing, continuous map learning, and speech perception. Adaptive Resonance Theory (ART) models are real-time neural networks for category learning, pattern recognition, and prediction. Unsupervised fuzzy ART networks synthesize fuzzy logic and neural networks, and supervised ARTMAP networks incorporate ART modules for prediction and classification. New ART and ARTMAP methods resulting from analyses of data structure, parameter specification, and category selection are developed. Architectural modifications providing flexibility for a variety of applications are also introduced and explored. A new methodology for automatic mapping from Landsat Thematic Mapper (TM) and terrain data, based on fuzzy ARTMAP, is developed. System capabilities are tested on a challenging remote sensing problem, prediction of vegetation classes in the Cleveland National Forest from spectral and terrain features. After training at the pixel level, performance is tested at the stand level, using sites not seen during training. Results are compared to those of maximum likelihood classifiers, back propagation neural networks, and K-nearest neighbor algorithms. Best performance is obtained using a hybrid system based on a convex combination of fuzzy ARTMAP and maximum likelihood predictions. This work forms the foundation for additional studies exploring fuzzy ARTMAP's capability to estimate class mixture composition for non-homogeneous sites. Exploratory simulations apply ARTMAP to the problem of learning continuous multidimensional mappings. A novel system architecture retains basic ARTMAP properties of incremental and fast learning in an on-line setting while adding components to solve this class of problems. The perceptual magnet effect is a language-specific phenomenon arising early in infant speech development that is characterized by a warping of speech sound perception. An unsupervised neural network model is proposed that embodies two principal hypotheses supported by experimental data--that sensory experience guides language-specific development of an auditory neural map and that a population vector can predict psychological phenomena based on map cell activities. Model simulations show how a nonuniform distribution of map cell firing preferences can develop from language-specific input and give rise to the magnet effect.

  2. Transactional Relations Between Marital Functioning and Depressive Symptoms

    PubMed Central

    Kouros, Chrystyna D.; Cummings, E. Mark

    2012-01-01

    The present study investigated dynamic, longitudinal associations between depressive symptoms and marital processes. Two hundred ninety-six couples reported on marital satisfaction, marital conflict, and depressive symptoms yearly for three years. Observational measures of marital conflict were also collected. Results suggested that different domains of marital functioning related to husbands’ versus wives’ symptoms. For husbands, transactional relations between marital satisfaction and depressive symptoms were identified: high levels of depressive symptoms predicted subsequent decreases in marital satisfaction, and decreased marital satisfaction predicted subsequent elevations in symptoms over time. For wives, high levels of marital conflict predicted subsequent elevations in symptoms over time. Cross-partner results indicated that husbands’ depressive symptoms were also related to subsequent declines in wives’ marital satisfaction. Results are discussed with regard to theoretical perspectives on the marital functioning-depression link and directions for future research are outlined. PMID:21219284

  3. HybridGO-Loc: mining hybrid features on gene ontology for predicting subcellular localization of multi-location proteins.

    PubMed

    Wan, Shibiao; Mak, Man-Wai; Kung, Sun-Yuan

    2014-01-01

    Protein subcellular localization prediction, as an essential step to elucidate the functions in vivo of proteins and identify drugs targets, has been extensively studied in previous decades. Instead of only determining subcellular localization of single-label proteins, recent studies have focused on predicting both single- and multi-location proteins. Computational methods based on Gene Ontology (GO) have been demonstrated to be superior to methods based on other features. However, existing GO-based methods focus on the occurrences of GO terms and disregard their relationships. This paper proposes a multi-label subcellular-localization predictor, namely HybridGO-Loc, that leverages not only the GO term occurrences but also the inter-term relationships. This is achieved by hybridizing the GO frequencies of occurrences and the semantic similarity between GO terms. Given a protein, a set of GO terms are retrieved by searching against the gene ontology database, using the accession numbers of homologous proteins obtained via BLAST search as the keys. The frequency of GO occurrences and semantic similarity (SS) between GO terms are used to formulate frequency vectors and semantic similarity vectors, respectively, which are subsequently hybridized to construct fusion vectors. An adaptive-decision based multi-label support vector machine (SVM) classifier is proposed to classify the fusion vectors. Experimental results based on recent benchmark datasets and a new dataset containing novel proteins show that the proposed hybrid-feature predictor significantly outperforms predictors based on individual GO features as well as other state-of-the-art predictors. For readers' convenience, the HybridGO-Loc server, which is for predicting virus or plant proteins, is available online at http://bioinfo.eie.polyu.edu.hk/HybridGoServer/.

  4. Preliminary power train design for a state-of-the-art electric vehicle

    NASA Technical Reports Server (NTRS)

    Ross, J. A.; Wooldridge, G. A.

    1978-01-01

    The state-of-the-art (SOTA) of electric vehicles built since 1965 was reviewed to establish a base for the preliminary design of a power train for a SOTA electric vehicle. The performance of existing electric vehicles were evaluated to establish preliminary specifications for a power train design using state-of-the-art technology and commercially available components. Power train components were evaluated and selected using a computer simulation of the SAE J227a Schedule D driving cycle. Predicted range was determined for a number of motor and controller combinations in conjunction with the mechanical elements of power trains and a battery pack of sixteen lead-acid batteries - 471.7 kg at 0.093 MJ/Kg (1040 lbs. at 11.7 Whr/lb). On the basis of maximum range and overall system efficiency using the Schedule D cycle, an induction motor and 3 phase inverter/controller was selected as the optimum combination when used with a two-speed transaxle and steel belted radial tires. The predicted Schedule D range is 90.4 km (56.2 mi). Four near term improvements to the SOTA were identified, evaluated, and predicted to increase range approximately 7%.

  5. Bidirectional-Compounding Effects of Rumination and Negative Emotion in Predicting Impulsive Behavior: Implications for Emotional Cascades.

    PubMed

    Selby, Edward A; Kranzler, Amy; Panza, Emily; Fehling, Kara B

    2016-04-01

    Influenced by chaos theory, the emotional cascade model proposes that rumination and negative emotion may promote each other in a self-amplifying cycle that increases over time. Accordingly, exponential-compounding effects may better describe the relationship between rumination and negative emotion when they occur in impulsive persons, and predict impulsive behavior. Forty-seven community and undergraduate participants who reported frequent engagement in impulsive behaviors monitored their ruminative thoughts and negative emotion multiple times daily for two weeks using digital recording devices. Hypotheses were tested using cross-lagged mixed model analyses. Findings indicated that rumination predicted subsequent elevations in rumination that lasted over extended periods of time. Rumination and negative emotion predicted increased levels of each other at subsequent assessments, and exponential functions for these associations were supported. Results also supported a synergistic effect between rumination and negative emotion, predicting larger elevations in subsequent rumination and negative emotion than when one variable alone was elevated. Finally, there were synergistic effects of rumination and negative emotion in predicting number of impulsive behaviors subsequently reported. These findings are consistent with the emotional cascade model in suggesting that momentary rumination and negative emotion progressively propagate and magnify each other over time in impulsive people, promoting impulsive behavior. © 2014 Wiley Periodicals, Inc.

  6. Visual arts training is linked to flexible attention to local and global levels of visual stimuli.

    PubMed

    Chamberlain, Rebecca; Wagemans, Johan

    2015-10-01

    Observational drawing skill has been shown to be associated with the ability to focus on local visual details. It is unclear whether superior performance in local processing is indicative of the ability to attend to, and flexibly switch between, local and global levels of visual stimuli. It is also unknown whether these attentional enhancements remain specific to observational drawing skill or are a product of a wide range of artistic activities. The current study aimed to address these questions by testing if flexible visual processing predicts artistic group membership and observational drawing skill in a sample of first-year bachelor's degree art students (n=23) and non-art students (n=23). A pattern of local and global visual processing enhancements was found in relation to artistic group membership and drawing skill, with local processing ability found to be specifically related to individual differences in drawing skill. Enhanced global processing and more fluent switching between local and global levels of hierarchical stimuli predicted both drawing skill and artistic group membership, suggesting that these are beneficial attentional mechanisms for art-making in a range of domains. These findings support a top-down attentional model of artistic expertise and shed light on the domain specific and domain-general attentional enhancements induced by proficiency in the visual arts. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. The evolution of genetic and conditional alternative reproductive tactics

    PubMed Central

    2016-01-01

    Frequency-dependent selection may drive adaptive diversification within species. It is yet unclear why the occurrence of alternative reproductive tactics (ARTs) is highly divergent between major animal taxa. Here we aim to clarify the environmental and social conditions favouring the evolution of intra-population variance of male reproductive phenotypes. Our results suggest that genetically determined ARTs that are fixed for life evolve when there is strong selection on body size due to size-dependent competitiveness, in combination with environmental factors reducing size benefits. The latter may result from growth costs or, more generally, from age-dependent but size-independent mortality causes. This generates disruptive selection on growth trajectories underlying tactic choice. In many parameter settings, the model also predicts ARTs to evolve that are flexible and responsive to current conditions. Interestingly, the conditions favouring the evolution of flexible tactics diverge considerably from those favouring genetic variability. Nevertheless, in a restricted but relevant parameter space, our model predicts the simultaneous emergence and maintenance of a mixture of multiple tactics, both genetically and conditionally determined. Important conditions for the emergence of ARTs include size variation of competitors, which is inherently greater in species with indeterminate growth than in taxa reproducing only after reaching their terminal body size. This is probably the reason why ARTs are more common in fishes than in other major taxa. PMID:26911960

  8. Associations of hormonal contraceptive use with measures of HIV disease progression and antiretroviral therapy effectiveness.

    PubMed

    Whiteman, Maura K; Jeng, Gary; Samarina, Anna; Akatova, Natalia; Martirosyan, Margarita; Kissin, Dmitry M; Curtis, Kathryn M; Marchbanks, Polly A; Hillis, Susan D; Mandel, Michele G; Jamieson, Denise J

    2016-01-01

    To examine the associations between hormonal contraceptive use and measures of HIV disease progression and antiretroviral treatment (ART) effectiveness. A prospective cohort study of women with prevalent HIV infection in St. Petersburg, Russia, was conducted. After contraceptive counseling, participants chose to use combined oral contraceptives (COCs), depot-medroxyprogesterone acetate (DMPA), a copper intrauterine device (IUD) or male condoms for pregnancy prevention. Among participants not using ART at enrollment, we used multivariate Cox regression to assess the association between current (time-varying) contraceptive use and disease progression, measured by the primary composite outcome of CD4 decline to <350 cells/mm(3), ART initiation or death. Among participants using ART at enrollment, we used linear mixed models to estimate the predicted mean CD4 change at select time points by contraceptive method. During a total of 5233 months follow-up among participants not using ART with enrollment CD4 ≥350 cells/mm(3) (n=315), 97 experienced disease progression. Neither current use of COCs [adjusted hazard ratio (aHR) 0.91, 95% confidence interval (CI) 0.56-1.48] nor DMPA (aHR 1.28, 95% CI 0.71-2.31) was associated with a statistically significant increased risk for disease progression compared with use of nonhormonal methods (IUD or condoms). Among participants using ART at enrollment (n=77), we found no statistically significant differences in the predicted mean changes in CD4 cell count comparing current use of COCs (p=.1) or DMPA (p=.3) with nonhormonal methods. Hormonal contraceptive use was not significantly associated with measures of HIV disease progression or ART effectiveness among women with prevalent HIV infection. Hormonal contraceptive use was not significantly associated with measures of HIV disease progression or ART effectiveness among women with prevalent HIV infection. Published by Elsevier Inc.

  9. The Influence of Socioeconomic, Parental, and District Factors on the 2013 MCAS Grade 4 Language Arts and Mathematics Scores

    ERIC Educational Resources Information Center

    Caldwell, Dale G.

    2017-01-01

    This correlational, explanatory study utilized multiple linear and hierarchical regression to examine the predictive power of socioeconomic, parental and district factors on the total percentage of students who scored Proficient or Advanced Proficient on the 2013 MCAS Grade 4 language arts and mathematics test. The population for this study…

  10. Reflecting on the Present and Looking Ahead: A Response to Shuler

    ERIC Educational Resources Information Center

    Tobias, Evan S.

    2014-01-01

    In considering how policy work might forward arts education, it is helpful to reflect on the present state of music and arts education while looking ahead at future challenges and possibilities. This response to Shuler's (2001) set of predictions related to music education and policy in the twenty-first century addresses such work in the…

  11. Predicting Default from Smoking Cessation Treatment Following Enrolment

    ERIC Educational Resources Information Center

    Challenger, Alison; Coleman, Tim; Lewis, Sarah

    2007-01-01

    Objective: To determine which factors predict default from subsequent treatment sessions after initial enrolment and attendance at a large, English smoking cessation service. Design: Cross-sectional survey using data obtained at smokers' initial enrolment attendance to compare the characteristics of those who subsequently default with those who do…

  12. HIV Treatment as Prevention: Systematic Comparison of Mathematical Models of the Potential Impact of Antiretroviral Therapy on HIV Incidence in South Africa

    PubMed Central

    Eaton, Jeffrey W.; Johnson, Leigh F.; Salomon, Joshua A.; Bärnighausen, Till; Bendavid, Eran; Bershteyn, Anna; Bloom, David E.; Cambiano, Valentina; Fraser, Christophe; Hontelez, Jan A. C.; Humair, Salal; Klein, Daniel J.; Long, Elisa F.; Phillips, Andrew N.; Pretorius, Carel; Stover, John; Wenger, Edward A.; Williams, Brian G.; Hallett, Timothy B.

    2012-01-01

    Background Many mathematical models have investigated the impact of expanding access to antiretroviral therapy (ART) on new HIV infections. Comparing results and conclusions across models is challenging because models have addressed slightly different questions and have reported different outcome metrics. This study compares the predictions of several mathematical models simulating the same ART intervention programmes to determine the extent to which models agree about the epidemiological impact of expanded ART. Methods and Findings Twelve independent mathematical models evaluated a set of standardised ART intervention scenarios in South Africa and reported a common set of outputs. Intervention scenarios systematically varied the CD4 count threshold for treatment eligibility, access to treatment, and programme retention. For a scenario in which 80% of HIV-infected individuals start treatment on average 1 y after their CD4 count drops below 350 cells/µl and 85% remain on treatment after 3 y, the models projected that HIV incidence would be 35% to 54% lower 8 y after the introduction of ART, compared to a counterfactual scenario in which there is no ART. More variation existed in the estimated long-term (38 y) reductions in incidence. The impact of optimistic interventions including immediate ART initiation varied widely across models, maintaining substantial uncertainty about the theoretical prospect for elimination of HIV from the population using ART alone over the next four decades. The number of person-years of ART per infection averted over 8 y ranged between 5.8 and 18.7. Considering the actual scale-up of ART in South Africa, seven models estimated that current HIV incidence is 17% to 32% lower than it would have been in the absence of ART. Differences between model assumptions about CD4 decline and HIV transmissibility over the course of infection explained only a modest amount of the variation in model results. Conclusions Mathematical models evaluating the impact of ART vary substantially in structure, complexity, and parameter choices, but all suggest that ART, at high levels of access and with high adherence, has the potential to substantially reduce new HIV infections. There was broad agreement regarding the short-term epidemiologic impact of ambitious treatment scale-up, but more variation in longer term projections and in the efficiency with which treatment can reduce new infections. Differences between model predictions could not be explained by differences in model structure or parameterization that were hypothesized to affect intervention impact. Please see later in the article for the Editors' Summary PMID:22802730

  13. Cell-free fetal DNA versus maternal serum screening for trisomy 21 in pregnant women with and without assisted reproduction technology: a prospective interventional study.

    PubMed

    Costa, Jean-Marc; Letourneau, Alexandra; Favre, Romain; Bidat, Laurent; Belaisch-Allart, Joelle; Jouannic, Jean-Marie; Quarello, Edwin; Senat, Marie-Victoire; Broussin, Bernard; Tsatsaris, Vassilis; Demain, Adèle; Kleinfinger, Pascale; Lohmann, Laurence; Agostini, Hélène; Bouyer, Jean; Benachi, Alexandra

    2018-03-01

    PurposeCell-free DNA (cfDNA) as a primary screening test has been available for years but few studies have addressed this option in a prospective manner. The question is of interest after reports that maternal serum screening (MSS) is less accurate for pregnancies resulting from assisted reproduction technologies (ART) than for spontaneous pregnancies (SP).MethodsA prospective interventional study was designed to address the performances of cfDNA compared with MSS in pregnancies with or without ART. Each patient was offered both MSS and cfDNA testing. The primary analysis cohort ultimately included 794 patients with a spontaneous pregnancy (SP) (n = 472) or pregnancy obtained after ART (n = 322).ResultsOverall, the false-positive rate and positive predictive value were 6.6% and 8.8% for MSS but 0% and 100% for cfDNA. MSS false-positive rate and positive predictive values were clearly poorer in the ART group (11.7% and 2.6%) than in the SP group (3.2% and 21.1%). The global rates of invasive procedures were 1.9% (15/794) with cfDNA but 8.4% (65/794) if MSS alone was proposed.ConclusioncfDNA achieved better performance than MSS in both spontaneous and ART pregnancies, thus decreasing the number of invasive procedures. Our findings suggest that cfDNA should be considered for primary screening, especially in pregnancies obtained after ART.GENETICS in MEDICINE advance online publication, 1 March 2018; doi:10.1038/gim.2018.4.

  14. Weather Forecasting From Woolly Art to Solid Science

    NASA Astrophysics Data System (ADS)

    Lynch, P.

    THE PREHISTORY OF SCIENTIFIC FORECASTING Vilhelm Bjerknes Lewis Fry Richardson Richardson's Forecast THE BEGINNING OF MODERN NUMERICAL WEATHER PREDICTION John von Neumann and the Meteorology Project The ENIAC Integrations The Barotropic Model Primitive Equation Models NUMERICAL WEATHER PREDICTION TODAY ECMWF HIRLAM CONCLUSIONS REFERENCES

  15. The role of art education in adult prisons: The Western Australian experience

    NASA Astrophysics Data System (ADS)

    Giles, Margaret; Paris, Lisa; Whale, Jacqui

    2016-12-01

    Incarceration costs are high; in Australia, for example, each prisoner costs an average of AUD 115,000 per year. Other countries are also feeling the fiscal pinch of high incarceration costs, and a number of jurisdictions are now closing some of their prisons. Most prison costs are non-discretionary (accommodation, meals, etc.). But some of the costs relate to discretionary activities, services and facilities (including schooling). In terms of correctional education, many prison managers try to invest any meagre correctional education resources available to them in those classes and courses which have proven to have the best results, such as improved labour market outcomes and reduced recidivism, minimising subsequent re-imprisonment. Course offers for prisoner-students include vocational training, adult basic education (ABE) and art studies. The two-tiered question this paper asks is: do art classes and courses produce these measurable outcomes and, if not, are there other reasons why they should continue to be funded? Addressing these issues, the authors argue that (1) these measurable outcomes are too narrow and do not reflect the complex but less quantifiable benefits to the individual and the community of studying art in prison, and (2) better measures of all impacts of art studies in prisons are needed, including qualitative and humanitarian aspects.

  16. External heat transfer predictions in a highly loaded transonic linear turbine guide vane cascade using an upwind biased Navier-Stokes solver

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

    Gehrer, A.; Jericha, H.

    External heat transfer predictions are performed for two-dimensional turbine blade cascades. The Reynolds-averaged Navier-Stokes equations with algebraic (Arnone and Pacciani, 1998), one-equation (Spalart and Allmaras, 1994), and two-equation (low-Re {kappa}-{epsilon}, Biswas and Fukuyama, 1994) turbulence closures are solved with a fully implicit time-marching finite volume method. Comparisons with measurements (Arts et al., 1990; Arts, 1994) for a highly loaded transonic turbine nozzle guide vane cascade show good agreement in some cases, but also reveal problems with transition prediction and turbulence modeling. Special attention has been focused on the low-Re {kappa}-{epsilon} model concerning the influence of the inlet boundary condition formore » the {epsilon}-equation and problems in the stagnation point region.« less

  17. Model to predict hyperbilirubinemia in healthy term and near-term newborns with exclusive breast feeding.

    PubMed

    Huang, Hsin-Chung; Yang, Hwai-I; Chang, Yu-Hsun; Chang, Rui-Jane; Chen, Mei-Huei; Chen, Chien-Yi; Chou, Hung-Chieh; Hsieh, Wu-Shiun; Tsao, Po-Nien

    2012-12-01

    The aim of this study was to identify high-risk newborns who will subsequently develop significant hyperbilirubinemia Days 4 to 10 of life by using the clinical data from the first three days of life. We retrospectively collected exclusively breastfeeding healthy term and near-term newborns born in our nursery between May 1, 2002, to June 30, 2005. Clinical data, including serum bilirubin were collected and the significant predictors were identified. Bilirubin level ≥15mg/dL during Days 4 to 10 of life was defined as significant hyperbilirubinemia. A prediction model to predict subsequent hyperbilirubinemia was established. This model was externally validated in another group of newborns who were enrolled by the same criteria to test its discrimination capability. Totally, 1979 neonates were collected and 1208 cases were excluded by our exclusion criteria. Finally, 771 newborns were enrolled and 182 (23.6%) cases developed significant hyperbilirubinemia during Days 4 to 10 of life. In the logistic regression analysis, gestational age, maximal body weight loss percentage, and peak bilirubin level during the first 72 hours of life were significantly associated with subsequent hyperbilirubinemia. A prediction model was derived with the area under receiver operating characteristic (AUROC) curve of 0.788. Model validation in the separate study (N = 209) showed similar discrimination capability (AUROC = 0.8340). Gestational age, maximal body weight loss percentage, and peak serum bilirubin level during the first 3 days of life have highest predictive value of subsequent significant hyperbilirubinemia. We provide a good model to predict the risk of subsequent significant hyperbilirubinemia. Copyright © 2012. Published by Elsevier B.V.

  18. Outcome of anti-retroviral treatment in HIV-infected orphans and non-orphans at an ART centre in North India.

    PubMed

    Bhattacharya, Malobika; Saxena, Romit

    2012-01-01

    Few Indian studies have reported the long-term efficacy of anti-retroviral treatment (ART) in children and in orphaned, HIV-infected children in particular. To study differences in outcome of ART in HIV-infected orphans compared with non-orphans. A retrospective study of 87 HIV-infected children who commenced ART in the period January 2006 to August 2007. The main measures were orphan status, absolute CD4 count and weight-for-height (WHZ) and height-for-age (HAZ) Z-scores. Median follow-up was 33 months. Forty (45·9%) children were orphaned. Orphans and non-orphans had similar baseline median WHZ and HAZ (-2·48 vs -2·63, P = 0·65 and -2·78 vs -2·91, P = 0·77, respectively). The two groups were similar in terms of WHO clinical stage and frequency of severe immunosuppression at presentation (P = 0·88 and 0·25, respectively). After ART initiation, the median absolute CD4 count increased progressively in both groups. Median WHZ and HAZ increased throughout the study period in the orphans and reached -1 at 27 and 39 months of ART, respectively. In the non-orphans, WHZ remained below that of the orphan group, the difference becoming statistically significant from 18 months of ART. The increment in HAZ in the non-orphan group was at par with the orphan group until 12 months of follow-up, after which it fell between 18 and 30 months. Subsequently, HAZ rose but remained below that of the orphan group. Both WHZ and HAZ failed to reach -1 in the non-orphan group. In both groups, 85% reported 100% adherence to ART. The outcome of ART is not affected by orphan status with the extended family adequately supporting orphaned children. Growth of children whose parents are HIV-infected may be constrained despite ART if there is inadequate family support.

  19. Does a frozen embryo transfer ameliorate the effect of elevated progesterone seen in fresh transfer cycles?

    PubMed

    Healy, Mae Wu; Patounakis, George; Connell, Matt T; Devine, Kate; DeCherney, Alan H; Levy, Michael J; Hill, Micah J

    2016-01-01

    To compare the effect of progesterone (P) on the day of trigger in fresh assisted reproduction technology (ART) transfer cycles versus its effect on subsequent frozen embryo transfer (FET) cycles. Retrospective cohort study. Large private ART practice. Fresh autologous and FET cycles from 2011-2013. None. Live birth. A paired analysis of patients who underwent both a fresh transfer and subsequent FET cycle and an unpaired analysis of data from all fresh transfer cycles and all FET cycles were performed. We analyzed 1,216 paired and 4,124 unpaired cycles, and P was negatively associated with birth in fresh but not FET cycles in all analyses. Interaction testing of P and cycle type indicated P had a different association with birth in fresh versus FET cycles. When P was ≥ 2 ng/mL at the time of trigger, live birth was more likely in FET versus fresh cycles in the paired analysis (47% vs. 10%), in the unpaired analysis (51% vs. 14%), and in unpaired, good blastocyst only transfer subgroup (51% vs. 29%). Live birth was similar in FET cycles, with P ≥ 2 ng/mL versus P < 2 ng/mL (51% vs. 49%). Conversely, live birth was lower in fresh cycles, with P ≥ 2 ng/mL versus P <2 ng/mL (15% vs. 45%). Elevated P levels on the day of trigger during the initial fresh cycle were negatively associated with live birth in the fresh transfer cycles but not in subsequent FET cycles. Freezing embryos and performing a subsequent FET cycle ameliorates the effect of elevated P on live-birth rates. Published by Elsevier Inc.

  20. Finding meaning in art: Preferred levels of ambiguity in art appreciation

    PubMed Central

    Jakesch, Martina; Leder, Helmut

    2011-01-01

    Uncertainty is typically not desirable in everyday experiences, but uncertainty in the form of ambiguity may be a defining feature of aesthetic experiences of modern art. In this study, we examined different hypotheses concerning the quantity and quality of information appreciated in art. Artworks were shown together with auditorily presented statements. We tested whether the amount of information, the amount of matching information, or the proportion of matching to nonmatching statements apparent in a picture (levels of ambiguity) affect liking and interestingness. Only the levels of ambiguity predicted differences in the two dependent variables. These findings reveal that ambiguity is an important determinant of aesthetic appreciation and that a certain level of ambiguity is appreciable. PMID:19565431

  1. Weight as predictors of clinical progression and treatment failure: results from the TREAT Asia Pediatric HIV Observational Database.

    PubMed

    Kariminia, Azar; Durier, Nicolas; Jourdain, Gonzague; Saghayam, Suneeta; Do, Chau V; Nguyen, Lam Van; Hansudewechakul, Rawiwan; Lumbiganon, Pagakrong; Chokephaibulkit, Kulkanya; Truong, Khanh Huu; Sirisanthana, Virat; Ung, Vibol; Vonthanak, Saphonn; Ananworanich, Jintanat; Nik Yusoff, Nik Khairulddin; Kurniati, Nia; Azahar Razali, Kamarul; Fong, Moy Siew; Nallusamy, Revathy; Wati, Dewi Kumara

    2014-09-01

    To evaluate the value of time-updated weight and height in predicting clinical progression, and immunological and virological failure in children receiving combination antiretroviral therapy (cART). We used Cox regression to analyze data of a cohort of Asian children. A total of 2608 children were included; median age at cART was 5.7 years. Time-updated weight for age z score < -3 was associated with mortality (P < 0.001) independent of CD4% and < -2 was associated with immunological failure (P ≤ 0.03) independent of age at cART. Weight monitoring provides useful data to inform clinical management of children on cART in resource-limited settings.

  2. Prediction of miRNA targets.

    PubMed

    Oulas, Anastasis; Karathanasis, Nestoras; Louloupi, Annita; Pavlopoulos, Georgios A; Poirazi, Panayiota; Kalantidis, Kriton; Iliopoulos, Ioannis

    2015-01-01

    Computational methods for miRNA target prediction are currently undergoing extensive review and evaluation. There is still a great need for improvement of these tools and bioinformatics approaches are looking towards high-throughput experiments in order to validate predictions. The combination of large-scale techniques with computational tools will not only provide greater credence to computational predictions but also lead to the better understanding of specific biological questions. Current miRNA target prediction tools utilize probabilistic learning algorithms, machine learning methods and even empirical biologically defined rules in order to build models based on experimentally verified miRNA targets. Large-scale protein downregulation assays and next-generation sequencing (NGS) are now being used to validate methodologies and compare the performance of existing tools. Tools that exhibit greater correlation between computational predictions and protein downregulation or RNA downregulation are considered the state of the art. Moreover, efficiency in prediction of miRNA targets that are concurrently verified experimentally provides additional validity to computational predictions and further highlights the competitive advantage of specific tools and their efficacy in extracting biologically significant results. In this review paper, we discuss the computational methods for miRNA target prediction and provide a detailed comparison of methodologies and features utilized by each specific tool. Moreover, we provide an overview of current state-of-the-art high-throughput methods used in miRNA target prediction.

  3. Predictive Models for Carcinogenicity and Mutagenicity: Frameworks, State-of-the-Art, and Perspectives

    EPA Science Inventory

    Mutagenicity and carcinogenicity are endpoints of major environmental and regulatory concern. These endpoints are also important targets for development of alternative methods for screening and prediction due to the large number of chemicals of potential concern and the tremendou...

  4. Predictive Models for Carcinogenicity and Mutagenicity: Frameworks,State-of-the-Art, and Perspectives

    EPA Science Inventory

    Mutagenicity and carcinogenicity are endpoints of major environmental and regulatory concern. These endpoints are also important targets for development of alternative methods for screening and prediction due to the large number of chemicals of potential concern and the tremendou...

  5. Initiation of ART during Early Acute HIV Infection Preserves Mucosal Th17 Function and Reverses HIV-Related Immune Activation

    PubMed Central

    Schuetz, Alexandra; Deleage, Claire; Sereti, Irini; Rerknimitr, Rungsun; Phanuphak, Nittaya; Phuang-Ngern, Yuwadee; Estes, Jacob D.; Sandler, Netanya G.; Sukhumvittaya, Suchada; Marovich, Mary; Jongrakthaitae, Surat; Akapirat, Siriwat; Fletscher, James L. K.; Kroon, Eugene; Dewar, Robin; Trichavaroj, Rapee; Chomchey, Nitiya; Douek, Daniel C.; O′Connell, Robert J.; Ngauy, Viseth; Robb, Merlin L.; Phanuphak, Praphan; Michael, Nelson L.; Excler, Jean-Louis; Kim, Jerome H.; de Souza, Mark S.; Ananworanich, Jintanat

    2014-01-01

    Mucosal Th17 cells play an important role in maintaining gut epithelium integrity and thus prevent microbial translocation. Chronic HIV infection is characterized by mucosal Th17 cell depletion, microbial translocation and subsequent immune-activation, which remain elevated despite antiretroviral therapy (ART) correlating with increased mortality. However, when Th17 depletion occurs following HIV infection is unknown. We analyzed mucosal Th17 cells in 42 acute HIV infection (AHI) subjects (Fiebig (F) stage I-V) with a median duration of infection of 16 days and the short-term impact of early initiation of ART. Th17 cells were defined as IL-17+ CD4+ T cells and their function was assessed by the co-expression of IL-22, IL-2 and IFNγ. While intact during FI/II, depletion of mucosal Th17 cell numbers and function was observed during FIII correlating with local and systemic markers of immune-activation. ART initiated at FI/II prevented loss of Th17 cell numbers and function, while initiation at FIII restored Th17 cell numbers but not their polyfunctionality. Furthermore, early initiation of ART in FI/II fully reversed the initially observed mucosal and systemic immune-activation. In contrast, patients treated later during AHI maintained elevated mucosal and systemic CD8+ T-cell activation post initiation of ART. These data support a loss of Th17 cells at early stages of acute HIV infection, and highlight that studies of ART initiation during early AHI should be further explored to assess the underlying mechanism of mucosal Th17 function preservation. PMID:25503054

  6. Virological failure and development of new resistance mutations according to CD4 count at combination antiretroviral therapy initiation.

    PubMed

    Jose, S; Quinn, K; Dunn, D; Cox, A; Sabin, C; Fidler, S

    2016-05-01

    No randomized controlled trials have yet reported an individual patient benefit of initiating combination antiretroviral therapy (cART) at CD4 counts > 350 cells/μL. It is hypothesized that earlier initiation of cART in asymptomatic and otherwise healthy individuals may lead to poorer adherence and subsequently higher rates of resistance development. In a large cohort of HIV-positive individuals, we investigated the emergence of new resistance mutations upon virological treatment failure according to the CD4 count at the initiation of cART. Of 7918 included individuals, 6514 (82.3%), 996 (12.6%) and 408 (5.2%) started cART with a CD4 count ≤ 350, 351-499 and ≥ 500 cells/μL, respectively. Virological rebound occurred while on cART in 488 (7.5%), 46 (4.6%) and 30 (7.4%) with a baseline CD4 count ≤ 350, 351-499 and ≥ 500 cells/μL, respectively. Only four (13.0%) individuals with a baseline CD4 count > 350 cells/μL in receipt of a resistance test at viral load rebound were found to have developed new resistance mutations. This compared to 107 (41.2%) of those with virological failure who had initiated cART with a CD4 count < 350 cells/μL. We found no evidence of increased rates of resistance development when cART was initiated at CD4 counts above 350 cells/μL. © 2015 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.

  7. Misdiagnosed HIV infection in pregnant women initiating universal ART in South Africa.

    PubMed

    Hsiao, Nei-Yuan; Zerbe, Allison; Phillips, Tamsin K; Myer, Landon; Abrams, Elaine J

    2017-08-29

    Rapid diagnostic tests (RDTs) are the primary diagnostic tools for HIV used in resource-constrained settings. Without a proper confirmation algorithm, there is concern that false-positive (FP) RDTs could result in misdiagnosis of HIV infection and inappropriate antiretroviral treatment (ART) initiation, but programmatic data on FP are few. We examined the accuracy of RDT diagnosis among HIV-infected pregnant women attending public sector antenatal services in Cape Town, South Africa. We describe the proportion of women found to have started on ART erroneously due to FP RDT results based on pre-ART viral load (VL) testing and enzyme-linked immunosorbent assay (ELISA). We analysed 952 consecutively enrolled pregnant women diagnosed as HIV infected based on two RDTs per local guideline and found 4.5% (43/952) of pre-ART VL results to be <50 copies/ml. After excluding 6 women who had detectable virus on subsequent VL measurements, ELISA was performed on the 37 remaining women. Of these, 3/952 (0.3%) HIV RDT diagnoses were found to be FP. We estimate that using ELISA to confirm all positive RDTs would cost $1110 (uncertainty interval $381-$5382) to identify one patient erroneously initiated on ART, while it costs $3912 for a lifetime of antiretrovirals with VL monitoring for one person. Compared to the cost of confirming the RDT-based diagnoses, the cost of HIV misdiagnosis is high. While testing programmes based on RDT should strive for constant quality improvement, where resources permit, laboratory confirmation algorithms can play an important role in strengthening the quality of HIV diagnosis in the era of universal ART.

  8. "Be the Tree": Classical Literature, Art Therapy, and Transcending Trauma in "Speak"

    ERIC Educational Resources Information Center

    Snider, Jessi

    2014-01-01

    Laurie Halse Anderson's young adult novel "Speak" concerns the rape and subsequent silence of ninth grade protagonist Melinda Sordino. By relying on extensive literary allusions involving trees, rape, silence, and transformation, Anderson creates a young adult problem novel that is both of the moment and timeless in its themes. The…

  9. Symmetry and the Golden Ratio in the Analysis of a Regular Pentagon

    ERIC Educational Resources Information Center

    Sparavigna, Amelia Carolina; Baldi, Mauro Maria

    2017-01-01

    The regular pentagon had a symbolic meaning in the Pythagorean and Platonic philosophies and a subsequent important role in Western thought, appearing also in arts and architecture. A property of regular pentagons, which was probably discovered by the Pythagoreans, is that the ratio between the diagonal and the side of these pentagons is equal to…

  10. Historical Dictionary of Children's Literature. Historical Dictionaries of Literature and the Arts

    ERIC Educational Resources Information Center

    O'Sullivan, Emer

    2010-01-01

    Children's literature comes from a number of different sources--folklore (folk- and fairy tales), books originally for adults and subsequently adapted for children, and material authored specifically for them--and its audience ranges from infants through middle graders to young adults (readers from about 12 to 18 years old). Its forms include…

  11. Creative and Critical Thinking in the Arts and Sciences: Some Examples of Congruence

    ERIC Educational Resources Information Center

    Karakas, Scott L.

    2010-01-01

    In his landmark 1959 Rede lecture and subsequent publication, physicist Charles Percy Snow expressed concerns over what he saw as a growing rift between scientific and literary scholarly communities (Snow 1959). In the 50 years since that time, scholars and other commentators have expended a great deal of intellectual capital in the analysis of…

  12. Acoustic Prediction State of the Art Assessment

    NASA Technical Reports Server (NTRS)

    Dahl, Milo D.

    2007-01-01

    The acoustic assessment task for both the Subsonic Fixed Wing and the Supersonic projects under NASA s Fundamental Aeronautics Program was designed to assess the current state-of-the-art in noise prediction capability and to establish baselines for gauging future progress. The documentation of our current capabilities included quantifying the differences between predictions of noise from computer codes and measurements of noise from experimental tests. Quantifying the accuracy of both the computed and experimental results further enhanced the credibility of the assessment. This presentation gives sample results from codes representative of NASA s capabilities in aircraft noise prediction both for systems and components. These include semi-empirical, statistical, analytical, and numerical codes. System level results are shown for both aircraft and engines. Component level results are shown for a landing gear prototype, for fan broadband noise, for jet noise from a subsonic round nozzle, and for propulsion airframe aeroacoustic interactions. Additional results are shown for modeling of the acoustic behavior of duct acoustic lining and the attenuation of sound in lined ducts with flow.

  13. Neural correlates of encoding processes predicting subsequent cued recall and source memory.

    PubMed

    Angel, Lucie; Isingrini, Michel; Bouazzaoui, Badiâa; Fay, Séverine

    2013-03-06

    In this experiment, event-related potentials were used to examine whether the neural correlates of encoding processes predicting subsequent successful recall differed from those predicting successful source memory retrieval. During encoding, participants studied lists of words and were instructed to memorize each word and the list in which it occurred. At test, they had to complete stems (the first four letters) with a studied word and then make a judgment of the initial temporal context (i.e. list). Event-related potentials recorded during encoding were segregated according to subsequent memory performance to examine subsequent memory effects (SMEs) reflecting successful cued recall (cued recall SME) and successful source retrieval (source memory SME). Data showed a cued recall SME on parietal electrode sites from 400 to 1200 ms and a late inversed cued recall SME on frontal sites in the 1200-1400 ms period. Moreover, a source memory SME was reported from 400 to 1400 ms on frontal areas. These findings indicate that patterns of encoding-related activity predicting successful recall and source memory are clearly dissociated.

  14. RCD+: Fast loop modeling server.

    PubMed

    López-Blanco, José Ramón; Canosa-Valls, Alejandro Jesús; Li, Yaohang; Chacón, Pablo

    2016-07-08

    Modeling loops is a critical and challenging step in protein modeling and prediction. We have developed a quick online service (http://rcd.chaconlab.org) for ab initio loop modeling combining a coarse-grained conformational search with a full-atom refinement. Our original Random Coordinate Descent (RCD) loop closure algorithm has been greatly improved to enrich the sampling distribution towards near-native conformations. These improvements include a new workflow optimization, MPI-parallelization and fast backbone angle sampling based on neighbor-dependent Ramachandran probability distributions. The server starts by efficiently searching the vast conformational space from only the loop sequence information and the environment atomic coordinates. The generated closed loop models are subsequently ranked using a fast distance-orientation dependent energy filter. Top ranked loops are refined with the Rosetta energy function to obtain accurate all-atom predictions that can be interactively inspected in an user-friendly web interface. Using standard benchmarks, the average root mean squared deviation (RMSD) is 0.8 and 1.4 Å for 8 and 12 residues loops, respectively, in the challenging modeling scenario in where the side chains of the loop environment are fully remodeled. These results are not only very competitive compared to those obtained with public state of the art methods, but also they are obtained ∼10-fold faster. © The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

  15. iEnhancer-EL: Identifying enhancers and their strength with ensemble learning approach.

    PubMed

    Liu, Bin; Li, Kai; Huang, De-Shuang; Chou, Kuo-Chen

    2018-06-07

    Identification of enhancers and their strength is important because they play a critical role in controlling gene expression. Although some bioinformatics tools were developed, they are limited in discriminating enhancers from non-enhancers only. Recently, a two-layer predictor called "iEnhancer-2L" was developed that can be used to predict the enhancer's strength as well. However, its prediction quality needs further improvement to enhance the practical application value. A new predictor called "iEnhancer-EL" was proposed that contains two layer predictors: the first one (for identifying enhancers) is formed by fusing an array of six key individual classifiers, and the second one (for their strength) formed by fusing an array of ten key individual classifiers. All these key classifiers were selected from 171 elementary classifiers formed by SVM (Support Vector Machine) based on kmer, subsequence profile, and PseKNC (Pseudo K-tuple Nucleotide Composition), respectively. Rigorous cross-validations have indicated that the proposed predictor is remarkably superior to the existing state-of-the-art one in this area. A web server for the iEnhancer-EL has been established at http://bioinformatics.hitsz.edu.cn/iEnhancer-EL/, by which users can easily get their desired results without the need to go through the mathematical details. bliu@hit.edu.cn, dshuang@tongji.edu.cn or kcchou@gordonlifescience.org. Supplementary data are available at Bioinformatics online.

  16. ‘Beauty Is No Quality in Things Themselves’: Epistemic Motivation Affects Implicit Preferences for Art

    PubMed Central

    Chirumbolo, Antonio; Brizi, Ambra; Mastandrea, Stefano; Mannetti, Lucia

    2014-01-01

    Art preferences are affected by a number of subjective factors. This paper reports two studies which investigated whether need for closure shapes implicit art preferences. It was predicted that higher need for closure would negatively affect implicit preferences for abstract art. In study one, 60 participants were tested for dispositional need for closure and then completed an Implicit Association Test (IAT) task to measure their implicit preference for abstract (vs. figurative) paintings. In study two, 54 participants completed the same IAT task. In this experiment need for closure was both manipulated by cognitive load and tapped as a dispositional trait. Results of the studies converged in showing that after controlling for other important individual factors such as participants'expertise and cognitive ability, need for closure, both as a dispositional trait and as a situationally induced motivational state, was negatively associated with implicit preference for abstract art. PMID:25360697

  17. Astrological counseling in contemporary India.

    PubMed

    Pugh, J F

    1983-09-01

    Astrological counseling constitutes an important but relatively unexplored sector of India's medical and psychiatric traditions. The present paper provides a critique of studies of divination-as-therapy and presents a symbolic or phenomenological approach to the analysis of astrology as a form of situation-focused counseling. Three arts of medicine--the art of dialogue, the art of prediction, and the art of remedy--organize the therapeutic effectiveness of the counseling session. In analyzing these arts, the discussion extends the idea of performative efficacy by developing the concept of "therapeutic space," defining it as the topographical framework which encompasses both the scene of the advisory session and the scene of the client's everyday life. The experiential continuities which are established in this space are constituted through imaginal activity, which is indigenously understood as "picturing" the client's situation. The discussion focuses on the text of an advisory session between an astrologer and his politician-client in the city of Banaras.

  18. 'Beauty is no quality in things themselves': epistemic motivation affects implicit preferences for art.

    PubMed

    Chirumbolo, Antonio; Brizi, Ambra; Mastandrea, Stefano; Mannetti, Lucia

    2014-01-01

    Art preferences are affected by a number of subjective factors. This paper reports two studies which investigated whether need for closure shapes implicit art preferences. It was predicted that higher need for closure would negatively affect implicit preferences for abstract art. In study one, 60 participants were tested for dispositional need for closure and then completed an Implicit Association Test (IAT) task to measure their implicit preference for abstract (vs. figurative) paintings. In study two, 54 participants completed the same IAT task. In this experiment need for closure was both manipulated by cognitive load and tapped as a dispositional trait. Results of the studies converged in showing that after controlling for other important individual factors such as participants'expertise and cognitive ability, need for closure, both as a dispositional trait and as a situationally induced motivational state, was negatively associated with implicit preference for abstract art.

  19. Determination of thickness of thin turbid painted over-layers using micro-scale spatially offset Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Conti, Claudia; Realini, Marco; Colombo, Chiara; Botteon, Alessandra; Bertasa, Moira; Striova, Jana; Barucci, Marco; Matousek, Pavel

    2016-12-01

    We present a method for estimating the thickness of thin turbid layers using defocusing micro-spatially offset Raman spectroscopy (micro-SORS). The approach, applicable to highly turbid systems, enables one to predict depths in excess of those accessible with conventional Raman microscopy. The technique can be used, for example, to establish the paint layer thickness on cultural heritage objects, such as panel canvases, mural paintings, painted statues and decorated objects. Other applications include analysis in polymer, biological and biomedical disciplines, catalytic and forensics sciences where highly turbid overlayers are often present and where invasive probing may not be possible or is undesirable. The method comprises two stages: (i) a calibration step for training the method on a well characterized sample set with a known thickness, and (ii) a prediction step where the prediction of layer thickness is carried out non-invasively on samples of unknown thickness of the same chemical and physical make up as the calibration set. An illustrative example of a practical deployment of this method is the analysis of larger areas of paintings. In this case, first, a calibration would be performed on a fragment of painting of a known thickness (e.g. derived from cross-sectional analysis) and subsequently the analysis of thickness across larger areas of painting could then be carried out non-invasively. The performance of the method is compared with that of the more established optical coherence tomography (OCT) technique on identical sample set. This article is part of the themed issue "Raman spectroscopy in art and archaeology".

  20. The English Language Arts (ELA) Exam and Academic Achievement: Is There a Relationship? Predictive Validity of Statewide Measures

    ERIC Educational Resources Information Center

    Mazza, Lynn

    2010-01-01

    The No Child Left Behind Act is a mandate from the federal government for education to increase student performance and school accountability. As a result of this mandate, many states have issued the use of high-stakes standardized tests as a means of monitoring schools' accountability. New York State administers the English Language Arts (ELA)…

  1. Deepening Literacy Learning: Art and Literature Engagements in K-8 Classrooms. Teaching--Learning Indigenous, Intercultural Worldviews: International Perspectives on Social Justice and Human Rights

    ERIC Educational Resources Information Center

    Reilly, Mary Ann; Gangi, Jane M.; Cohen, Rob

    2010-01-01

    This book is a wonderful blending of methodologies. This juxtaposition of art and literature serves as an instrument for teachers to inspire their students to create, critique, compare and predict, all higher-level intellectual behaviors, while composing across symbol systems. The work contains detailed classroom transcripts of strategies that…

  2. Model Study for an Economic Data Program on the Conditions of Arts and Cultural Institutions. Final Report.

    ERIC Educational Resources Information Center

    Deane, Robert T.; And Others

    The development of econometric models and a data base to predict the responsiveness of arts institutions to changes in the economy is reported. The study focused on models for museums, theaters (profit and non-profit), symphony, ballet, opera, and dance. The report details four objectives of the project: to identify useful databases and studies on…

  3. Graph regularized nonnegative matrix factorization for temporal link prediction in dynamic networks

    NASA Astrophysics Data System (ADS)

    Ma, Xiaoke; Sun, Penggang; Wang, Yu

    2018-04-01

    Many networks derived from society and nature are temporal and incomplete. The temporal link prediction problem in networks is to predict links at time T + 1 based on a given temporal network from time 1 to T, which is essential to important applications. The current algorithms either predict the temporal links by collapsing the dynamic networks or collapsing features derived from each network, which are criticized for ignoring the connection among slices. to overcome the issue, we propose a novel graph regularized nonnegative matrix factorization algorithm (GrNMF) for the temporal link prediction problem without collapsing the dynamic networks. To obtain the feature for each network from 1 to t, GrNMF factorizes the matrix associated with networks by setting the rest networks as regularization, which provides a better way to characterize the topological information of temporal links. Then, the GrNMF algorithm collapses the feature matrices to predict temporal links. Compared with state-of-the-art methods, the proposed algorithm exhibits significantly improved accuracy by avoiding the collapse of temporal networks. Experimental results of a number of artificial and real temporal networks illustrate that the proposed method is not only more accurate but also more robust than state-of-the-art approaches.

  4. The light up and early evolution of high redshift Supermassive Black Holes

    NASA Astrophysics Data System (ADS)

    Comastri, Andrea; Brusa, Marcella; Aird, James; Lanzuisi, Giorgio

    2016-07-01

    The known AGN population at z > 6 is made by luminous optical QSO hosting Supermassive Black Holes (M > 10 ^{9}solar masses), likely to represent the tip of the iceberg of the luminosity and mass function. According to theoretical models for structure formation, Massive Black Holes (M _{BH} 10^{4-7} solar masses) are predicted to be abundant in the early Universe (z > 6). The majority of these lower luminosity objects are expected to be obscured and severely underepresented in current optical near-infrared surveys. The detection of such a population would provide unique constraints on the Massive Black Holes formation mechanism and subsequent growth and is within the capabilities of deep and large area ATHENA surveys. After a summary of the state of the art of present deep XMM and Chandra surveys, at z >3-6 also mentioning the expectations for the forthcoming eROSITA all sky survey; I will present the observational strategy of future multi-cone ATHENA Wide Field Imager (WFI) surveys and the expected breakthroughs in the determination of the luminosity function and its evolution at high (> 4) and very high (>6) redshifts.

  5. Robust Cell Detection of Histopathological Brain Tumor Images Using Sparse Reconstruction and Adaptive Dictionary Selection

    PubMed Central

    Su, Hai; Xing, Fuyong; Yang, Lin

    2016-01-01

    Successful diagnostic and prognostic stratification, treatment outcome prediction, and therapy planning depend on reproducible and accurate pathology analysis. Computer aided diagnosis (CAD) is a useful tool to help doctors make better decisions in cancer diagnosis and treatment. Accurate cell detection is often an essential prerequisite for subsequent cellular analysis. The major challenge of robust brain tumor nuclei/cell detection is to handle significant variations in cell appearance and to split touching cells. In this paper, we present an automatic cell detection framework using sparse reconstruction and adaptive dictionary learning. The main contributions of our method are: 1) A sparse reconstruction based approach to split touching cells; 2) An adaptive dictionary learning method used to handle cell appearance variations. The proposed method has been extensively tested on a data set with more than 2000 cells extracted from 32 whole slide scanned images. The automatic cell detection results are compared with the manually annotated ground truth and other state-of-the-art cell detection algorithms. The proposed method achieves the best cell detection accuracy with a F1 score = 0.96. PMID:26812706

  6. Statistical algorithms improve accuracy of gene fusion detection

    PubMed Central

    Hsieh, Gillian; Bierman, Rob; Szabo, Linda; Lee, Alex Gia; Freeman, Donald E.; Watson, Nathaniel; Sweet-Cordero, E. Alejandro

    2017-01-01

    Abstract Gene fusions are known to play critical roles in tumor pathogenesis. Yet, sensitive and specific algorithms to detect gene fusions in cancer do not currently exist. In this paper, we present a new statistical algorithm, MACHETE (Mismatched Alignment CHimEra Tracking Engine), which achieves highly sensitive and specific detection of gene fusions from RNA-Seq data, including the highest Positive Predictive Value (PPV) compared to the current state-of-the-art, as assessed in simulated data. We show that the best performing published algorithms either find large numbers of fusions in negative control data or suffer from low sensitivity detecting known driving fusions in gold standard settings, such as EWSR1-FLI1. As proof of principle that MACHETE discovers novel gene fusions with high accuracy in vivo, we mined public data to discover and subsequently PCR validate novel gene fusions missed by other algorithms in the ovarian cancer cell line OVCAR3. These results highlight the gains in accuracy achieved by introducing statistical models into fusion detection, and pave the way for unbiased discovery of potentially driving and druggable gene fusions in primary tumors. PMID:28541529

  7. Bootstrap Prediction Intervals in Non-Parametric Regression with Applications to Anomaly Detection

    NASA Technical Reports Server (NTRS)

    Kumar, Sricharan; Srivistava, Ashok N.

    2012-01-01

    Prediction intervals provide a measure of the probable interval in which the outputs of a regression model can be expected to occur. Subsequently, these prediction intervals can be used to determine if the observed output is anomalous or not, conditioned on the input. In this paper, a procedure for determining prediction intervals for outputs of nonparametric regression models using bootstrap methods is proposed. Bootstrap methods allow for a non-parametric approach to computing prediction intervals with no specific assumptions about the sampling distribution of the noise or the data. The asymptotic fidelity of the proposed prediction intervals is theoretically proved. Subsequently, the validity of the bootstrap based prediction intervals is illustrated via simulations. Finally, the bootstrap prediction intervals are applied to the problem of anomaly detection on aviation data.

  8. Prediction method abstracts

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

    NONE

    1994-12-31

    This conference was held December 4--8, 1994 in Asilomar, California. The purpose of this meeting was to provide a forum for exchange of state-of-the-art information concerning the prediction of protein structure. Attention if focused on the following: comparative modeling; sequence to fold assignment; and ab initio folding.

  9. Birth defects and congenital health risks in children conceived through assisted reproduction technology (ART): a meeting report.

    PubMed

    2014-08-01

    Assisted Reproduction Treatment (ART) is here to stay. This review addresses the parental background of birth defects, before, during and after conception and focuses both on the underlying subfertility and on the question whether ART as a treatment is an additional contributing factor. Searches were performed in Medline and other databases. Summaries were discussed in a Delphi panel set-up by the European Society of Human Reproduction and Embryology (ESHRE). Several birth defects and adult diseases arise during the earliest stages of ovarian development and oocyte differentiation: this is the case of cleft palate disorders in offspring from female rat exposed to Dioxin during fetal life or the polycystic ovary diseases in female offspring (primates) exposed to elevated androgen concentration during fetal life. Human oocytes and embryos often fail to stop the propagation of aneuploid cells but maintain their ability to repair DNA damages including those introduced by the fertilizing sperm. There is a 29 % increased risk of birth defects in the newborns spontaneously conceived by subfertile couples and the risk is further increased (34 %) when conception is achieved by treating infertlity with ART (Danish IVF Registry). Periconceptional conditions are critical for ART babies: their birth weight is in general smaller (Norvegian Registry) but a more prolonged culture time doubled the number of large babies (Finnish Registry). The long-term developmental effects of ART on child and subsequent health as an adult remains a subject worthy of futher monitoring and investigation.

  10. Effect of analytical treatment interruption and reinitiation of antiretroviral therapy on HIV reservoirs and immunologic parameters in infected individuals.

    PubMed

    Clarridge, Katherine E; Blazkova, Jana; Einkauf, Kevin; Petrone, Mary; Refsland, Eric W; Justement, J Shawn; Shi, Victoria; Huiting, Erin D; Seamon, Catherine A; Lee, Guinevere Q; Yu, Xu G; Moir, Susan; Sneller, Michael C; Lichterfeld, Mathias; Chun, Tae-Wook

    2018-01-01

    Therapeutic strategies aimed at achieving antiretroviral therapy (ART)-free HIV remission in infected individuals are under active investigation. Considering the vast majority of HIV-infected individuals experience plasma viral rebound upon cessation of therapy, clinical trials evaluating the efficacy of curative strategies would likely require inclusion of ART interruption. However, it is unclear what impact short-term analytical treatment interruption (ATI) and subsequent reinitiation of ART have on immunologic and virologic parameters of HIV-infected individuals. Here, we show a significant increase of HIV burden in the CD4+ T cells of infected individuals during ATI that was correlated with the level of plasma viral rebound. However, the size of the HIV reservoirs as well as immune parameters, including markers of exhaustion and activation, returned to pre-ATI levels 6-12 months after the study participants resumed ART. Of note, the proportions of near full-length, genome-intact and structurally defective HIV proviral DNA sequences were similar prior to ATI and following reinitiation of ART. In addition, there was no evidence of emergence of antiretroviral drug resistance mutations within intact HIV proviral DNA sequences following reinitiation of ART. These data demonstrate that short-term ATI does not necessarily lead to expansion of the persistent HIV reservoir nor irreparable damages to the immune system in the peripheral blood, warranting the inclusion of ATI in future clinical trials evaluating curative strategies.

  11. Effect of analytical treatment interruption and reinitiation of antiretroviral therapy on HIV reservoirs and immunologic parameters in infected individuals

    PubMed Central

    Petrone, Mary; Justement, J. Shawn; Shi, Victoria; Huiting, Erin D.; Yu, Xu G.; Moir, Susan; Sneller, Michael C.; Lichterfeld, Mathias

    2018-01-01

    Therapeutic strategies aimed at achieving antiretroviral therapy (ART)-free HIV remission in infected individuals are under active investigation. Considering the vast majority of HIV-infected individuals experience plasma viral rebound upon cessation of therapy, clinical trials evaluating the efficacy of curative strategies would likely require inclusion of ART interruption. However, it is unclear what impact short-term analytical treatment interruption (ATI) and subsequent reinitiation of ART have on immunologic and virologic parameters of HIV-infected individuals. Here, we show a significant increase of HIV burden in the CD4+ T cells of infected individuals during ATI that was correlated with the level of plasma viral rebound. However, the size of the HIV reservoirs as well as immune parameters, including markers of exhaustion and activation, returned to pre-ATI levels 6–12 months after the study participants resumed ART. Of note, the proportions of near full-length, genome-intact and structurally defective HIV proviral DNA sequences were similar prior to ATI and following reinitiation of ART. In addition, there was no evidence of emergence of antiretroviral drug resistance mutations within intact HIV proviral DNA sequences following reinitiation of ART. These data demonstrate that short-term ATI does not necessarily lead to expansion of the persistent HIV reservoir nor irreparable damages to the immune system in the peripheral blood, warranting the inclusion of ATI in future clinical trials evaluating curative strategies. PMID:29324842

  12. Adaptive and maladaptive perfectionism in medical students: a longitudinal investigation.

    PubMed

    Enns, M W; Cox, B J; Sareen, J; Freeman, P

    2001-11-01

    The personality of medical students may have an important impact on both their academic performance and emotional adjustment during medical school. There has been little systematic study of the impact of perfectionism on medical students. The present study sought to compare the perfectionism profile of medical students with that of a general arts student group and to examine the relationship among perfectionism, distress symptoms and academic expectations and satisfaction. Medical students (n=96) and arts students (n=289) completed a baseline assessment including two multidimensional perfectionism scales. The medical students also completed measures of distress symptoms, personality (neuroticism, conscientiousness) and questions about their perceptions of their academic performance. Of the medical students, 58 completed a second set of questionnaires 6 months later (time 2). First-, second- and third year medical students and first-year arts students. In comparison with arts students, the perfectionism profile of medical students showed higher personal standards, lower doubts about actions and lower maladaptive perfectionism scores. In the medical students adaptive perfectionism (achievement striving) was significantly correlated with baseline academic performance expectations and conscientiousness and was predictive of dissatisfaction with academic performance at time 2. Maladaptive perfectionism (excessive evaluative concerns) was significantly correlated with baseline distress symptoms and neuroticism and was predictive of symptoms of depression and hopelessness at time 2. Perfectionism in medical students differs systematically from perfectionism in general arts students. Distinguishing adaptive and maladaptive aspects of perfectionism is important in understanding the cross-sectional and longitudinal implications of perfectionism for medical students.

  13. Serum Phosphate Predicts Early Mortality among Underweight Adults Starting ART in Zambia: A Novel Context for Refeeding Syndrome?

    PubMed Central

    Koethe, John R.; Blevins, Meridith; Nyirenda, Christopher K.; Kabagambe, Edmond K.; Chiasera, Janelle M.; Shepherd, Bryan E.; Zulu, Isaac; Heimburger, Douglas C.

    2013-01-01

    Background. Low body mass index (BMI) at antiretroviral therapy (ART) initiation is associated with early mortality, but the etiology is not well understood. We hypothesized that low pretreatment serum phosphate, a critical cellular metabolism intermediate primarily stored in skeletal muscle, may predict mortality within the first 12 weeks of ART. Methods. We prospectively studied 352 HIV-infected adults initiating ART in Lusaka, Zambia to estimate the odds of death for each 0.1 mmol/L decrease in baseline phosphate after adjusting for established predictors of mortality. Results. The distribution of phosphate values was similar across BMI categories (median value 1.2 mmol/L). Among the 145 participants with BMI <18.5 kg/m2, 28 (19%) died within 12 weeks. Lower pretreatment serum phosphate was associated with increased mortality (odds ratio (OR) 1.24 per 0.1 mmol/L decrement, 95% CI: 1.05 to 1.47; P = 0.01) after adjusting for sex, age, and CD4+ lymphocyte count. A similar relationship was not observed among participants with BMI ≥18.5 kg/m2 (OR 0.96, 95% CI: 0.76 to 1.21; P = 0.74). Conclusions. The association of low pretreatment serum phosphate level and early ART mortality among undernourished individuals may represent a variant of the refeeding syndrome. Further studies of cellular metabolism in this population are needed. PMID:23691292

  14. On the importance of cotranscriptional RNA structure formation

    PubMed Central

    Lai, Daniel; Proctor, Jeff R.; Meyer, Irmtraud M.

    2013-01-01

    The expression of genes, both coding and noncoding, can be significantly influenced by RNA structural features of their corresponding transcripts. There is by now mounting experimental and some theoretical evidence that structure formation in vivo starts during transcription and that this cotranscriptional folding determines the functional RNA structural features that are being formed. Several decades of research in bioinformatics have resulted in a wide range of computational methods for predicting RNA secondary structures. Almost all state-of-the-art methods in terms of prediction accuracy, however, completely ignore the process of structure formation and focus exclusively on the final RNA structure. This review hopes to bridge this gap. We summarize the existing evidence for cotranscriptional folding and then review the different, currently used strategies for RNA secondary-structure prediction. Finally, we propose a range of ideas on how state-of-the-art methods could be potentially improved by explicitly capturing the process of cotranscriptional structure formation. PMID:24131802

  15. Loss to follow-up before and after initiation of antiretroviral therapy in HIV facilities in Lilongwe, Malawi.

    PubMed

    Tweya, Hannock; Oboho, Ikwo Kitefre; Gugsa, Salem T; Phiri, Sam; Rambiki, Ethel; Banda, Rebecca; Mwafilaso, Johnbosco; Munthali, Chimango; Gupta, Sundeep; Bateganya, Moses; Maida, Alice

    2018-01-01

    Although several studies have explored factors associated with loss to follow-up (LTFU) from HIV care, there remains a gap in understanding how these factors vary by setting, volume of patient and patients' demographic and clinical characteristics. We determined rates and factors associated with LTFU in HIV care Lilongwe, Malawi. We conducted a retrospective cohort study of HIV-infected individuals aged 15 years or older at the time of registration for HIV care in 12 ART facilities, between April 2012 and March 2013. HIV-positive individuals who had not started ART (pre-ART patients) were clinically assessed to determine ART eligibility at registration and during clinic follow-up visits. ART-eligible patients were initiated on triple antiretroviral combination. Study data were abstracted from patients' cards, facility ART registers or electronic medical record system from the date of registration for HIV care to a maximum follow-up period of 24 months. Descriptive statistics were undertaken to summarize characteristics of the study patients. Separate univariable and multivariable poisson regression models were used to explore factors associated with LTFU in pre-ART and ART care. A total of 10,812 HIV-infected individuals registered for HIV care. Of these patients, 1,907 (18%) and 8,905 (82%) enrolled in pre-ART and ART care, respectively. Of the 1,907 pre-ART patients, 490 (26%) subsequently initiated ART and were included in both the pre-ART and ART analyses. The LTFU rates among patients in pre-ART and ART care were 48 and 26 per 100 person-years, respectively. Of the 9,105 ART patients with reasons for starting ART, 2,451 (27%) were initiated on ART because of pregnancy or breastfeeding (Option B+) status. Multivariable analysis showed that being ≥35 years and female were associated with decreased risk of LTFU in the pre-ART and ART phases of HIV care. However, being in WHO clinical stage 3 (adjusted risk ratio (aRR) 1.35, 95% confidence interval (CI): 1.20-1.51) and stage 4 (aRR 1.87, 95% CI: 1.62-2.18), body mass index ≤ 18.4 (aRR 1.24, 95% CI: 1.11-1.39) at ART initiation, poor adherence to clinic appointments (aRR 4.55, 95% CI: 4.16-4.97) and receiving HIV care in rural facilities (aRR 2.32, 95% CI: 1.94-2.87) were associated with increased risk of LTFU among ART patients. Being re-initiated on ART once (aRR 0.20, 95% CI: 0.17-0.22), more than once (aRR 0.06, 95% CI: 0.05-0.07), and being enrolled at a low-volume facility (aRR 0.25, 95% CI: 0.20-0.30) were associated with decreased risk of LTFU from ART care. A sizeable proportion of ART LTFU occurred among women enrolled during pregnancy or breast-feeding. Non- compliance to clinic and receiving ART in a rural facility or high-volume facility were associated with increased risk of LTFU from ART care. Developing effective interventions that target high-risk subgroups and contexts may help reduce LTFU from HIV care.

  16. Validation of the Risk Prediction Models STATE-Score and START-Strategy to Guide TACE Treatment in Patients with Hepatocellular Carcinoma.

    PubMed

    Mähringer-Kunz, Aline; Kloeckner, Roman; Pitton, Michael B; Düber, Christoph; Schmidtmann, Irene; Galle, Peter R; Koch, Sandra; Weinmann, Arndt

    2017-07-01

    Several scoring systems that guide patients' treatment regimen for transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) have been introduced, but none have gained widespread acceptance in clinical practice. The purpose of this study is to externally validate the Selection for TrAnsarterial chemoembolization TrEatment (STATE)-score and START-strategy [i.e., sequential use of the STATE-score and Assessment for Retreatment with TACE (ART)-score]. From January 2000 to September 2015, 933 patients with HCC underwent TACE at our institution. All variables needed to calculate the STATE-score and implement the START-strategy were determined. STATE comprised serum albumin, up-to-seven criteria, and C-reactive protein (CRP). ART comprised an increase in aspartate aminotransferase, the Child-Pugh score, and a radiological tumor response. Overall survival was calculated, and multivariate analysis performed. In addition, the STATE-score and START-strategy were validated using the Harrell's C-index and integrated Brier score (IBS). The STATE-score was calculated in 228 patients. Low and high STATE-scores corresponded to median survival of 14.3 and 20.2 months, respectively. Harrell's C was 0.558 and IBS 0.133. For the STATE-score, significant predictors of survival were up-to-seven criteria (p = 0.006) and albumin (p = 0.022). CRP values were not predictive (p = 0.367). The ART-score was calculated in 207 patients. Combining the STATE-score and ART-score led to a Harrell's C of 0.580 and IBS of 0.132. The STATE-score was unable to reliably determine the suitability for initial TACE. The START-strategy only slightly improved the predictive ability compared to the ART-score alone. Therefore, neither the STATE-score nor START-strategy alone provides sufficient certainty for clear-cut clinical decisions.

  17. Self-reported dietary intake and appetite predict early treatment outcome among low-BMI adults initiating HIV treatment in sub-Saharan Africa.

    PubMed

    Koethe, John R; Blevins, Meridith; Bosire, Claire; Nyirenda, Christopher; Kabagambe, Edmond K; Mwango, Albert; Kasongo, Webster; Zulu, Isaac; Shepherd, Bryan E; Heimburger, Douglas C

    2013-03-01

    Low BMI is a major risk factor for early mortality among HIV-infected persons starting antiretrovial therapy (ART) in sub-Saharan Africa and the common patient belief that antiretroviral medications produce distressing levels of hunger is a barrier to treatment adherence. We assessed relationships between appetite, dietary intake and treatment outcome 12 weeks after ART initiation among HIV-infected adults with advanced malnutrition and immunosuppression. A prospective, observational cohort study. Dietary intake was assessed using a 24 h recall survey. The relationships of appetite, intake and treatment outcome were analysed using time-varying Cox models. A public-sector HIV clinic in Lusaka, Zambia. One hundred and forty-two HIV-infected adults starting ART with BMI <16 kg/m2 and/or CD4+ lymphocyte count <50 cells/μl. Median age, BMI and CD4+ lymphocyte count were 32 years, 16 kg/m2 and 34 cells/μl, respectively. Twenty-five participants (18%) died before 12 weeks and another thirty-three (23%) were lost to care. A 500 kJ/d higher energy intake at any time after ART initiation was associated with an approximate 16% reduction in the hazard of death (adjusted hazard ratio = 0.84; P = 0.01), but the relative contribution of carbohydrate, protein or fat to total energy was not a significant predictor of outcome. Appetite normalized gradually among survivors and hunger was rarely reported. Poor early ART outcomes were strikingly high in a cohort of HIV-infected adults with advanced malnutrition and mortality was predicted by lower dietary intake. Intervention trials to promote post-ART intake in this population may benefit survival and are warranted.

  18. Self-reported Dietary Intake and Appetite Predict Early Treatment Outcome among Low Body Mass Index Adults Initiating HIV Treatment in sub-Saharan Africa

    PubMed Central

    Koethe, John R.; Blevins, Meridith; Bosire, Claire; Nyirenda, Christopher; Kabagambe, Edmond K.; Mwango, Albert; Kasongo, Webster; Zulu, Isaac; Shepherd, Bryan E.; Heimburger, Douglas C.

    2013-01-01

    Objective Low body mass index (BMI) is a major risk factor for early mortality among HIV infected persons starting antiretrovial therapy (ART) in sub-Saharan Africa, and the common patient belief that antiretroviral medications produce distressing levels of hunger is a barrier to treatment adherence. We assessed relationships between appetite, dietary intake, and treatment outcome 12 weeks after ART initiation among HIV infected adults with advanced malnutrition and immunosuppression. Design A prospective, observational cohort study. Dietary intake was assessed using a 24-hour recall survey. The relationships of appetite, intake, and treatment outcome were analyzed using time-varying Cox models. Setting A public-sector HIV clinic in Lusaka, Zambia. Subjects 142 HIV-infected adults starting ART with BMI <16 kg/m2 and/or CD4+ lymphocyte count <50 cells/µl. Results Median age, BMI, and CD4+ lymphocyte count were 32 years, 16 kg/m2, and 34 cells/µL, respectively. Twenty-five participants (18%) died before 12 weeks, and another 33 (23%) were lost to care. A 500 kJ/day higher energy intake at any time after ART initiation was associated with an approximate 16% reduction in the hazard of death (AHR 0.84; p=0.01), but the relative contribution of carbohydrate, protein, and fat to total energy was not a significant predictor of outcome. Appetite normalized gradually among survivors, and hunger was rarely reported. Conclusions Poor early ART outcomes were strikingly high in a cohort of HIV-infected adults with advanced malnutrition, and mortality was predicted by lower dietary intake. Intervention trials to promote post-ART intake in this population may benefit survival and are warranted. PMID:22691872

  19. Paradoxical Tuberculosis Immune Reconstitution Inflammatory Syndrome (TB-IRIS) in HIV Patients with Culture Confirmed Pulmonary Tuberculosis in India and the Potential Role of IL-6 in Prediction

    PubMed Central

    Porter, Brian O.; Chandrasekhar, Chockalingam; Venkatesan, Perumal; Menon, Pradeep A.; Subramanian, Sudha; Anbalagan, Selvaraj; Bhavani, Kannabiran P.; Sekar, Sathiyavelu; Padmapriyadarshini, Chandrasekaran; Kumar, Satagopan; Ravichandran, Narayanan; Raja, Krishnaraj; Bhanu, Kesavamurthy; Mahilmaran, Ayyamperumal; Sekar, Lakshmanan; Sher, Alan; Sereti, Irini; Swaminathan, Soumya

    2013-01-01

    Background The incidence, manifestations, outcome and clinical predictors of paradoxical TB-IRIS in patients with HIV and culture confirmed pulmonary tuberculosis (PTB) in India have not been studied prospectively. Methods HIV+ patients with culture confirmed PTB started on anti-tuberculosis therapy (ATT) were followed prospectively after anti-retroviral therapy (ART) initiation. Established criteria for IRIS diagnosis were used including decline in plasma HIV RNA at IRIS event. Pre-ART plasma levels of interleukin (IL)-6 and C-reactive protein (CRP) were measured. Univariate and multivariate logistic regression models were used to evaluate associations between baseline variables and IRIS. Results Of 57 patients enrolled, 48 had complete follow up data. Median ATT-ART interval was 28 days (interquartile range, IQR 14–47). IRIS events occurred in 26 patients (54.2%) at a median of 11 days (IQR: 7–16) after ART initiation. Corticosteroids were required for treatment of most IRIS events that resolved within a median of 13 days (IQR: 9–23). Two patients died due to CNS TB-IRIS. Lower CD4+ T-cell counts, higher plasma HIV RNA levels, lower CD4/CD8 ratio, lower hemoglobin, shorter ATT to ART interval, extra-pulmonary or miliary TB and higher plasma IL-6 and CRP levels at baseline were associated with paradoxical TB-IRIS in the univariate analysis. Shorter ATT to ART interval, lower hemoglobin and higher IL-6 and CRP levels remained significant in the multivariate analysis. Conclusion Paradoxical TB–IRIS frequently complicates HIV-TB therapy in India. IL-6 and CRP may assist in predicting IRIS events and serve as potential targets for immune interventions. PMID:23691062

  20. Simplified HCC-ART score for highly sensitive detection of small-sized and early-stage hepatocellular carcinoma in the widely used Okuda, CLIP, and BCLC staging systems.

    PubMed

    Attallah, Abdelfattah M; Omran, Mohamed M; Attallah, Ahmed A; Abdelrazek, Mohamed A; Farid, Khaled; El-Dosoky, Ibrahim

    2017-04-01

    Small-sized HCC can be effectively cured by surgery with good clinical outcomes. A highly sensitive HCC α-fetoprotein routine test (HCC-ART) for HCC diagnosis as well as a simplied form of the HCC-ART were reported in the British Journal of Cancer. Here, we verified and studied the applicability of the HCC-ART to the detection of early-stage HCC. 341 cirrhotic patients and 318 HCC patients were included in this study. For each, the HCC-ART score was calculated, and then the sensitivity, specificity, and results of an ROC curve analysis were compared between the HCC-ART and AFP when these biomarkers were used to detect small-sized HCC. Different HCC-ART cutoffs were set for the detection of different tumor sizes. The HCC-ART (AUC = 0.871, 70% sensitivity, 97% specificity) and the simplified HCC-ART (AUC = 0.934, 82% sensitivity, 100% specificity) were found to have high predictive power when attempting to separate cirrhotic patients from those with small-sized HCC. The simplified HCC-ART score was superior to AFP for determining stages according to the early Okuda (0.950 AUC, 84% sensitivity, 99% specificity), CLIP (0.945 AUC, 84% sensitivity, 99% specificity), and BCLC (1.000 AUC, 100% sensitivity, 99% specificity) staging systems. The simplified HCC-ART score was more strongly correlated than AFP and other staging systems with HCC tumor size (P < 0.0001; r = 0.8). The HCC-ART is superior to AFP for diagnosing early-stage HCC. Due to its advantages of minimal variability and a wide continuous scale for assessing HCC severity, the simplified HCC-ART has the potential to be more widely used than the original HCC-ART.

  1. Exploring the population-level impact of antiretroviral treatment: the influence of baseline intervention context.

    PubMed

    Mishra, Sharmistha; Mountain, Elisa; Pickles, Michael; Vickerman, Peter; Shastri, Suresh; Gilks, Charles; Dhingra, Nandini K; Washington, Reynold; Becker, Marissa L; Blanchard, James F; Alary, Michel; Boily, Marie-Claude

    2014-01-01

    To compare the potential population-level impact of expanding antiretroviral treatment (ART) in HIV epidemics concentrated among female sex workers (FSWs) and clients, with and without existing condom-based FSW interventions. Mathematical model of heterosexual HIV transmission in south India. We simulated HIV epidemics in three districts to assess the 10-year impact of existing ART programs (ART eligibility at CD4 cell count ≤350) beyond that achieved with high condom use, and the incremental benefit of expanding ART by either increasing ART eligibility, improving access to care, or prioritizing ART expansion to FSWs/clients. Impact was estimated in the total population (including FSWs and clients). In the presence of existing condom-based interventions, existing ART programs (medium-to-good coverage) were predicted to avert 11-28% of remaining HIV infections between 2014 and 2024. Increasing eligibility to all risk groups prevented an incremental 1-15% over existing ART programs, compared with 29-53% when maximizing access to all risk groups. If there was no condom-based intervention, and only poor ART coverage, then expanding ART prevented a larger absolute number but a smaller relative fraction of HIV infections for every additional person-year of ART. Across districts and baseline interventions, for every additional person-year of treatment, prioritizing access to FSWs was most efficient (and resource saving), followed by prioritizing access to FSWs and clients. The relative and absolute benefit of ART expansion depends on baseline condom use, ART coverage, and epidemic size. In south India, maximizing FSWs' access to care, followed by maximizing clients' access are the most efficient ways to expand ART for HIV prevention, across baseline intervention context.

  2. Biased ART: a neural architecture that shifts attention toward previously disregarded features following an incorrect prediction.

    PubMed

    Carpenter, Gail A; Gaddam, Sai Chaitanya

    2010-04-01

    Memories in Adaptive Resonance Theory (ART) networks are based on matched patterns that focus attention on those portions of bottom-up inputs that match active top-down expectations. While this learning strategy has proved successful for both brain models and applications, computational examples show that attention to early critical features may later distort memory representations during online fast learning. For supervised learning, biased ARTMAP (bARTMAP) solves the problem of over-emphasis on early critical features by directing attention away from previously attended features after the system makes a predictive error. Small-scale, hand-computed analog and binary examples illustrate key model dynamics. Two-dimensional simulation examples demonstrate the evolution of bARTMAP memories as they are learned online. Benchmark simulations show that featural biasing also improves performance on large-scale examples. One example, which predicts movie genres and is based, in part, on the Netflix Prize database, was developed for this project. Both first principles and consistent performance improvements on all simulation studies suggest that featural biasing should be incorporated by default in all ARTMAP systems. Benchmark datasets and bARTMAP code are available from the CNS Technology Lab Website: http://techlab.bu.edu/bART/. Copyright 2009 Elsevier Ltd. All rights reserved.

  3. Artemisinin-based combination therapies are efficacious and safe for treatment of uncomplicated malaria in HIV-infected Ugandan children.

    PubMed

    Kakuru, Abel; Achan, Jane; Muhindo, Mary K; Ikilezi, Gloria; Arinaitwe, Emmanuel; Mwangwa, Florence; Ruel, Theodore; Clark, Tamara D; Charlebois, Edwin; Rosenthal, Philip J; Havlir, Diane; Kamya, Moses R; Tappero, Jordan W; Dorsey, Grant

    2014-08-01

    Artemisinin-based combination therapies (ACTs) are highly efficacious and safe, but data from human immunodeficiency virus (HIV)-infected children concurrently receiving antiretroviral therapy (ART) and ACTs are limited. We evaluated 28-day outcomes following malaria treatment with artemether-lumefantrine (AL) or dihydroartemisinin-piperaquine (DP) in 2 cohorts of HIV-infected Ugandan children taking various ART regimens. In one cohort, children <6 years of age were randomized to lopinavir/ritonavir (LPV/r) or nonnucleoside reverse transcriptase inhibitor-based ART and treated with AL for uncomplicated malaria. In another cohort, children <12 months of age were started on nevirapine-based ART if they were eligible, and randomized to AL or DP for the treatment of their first and all subsequent uncomplicated malaria episodes. There were 773 and 165 treatments for malaria with AL and DP, respectively. Initial response to therapy was excellent, with 99% clearance of parasites and <1% risk of repeat therapy within 3 days. Recurrent parasitemia within 28 days was common following AL treatment. The risk of recurrent parasitemia was significantly lower among children taking LPV/r-based ART compared with children taking nevirapine-based ART following AL treatment (15.3% vs 35.5%, P = .009), and those treated with DP compared with AL (8.6% vs 36.2%, P < .001). Both ACT regimens were safe and well tolerated. Treatment of uncomplicated malaria with AL or DP was efficacious and safe in HIV-infected children taking ART. However, there was a high risk of recurrent parasitemia following AL treatment, which was significantly lower in children taking LPV/r-based ART compared with nevirapine-based ART. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  4. Implementation of isoniazid preventive therapy in an HIV clinic in Cambodia: high rates of discontinuation when combined with antiretroviral therapy.

    PubMed

    van Griensven, Johan; Choun, Kimcheng; Chim, Bopha; Thai, Sopheak; Lorent, Natalie; Lynen, Lutgarde

    2015-12-01

    Data on feasibility and completion rates of isoniazid preventive therapy (IPT) in HIV-infected patient in Asia are limited. Within a hospital-based HIV programme in Phnom Penh, Cambodia, we determined the proportion completing IPT and reasons for non-completion. Retrospective cohort study using HIV/IPT programme data, including all adults starting IPT (300 mg/day self-administered for 24 weeks) from February 2011 to March 2013. All patients underwent symptom screening and further investigations as indicated. After ruling out tuberculosis (TB), IPT was started, with monthly follow-up visits. As per national guideline, IPT was only prescribed for ART-naïve patients. IPT completion was defined as taking IPT for at least 22 of the planned 24 weeks. Stavudine/lamivudine/nevirapine was the preferential first-line ART regimen. Among 445 ART-naïve patients starting IPT (median age: 35 years (IQR: 31-43), median CD4 count 354 cells/μl (IQR 215-545) and 288 (65%) were female), 214 (48%) started ART after a median of 4 weeks (IQR 2-6) on IPT ('concurrent ART'). Overall, 348 (78%) completed IPT. Among individuals with concurrent ART, the completion rate was 73% (157/214). Those without concurrent ART had a higher completion rate (83%; 191/231; P 0.017). The main reason for non-completion with concurrent ART was drug toxicity (mainly hepatotoxicity/rash), occurring in 22% (48/214). Without concurrent ART, the main reason for non-completion was loss to follow-up (16/231; 7%). Fourteen (3%) patients were diagnosed with TB while on IPT, of whom three had a positive TB culture at baseline. An additional 14 TB cases were diagnosed after IPT completion; four were bacteriologically confirmed. Although overall completion rates were acceptable, IPT discontinuation due to drug toxicity was common in patients subsequently initiating ART. Future studies should evaluate whether this relates to IPT, ARVs or both, and whether the increased toxicity would justify delaying IPT initiation until stabilisation on ART. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  5. Health and development of ART conceived young adults: a study protocol for the follow-up of a cohort

    PubMed Central

    2013-01-01

    Background Use of assisted reproductive technologies (ART) continues to increase, yet little is known of the longer term health of ART conceived offspring. There are some adverse birth outcomes associated with ART conception but the subsequent developmental trajectory is unclear. Undertaking research in this area is challenging due the sensitive nature of the topic and the time elapsed since birth of the ART conceived young adults. The aim of this report is to describe a research protocol, including design and ethical considerations, used to compare the physical and psychosocial health outcomes of ART conceived young adults aged 18-28 years, with their spontaneously conceived peers. Design This is a retrospective cohort study of mothers who conceived with ART in Victoria, Australia and gave birth to a singleton child between 1982 and 1992. A current address for each mother was located and a letter of invitation to participate in the study was sent by registered mail. Participation involved completing a telephone interview about her young adult offspring’s health and development from birth to the present. Mothers were also asked for consent for the researcher to contact their son/daughter to invite them to complete a structured telephone interview about their physical and psychosocial health. A comparison group of women living in Victoria, Australia, who had given birth to a spontaneously conceived singleton child between 1982 and 1992 was recruited from the general population using random digit dialling. Data were collected from them and their young adult offspring in the same way. Regression analyses were used to evaluate relationships between ART exposure and health status, including birth defects, chronic health conditions, hospital admissions, growth and sexual development. Psychosocial wellbeing, parental relationships and educational achievement were also assessed. Factors associated with the age of disclosure of ART conception were explored with the ART group only. Discussion The conceptualization and development of this large project posed a number of methodological, logistical and ethical challenges which we were able to overcome. The lessons we learnt can assist others who are investigating the long-term health implications for ART conceived offspring. PMID:23497379

  6. The Science of Optics; The History of Art

    NASA Astrophysics Data System (ADS)

    Falco, Charles

    Recently, renowned artist David Hockney observed that certain drawings and paintings from as early as the Renaissance seemed almost ''photographic'' in detail. Following an extensive visual investigation of western art of the past 1000 years, he made the revolutionary claim that artists even of the prominence of van Eyck and Bellini must have used optical aids. However, many art historians insisted there was no supporting evidence for such a remarkable assertion. In this talk I will show a wealth of optical evidence for his claim that Hockney and I subsequently discovered during an unusual, and remarkably productive, collaboration between an artist and a scientist. I also discuss the imaging properties of the concave mirror and some of the implications this work has for the history of science as well as the history of art (and the modern fields of machine vision and computerized image analysis). These discoveries convincingly demonstrate optical instruments were in use - by artists, not scientists - nearly 200 years earlier than commonly thought possible, and account for the remarkable transformation in the reality of portraits that occurred early in the 15th century. Acknowledgment: This work was done in collaboration with David Hockney.

  7. The Predictive Validity of Interim Assessment Scores Based on the Full-Information Bifactor Model for the Prediction of End-of-Grade Test Performance

    ERIC Educational Resources Information Center

    Immekus, Jason C.; Atitya, Ben

    2016-01-01

    Interim tests are a central component of district-wide assessment systems, yet their technical quality to guide decisions (e.g., instructional) has been repeatedly questioned. In response, the study purpose was to investigate the validity of a series of English Language Arts (ELA) interim assessments in terms of dimensionality and prediction of…

  8. Cognitive Function and Neurodevelopmental Outcomes in HIV-Infected Children Older than 1 Year of Age Randomized to Early Versus Deferred Antiretroviral Therapy: The PREDICT Neurodevelopmental Study

    PubMed Central

    Puthanakit, Thanyawee; Ananworanich, Jintanat; Vonthanak, Saphonn; Kosalaraksa, Pope; Hansudewechakul, Rawiwan; van der Lugt, Jasper; Kerr, Stephen J.; Kanjanavanit, Suparat; Ngampiyaskul, Chaiwat; Wongsawat, Jurai; Luesomboon, Wicharn; Vibol, Ung; Pruksakaew, Kanchana; Suwarnlerk, Tulathip; Apornpong, Tanakorn; Ratanadilok, Kattiya; Paul, Robert; Mofenson, Lynne M.; Fox, Lawrence; Valcour, Victor; Brouwers, Pim; Ruxrungtham, Kiat

    2013-01-01

    Background We previously reported similar AIDS-free survival at 3 years in children who were >1 year old initiating antiretroviral therapy (ART) and randomized to early vs. deferred ART in the PREDICT Study. We now report neurodevelopmental outcomes. Methods 284 HIV-infected Thai and Cambodian children aged 1–12 years with CD4 counts between 15–24% and no AIDS-defining illness were randomized to initiate ART at enrollment (“early”, n=139) or when CD4 count became <15% or a CDC C event developed (“deferred”, n=145). All underwent age-appropriate neurodevelopment testing including Beery Visual Motor Integration (VMI), Purdue Pegboard, Color Trails and Child Behavioral Checklist (CBCL). Thai children (n=170) also completed Wechsler Intelligence Scale (IQ) and Stanford Binet Memory test. We compared week 144 measures by randomized group and to HIV-uninfected children (n=319). Results At week 144, the median age was 9 years and 69 (48%) of the deferred arm children had initiated ART. The early arm had a higher CD4 (33% vs. 24%, p<0.001) and a greater percentage of children with viral suppression (91% vs. 40%, p<0.001). Neurodevelopmental scores did not differ by arm and there were no differences in changes between arms across repeated assessments in time-varying multivariate models. HIV-infected children performed worse than uninfected children on IQ, Beery VMI, Binet memory and CBCL Conclusions In HIV-infected children surviving beyond one year of age without ART, neurodevelopmental outcomes were similar with ART initiation at CD4 15–24% vs. < 15%; but both groups performed worse than HIV-uninfected children. The window of opportunity for a positive effect of ART initiation on neurodevelopment may remain in infancy. PMID:23263176

  9. Cognitive function and neurodevelopmental outcomes in HIV-infected Children older than 1 year of age randomized to early versus deferred antiretroviral therapy: the PREDICT neurodevelopmental study.

    PubMed

    Puthanakit, Thanyawee; Ananworanich, Jintanat; Vonthanak, Saphonn; Kosalaraksa, Pope; Hansudewechakul, Rawiwan; van der Lugt, Jasper; Kerr, Stephen J; Kanjanavanit, Suparat; Ngampiyaskul, Chaiwat; Wongsawat, Jurai; Luesomboon, Wicharn; Vibol, Ung; Pruksakaew, Kanchana; Suwarnlerk, Tulathip; Apornpong, Tanakorn; Ratanadilok, Kattiya; Paul, Robert; Mofenson, Lynne M; Fox, Lawrence; Valcour, Victor; Brouwers, Pim; Ruxrungtham, Kiat

    2013-05-01

    We previously reported similar AIDS-free survival at 3 years in children who were >1 year old initiating antiretroviral therapy (ART) and randomized to early versus deferred ART in the Pediatric Randomized to Early versus Deferred Initiation in Cambodia and Thailand (PREDICT) study. We now report neurodevelopmental outcomes. Two hundred eighty-four HIV-infected Thai and Cambodian children aged 1-12 years with CD4 counts between 15% and 24% and no AIDS-defining illness were randomized to initiate ART at enrollment ("early," n = 139) or when CD4 count became <15% or a Centers for Disease Control (CDC) category C event developed ("deferred," n = 145). All underwent age-appropriate neurodevelopment testing including Beery Visual Motor Integration, Purdue Pegboard, Color Trails and Child Behavioral Checklist. Thai children (n = 170) also completed Wechsler Intelligence Scale (intelligence quotient) and Stanford Binet Memory test. We compared week 144 measures by randomized group and to HIV-uninfected children (n = 319). At week 144, the median age was 9 years and 69 (48%) of the deferred arm children had initiated ART. The early arm had a higher CD4 (33% versus 24%, P < 0.001) and a greater percentage of children with viral suppression (91% versus 40%, P < 0.001). Neurodevelopmental scores did not differ by arm, and there were no differences in changes between arms across repeated assessments in time-varying multivariate models. HIV-infected children performed worse than uninfected children on intelligence quotient, Beery Visual Motor Integration, Binet memory and Child Behavioral Checklist. In HIV-infected children surviving beyond 1 year of age without ART, neurodevelopmental outcomes were similar with ART initiation at CD4 15%-24% versus <15%, but both groups performed worse than HIV-uninfected children. The window of opportunity for a positive effect of ART initiation on neurodevelopment may remain in infancy.

  10. Clinical performances of two real-time PCR assays and bDNA/TMA to early monitor treatment outcome in patients with chronic hepatitis C.

    PubMed

    Martinot-Peignoux, Michelle; Khiri, Hacène; Leclere, Laurence; Maylin, Sarah; Marcellin, Patrick; Halfon, Philippe

    2009-11-01

    Early viral monitoring is essential for the management of treatment outcome in patients with chronic hepatitis C. A variety of commercially available assays are now available to quantify HCV-RNA in routine clinical practice. Compare the clinical results of 3 commercially available assays to evaluate the positive predictive value (PPV) and the negative predictive value (NPV) of rapid virological response (RVR) at week 4 and early virological response (EVR) at week 12. 287 patients treated with standard care regimen combination therapy were studied. HCV-RNA values measured at baseline, week 4, week 12 with VERSANT HCV 3.0 Assay (bDNA), and VERSANT HCV-RNA Qualitative Assay (TMA) (bDNA/TMA); COBAS Ampliprep/COBAS/TaqMan (CAP/CTM) and Abbott m2000sp extraction/m2000rt amplification system (ART). RVR was defined as undetectable serum HCV-RNA and EVR as a > OR =2 log decline in baseline viral load (BLV). Median (range) BVLs were: 5.585(2.585-6.816), 5.189(2.792-7.747) and 4.804(2.380-6.580) log(10)IU/ml, with bDNA/TMA, CAP/CTM and ART, respectively (p<0.01); RVR was observed in 22%, 30% and 27% of the patients and PPVs were 97%, 91% and 94% with bDNA/TMA, CAP/CTM and ART, respectively (p=0.317). EVR was observed in 76%, 73% and 67% of the patients and NPVs were 93%, 83% and 79% with bDNA/TMA, CAP/CTM and ART, respectively (p=0.09). Treatment monitoring should include both detection of serum HCV-RNA at week 4 to predict SVR and at week 12 to predict non-SVR. The value of all 3 assays was similar for evaluating RVR or EVR. Because of viral load discrepancies the same assay should be used throughout patient treatment follow-up.

  11. Cerebrospinal fluid neopterin decay characteristics after initiation of antiretroviral therapy.

    PubMed

    Yilmaz, Aylin; Yiannoutsos, Constantin T; Fuchs, Dietmar; Price, Richard W; Crozier, Kathryn; Hagberg, Lars; Spudich, Serena; Gisslén, Magnus

    2013-05-10

    Neopterin, a biomarker of macrophage activation, is elevated in the cerebrospinal fluid (CSF) of most HIV-infected individuals and decreases after initiation of antiretroviral therapy (ART). We studied decay characteristics of neopterin in CSF and blood after commencement of ART in HIV-infected subjects and estimated the set-point levels of CSF neopterin after ART-mediated viral suppression. CSF and blood neopterin were longitudinally measured in 102 neurologically asymptomatic HIV-infected subjects who were treatment-naïve or had been off ART for ≥ 6 months. We used a non-linear model to estimate neopterin decay in response to ART and a stable neopterin set-point attained after prolonged ART. Seven subjects with HIV-associated dementia (HAD) who initiated ART were studied for comparison. Non-HAD patients were followed for a median 84.7 months. Though CSF neopterin concentrations decreased rapidly after ART initiation, it was estimated that set-point levels would be below normal CSF neopterin levels (<5.8 nmol/L) in only 60/102 (59%) of these patients. Pre-ART CSF neopterin was the primary predictor of set-point (P <0.001). HAD subjects had higher baseline median CSF neopterin levels than non-HAD subjects (P <0.0001). Based on the non-HAD model, only 14% of HAD patients were predicted to reach normal levels. After virologically suppressive ART, abnormal CSF neopterin levels persisted in 41% of non-HAD and the majority of HAD patients. ART is not fully effective in ameliorating macrophage activation in CNS as well as blood, especially in subjects with higher pre-ART levels of immune activation.

  12. The Historian's and the Preservationist's Dilemma: The Challenge of the Recent Past in Campus Heritage Efforts

    ERIC Educational Resources Information Center

    Christen, Barbara S.

    2011-01-01

    This article will consider the intent and approach of the Campus Heritage Preservation Conference held in Chicago in May 2002. Organized by the School of Architecture and Allied Arts at the University of Oregon in concert with the Getty Foundation, this national conference served as an important touchstone for subsequent efforts regarding campus…

  13. Patient-Reported Symptoms on the Antiretroviral Regimen Efavirenz/Emtricitabine/Tenofovir

    PubMed Central

    Gordon, Kirsha; Rodriguez-Barradas, Maria C.; Justice, Amy C.

    2012-01-01

    Abstract Most patients (80–90%) newly diagnosed with HIV are started on the antiretroviral regimen efavirenz, emtricitabine, and tenofovir (EFV/FTC/TDF). Existing studies of patient tolerability, however, are limited. We compared symptom experiences of patients on EFV/FTC/TDF, and the subsequent impact on health-related quality of life, with those of patients on other combination antiretroviral therapy (cART). We conducted a cross-sectional analysis of the Veterans Aging Cohort Study from February 2008 to August 2009 to compare the symptom experiences of patients on EFV/FTC/TDF vs. other cART, unadjusted and then adjusted for treatment characteristics, and comorbid disease severity. We then assessed the association between EFV/FTC/TDF use and health-related quality of life. Among the 1,759 patients in our analytic sample, EFV/FTC/TDF use was associated with fewer symptoms than was other cART. The use of EFV/FTC/TDF was independently associated with health-related quality of life, and this association was at least partially explained by symptom burden. PMID:22612469

  14. The chronology of hand stencils in European Palaeolithic rock art: implications of new U-series results from El Castillo Cave (Cantabria, Spain).

    PubMed

    García-Diez, Marcos; Garrido, Daniel; Hoffmann, Dirk; Pettitt, Paul; Pike, Alistair; Zilhão, Joao

    2015-07-20

    The hand stencils of European Paleolithic art tend to be considered of pre-Magdalenian age and scholars have generally assigned them to the Gravettian period. At El Castillo Cave, application of U-series dating to calcite accretions has established a minimum age of 37,290 years for underlying red hand stencils, implying execution in the earlier part of the Aurignacian if not beforehand. Together with the series of red disks, one of which has a minimum age of 40,800 years, these motifs lie at the base of the El Castillo parietal stratigraphy. The similarity in technique and colour support the notion that both kinds of artistic manifestations are synchronic and define an initial, non-figurative phase of European cave art. However, available data indicate that hand stencils continued to be painted subsequently. Currently, the youngest, reliably dated examples fall in the Late Gravettian, approximately 27,000 years ago.

  15. Weighing the evidence: Risks and benefits of participatory documentary in corporatized clinics

    PubMed Central

    Hansen, Helena

    2014-01-01

    This paper describes the effects of one U.S.-based public psychiatry clinic’s shift to a centralized, corporate style of management, in response to pressures to cut expenditures by focusing on “evidence based” treatments. Participant observation research conducted between 2008 and 2012 for a larger study involving 127 interviews with policy makers, clinic managers, clinical practitioners and patients revealed that the shift heralded the decline of arts based therapies in the clinic, and of the social networks that had developed around them. It also inspired a participatory video self-documentary project among art group members, to portray the importance of arts-based therapies and garner public support for such therapies. Group members found a way to take action in the face of unilateral decision making, but experienced subsequent restrictions on clinic activities and discharge of core members from the clinic. The paper ends with a discussion of biopolitics, central legibility through corporate standardization, and the potential and risks of participatory documentaries to resist these trends. PMID:23932854

  16. Artistic Skills Recovery and Compensation in Visual Artists after Stroke.

    PubMed

    Petcu, Eugen Bogdan; Sherwood, Katherine; Popa-Wagner, Aurel; Buga, Ana Maria; Aceti, Lanfranco; Miroiu, Rodica Ileana

    2016-01-01

    Art is a characteristic of mankind, which requires superior central nervous processing and integration of motor functions with visual information. At the present time, a significant amount of information related to neurobiological basis of artistic creation has been derived from neuro-radiological cognitive studies, which have revealed that subsequent to tissue destruction, the artists continue to create art. The current study aims to review the most important cases of visual artists with stroke and to discuss artistic skills recovery and compensation as well as artistic style after stroke. The role of various central nervous system regions in artistic creation was reviewed on the basis of previously published functional studies. Our PubMed search (1995-2015) has identified 10 famous artists with right cerebral stroke as well as 5 with left cerebral stroke who survived and continued to create art after stroke. As the artists included in this review lived at various times during the twentieth century and in different countries, clinical information related to their case was limited. However, it appears that artistic skills recovery and compensation appear within days after stroke. Some of the artists would subsequently change their artistic style. All these elements have been evaluated within the context of specific clinical cases. The poststroke artistic skills recovery and compensation with development of a new style or the opposite, regaining the previous prestroke style, represents a significant element of clinical importance in medical rehabilitation as well as neuroesthetics, which requires further evaluation. At the present time, the molecular mechanisms of artistic creation are poorly understood, and more standardized clinical and experimental studies are needed.

  17. Renal impairment in HIV-infected patients initiating tenofovir-containing antiretroviral therapy regimens in a Primary Healthcare Setting in South Africa.

    PubMed

    Kamkuemah, Monika; Kaplan, Richard; Bekker, Linda-Gail; Little, Francesca; Myer, Landon

    2015-04-01

    Long-term use of tenofovir disoproxil fumarate is associated with declines in glomerular function and chronic kidney disease in HIV-infected patients. We aimed to assess the prevalence and incidence of renal impairment in a primary care setting in sub-Saharan Africa. We analysed data from 1092 HIV-infected patients initiating tenofovir at a primary care clinic in Cape Town, South Africa. Renal function was assessed for the first 12 months on ART by estimating glomerular filtration rate (eGFR) calculated using the Cockroft-Gault equation categorised into normal, mild, moderate and severe reduction in renal function based on values >90, 60-89, 30-59 and <30 ml/min/1.73 m(2) , respectively. Associations were assessed using logistic regression, and average GFR trajectory over time was modelled using linear mixed-effects models. The cohort consisted of 62% women; median age was 34 years (IQR 29; 41 years). The majority had normal renal function pre-ART (79%), 19% had mildly reduced GFR, and 2% had moderate renal impairment. Older age, more advanced WHO stage and anaemia were independently associated with prevalent renal impairment. On average, estimated glomerular function improved over the first year on tenofovir [1.10 ml/min/1.73 m(2) average increase over 12 months (95% CI: 0.80; 1.40)]. Male gender, anaemia and immunosuppression (WHO Stage III/IV and CD4 cell counts <100 cells/mm(3) ) were associated with lower average eGFR levels over time. Overall, 3% developed eGFR <50 ml/min/1.73 m(2) during this period. Serum creatinine tests conducted before 4 months on ART had low predictive value for predicting change in eGFR after a year on ART. Generally, renal function improved in HIV-infected adults initiating ART in this primary healthcare setting during the first year on ART. While monitoring of renal function is recommended in the first 4 months on ART, renal impairment appears uncommon during the first 12 months of tenofovir-containing ART in primary care populations. © 2014 John Wiley & Sons Ltd.

  18. Determining geophysical properties from well log data using artificial neural networks and fuzzy inference systems

    NASA Astrophysics Data System (ADS)

    Chang, Hsien-Cheng

    Two novel synergistic systems consisting of artificial neural networks and fuzzy inference systems are developed to determine geophysical properties by using well log data. These systems are employed to improve the determination accuracy in carbonate rocks, which are generally more complex than siliciclastic rocks. One system, consisting of a single adaptive resonance theory (ART) neural network and three fuzzy inference systems (FISs), is used to determine the permeability category. The other system, which is composed of three ART neural networks and a single FIS, is employed to determine the lithofacies. The geophysical properties studied in this research, permeability category and lithofacies, are treated as categorical data. The permeability values are transformed into a "permeability category" to account for the effects of scale differences between core analyses and well logs, and heterogeneity in the carbonate rocks. The ART neural networks dynamically cluster the input data sets into different groups. The FIS is used to incorporate geologic experts' knowledge, which is usually in linguistic forms, into systems. These synergistic systems thus provide viable alternative solutions to overcome the effects of heterogeneity, the uncertainties of carbonate rock depositional environments, and the scarcity of well log data. The results obtained in this research show promising improvements over backpropagation neural networks. For the permeability category, the prediction accuracies are 68.4% and 62.8% for the multiple-single ART neural network-FIS and a single backpropagation neural network, respectively. For lithofacies, the prediction accuracies are 87.6%, 79%, and 62.8% for the single-multiple ART neural network-FIS, a single ART neural network, and a single backpropagation neural network, respectively. The sensitivity analysis results show that the multiple-single ART neural networks-FIS and a single ART neural network possess the same matching trends in determining lithofacies. This research shows that the adaptive resonance theory neural networks enable decision-makers to clearly distinguish the importance of different pieces of data which are useful in three-dimensional subsurface modeling. Geologic experts' knowledge can be easily applied and maintained by using the fuzzy inference systems.

  19. Reproductive, Perinatal, and Environmental Factors as Predictors of the Cognitive and Language Development of Preterm and Full-Term Infants.

    ERIC Educational Resources Information Center

    Siegel, Linda S.

    1982-01-01

    The accuracy of a risk index based on reproductive and demographic factors for predicting subsequent development was tested with 51 full-term and 53 preterm infants. In addition, the possibility that scores on the Home Observation for Measurement of the Environment scale might contribute significantly to the prediction of subsequent development…

  20. Increased prevalence of pregnancy and comparative risk of program attrition among individuals starting HIV treatment in East Africa.

    PubMed

    Holmes, Charles B; Yiannoutsos, Constantin T; Elul, Batya; Bukusi, Elizabeth; Ssali, John; Kambugu, Andrew; Musick, Beverly S; Cohen, Craig; Williams, Carolyn; Diero, Lameck; Padian, Nancy; Wools-Kaloustian, Kara K

    2018-01-01

    The World Health Organization now recommends initiating all pregnant women on life-long antiretroviral therapy (ART), yet there is limited information about the characteristics and program outcomes of pregnant women already on ART in Africa. Our hypothesis was that pregnant women comprised an increasing proportion of those starting ART, and that sub-groups of these women were at higher risk for program attrition. We used the International Epidemiology Databases to Evaluate AIDS- East Africa (IeDEA-EA) to conduct a retrospective cohort study including HIV care and treatment programs in Kenya, Uganda, and Tanzania. The cohort consecutively included HIV-infected individuals 13 years or older starting ART 2004-2014. We examined trends over time in the proportion pregnant, their characteristics and program attrition rates compared to others initiating and already receiving ART. 156,474 HIV-infected individuals (67.0% women) started ART. The proportion of individuals starting ART who were pregnant women rose from 5.3% in 2004 to 12.2% in 2014. Mean CD4 cell counts at ART initiation, weighted for annual program size, increased from 2004 to 2014, led by non-pregnant women (annual increase 20 cells/mm3) and men (17 cells/mm3 annually), with lower rates of change in pregnant women (10 cells/mm3 per year) (p<0.0001). There was no significant difference in the cumulative incidence of program attrition at 6 months among pregnant women starting ART and non-pregnant women. However, healthy pregnant women starting ART (WHO stage 1/2) had a higher rate of attrition rate (9.6%), compared with healthy non-pregnant women (6.5%); in contrast among women with WHO stage 3/4 disease, pregnant women had lower attrition (8.4%) than non-pregnant women (14.4%). Among women who initiated ART when healthy and remained in care for six months, subsequent six-month attrition was slightly higher among pregnant women at ART start (3.5%) compared to those who were not pregnant (2.4%), (absolute difference 1.1%, 95% CI 0.7%-1.5%). Pregnant women comprise an increasing proportion of those initiating ART in Africa, and pregnant women starting ART while healthy are at higher risk for program attrition than non-pregnant women. As ART programs further expand access to healthier pregnant women, further studies are needed to better understand the drivers of loss among this high risk group of women to optimize retention.

  1. Dual Pathways from Reactive Aggression to Depressive Symptoms in Children: Further Examination of the Failure Model.

    PubMed

    Evans, Spencer C; Fite, Paula J

    2018-04-13

    The failure model posits that peer rejection and poor academic performance are dual pathways in the association between early aggressive behavior and subsequent depressive symptoms. We examined this model using an accelerated longitudinal design while also incorporating proactive and reactive aggression and gender moderation. Children in 1st, 3rd, and 5th grades (n = 912; ages 6-12; 48% female) were rated three times annually by their primary teachers on measures of proactive and reactive aggression, peer rejection, academic performance, and depressive symptoms. Using Bayesian cross-classified estimation to account for nested and planned-missing data, path models were estimated to examine whether early reactive aggression predicted subsequent peer rejection and academic performance, and whether these, in turn, predicted subsequent depressive symptoms. From 1st to 3rd grade, reactive aggression predicted peer rejection (not academic performance), proactive aggression predicted academic performance (not peer rejection), and academic performance and peer rejection both predicted depressive symptoms. From 3rd to 5th grade, however, neither peer rejection nor academic performance predicted subsequent depressive symptoms. Results were not moderated by gender. Overall, these findings provide mixed and limited support for the failure model among school-age children. Early reactive aggression may be a key risk factor for social problems, whereas proactive aggression may be linked to improved academic functioning. The "dual pathways" of peer rejection and academic performance may operate during early but not later elementary school. Limitations and implications are discussed.

  2. Cognitive Impairment Precedes and Predicts Functional Impairment in Mild Alzheimer's Disease.

    PubMed

    Liu-Seifert, Hong; Siemers, Eric; Price, Karen; Han, Baoguang; Selzler, Katherine J; Henley, David; Sundell, Karen; Aisen, Paul; Cummings, Jeffrey; Raskin, Joel; Mohs, Richard

    2015-01-01

    The temporal relationship of cognitive deficit and functional impairment in Alzheimer's disease (AD) is not well characterized. Recent analyses suggest cognitive decline predicts subsequent functional decline throughout AD progression. To better understand the relationship between cognitive and functional decline in mild AD using autoregressive cross-lagged (ARCL) panel analyses in several clinical trials. Data included placebo patients with mild AD pooled from two multicenter, double-blind, Phase 3 solanezumab (EXPEDITION/2) or semagacestat (IDENTITY/2) studies, and from AD patients participating in the Alzheimer's Disease Neuroimaging Initiative (ADNI). Cognitive and functional outcomes were assessed using AD Assessment Scale-Cognitive subscale (ADAS-Cog), AD Cooperative Study-Activities of Daily Living instrumental subscale (ADCS-iADL), or Functional Activities Questionnaire (FAQ), respectively. ARCL panel analyses evaluated relationships between cognitive and functional impairment over time. In EXPEDITION, ARCL panel analyses demonstrated cognitive scores significantly predicted future functional impairment at 5 of 6 time points, while functional scores predicted subsequent cognitive scores in only 1 of 6 time points. Data from IDENTITY and ADNI programs yielded consistent results whereby cognition predicted subsequent function, but not vice-versa. Analyses from three databases indicated cognitive decline precedes and predicts subsequent functional decline in mild AD dementia, consistent with previously proposed hypotheses, and corroborate recent publications using similar methodologies. Cognitive impairment may be used as a predictor of future functional impairment in mild AD dementia and can be considered a critical target for prevention strategies to limit future functional decline in the dementia process.

  3. Antiretroviral Therapy and Pre-exposure Prophylaxis: Combined Impact on HIV Transmission and Drug Resistance in South Africa

    PubMed Central

    Abbas, Ume L.; Glaubius, Robert; Mubayi, Anuj; Hood, Gregory; Mellors, John W.

    2013-01-01

    Background. The potential impact of antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) with overlapping and nonoverlapping antiretrovirals (ARVs) on human immunodeficiency virus (HIV) transmission and drug resistance is unknown. Methods. A detailed mathematical model was used to simulate the epidemiological impact of ART alone, PrEP alone, and combined ART + PrEP in South Africa. Results. ART alone initiated at a CD4 lymphocyte cell count <200 cells/µL (80% coverage and 96% effectiveness) prevents 20% of HIV infections over 10 years but increases drug resistance prevalence to 6.6%. PrEP alone (30% coverage and 75% effectiveness) also prevents 21% of infections but with lower resistance prevalence of 0.5%. The ratio of cumulative infections prevented to prevalent drug-resistant cases after 10 years is 7-fold higher for PrEP than for ART. Combined ART + PrEP with overlapping ARVs prevents 35% of infections but increases resistance prevalence to 8.2%, whereas ART + PrEP with nonoverlapping ARVs prevents slightly more infections (37%) and reduces resistance prevalence to 7.2%. Conclusions. Combined ART + PrEP is likely to prevent more HIV infections than either strategy alone, but with higher prevalence of drug resistance. ART is predicted to contribute more to resistance than is PrEP. Optimizing both ART and PrEP effectiveness and delivery are the keys to preventing HIV transmission and drug resistance. PMID:23570850

  4. A Program for Computing Steady Inviscid Three-Dimensional Supersonic Flow on Reentry Vehicles. Volume I: Analysis and Programming

    DTIC Science & Technology

    1977-02-11

    Continue an reverse aide If necessaty and Identify by block number) A comprehensive computational procedure is presented for predicting the...Aeroballistic Reentry Technology ( ART ) program with some of the fundamental analytical and numerical work supported by NSWC Independent Research Funds. Most of...the Aerospace Corporation. The authors gratefully acknowledge the efforts of Mr. R. Feldhuhn, NSWC coordinator for the ART program, who was responsible

  5. Using Art to Teach Students Science Outdoors: How Creative Science Instruction Influences Observation, Question Formation, and Involvement

    NASA Astrophysics Data System (ADS)

    Cone, Christina Schull

    Elementary education has become increasingly divided into subjects and focused on the demand for high math and reading scores. Consequently, teachers spend less time devoted to science and art instruction. However, teaching art and science is crucial to developing creative and rational thinking, especially for observation and questioning skills. In this study, third grade students attending an urban school in Portland, Oregon received instruction of an art strategy using observational and quantifying drawing techniques. This study examines, "Will an art strategy observing the local environment help students make observations and ask questions?" and "In what ways are student learning and perspectives of science affected by the art strategy?" The independent variable is the art strategy developed for this study. There are three dependent variables: quality of student observations, quality of questions, and themes on student learning and perspectives of science. I predicted students would develop strong observation and questioning skills and that students would find the strategy useful or have an increased interest in science. The art scores were high for relevance and detail, but not for text. There were significant correlations between art scores and questions. Interviews revealed three themes: observations create questions, drawing is helpful and challenging, and students connected to science. By examining science through art, students were engaged and created strong observations and questions. Teachers need to balance unstructured drawing time with scaffolding for optimal results. This study provides an integrated science and art strategy that teachers can use outdoors or adapt for the classroom.

  6. Computational prediction of virus-human protein-protein interactions using embedding kernelized heterogeneous data.

    PubMed

    Nourani, Esmaeil; Khunjush, Farshad; Durmuş, Saliha

    2016-05-24

    Pathogenic microorganisms exploit host cellular mechanisms and evade host defense mechanisms through molecular pathogen-host interactions (PHIs). Therefore, comprehensive analysis of these PHI networks should be an initial step for developing effective therapeutics against infectious diseases. Computational prediction of PHI data is gaining increasing demand because of scarcity of experimental data. Prediction of protein-protein interactions (PPIs) within PHI systems can be formulated as a classification problem, which requires the knowledge of non-interacting protein pairs. This is a restricting requirement since we lack datasets that report non-interacting protein pairs. In this study, we formulated the "computational prediction of PHI data" problem using kernel embedding of heterogeneous data. This eliminates the abovementioned requirement and enables us to predict new interactions without randomly labeling protein pairs as non-interacting. Domain-domain associations are used to filter the predicted results leading to 175 novel PHIs between 170 human proteins and 105 viral proteins. To compare our results with the state-of-the-art studies that use a binary classification formulation, we modified our settings to consider the same formulation. Detailed evaluations are conducted and our results provide more than 10 percent improvements for accuracy and AUC (area under the receiving operating curve) results in comparison with state-of-the-art methods.

  7. Scattering Solar Thermal Concentrators

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

    Giebink, Noel C.

    2015-01-31

    This program set out to explore a scattering-based approach to concentrate sunlight with the aim of improving collector field reliability and of eliminating wind loading and gross mechanical movement through the use of a stationary collection optic. The approach is based on scattering sunlight from the focal point of a fixed collection optic into the confined modes of a sliding planar waveguide, where it is transported to stationary tubular heat transfer elements located at the edges. Optical design for the first stage of solar concentration, which entails focusing sunlight within a plane over a wide range of incidence angles (>120more » degree full field of view) at fixed tilt, led to the development of a new, folded-path collection optic that dramatically out-performs the current state-of-the-art in scattering concentration. Rigorous optical simulation and experimental testing of this collection optic have validated its performance. In the course of this work, we also identified an opportunity for concentrating photovoltaics involving the use of high efficiency microcells made in collaboration with partners at the University of Illinois. This opportunity exploited the same collection optic design as used for the scattering solar thermal concentrator and was therefore pursued in parallel. This system was experimentally demonstrated to achieve >200x optical concentration with >70% optical efficiency over a full day by tracking with <1 cm of lateral movement at fixed latitude tilt. The entire scattering concentrator waveguide optical system has been simulated, tested, and assembled at small scale to verify ray tracing models. These models were subsequently used to predict the full system optical performance at larger, deployment scale ranging up to >1 meter aperture width. Simulations at an aperture widths less than approximately 0.5 m with geometric gains ~100x predict an overall optical efficiency in the range 60-70% for angles up to 50 degrees from normal. However, the concentrator optical efficiency was found to decrease significantly with increasing aperture width beyond 0.5 m due to parasitic waveguide out-coupling loss and low-level absorption that become dominant at larger scale. A heat transfer model was subsequently implemented to predict collector fluid heat gain and outlet temperature as a function of flow rate using the optical model as a flux input. It was found that the aperture width size limitation imposed by the optical efficiency characteristics of the waveguide limits the absolute optical power delivered to the heat transfer element per unit length. As compared to state-of-the-art parabolic trough CPV system aperture widths approaching 5 m, this limitation leads to an approximate factor of order of magnitude increase in heat transfer tube length to achieve the same heat transfer fluid outlet temperature. The conclusion of this work is that scattering solar thermal concentration cannot be implemented at the scale and efficiency required to compete with the performance of current parabolic trough CSP systems. Applied within the alternate context of CPV, however, the results of this work have likely opened up a transformative new path that enables quasi-static, high efficiency CPV to be implemented on rooftops in the form factor of traditional fixed-panel photovoltaics.« less

  8. Loss to follow-up before and after initiation of antiretroviral therapy in HIV facilities in Lilongwe, Malawi

    PubMed Central

    Tweya, Hannock; Oboho, Ikwo Kitefre; Gugsa, Salem T.; Phiri, Sam; Rambiki, Ethel; Banda, Rebecca; Mwafilaso, Johnbosco; Munthali, Chimango; Gupta, Sundeep; Bateganya, Moses; Maida, Alice

    2018-01-01

    Introduction Although several studies have explored factors associated with loss to follow-up (LTFU) from HIV care, there remains a gap in understanding how these factors vary by setting, volume of patient and patients’ demographic and clinical characteristics. We determined rates and factors associated with LTFU in HIV care Lilongwe, Malawi. Methods We conducted a retrospective cohort study of HIV-infected individuals aged 15 years or older at the time of registration for HIV care in 12 ART facilities, between April 2012 and March 2013. HIV-positive individuals who had not started ART (pre-ART patients) were clinically assessed to determine ART eligibility at registration and during clinic follow-up visits. ART-eligible patients were initiated on triple antiretroviral combination. Study data were abstracted from patients’ cards, facility ART registers or electronic medical record system from the date of registration for HIV care to a maximum follow-up period of 24 months. Descriptive statistics were undertaken to summarize characteristics of the study patients. Separate univariable and multivariable poisson regression models were used to explore factors associated with LTFU in pre-ART and ART care. Results A total of 10,812 HIV-infected individuals registered for HIV care. Of these patients, 1,907 (18%) and 8,905 (82%) enrolled in pre-ART and ART care, respectively. Of the 1,907 pre-ART patients, 490 (26%) subsequently initiated ART and were included in both the pre-ART and ART analyses. The LTFU rates among patients in pre-ART and ART care were 48 and 26 per 100 person-years, respectively. Of the 9,105 ART patients with reasons for starting ART, 2,451 (27%) were initiated on ART because of pregnancy or breastfeeding (Option B+) status. Multivariable analysis showed that being ≥35 years and female were associated with decreased risk of LTFU in the pre-ART and ART phases of HIV care. However, being in WHO clinical stage 3 (adjusted risk ratio (aRR) 1.35, 95% confidence interval (CI): 1.20–1.51) and stage 4 (aRR 1.87, 95% CI: 1.62–2.18), body mass index ≤ 18.4 (aRR 1.24, 95% CI: 1.11–1.39) at ART initiation, poor adherence to clinic appointments (aRR 4.55, 95% CI: 4.16–4.97) and receiving HIV care in rural facilities (aRR 2.32, 95% CI: 1.94–2.87) were associated with increased risk of LTFU among ART patients. Being re-initiated on ART once (aRR 0.20, 95% CI: 0.17–0.22), more than once (aRR 0.06, 95% CI: 0.05–0.07), and being enrolled at a low-volume facility (aRR 0.25, 95% CI: 0.20–0.30) were associated with decreased risk of LTFU from ART care. Conclusion A sizeable proportion of ART LTFU occurred among women enrolled during pregnancy or breast-feeding. Non- compliance to clinic and receiving ART in a rural facility or high-volume facility were associated with increased risk of LTFU from ART care. Developing effective interventions that target high-risk subgroups and contexts may help reduce LTFU from HIV care. PMID:29373574

  9. Predictive Accuracy of the Veterans Aging Cohort Study (VACS) Index for Mortality with HIV Infection: A North American Cross Cohort Analysis

    PubMed Central

    Justice, AC; Modur, S; Tate, JP; Althoff, KN; Jacobson, LP; Gebo, K; Kitahata, M; Horberg, M; Brooks, J; Buchacz, K; Rourke, SB; Rachlis, A; Napravnik, S; Eron, J; Willig, H; Moore, R; Kirk, GD; Bosch, R; Rodriguez, B; Hogg, RS; Thorne, J; Goedert, JJ; Klein, M; Gill, MJ; Deeks, S; Sterling, TR; Anastos, K; Gange, SJ

    2013-01-01

    Background By supplementing an index composed of HIV biomarkers and age (Restricted Index) with measures of organ injury, the Veterans Aging Cohort Study (VACS) Index more completely reflects risk of mortality. We compare the accuracy of the VACS and Restricted Indices 1) among subjects outside the Veterans Healthcare System (VA), 2) over 1–5 years of prior exposure to antiretroviral therapy (ART), and 3) within important patient subgroups. Methods We used data from 13 cohorts in the North American AIDS Cohort Collaboration (NA-ACCORD, n=10, 835) limiting analyses to HIV-infected subjects with at least 12 months exposure to ART. Variables included demographic, laboratory (CD4 count, HIV-1 RNA, hemoglobin, platelets, aspartate and alanine transaminase, creatinine and hepatitis C status), and survival. We used C statistic and net reclassification improvement (NRI) to test discrimination varying prior ART exposure from 1–5 years. We then combined VA (n=5,066) and NA-ACCORD data, fit a parametric survival model, and compared predicted to observed mortality by cohort, gender, age, race, and HIV-1 RNA level. Results Mean follow-up was 3.3 years (655 deaths). Compared with the Restricted Index, the VACS Index showed greater discrimination (C statistic: 0.77 vs. 0.74; NRI 12%; p<0.0001). NRI was highest among those with HIV-1 RNA<500 copies/ml (25%) and age ≥50 years (20%). Predictions were similar to observed mortality among all subgroups. Conclusion VACS Index scores discriminate risk and translate into accurate mortality estimates over 1–5 years of exposures to ART and for diverse patient subgroups from North American PMID:23187941

  10. Predicting the epidemiological impact of antiretroviral allocation strategies in KwaZulu-Natal: the effect of the urban-rural divide.

    PubMed

    Wilson, David P; Kahn, James; Blower, Sally M

    2006-09-19

    Antiretroviral therapy (ART) is becoming available in South Africa. Demand will exceed supply; thus, difficult decisions will have to be made in allocating ART. The majority of those treated for HIV are likely to be in cities, because health infrastructure and personnel are concentrated in urban centers. We predict the epidemiological impact of drug allocation strategies (DAS) by using a spatially explicit model that links urban and rural epidemics. We parameterize our model by using data from the KwaZulu-Natal province in South Africa. We model the South African government's treatment plan from 2004-2008, and we predict the consequences of one DAS that allocates drugs only to Durban and of two DAS that allocate drugs to both urban and rural areas. All three strategies would treat 500,000 people by 2008. Not surprisingly, the Durban-only DAS would prevent the greatest number of infections (an additional 15,000 infections by 2008). However, it may have been expected that this DAS would generate the highest levels of transmitted resistance, because it concentrates ART in one location. Paradoxically, we found that this DAS would generate the lowest levels of transmitted resistance. Concentrating treatment in Durban would also avert the greatest number of AIDS-related deaths. We discuss the difference between using the principle of treatment equity versus using the principle of utilitarianism/efficiency to allocate ART. Decisions about allocating scarce drugs should consider treatment equity as well as epidemiological consequences. Notably, a Durban-only DAS would lead to new disparities in healthcare between urban and rural areas in KwaZulu-Natal.

  11. Predictive factors of gestational diabetes in pregnancies following assisted reproductive technology: a nested case-control study.

    PubMed

    Kouhkan, Azam; Khamseh, Mohammad E; Moini, Ashraf; Pirjani, Reihaneh; Valojerdi, Ameneh Ebrahim; Arabipoor, Arezoo; Hosseini, Roya; Baradaran, Hamid Reza

    2018-05-05

    To evaluate predictive factors for gestational diabetes mellitus (GDM) in singleton pregnancy following assisted reproductive technology (ART). This nested case-control study was performed during October 2016-June 2017. Pregnant women who conceived following ART procedures referred to infertility clinic were selected and categorized into GDM and non-GDM based on ADA/IAPDSG criteria. The study variables including age, educational status, first-degree family history of chronic diseases, systolic and diastolic blood pressure, previous obstetric and perinatal outcomes, infertility history, and ART cycle characteristics were collected from medical records. Prediction model to develop GDM was employed by binary logistic regression analysis after adjustment for age and body mass index, family history of diabetes, and gravidity. In total, 270 women with singleton pregnancies (consisted of 135 GDM and 135 non-GDM women) conceived were studied. According to the final model, significant predictors of GDM were history of polycystic ovarian syndrome (PCOS), previous ovarian hyper-stimulation syndrome (OHSS) risk and progesterone injections. Administration of injectable progesterone during the first 10-12 weeks of pregnancy was associated with an approximately twofold increased risk of developing GDM [odds ratio (OR) 2.28, 95% confidence interval (CI) 1.27-4.09)] compared to vaginal progesterone. In addition, the regression analysis revealed that previous OHSS risk (OR 2.40, 95% CI 1.34-4.31) and history of PCOS (OR 2.76, 95% CI 1.26-6.06) were other most important predictors of GDM. The route of progesterone administration, previous OHSS risk and history of PCOS seem to be putative risk factors for GDM in women conceived by ART.

  12. Predicting Success on a Bachelor of Arts Primary Education Degree Course

    ERIC Educational Resources Information Center

    Barmby, Patrick; Bolden, David; Higgins, Steve; Tymms, Peter

    2012-01-01

    Background: Successfully selecting students for undergraduate courses and for teaching is notoriously difficult. Traditionally, in England, A level grades and interviews have been used in conjunction with a variety of other approaches. Purpose: This paper examines the predictive validity of students' A level grades and of scores from a structured…

  13. Predictive Validity and Accuracy of Oral Reading Fluency for English Learners

    ERIC Educational Resources Information Center

    Vanderwood, Michael L.; Tung, Catherine Y.; Checca, C. Jason

    2014-01-01

    The predictive validity and accuracy of an oral reading fluency (ORF) measure for a statewide assessment in English language arts was examined for second-grade native English speakers (NESs) and English learners (ELs) with varying levels of English proficiency. In addition to comparing ELs with native English speakers, the impact of English…

  14. Factors Associated with Timing of Initiation of Antiretroviral Therapy among HIV-1 Infected Adults in the Niger Delta Region of Nigeria

    PubMed Central

    Ogoina, Dimie

    2015-01-01

    Introduction Based on growing evidence mainly from countries outside Sub-Saharan Africa, the World Health Organisation (WHO) now recommends initiation of antiretroviral therapy (ART) in HIV-infected individuals in developing countries when CD4 cell count (CD4+) is ≤ 500cells/ul. Nigeria accounts for about 14% of the estimated HIV/AIDS burden in Sub-Saharan Africa. We evaluated the factors associated with timing of initiation of ART among treatment-ineligible HIV-infected adults from Nigeria. Methods We retrospectively reviewed the hospital records of ART ineligible HIV-infected adults who enrolled into HIV care between January 2008 and December 2012 at two major tertiary hospitals in Bayelsa State, South-South Nigeria. Demographic, clinical and laboratories data were obtained at presentation, at each subsequent visit at 6 monthly intervals and at time of initiation of ART. Cox proportional regression and Kaplan-Meier survival analysis were used to evaluate independent predictors of time to initiation of ART. Results Amongst the 280 study participants, 70.6% were females, 62.6% had CD4+ ≥500cells/ul, 48.4% had WHO HIV Stage 1 disease and 34.3% were lost to follow up. In a cohort of 180 participants followed up for ≥3months, participants with CD4+ of 351-500cells/ul and stage 2 disease were more likely to start ART earlier than those with CD4+ > 500cells/ul (Hazard ratio [HR]-1.7, 95% confidence interval [CI] of 1.0-2.9) and stage 1 disease (HR-2.3 (95% CI-1.3-4.2) respectively. HIV-infected adults with faster CD4+ decay required earlier ART initiation, especially in the first year of follow up. Conclusion ART-ineligible HIV-infected adults on follow up in South-South Nigeria are more likely to require earlier initiation of ART if they have stage 2 HIV disease or CD4+ ≤500cells/ul at presentation. Our findings suggest faster progression of HIV-disease in these groups of individuals and corroborate the growing evidence in support for earlier initiation of ART. PMID:25933356

  15. A Desirable Engineer Providing Manifold Prospects Enhanced by Synergy Effect of Science and Liberal Arts

    NASA Astrophysics Data System (ADS)

    Harada, Shoji

    Quick globalization makes prediction of future human activity on production and economy more difficult. This is mainly because of increase in factors affecting relationship among different people with different way of life, culture, tradition and so on. To survive in such complicated world each engineer is desired to provide the knowledge of liberal arts as well as highly specialized knowledge. A synergy power generated by collaborative work of science-and liberal arts-minded way of thinking is a promising tool to unveil difficult world. This paper first describes degradation of liberal arts education during past two decades. Then, several movements for stopping that degradation are introduced in conjunction with the author‧s overseas experiences. Finally, a necessity of bringing up well competitive desirable engineer through collaborative work by university and company is proposed.

  16. Relationships among gender, cognitive style, academic major, and performance on the Piaget water-level task.

    PubMed

    Hammer, R E; Hoffer, N; King, W L

    1995-06-01

    Many researchers have found that more college-age adults than would be expected fail Piaget's water-level task, with women failing more frequently than men. It has been hypothesized that differences in cognitive style may account for performance differences on the water-level task. In the present study, 27 male and 27 female architectural students and 27 male and 27 female liberal-arts students were assessed for their performance on both Piaget's Water-level Task and Witkin's Group Embedded Figures Test. No difference was found in performance of male and female architectural students on either task, but male liberal-arts students scored significantly higher than female liberal-arts students on both measures. A disembedding cognitive style predicted success on the water-level task for the architectural students but not for the liberal arts students.

  17. Vanishing twin syndrome among ART singletons and pregnancy outcomes.

    PubMed

    Magnus, Maria C; Ghaderi, Sara; Morken, Nils-Halvdan; Magnus, Per; Bente Romundstad, Liv; Skjærven, Rolv; Wilcox, Allen J; Eldevik Håberg, Siri

    2017-11-01

    Among babies born by ART, do singleton survivors of a vanishing twin have lower birth weight than other singletons? Vanishing twin syndrome (VTS) was associated with lower birth weight among ART singletons; a sibship analysis indicated that the association was not confounded by maternal characteristics that remain stable between deliveries. Previous studies indicate that ART singletons with VTS have increased risk of adverse pregnancy outcomes, compared with other ART singletons. The potential contribution of unmeasured maternal background characteristics has been unclear. This was a Norwegian population-based registry study, including 17 368 mothers with 20 410 ART singleton deliveries between January 1984 and December 2013. The study population included 17 291 ART singletons without VTS, 638 ART singletons with VTS and 2418 ART singletons with uncertain vanishing twin status. We estimated differences in birth weight and gestational age comparing ART singletons with VTS first to all ART singletons without VTS, and subsequently to their ART siblings without VTS, using random- and fixed-effects linear regression, respectively. The corresponding comparisons for the associations with preterm birth and small for gestational age (SGA) were conducted using random-and fixed-effects logistic regression. The sibling analysis of preterm birth included 587 discordant siblings, while the sibling analysis of SGA included 674 discordant siblings. ART singletons with VTS had lower birth weight when compared to all ART singletons without VTS, with an adjusted mean difference (95% CI) of -116 g (-165, -67). When we compared ART singletons with VTS to their ART singletons sibling without VTS, the adjusted mean difference was -112 g (-209, -15). ART singletons with VTS also had increased risk of being born SGA, with an adjusted odds ratio (OR) (95% CI) of 1.48 (1.07, 2.03) compared to all ART singletons without VTS, and 2.79 (1.12, 6.91) in the sibship analyses. ART singletons with VTS were also more likely to be born preterm, although this difference did not reach statistical significance. We did not have information on maternal socio-economic status, but this factor is accounted for in the sibship analyses. We also had no information on whether fresh or frozen embryos were replaced. The reduction in birth weight and increased risk of SGA in ART singletons with VTS may suggest the presence of harmful intrauterine factors with long-term health impact. While vanishing twins are not routinely observed in naturally conceived pregnancies, loss of a twin is potentially a risk factor for the surviving foetus in any pregnancy. This could be further explored in large samples of naturally conceived pregnancies with the necessary information. The authors of this study are supported in part by the UK Medical Research Council, US National Institute of Environmental Health Sciences and the Norwegian Research Council. The authors have no conflicts of interest. N/A. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology.

  18. Cerebrospinal fluid neopterin decay characteristics after initiation of antiretroviral therapy

    PubMed Central

    2013-01-01

    Background Neopterin, a biomarker of macrophage activation, is elevated in the cerebrospinal fluid (CSF) of most HIV-infected individuals and decreases after initiation of antiretroviral therapy (ART). We studied decay characteristics of neopterin in CSF and blood after commencement of ART in HIV-infected subjects and estimated the set-point levels of CSF neopterin after ART-mediated viral suppression. Methods CSF and blood neopterin were longitudinally measured in 102 neurologically asymptomatic HIV-infected subjects who were treatment-naïve or had been off ART for ≥ 6 months. We used a non-linear model to estimate neopterin decay in response to ART and a stable neopterin set-point attained after prolonged ART. Seven subjects with HIV-associated dementia (HAD) who initiated ART were studied for comparison. Results Non-HAD patients were followed for a median 84.7 months. Though CSF neopterin concentrations decreased rapidly after ART initiation, it was estimated that set-point levels would be below normal CSF neopterin levels (<5.8 nmol/L) in only 60/102 (59%) of these patients. Pre-ART CSF neopterin was the primary predictor of set-point (P <0.001). HAD subjects had higher baseline median CSF neopterin levels than non-HAD subjects (P <0.0001). Based on the non-HAD model, only 14% of HAD patients were predicted to reach normal levels. Conclusions After virologically suppressive ART, abnormal CSF neopterin levels persisted in 41% of non-HAD and the majority of HAD patients. ART is not fully effective in ameliorating macrophage activation in CNS as well as blood, especially in subjects with higher pre-ART levels of immune activation. PMID:23664008

  19. Post-treatment control of HIV infection

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

    Conway, Jessica M.; Perelson, Alan S.

    Antiretroviral therapy (ART) for HIV is not a cure. However, recent studies suggest that ART, initiated early during primary infection, may induce post-treatment control (PTC) of HIV infection with HIV RNA maintained at <50 copies per mL. We investigate the hypothesis that ART initiated early during primary infection permits PTC by limiting the size of the latent reservoir, which, if small enough at treatment termination, may allow the adaptive immune response to prevent viral rebound (VR) and control infection. We use a mathematical model of within host HIV dynamics to capture interactions among target cells, productively infected cells, latently infectedmore » cells, virus, and cytotoxic T lymphocytes (CTLs). Analysis of our model reveals a range in CTL response strengths where a patient may show either VR or PTC, depending on the size of the latent reservoir at treatment termination. Below this range, patients will always rebound, whereas above this range, patients are predicted to behave like elite controllers. As a result, using data on latent reservoir sizes in patients treated during primary infection, we also predict population-level VR times for non-controllers consistent with observations.« less

  20. Post-treatment control of HIV infection

    DOE PAGES

    Conway, Jessica M.; Perelson, Alan S.

    2015-04-13

    Antiretroviral therapy (ART) for HIV is not a cure. However, recent studies suggest that ART, initiated early during primary infection, may induce post-treatment control (PTC) of HIV infection with HIV RNA maintained at <50 copies per mL. We investigate the hypothesis that ART initiated early during primary infection permits PTC by limiting the size of the latent reservoir, which, if small enough at treatment termination, may allow the adaptive immune response to prevent viral rebound (VR) and control infection. We use a mathematical model of within host HIV dynamics to capture interactions among target cells, productively infected cells, latently infectedmore » cells, virus, and cytotoxic T lymphocytes (CTLs). Analysis of our model reveals a range in CTL response strengths where a patient may show either VR or PTC, depending on the size of the latent reservoir at treatment termination. Below this range, patients will always rebound, whereas above this range, patients are predicted to behave like elite controllers. As a result, using data on latent reservoir sizes in patients treated during primary infection, we also predict population-level VR times for non-controllers consistent with observations.« less

  1. Attendance Rates in a Workplace Predict Subsequent Outcome of Employment-Based Reinforcement of Cocaine Abstinence in Methadone Patients

    ERIC Educational Resources Information Center

    Donlin, Wendy D.; Knealing, Todd W.; Needham, Mick; Wong, Conrad J.; Silverman, Kenneth

    2008-01-01

    This study assessed whether attendance rates in a workplace predicted subsequent outcome of employment-based reinforcement of cocaine abstinence. Unemployed adults in Baltimore methadone programs who used cocaine (N = 111) could work in a workplace for 4 hr every weekday and earn $10.00 per hour in vouchers for 26 weeks. During an induction…

  2. Is the First-Year Predictive for Study Success in Subsequent Years? Findings from an Academy of Music

    ERIC Educational Resources Information Center

    Mennen, Josien; van der Klink, Marcel

    2017-01-01

    In higher education, departments are under increasing pressure to improve study success. Research in this field focusing on higher music education is scarce. The aim of this study was to gain insight into the predictive capability of the first year for study success of students at an academy of music in subsequent years. Data on study progression…

  3. Same-day antiretroviral therapy (ART) initiation in pregnancy is not associated with viral suppression or engagement in care: A cohort study.

    PubMed

    Langwenya, Nontokozo; Phillips, Tamsin K; Brittain, Kirsty; Zerbe, Allison; Abrams, Elaine J; Myer, Landon

    2018-06-01

    Many prevention of mother-to-child HIV transmission programmes across Africa initiate HIV-infected (HIV positive) pregnant women on lifelong antiretroviral therapy (ART) on the first day of antenatal care ("same-day" initiation). However, there are concerns that same-day initiation may limit patient preparation before starting ART and contribute to subsequent non-adherence, disengagement from care and raised viral load. We examined if same-day initiation was associated with viral suppression and engagement in care during pregnancy. Consecutive ART-eligible pregnant women making their first antenatal care (ANC) visit at a primary care facility in Cape Town, South Africa were enrolled into a prospective cohort between March 2013 and June 2014. Before July 2013, ART eligibility was based on CD4 cell count ≤350 cells/μL ("Option A"), with a 1 to 2 week delay from the first ANC visit to ART initiation for patient preparation; thereafter all women were eligible regardless of CD4 cell count ("Option B+") and offered ART on the same day as first ANC visit. Women were followed with viral load testing conducted separately from routine ART services, and engagement in ART services was measured using routinely collected clinic, pharmacy and laboratory records through 12 months postpartum. Among 628 HIV-positive women (median age, 28 years; median gestation at ART start, 21 weeks; 55% newly diagnosed with HIV), 73% initiated ART same-day; this proportion was higher under Option B+ versus Option A (85% vs. 20%). Levels of viral suppression (viral load <50 copies/mL) at delivery (74% vs. 82%) and 12 months postpartum (74% vs. 71%) were similar under same-day versus delayed initiation respectively. Findings were consistent when viral suppression was defined at <1000 copies/mL, after adjustment for demographic/clinical measures and across subgroups of age, CD4 and timing of HIV diagnosis. Time to first viral rebound following initial suppression did not differ by timing of ART initiation nor did engagement in care through 12 months postpartum (same-day = 73%, delayed = 73%, p = 0.910). These data suggest that same-day ART initiation during pregnancy is not associated with lower levels of engagement in care or viral suppression through 12 months post-delivery in this setting, providing reassurance to ART programmes implementing Option B+. © 2018 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

  4. Static and Dynamic Human Shape Modeling - A Review of the Literature and State of the Art

    DTIC Science & Technology

    2009-04-01

    Figure 60. Confluent marker-based animation (Aguiar et al. 2006). Subsequent frames showing the female scan authentically performing a soccer kick ...Infoscitex Corp. 4027 Colonel Glenn Highway Suite 210 Dayton OH 45431-1672 Kathleen Robinette Biosciences and Protection Division Biomechanics ...Biosciences and Protection Division Biomechanics Branch Wright-Patterson AFB OH 45433 Approved for public release; distribution unlimited. NOTICE

  5. Statistics of Land-Grant Colleges and Universities, Year Ended June 30, 1953. Bulletin, 1954, No. 8

    ERIC Educational Resources Information Center

    Carlson, Neva A.

    1954-01-01

    Under the provisions of the Morrill Act of 1862, the income from certain public lands, or the equivalent in script, was granted to the States for the advancement of instruction in agriculture and the mechanic arts in at least one college in each State. Subsequent acts expanded the scope and increased the Federal support of the colleges and…

  6. State-of-the-art radiological techniques improve the assessment of postoperative lung function in patients with non-small cell lung cancer.

    PubMed

    Ohno, Yoshiharu; Koyama, Hisanobu; Nogami, Munenobu; Takenaka, Daisuke; Onishi, Yumiko; Matsumoto, Keiko; Matsumoto, Sumiaki; Maniwa, Yoshimasa; Yoshimura, Masahiro; Nishimura, Yoshihiro; Sugimura, Kazuro

    2011-01-01

    The purpose of this study was to compare predictive capabilities for postoperative lung function in non-small cell lung cancer (NSCLC) patients of the state-of-the-art radiological methods including perfusion MRI, quantitative CT and SPECT/CT with that of anatomical method (i.e. qualitative CT) and traditional nuclear medicine methods such as planar imaging and SPECT. Perfusion MRI, CT, nuclear medicine study and measurements of %FEV(1) before and after lung resection were performed for 229 NSCLC patients (125 men and 104 women). For perfusion MRI, postoperative %FEV(1) (po%FEV(1)) was predicted from semi-quantitatively assessed blood volumes within total and resected lungs, for quantitative CT, it was predicted from the functional lung volumes within total and resected lungs, for qualitative CT, from the number of segments of total and resected lungs, and for nuclear medicine studies, from uptakes within total and resected lungs. All SPECTs were automatically co-registered with CTs for preparation of SPECT/CTs. Predicted po%FEV(1)s were then correlated with actual po%FEV(1)s, which were measured %FEV(1)s after operation. The limits of agreement were also evaluated. All predicted po%FEV(1)s showed good correlation with actual po%FEV(1)s (0.83≤r≤0.88, p<0.0001). Perfusion MRI, quantitative CT and SPECT/CT demonstrated better correlation than other methods. The limits of agreement of perfusion MRI (4.4±14.2%), quantitative CT (4.7±14.2%) and SPECT/CT (5.1±14.7%) were less than those of qualitative CT (6.0±17.4%), planar imaging (5.8±18.2%), and SPECT (5.5±16.8%). State-of-the-art radiological methods can predict postoperative lung function in NSCLC patients more accurately than traditional methods. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

  7. Computational Paradigm to Elucidate the Effects of Arts-Based Approaches and Interventions: Individual and Collective Emerging Behaviors in Artwork Construction

    PubMed Central

    Sandak, Billie; Huss, Ephrat; Sarid, Orly; Harel, David

    2015-01-01

    Art therapy, as well as other arts-based therapies and interventions, is used to reduce pain, stress, depression, breathlessness and other symptoms in a wide variety of serious and chronic diseases, such as cancer, Alzheimer and schizophrenia. Arts-based approaches are also known to contribute to one’s well-being and quality of life. However, much research is required, since the mechanisms by which these non-pharmacological treatments exert their therapeutic and psychosocial effects are not adequately understood. A typical clinical setting utilizing the arts consists of the creation work itself, such as the artwork, as well as the therapist and the patient, all of which constitute a rich and dynamic environment of occurrences. The underlying complex, simultaneous and interwoven processes of this setting are often considered intractable to human observers, and as a consequence are usually interpreted subjectively and described verbally, which affect their subsequent analyses and understanding. We introduce a computational research method for elucidating and analyzing emergent expressive and social behaviors, aiming to understand how arts-based approaches operate. Our methodology, which centers on the visual language of Statecharts and tools for its execution, enables rigorous qualitative and quantitative tracking, analysis and documentation of the underlying creation and interaction processes. Also, it enables one to carry out exploratory, hypotheses-generating and knowledge discovery investigations, which are empirical-based. Furthermore, we illustrate our method’s use in a proof-of-principle study, applying it to a real-world artwork investigation with human participants. We explore individual and collective emergent behaviors impacted by diverse drawing tasks, yielding significant gender and age hypotheses, which may account for variation factors in response to art use. We also discuss how to gear our research method to systematic and mechanistic investigations, as we wish to provide a broad empirical evidence for the uptake of arts-based approaches, also aiming to ameliorate their use in clinical settings. PMID:26061736

  8. Efficacy of second-line antiretroviral therapy among people living with HIV/AIDS in Asia: Results from the TREAT Asia HIV Observational Database

    PubMed Central

    BOETTIGER, David C; NGUYEN, Van Kinh; DURIER, Nicolas; BUI, Huy Vu; SIM, Benedict Lim Heng; AZWA, Iskandar; LAW, Matthew; RUXRUNGTHAM, Kiat

    2014-01-01

    Background Roughly 4% of the 1.25 million patients on antiretroviral therapy (ART) in Asia are using second-line therapy. To maximize patient benefit and regional resources it is important to optimize the timing of second-line ART initiation and use the most effective compounds available. Methods HIV positive patients enrolled in the TREAT Asia HIV Observational Database who had used second-line ART for ≥6 months were included. ART use and rates and predictors of second-line treatment failure were evaluated. Results There were 302 eligible patients. Most were male (76.5%) and exposed to HIV via heterosexual contact (71.5%). Median age at second-line initiation was 39.2 years, median CD4 cell count was 146 cells/mm3, and median HIV viral load was 16,224 copies/mL. Patients started second-line ART before 2007 (n=105), 2007-2010 (n=147) and after 2010 (n=50). Ritonavir-boosted lopinavir and atazanavir accounted for the majority of protease inhibitor use after 2006. Median follow-up time on second-line was 2.3 years. The rates of treatment failure and mortality per 100 patient/years were 8.8 (95%CI 7.1 to 10.9) and 1.1 (95%CI 0.6 to 1.9), respectively. Older age, high baseline viral load and use of a protease inhibitor other than lopinavir or atazanavir were associated with a significantly shorter time to second-line failure. Conclusions Increased access to viral load monitoring to facilitate early detection of first-line ART failure and subsequent treatment switch is important for maximizing the durability of second-line therapy in Asia. Although second-line ART is highly effective in the region, the reported rate of failure emphasizes the need for third-line ART in a small portion of patients. PMID:25590271

  9. Efficacy of second-line antiretroviral therapy among people living with HIV/AIDS in Asia: results from the TREAT Asia HIV observational database.

    PubMed

    Boettiger, David C; Nguyen, Van K; Durier, Nicolas; Bui, Huy V; Heng Sim, Benedict L; Azwa, Iskandar; Law, Matthew; Ruxrungtham, Kiat

    2015-02-01

    Roughly 4% of the 1.25 million patients on antiretroviral therapy (ART) in Asia are using second-line therapy. To maximize patient benefit and regional resources, it is important to optimize the timing of second-line ART initiation and use the most effective compounds available. HIV-positive patients enrolled in the TREAT Asia HIV Observational Database who had used second-line ART for ≥6 months were included. ART use and rates and predictors of second-line treatment failure were evaluated. There were 302 eligible patients. Most were male (76.5%) and exposed to HIV via heterosexual contact (71.5%). Median age at second-line initiation was 39.2 years, median CD4 cell count was 146 cells per cubic millimeter, and median HIV viral load was 16,224 copies per milliliter. Patients started second-line ART before 2007 (n = 105), 2007-2010 (n = 147) and after 2010 (n = 50). Ritonavir-boosted lopinavir and atazanavir accounted for the majority of protease inhibitor use after 2006. Median follow-up time on second-line therapy was 2.3 years. The rates of treatment failure and mortality per 100 patient/years were 8.8 (95% confidence interval: 7.1 to 10.9) and 1.1 (95% confidence interval: 0.6 to 1.9), respectively. Older age, high baseline viral load, and use of a protease inhibitor other than lopinavir or atazanavir were associated with a significantly shorter time to second-line failure. Increased access to viral load monitoring to facilitate early detection of first-line ART failure and subsequent treatment switch is important for maximizing the durability of second-line therapy in Asia. Although second-line ART is highly effective in the region, the reported rate of failure emphasizes the need for third-line ART in a small portion of patients.

  10. The associations of earlier trauma exposures and history of mental disorders with PTSD after subsequent traumas

    PubMed Central

    Kessler, Ronald C.; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Bromet, Evelyn J.; Gureje, Oye; Karam, Elie G.; Koenen, Karestan C.; Lee, Sing; Liu, Howard; Pennell, Beth-Ellen; Petukhova, Maria V.; Sampson, Nancy A.; Shahly, Victoria L.; Stein, Dan J.; Atwoli, Lukoye; Borges, Guilherme; Bunting, Brendan; de Girolamo, Giovanni; Gluzman, Semyon; Haro, Josep Maria; Hinkov, Hristo; Kawakami, Norito; Kovess-Masfety, Viviane; Navarro-Mateu, Fernando; Posada-Villa, Jose; Scott, Kate M.; Shalev, Arieh Y.; Have, Margreet ten; Torres, Yolanda; Viana, Maria Carmen; Zaslavsky, Alan M.

    2017-01-01

    Although earlier trauma exposure is known to predict post-traumatic stress disorder (PTSD) after subsequent traumas, it is unclear if this association is limited to cases where the earlier trauma led to PTSD. Resolution of this uncertainty has important implications for research on pre-trauma vulnerability to PTSD. We examined this issue in the WHO World Mental Health (WMH) Surveys with 34,676 respondents who reported lifetime trauma exposure. One lifetime trauma was selected randomly for each respondent. DSM-IV PTSD due to that trauma was assessed. We reported in a previous paper that four earlier traumas involving interpersonal violence significantly predicted PTSD after subsequent random traumas (OR=1.3–2.5). We also assessed 14 lifetime DSM-IV mood, anxiety, disruptive behavior, and substance disorders prior to random traumas. We show in the current report that only prior anxiety disorders significantly predicted PTSD in a multivariate model (OR=1.5–4.3) and that these disorders interacted significantly with three of the earlier traumas (witnessing atrocities, physical violence victimization, rape). History of witnessing atrocities significantly predicted PTSD after subsequent random traumas only among respondents with prior PTSD (OR=5.6). Histories of physical violence victimization (OR=1.5) and rape after age 17 (OR=17.6) significantly predicted only among respondents with no history of prior anxiety disorders. Although only preliminary due to reliance on retrospective reports, these results suggest that history of anxiety disorders and history of a limited number of earlier traumas might usefully be targeted in future prospective studies as distinct foci of research on individual differences in vulnerability to PTSD after subsequent traumas. PMID:28924183

  11. WONOEP appraisal: Biomarkers of epilepsy-associated comorbidities.

    PubMed

    Ravizza, Teresa; Onat, Filiz Y; Brooks-Kayal, Amy R; Depaulis, Antoine; Galanopoulou, Aristea S; Mazarati, Andrey; Numis, Adam L; Sankar, Raman; Friedman, Alon

    2017-03-01

    Neurologic and psychiatric comorbidities are common in patients with epilepsy. Diagnostic, predictive, and pharmacodynamic biomarkers of such comorbidities do not exist. They may share pathogenetic mechanisms with epileptogenesis/ictogenesis, and as such are an unmet clinical need. The objectives of the subgroup on biomarkers of comorbidities at the XIII Workshop on the Neurobiology of Epilepsy (WONOEP) were to present the state-of-the-art recent research findings in the field that highlighting potential biomarkers for comorbidities in epilepsy. We review recent progress in the field, including molecular, imaging, and genetic biomarkers of comorbidities as discussed during the WONOEP meeting on August 31-September 4, 2015, in Heybeliada Island (Istanbul, Turkey). We further highlight new directions and concepts from studies on comorbidities and potential new biomarkers for the prediction, diagnosis, and treatment of epilepsy-associated comorbidities. The activation of various molecular signaling pathways such as the "Janus Kinase/Signal Transducer and Activator of Transcription," "mammalian Target of Rapamycin," and oxidative stress have been shown to correlate with the presence and severity of subsequent cognitive abnormalities. Furthermore, dysfunction in serotonergic transmission, hyperactivity of the hypothalamic-pituitary-adrenocortical axis, the role of the inflammatory cytokines, and the contributions of genetic factors have all recently been regarded as relevant for understanding epilepsy-associated depression and cognitive deficits. Recent evidence supports the utility of imaging studies as potential biomarkers. The role of such biomarker may be far beyond the diagnosis of comorbidities, as accumulating clinical data indicate that comorbidities can predict epilepsy outcomes. Future research is required to reveal whether molecular changes in specific signaling pathways or advanced imaging techniques could be detected in the clinical settings and correlate with epilepsy-associated comorbidities. A reliable biomarker will allow a more accurate diagnosis and improved treatment of epilepsy-associated comorbidities. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

  12. Glioma-associated stem cells: a novel class of tumor-supporting cells able to predict prognosis of human low-grade gliomas.

    PubMed

    Bourkoula, Evgenia; Mangoni, Damiano; Ius, Tamara; Pucer, Anja; Isola, Miriam; Musiello, Daniela; Marzinotto, Stefania; Toffoletto, Barbara; Sorrentino, Marisa; Palma, Anita; Caponnetto, Federica; Gregoraci, Giorgia; Vindigni, Marco; Pizzolitto, Stefano; Falconieri, Giovanni; De Maglio, Giovanna; Pecile, Vanna; Ruaro, Maria Elisabetta; Gri, Giorgia; Parisse, Pietro; Casalis, Loredana; Scoles, Giacinto; Skrap, Miran; Beltrami, Carlo Alberto; Beltrami, Antonio Paolo; Cesselli, Daniela

    2014-05-01

    Translational medicine aims at transferring advances in basic science research into new approaches for diagnosis and treatment of diseases. Low-grade gliomas (LGG) have a heterogeneous clinical behavior that can be only partially predicted employing current state-of-the-art markers, hindering the decision-making process. To deepen our comprehension on tumor heterogeneity, we dissected the mechanism of interaction between tumor cells and relevant components of the neoplastic environment, isolating, from LGG and high-grade gliomas (HGG), proliferating stem cell lines from both the glioma stroma and, where possible, the neoplasm. We isolated glioma-associated stem cells (GASC) from LGG (n=40) and HGG (n=73). GASC showed stem cell features, anchorage-independent growth, and supported the malignant properties of both A172 cells and human glioma-stem cells, mainly through the release of exosomes. Finally, starting from GASC obtained from HGG (n=13) and LGG (n=12) we defined a score, based on the expression of 9 GASC surface markers, whose prognostic value was assayed on 40 subsequent LGG-patients. At the multivariate Cox analysis, the GASC-based score was the only independent predictor of overall survival and malignant progression free-survival. The microenvironment of both LGG and HGG hosts non-tumorigenic multipotent stem cells that can increase in vitro the biological aggressiveness of glioma-initiating cells through the release of exosomes. The clinical importance of this finding is supported by the strong prognostic value associated with the characteristics of GASC. This patient-based approach can provide a groundbreaking method to predict prognosis and to exploit novel strategies that target the tumor stroma. © 2013 AlphaMed Press.

  13. Mathematical modeling and computational prediction of cancer drug resistance.

    PubMed

    Sun, Xiaoqiang; Hu, Bin

    2017-06-23

    Diverse forms of resistance to anticancer drugs can lead to the failure of chemotherapy. Drug resistance is one of the most intractable issues for successfully treating cancer in current clinical practice. Effective clinical approaches that could counter drug resistance by restoring the sensitivity of tumors to the targeted agents are urgently needed. As numerous experimental results on resistance mechanisms have been obtained and a mass of high-throughput data has been accumulated, mathematical modeling and computational predictions using systematic and quantitative approaches have become increasingly important, as they can potentially provide deeper insights into resistance mechanisms, generate novel hypotheses or suggest promising treatment strategies for future testing. In this review, we first briefly summarize the current progress of experimentally revealed resistance mechanisms of targeted therapy, including genetic mechanisms, epigenetic mechanisms, posttranslational mechanisms, cellular mechanisms, microenvironmental mechanisms and pharmacokinetic mechanisms. Subsequently, we list several currently available databases and Web-based tools related to drug sensitivity and resistance. Then, we focus primarily on introducing some state-of-the-art computational methods used in drug resistance studies, including mechanism-based mathematical modeling approaches (e.g. molecular dynamics simulation, kinetic model of molecular networks, ordinary differential equation model of cellular dynamics, stochastic model, partial differential equation model, agent-based model, pharmacokinetic-pharmacodynamic model, etc.) and data-driven prediction methods (e.g. omics data-based conventional screening approach for node biomarkers, static network approach for edge biomarkers and module biomarkers, dynamic network approach for dynamic network biomarkers and dynamic module network biomarkers, etc.). Finally, we discuss several further questions and future directions for the use of computational methods for studying drug resistance, including inferring drug-induced signaling networks, multiscale modeling, drug combinations and precision medicine. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. Cognitive models for panic disorder with agoraphobia: A study of disaggregated within-person effects.

    PubMed

    Hoffart, Asle

    2016-09-01

    The purpose of this study was to test 2 cognitive models of panic disorder with agoraphobia (PDA)-a catastrophic cognitions model and a low self-efficacy model-by examining the within-person effects of model-derived cognitive variables on subsequent anxiety symptoms. Participants were 46 PDA patients with agoraphobic avoidance of moderate to severe degree who were randomly allocated to 6 weeks of either cognitive therapy, based on the catastrophic cognitions model of PDA, or guided mastery (guided exposure) therapy, based on the self-efficacy model of PDA. Cognitions and anxiety were measured weekly over the course of treatment. The data were analyzed with mixed models, using person-mean centering to disaggregate within- and between-person effects. All of the studied variables changed in the expected way over the course of therapy. There was a within-person effect of physical fears, loss of control fears, social fears, and self-efficacy when alone on subsequent state anxiety. On the other hand, within-person changes in anxiety did not predict subsequent cognitions. Loss of control and social fears both predicted subsequent self-efficacy, whereas self-efficacy did not predict catastrophic cognitions. In a multipredictor analysis, within-person catastrophic cognitions still predicted subsequent anxiety, but self-efficacy when alone did not. Overall, the findings indicate that anxiety in PDA, at least in severe and long-standing cases, is driven by catastrophic cognitions. Thus, these cognitions seem to be useful therapeutic targets. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  15. Testing the bi-dimensional effects of attitudes on behavioural intentions and subsequent behaviour.

    PubMed

    Elliott, Mark A; Brewster, Sarah E; Thomson, James A; Malcolm, Carly; Rasmussen, Susan

    2015-11-01

    Attitudes are typically treated as unidimensional predictors of both behavioural intentions and subsequent behaviour. On the basis of previous research showing that attitudes comprise two independent, positive and negative dimensions, we hypothesized that attitudes would be bi-dimensional predictors of both behavioural intentions and subsequent behaviour. We focused on health-risk behaviours. We therefore also hypothesized that the positive dimension of attitude (evaluations of positive behavioural outcomes) would better predict both behavioural intentions and subsequent behaviour than would the negative dimension, consistent with the positivity bias/offset principle. In Study 1 (cross sectional design), N = 109 university students completed questionnaire measures of their intentions to binge-drink and the positive and negative dimensions of attitude. Consistent with the hypotheses, both attitude dimensions independently predicted behavioural intentions and the positive dimension was a significantly better predictor than was the negative dimension. The same pattern of findings emerged in Study 2 (cross sectional design; N = 186 university students) when we predicted intentions to binge-drink, smoke and consume a high-fat diet. Similarly, in Study 3 (prospective design; N = 1,232 speed limit offenders), both the positive and negative dimensions of attitude predicted subsequent (6-month post-baseline) speeding behaviour on two different road types and the positive dimension was the better predictor. The implications for understanding the motivation of behaviour and the development of behaviour-change interventions are discussed. © 2014 The British Psychological Society.

  16. Gestational age-specific perinatal mortality rates for assisted reproductive technology (ART) and other births.

    PubMed

    Chughtai, Abrar A; Wang, Alex Y; Hilder, Lisa; Li, Zhuoyang; Lui, Kei; Farquhar, Cindy; Sullivan, Elizabeth A

    2018-02-01

    Is perinatal mortality rate higher among births born following assisted reproductive technology (ART) compared to non-ART births? Overall perinatal mortality rates in ART births was higher compared to non-ART births, but gestational age-specific perinatal mortality rate of ART births was lower for very preterm and moderate to late preterm births. Births born following ART are reported to have higher risk of adverse perinatal outcomes compared to non-ART births. This population-based retrospective cohort study included 407 368 babies (391 952 non-ART and 15 416 ART)-393 491 singletons and 10 877 twins or high order multiples. All births (≥20 weeks of gestation and/or ≥400 g of birthweight) in five states and territories in Australia during the period 2007-2009 were included in the study, using National Perinatal Data Collection (NPDC). Primary outcome measures were rates of stillbirth, neonatal and perinatal deaths. Adjusted odds ratio (AOR) and 95% confidence interval (CI) were used to estimate the likelihood of perinatal death. Rates of multiple birth and low birthweight were significantly higher in ART group compared to the non-ART group (P < 0.01). Overall perinatal mortality rate was significantly higher for ART births (16.5 per 1000 births, 95% CI 14.5-18.6), compared to non-ART births (11.3 per 1000 births, 95% CI 11.0-11.6) (AOR 1.45, 95% CI 1.26-1.68). However, gestational age-specific perinatal mortality rate of ART births (including both singletons and multiples) was lower for very preterm (<32 weeks' gestation) and moderate to late preterm births (32-36 weeks' gestation) (AOR 0.61, 95% CI 0.53-0.70 and AOR 0.61, 95% CI 0.53-0.70, respectively) compared to non-ART births. Congenital abnormality and spontaneous preterm were the most common causes of neonatal deaths in both ART and non-ART group. Due to different cut-off limit for perinatal period in Australia, the results of this study should be interpreted with cautions for other countries. Australian definition of perinatal period commences at 20 completed weeks (140 days) of gestation and ends 27 completed days after birth which is different from the definition by World Health Organisation (commences at 22 completed weeks (154 days) of gestation and ends seven completed days after birth) and by Centers for Disease Control and Prevention (includes infant deaths under age 7 days and fetal deaths at 28 weeks of gestation or more). Preterm birth is the single most important contributing factor to increased risk of perinatal mortality among ART singletons compared to non-ART singletons. Further research on reducing early preterm delivery, with the aim of reducing the perinatal mortality among ART births is needed. Couples who access ART treatment should be fully informed regarding the risk of preterm birth and subsequent risk of perinatal death. There was no funding associated with this study. No conflict of interest was declared. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  17. Does resident ranking during recruitment accurately predict subsequent performance as a surgical resident?

    PubMed

    Fryer, Jonathan P; Corcoran, Noreen; George, Brian; Wang, Ed; Darosa, Debra

    2012-01-01

    While the primary goal of ranking applicants for surgical residency training positions is to identify the candidates who will subsequently perform best as surgical residents, the effectiveness of the ranking process has not been adequately studied. We evaluated our general surgery resident recruitment process between 2001 and 2011 inclusive, to determine if our recruitment ranking parameters effectively predicted subsequent resident performance. We identified 3 candidate ranking parameters (United States Medical Licensing Examination [USMLE] Step 1 score, unadjusted ranking score [URS], and final adjusted ranking [FAR]), and 4 resident performance parameters (American Board of Surgery In-Training Examination [ABSITE] score, PGY1 resident evaluation grade [REG], overall REG, and independent faculty rating ranking [IFRR]), and assessed whether the former were predictive of the latter. Analyses utilized Spearman correlation coefficient. We found that the URS, which is based on objective and criterion based parameters, was a better predictor of subsequent performance than the FAR, which is a modification of the URS based on subsequent determinations of the resident selection committee. USMLE score was a reliable predictor of ABSITE scores only. However, when we compared our worst residence performances with the performances of the other residents in this evaluation, the data did not produce convincing evidence that poor resident performances could be reliably predicted by any of the recruitment ranking parameters. Finally, stratifying candidates based on their rank range did not effectively define a ranking cut-off beyond which resident performance would drop off. Based on these findings, we recommend surgery programs may be better served by utilizing a more structured resident ranking process and that subsequent adjustments to the rank list generated by this process should be undertaken with caution. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  18. Management of infertility in women over 40.

    PubMed

    Cabry, Rosalie; Merviel, Philippe; Hazout, Andre; Belloc, Stephanie; Dalleac, Alain; Copin, Henri; Benkhalifa, Moncef

    2014-05-01

    Women's fertility potential is declining with age because of multiples intrinsic and extrinsic factors such as life style, oxidative stress and/or endocrine disruptors and is affecting the ability of these women to conceive naturally. This declining fertility potential and the late age of motherhood is increasing significantly the number of patients consulting infertility specialists. Different strategies of investigation and management are proposed to patients over 40 in order to overcome their infertility and improve the live birth rate in these patients. Intra Uterine Insemination (IUI) in women over 40 is associated with a low rate of ongoing pregnancy and IUI should not therefore be offered always as the first line of treatment. When the predictive factors are positive IVF/ICSI seem to be good alternatives until 43 years of age. Customized ovarian stimulation and flexible laboratory methods such as in vitro maturation (IVM), preimplantation genetic diagnosis (PGD), embryo vitrification and transfer after thawing in subsequent natural or artificial cycles can improve the success rate of ART in patients over 40. Meanwhile, oocyte and embryos donation remain good options for patient over 40 with a bad prognosis and can lead to successful ongoing pregnancies until 45 years of age. Ovarian tissue cryopreservation, oocyte vitrification at the germinal vesicle (GV) stage or metaphase II stage present a breakthrough for fertility preservation but the ideal age for starting fertility preservation is still debated as well as the minimum number of oocytes to be vitrified in order to optimize the chances of pregnancy when needed at an older age. This manuscript reports the results of our own experience from patients older than 40 in the light of the published data and discusses the different therapeutic alternatives which can be proposed to patients over 40 consulting ART centres. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. A validated approach for modeling collapse of steel structures

    NASA Astrophysics Data System (ADS)

    Saykin, Vitaliy Victorovich

    A civil engineering structure is faced with many hazardous conditions such as blasts, earthquakes, hurricanes, tornadoes, floods, and fires during its lifetime. Even though structures are designed for credible events that can happen during a lifetime of the structure, extreme events do happen and cause catastrophic failures. Understanding the causes and effects of structural collapse is now at the core of critical areas of national need. One factor that makes studying structural collapse difficult is the lack of full-scale structural collapse experimental test results against which researchers could validate their proposed collapse modeling approaches. The goal of this work is the creation of an element deletion strategy based on fracture models for use in validated prediction of collapse of steel structures. The current work reviews the state-of-the-art of finite element deletion strategies for use in collapse modeling of structures. It is shown that current approaches to element deletion in collapse modeling do not take into account stress triaxiality in vulnerable areas of the structure, which is important for proper fracture and element deletion modeling. The report then reviews triaxiality and its role in fracture prediction. It is shown that fracture in ductile materials is a function of triaxiality. It is also shown that, depending on the triaxiality range, different fracture mechanisms are active and should be accounted for. An approach using semi-empirical fracture models as a function of triaxiality are employed. The models to determine fracture initiation, softening and subsequent finite element deletion are outlined. This procedure allows for stress-displacement softening at an integration point of a finite element in order to subsequently remove the element. This approach avoids abrupt changes in the stress that would create dynamic instabilities, thus making the results more reliable and accurate. The calibration and validation of these models are shown. The calibration is performed using a particle swarm optimization algorithm to establish accurate parameters when calibrated to circumferentially notched tensile coupons. It is shown that consistent, accurate predictions are attained using the chosen models. The variation of triaxiality in steel material during plastic hardening and softening is reported. The range of triaxiality in steel structures undergoing collapse is investigated in detail and the accuracy of the chosen finite element deletion approaches is discussed. This is done through validation of different structural components and structural frames undergoing severe fracture and collapse.

  20. Wind Turbine Dynamics

    NASA Technical Reports Server (NTRS)

    Thresher, R. W. (Editor)

    1981-01-01

    Recent progress in the analysis and prediction of the dynamic behavior of wind turbine generators is discussed. The following areas were addressed: (1) the adequacy of state of the art analysis tools for designing the next generation of wind power systems; (2) the use of state of the art analysis tools designers; and (3) verifications of theory which might be lacking or inadequate. Summaries of these informative discussions as well as the questions and answers which followed each paper are documented in the proceedings.

  1. "DEP'ART." Un Modele de Prevision des Departs des Enseignants. Documents Demographie Scolaire 9-16 ("DEP'ART." A Model for Predicting Teacher Attrition. Scholastic Demographic Document 9-16).

    ERIC Educational Resources Information Center

    Meublat, Guy

    This document forms part of a research project initiated by the Ministry of Education in Quebec and designed to forecast teacher demand over the next 15 years. It analyzes the problem of identifying potential teacher dropouts by means of a statistical model which provides simulations of various hypotheses and which can be easily revised by the…

  2. HIV-1 non-R5 tropism correlates with a larger size of the cellular viral reservoir and a detectable residual viremia in patients under suppressive ART.

    PubMed

    Lombardi, Francesca; Belmonti, Simone; Rapone, Lucrezia; Borghetti, Alberto; Ciccullo, Arturo; Gagliardini, Roberta; Baldin, Gianmaria; Montagnani, Francesca; Moschese, Davide; Emiliozzi, Arianna; Rossetti, Barbara; De Luca, Andrea; Di Giambenedetto, Simona

    2018-06-01

    The influence of HIV-1 co-receptor usage on the course of therapy in subjects fully responding to ART has been poorly investigated. To explore the relationship between co-receptor tropism and cellular reservoir size, residual viremia and subsequent virological outcome in ART-treated patients with HIV-1 RNA stable <50 copies/mL. Viral co-receptor usage was predicted by viral env DNA sequencing with geno2pheno interpretation (FPR20%) and classified as R5 and non-R5. Total blood-associated HIV-1 DNA levels (log 10 copies/10 6 leukocytes) were measured by qRT-PCR (5'LTR). Residual plasma viremia was categorized as detectable (1-49 cps/mL) or undetectable (<1 copy/mL). Virological rebounds (any HIV-1 RNA >50 copies/mL) were evaluated over 96 weeks. The study included 116 subjects. Patients with R5 virus (n = 59) and non-R5 virus (n = 57) were homogeneous for the main characteristics except for the lower nadir CD4 cell count in the non-R5 group. Patients with non-R5 variants showed higher levels of HIV-1 DNA as compared to patients with R5 virus: mean 2.47 (95% CI 2.37-2.56) vs 2.17 (2.08-2.26) (p < 0.001). Moreover, a higher proportion of patients in the non-R5 group displayed detectable residual viremia with respect to the R5-group (54.4% vs 32.2%, p = .016). Detectable residual viremia was found to be significantly associated with viral rebounds. The presence of non-R5 viral DNA variants is related to a higher probability of residual viremia and to a larger size of the cellular viral reservoir in this setting. These data highlight a potential role of viral tropism in the monitoring of HIV-1 infection in virologically controlled subject. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Challenging the state-of-the-art in protein structure prediction: Highlights of experimental target structures for the 10th Critical Assessment of Techniques for Protein Structure Prediction Experiment CASP10

    PubMed Central

    Kryshtafovych, Andriy; Moult, John; Bales, Patrick; Bazan, J. Fernando; Biasini, Marco; Burgin, Alex; Chen, Chen; Cochran, Frank V.; Craig, Timothy K.; Das, Rhiju; Fass, Deborah; Garcia-Doval, Carmela; Herzberg, Osnat; Lorimer, Donald; Luecke, Hartmut; Ma, Xiaolei; Nelson, Daniel C.; van Raaij, Mark J.; Rohwer, Forest; Segall, Anca; Seguritan, Victor; Zeth, Kornelius; Schwede, Torsten

    2014-01-01

    For the last two decades, CASP has assessed the state of the art in techniques for protein structure prediction and identified areas which required further development. CASP would not have been possible without the prediction targets provided by the experimental structural biology community. In the latest experiment, CASP10, over 100 structures were suggested as prediction targets, some of which appeared to be extraordinarily difficult for modeling. In this paper, authors of some of the most challenging targets discuss which specific scientific question motivated the experimental structure determination of the target protein, which structural features were especially interesting from a structural or functional perspective, and to what extent these features were correctly reproduced in the predictions submitted to CASP10. Specifically, the following targets will be presented: the acid-gated urea channel, a difficult to predict trans-membrane protein from the important human pathogen Helicobacter pylori; the structure of human interleukin IL-34, a recently discovered helical cytokine; the structure of a functionally uncharacterized enzyme OrfY from Thermoproteus tenax formed by a gene duplication and a novel fold; an ORFan domain of mimivirus sulfhydryl oxidase R596; the fibre protein gp17 from bacteriophage T7; the Bacteriophage CBA-120 tailspike protein; a virus coat protein from metagenomic samples of the marine environment; and finally an unprecedented class of structure prediction targets based on engineered disulfide-rich small proteins. PMID:24318984

  4. Deep learning methods for protein torsion angle prediction.

    PubMed

    Li, Haiou; Hou, Jie; Adhikari, Badri; Lyu, Qiang; Cheng, Jianlin

    2017-09-18

    Deep learning is one of the most powerful machine learning methods that has achieved the state-of-the-art performance in many domains. Since deep learning was introduced to the field of bioinformatics in 2012, it has achieved success in a number of areas such as protein residue-residue contact prediction, secondary structure prediction, and fold recognition. In this work, we developed deep learning methods to improve the prediction of torsion (dihedral) angles of proteins. We design four different deep learning architectures to predict protein torsion angles. The architectures including deep neural network (DNN) and deep restricted Boltzmann machine (DRBN), deep recurrent neural network (DRNN) and deep recurrent restricted Boltzmann machine (DReRBM) since the protein torsion angle prediction is a sequence related problem. In addition to existing protein features, two new features (predicted residue contact number and the error distribution of torsion angles extracted from sequence fragments) are used as input to each of the four deep learning architectures to predict phi and psi angles of protein backbone. The mean absolute error (MAE) of phi and psi angles predicted by DRNN, DReRBM, DRBM and DNN is about 20-21° and 29-30° on an independent dataset. The MAE of phi angle is comparable to the existing methods, but the MAE of psi angle is 29°, 2° lower than the existing methods. On the latest CASP12 targets, our methods also achieved the performance better than or comparable to a state-of-the art method. Our experiment demonstrates that deep learning is a valuable method for predicting protein torsion angles. The deep recurrent network architecture performs slightly better than deep feed-forward architecture, and the predicted residue contact number and the error distribution of torsion angles extracted from sequence fragments are useful features for improving prediction accuracy.

  5. Prediction of Developmentally Competent Chromatin Conformation in Mouse Antral Oocytes.

    PubMed

    Daszkiewicz, Regina; Szymoniak, Magdalena; Gąsior, Łukasz; Polański, Zbigniew

    Mouse prophase oocytes isolated from antral follicles may possess two alternative types of chromatin configuration: NSN configuration represents more dispersed chromatin and is characteristic mainly for growing oocytes whereas SN configuration, attained upon oocyte growth, comprises more condensed chromatin with a significant fraction concentrated around the nucleolus. Importantly, fully grown oocytes isolated from antral follicles represent a non-homogenous population in which some oocytes posses NSN-type and others SN-type of chromatin conformation. From these two, only oocytes with SN configuration are able to complete full development upon fertilization. We show that among mouse oocytes isolated from antral follicles, those surrounded by cumulus cells were larger and more frequently possessed SN chromatin than oocytes lacking the complete cumulus cell layer. Females primed with PMSG gave a higher number of oocytes with a complete layer of cumulus cells and the frequency of oocytes with SN chromatin was also elevated. Within the whole population of isolated antral oocytes, we observed subtle variation in size which allowed fractionation of oocytes under a stereomicroscope into groups representing oocytes of slightly different sizes. The occurrence of SN chromatin configuration was highly dependent on the oocyte size and its frequency increased gradually in subsequent size groups reaching 95-100% in the group representing the largest oocytes. These findings demonstrate that the subtle differences in the size of antral oocytes allow prediction of the status of their chromatin, thus providing a simple, fast, non-invasive and non-expensive way to select good quality oocytes for ART purposes in mammals.

  6. Identification of the Predictive Power of Five Factor Personality Traits for Individual Instrument Performance Anxiety

    ERIC Educational Resources Information Center

    Özdemir, Gökhan; Dalkiran, Esra

    2017-01-01

    This study, with the aim of identifying the predictive power of the five-factor personality traits of music teacher candidates on individual instrument performance anxiety, was designed according to the relational screening model. The study population was students attending the Music Education branch of Fine Arts Education Departments in…

  7. How Well Does the SAT and GPA Predict the Retention of Science, Technology, Engineering, Mathematics, and Business Students

    ERIC Educational Resources Information Center

    Rohr, Samuel L.

    2013-01-01

    This study examined the relationship between various admissions selection criteria utilized by a small, Liberal Arts College in Indiana. More specifically, the study examined if a higher college preparatory GPA and a higher aggregate score on the SAT helped predict the retention of science, technology, engineering, mathematics, and business…

  8. Using First-Grade Teacher Ratings to Predict Third-Grade English Language Arts and Mathematics Achievement on a High-Stakes Statewide Assessment

    ERIC Educational Resources Information Center

    Gallant, Dorinda J.

    2013-01-01

    Early childhood professional organizations support teachers as the best assessors of students' academic, social, emotional, and physical development. This study investigates the predictive nature of teacher ratings of first-grade students' performance on a standards-based curriculum-embedded performance assessment within the context of a state…

  9. Data Mining and Predictive Modeling in Institutional Advancement: How Ten Schools Found Success. Technical Report

    ERIC Educational Resources Information Center

    Luperchio, Dan

    2009-01-01

    This technical report, produced in partnership by the Council for Advancement and Support of Education (CASE) and SPSS Inc., explores the promise of data mining alumni records at educational institutions. Working with individual alumni records from The Johns Hopkins Zanvyl Krieger School of Arts and Sciences, a predictive regression model is…

  10. Progress towards understanding and predicting convection heat transfer in the turbine gas path

    NASA Technical Reports Server (NTRS)

    Simoneau, Robert J.; Simon, Frederick F.

    1992-01-01

    A new era is drawing in the ability to predict convection heat transfer in the turbine gas path. We feel that the technical community now has the capability to mount a major assault on this problem, which has eluded significant progress for a long time. We hope to make a case for this bold statement by reviewing the state of the art in three major heat transfer, configuration-specific experiments, whose data have provided the big picture and guided both the fundamental modeling research and the code development. Following that, we review progress and directions in the development of computer codes to predict turbine gas path heat transfer. Finally, we cite examples and make observations on the more recent efforts to do all this work in a simultaneous, interactive, and more synergistic manner. We conclude with an assessment of progress, suggestions for how to use the current state of the art, and recommendations for the future.

  11. Global brain dynamics during social exclusion predict subsequent behavioral conformity

    PubMed Central

    Wasylyshyn, Nick; Hemenway Falk, Brett; Garcia, Javier O; Cascio, Christopher N; O’Donnell, Matthew Brook; Bingham, C Raymond; Simons-Morton, Bruce; Vettel, Jean M; Falk, Emily B

    2018-01-01

    Abstract Individuals react differently to social experiences; for example, people who are more sensitive to negative social experiences, such as being excluded, may be more likely to adapt their behavior to fit in with others. We examined whether functional brain connectivity during social exclusion in the fMRI scanner can be used to predict subsequent conformity to peer norms. Adolescent males (n = 57) completed a two-part study on teen driving risk: a social exclusion task (Cyberball) during an fMRI session and a subsequent driving simulator session in which they drove alone and in the presence of a peer who expressed risk-averse or risk-accepting driving norms. We computed the difference in functional connectivity between social exclusion and social inclusion from each node in the brain to nodes in two brain networks, one previously associated with mentalizing (medial prefrontal cortex, temporoparietal junction, precuneus, temporal poles) and another with social pain (dorsal anterior cingulate cortex, anterior insula). Using predictive modeling, this measure of global connectivity during exclusion predicted the extent of conformity to peer pressure during driving in the subsequent experimental session. These findings extend our understanding of how global neural dynamics guide social behavior, revealing functional network activity that captures individual differences. PMID:29529310

  12. Obstacles to prior art searching by the trilateral patent offices: empirical evidence from International Search Reports.

    PubMed

    Wada, Tetsuo

    Despite many empirical studies having been carried out on examiner patent citations, few have scrutinized the obstacles to prior art searching when adding patent citations during patent prosecution at patent offices. This analysis takes advantage of the longitudinal gap between an International Search Report (ISR) as required by the Patent Cooperation Treaty (PCT) and subsequent national examination procedures. We investigate whether several kinds of distance actually affect the probability that prior art is detected at the time of an ISR; this occurs much earlier than in national phase examinations. Based on triadic PCT applications between 2002 and 2005 for the trilateral patent offices (the European Patent Office, the US Patent and Trademark Office, and the Japan Patent Office) and their family-level citations made by the trilateral offices, we find evidence that geographical distance negatively affects the probability of capture of prior patents in an ISR. In addition, the technological complexity of an application negatively affects the probability of capture, whereas the volume of forward citations of prior art affects it positively. These results demonstrate the presence of obstacles to searching at patent offices, and suggest ways to design work sharing by patent offices, such that the duplication of search costs arises only when patent office search horizons overlap.

  13. Age of Barrier Canyon-style rock art constrained by cross-cutting relations and luminescence dating techniques.

    PubMed

    Pederson, Joel L; Chapot, Melissa S; Simms, Steven R; Sohbati, Reza; Rittenour, Tammy M; Murray, Andrew S; Cox, Gary

    2014-09-09

    Rock art compels interest from both researchers and a broader public, inspiring many hypotheses about its cultural origin and meaning, but it is notoriously difficult to date numerically. Barrier Canyon-style (BCS) pictographs of the Colorado Plateau are among the most debated examples; hypotheses about its age span the entire Holocene epoch and previous attempts at direct radiocarbon dating have failed. We provide multiple age constraints through the use of cross-cutting relations and new and broadly applicable approaches in optically stimulated luminescence dating at the Great Gallery panel, the type section of BCS art in Canyonlands National Park, southeastern Utah. Alluvial chronostratigraphy constrains the burial and exhumation of the alcove containing the panel, and limits are also set by our related research dating both a rockfall that removed some figures and the rock's exposure duration before that time. Results provide a maximum possible age, a minimum age, and an exposure time window for the creation of the Great Gallery panel, respectively. The only prior hypothesis not disproven is a late Archaic origin for BCS rock art, although our age result of A.D. ∼ 1-1100 coincides better with the transition to and rise of the subsequent Fremont culture. This chronology is for the type locality only, and variability in the age of other sites is likely. Nevertheless, results suggest that BCS rock art represents an artistic tradition that spanned cultures and the transition from foraging to farming in the region.

  14. Age of Barrier Canyon-style rock art constrained by cross-cutting relations and luminescence dating techniques

    PubMed Central

    Pederson, Joel L.; Chapot, Melissa S.; Simms, Steven R.; Sohbati, Reza; Rittenour, Tammy M.; Murray, Andrew S.; Cox, Gary

    2014-01-01

    Rock art compels interest from both researchers and a broader public, inspiring many hypotheses about its cultural origin and meaning, but it is notoriously difficult to date numerically. Barrier Canyon-style (BCS) pictographs of the Colorado Plateau are among the most debated examples; hypotheses about its age span the entire Holocene epoch and previous attempts at direct radiocarbon dating have failed. We provide multiple age constraints through the use of cross-cutting relations and new and broadly applicable approaches in optically stimulated luminescence dating at the Great Gallery panel, the type section of BCS art in Canyonlands National Park, southeastern Utah. Alluvial chronostratigraphy constrains the burial and exhumation of the alcove containing the panel, and limits are also set by our related research dating both a rockfall that removed some figures and the rock’s exposure duration before that time. Results provide a maximum possible age, a minimum age, and an exposure time window for the creation of the Great Gallery panel, respectively. The only prior hypothesis not disproven is a late Archaic origin for BCS rock art, although our age result of A.D. ∼1–1100 coincides better with the transition to and rise of the subsequent Fremont culture. This chronology is for the type locality only, and variability in the age of other sites is likely. Nevertheless, results suggest that BCS rock art represents an artistic tradition that spanned cultures and the transition from foraging to farming in the region. PMID:25157162

  15. Eye of the beholder: when the public can't separate art from science, are you doing both?

    NASA Astrophysics Data System (ADS)

    Hut, Rolf; Bogaard, Thom

    2017-04-01

    "So what statement are you trying to make?" "How do you mean?" "Well, you're doing this to raise awareness for something important, right?" "No" "So it's art for art's sake?" I just explained my brother that I am going to Mandalay, Myanmar to throw a few hundred biodegradable balloons, fitted with LED-lights (Dutch bike lights actually…) into the Irrawaddy River. No, we are not doing it for art's sake, we are doing it for science. Local student teams will record at what times the balloons pass major bridges along the river. That data will allow us to calibrate the hydrodynamics of the river, to better predict its behavior in the future: during both normal flow conditions and floods. So that is what I explain to him. "But you are going to take pictures are you? Because it sounds like it will look great!" "Sure we are, video even!" Maybe we are making art. I don't know. We started out doing this for science. But if the public can't separate science from art, maybe we are doing both. Are we?

  16. Late-Life Depressive Symptoms and Lifetime History of Major Depression: Cognitive Deficits are Largely Due to Incipient Dementia rather than Depression.

    PubMed

    Heser, Kathrin; Bleckwenn, Markus; Wiese, Birgitt; Mamone, Silke; Riedel-Heller, Steffi G; Stein, Janine; Lühmann, Dagmar; Posselt, Tina; Fuchs, Angela; Pentzek, Michael; Weyerer, Siegfried; Werle, Jochen; Weeg, Dagmar; Bickel, Horst; Brettschneider, Christian; König, Hans-Helmut; Maier, Wolfgang; Scherer, Martin; Wagner, Michael

    2016-08-01

    Late-life depression is frequently accompanied by cognitive impairments. Whether these impairments indicate a prodromal state of dementia, or are a symptomatic expression of depression per se is not well-studied. In a cohort of very old initially non-demented primary care patients (n = 2,709, mean age = 81.1 y), cognitive performance was compared between groups of participants with or without elevated depressive symptoms and with or without subsequent dementia using ANCOVA (adjusted for age, sex, and education). Logistic regression analyses were computed to predict subsequent dementia over up to six years of follow-up. The same analytical approach was performed for lifetime major depression. Participants with elevated depressive symptoms without subsequent dementia showed only small to medium cognitive deficits. In contrast, participants with depressive symptoms with subsequent dementia showed medium to very large cognitive deficits. In adjusted logistic regression models, learning and memory deficits predicted the risk for subsequent dementia in participants with depressive symptoms. Participants with a lifetime history of major depression without subsequent dementia showed no cognitive deficits. However, in adjusted logistic regression models, learning and orientation deficits predicted the risk for subsequent dementia also in participants with lifetime major depression. Marked cognitive impairments in old age depression should not be dismissed as "depressive pseudodementia", but require clinical attention as a possible sign of incipient dementia. Non-depressed elderly with a lifetime history of major depression, who remained free of dementia during follow-up, had largely normal cognitive performance.

  17. A graph kernel approach for alignment-free domain-peptide interaction prediction with an application to human SH3 domains.

    PubMed

    Kundu, Kousik; Costa, Fabrizio; Backofen, Rolf

    2013-07-01

    State-of-the-art experimental data for determining binding specificities of peptide recognition modules (PRMs) is obtained by high-throughput approaches like peptide arrays. Most prediction tools applicable to this kind of data are based on an initial multiple alignment of the peptide ligands. Building an initial alignment can be error-prone, especially in the case of the proline-rich peptides bound by the SH3 domains. Here, we present a machine-learning approach based on an efficient graph-kernel technique to predict the specificity of a large set of 70 human SH3 domains, which are an important class of PRMs. The graph-kernel strategy allows us to (i) integrate several types of physico-chemical information for each amino acid, (ii) consider high-order correlations between these features and (iii) eliminate the need for an initial peptide alignment. We build specialized models for each human SH3 domain and achieve competitive predictive performance of 0.73 area under precision-recall curve, compared with 0.27 area under precision-recall curve for state-of-the-art methods based on position weight matrices. We show that better models can be obtained when we use information on the noninteracting peptides (negative examples), which is currently not used by the state-of-the art approaches based on position weight matrices. To this end, we analyze two strategies to identify subsets of high confidence negative data. The techniques introduced here are more general and hence can also be used for any other protein domains, which interact with short peptides (i.e. other PRMs). The program with the predictive models can be found at http://www.bioinf.uni-freiburg.de/Software/SH3PepInt/SH3PepInt.tar.gz. We also provide a genome-wide prediction for all 70 human SH3 domains, which can be found under http://www.bioinf.uni-freiburg.de/Software/SH3PepInt/Genome-Wide-Predictions.tar.gz. Supplementary data are available at Bioinformatics online.

  18. A graph kernel approach for alignment-free domain–peptide interaction prediction with an application to human SH3 domains

    PubMed Central

    Kundu, Kousik; Costa, Fabrizio; Backofen, Rolf

    2013-01-01

    Motivation: State-of-the-art experimental data for determining binding specificities of peptide recognition modules (PRMs) is obtained by high-throughput approaches like peptide arrays. Most prediction tools applicable to this kind of data are based on an initial multiple alignment of the peptide ligands. Building an initial alignment can be error-prone, especially in the case of the proline-rich peptides bound by the SH3 domains. Results: Here, we present a machine-learning approach based on an efficient graph-kernel technique to predict the specificity of a large set of 70 human SH3 domains, which are an important class of PRMs. The graph-kernel strategy allows us to (i) integrate several types of physico-chemical information for each amino acid, (ii) consider high-order correlations between these features and (iii) eliminate the need for an initial peptide alignment. We build specialized models for each human SH3 domain and achieve competitive predictive performance of 0.73 area under precision-recall curve, compared with 0.27 area under precision-recall curve for state-of-the-art methods based on position weight matrices. We show that better models can be obtained when we use information on the noninteracting peptides (negative examples), which is currently not used by the state-of-the art approaches based on position weight matrices. To this end, we analyze two strategies to identify subsets of high confidence negative data. The techniques introduced here are more general and hence can also be used for any other protein domains, which interact with short peptides (i.e. other PRMs). Availability: The program with the predictive models can be found at http://www.bioinf.uni-freiburg.de/Software/SH3PepInt/SH3PepInt.tar.gz. We also provide a genome-wide prediction for all 70 human SH3 domains, which can be found under http://www.bioinf.uni-freiburg.de/Software/SH3PepInt/Genome-Wide-Predictions.tar.gz. Contact: backofen@informatik.uni-freiburg.de Supplementary information: Supplementary data are available at Bioinformatics online. PMID:23813002

  19. Rumination, anxiety, depressive symptoms and subsequent depression in adolescents at risk for psychopathology: a longitudinal cohort study.

    PubMed

    Wilkinson, Paul O; Croudace, Tim J; Goodyer, Ian M

    2013-10-08

    A ruminative style of responding to low mood is associated with subsequent high depressive symptoms and depressive disorder in children, adolescents and adults. Scores on self-report rumination scales correlate strongly with scores on anxiety and depression symptom scales. This may confound any associations between rumination and subsequent depression. Our sample comprised 658 healthy adolescents at elevated risk for psychopathology. This study applied ordinal item (non-linear) factor analysis to pooled items from three self-report questionnaires to explore whether there were separate, but correlated, constructs of rumination, depression and anxiety. It then tested whether rumination independently predicted depressive disorder and depressive symptoms over the subsequent 12 months, after adjusting for confounding variables. We identified a single rumination factor, which was correlated with factors representing cognitive symptoms of depression, somatic symptoms of depression and anxiety symptoms; and one factor representing adaptive responses to low mood. Elevated rumination scores predicted onset of depressive disorders over the subsequent year (p = 0.035), and levels of depressive symptoms 12 months later (p < 0.0005), after adjustment for prior levels of depressive and anxiety symptoms. High rumination predicts onset of depressive disorder in healthy adolescents. Therapy that reduces rumination and increases distraction/problem-solving may reduce onset and relapse rates of depression.

  20. The Impact of HIV, an Antiretroviral Programme and Tuberculosis on Mortality in South African Platinum Miners, 1992–2010

    PubMed Central

    Lim, Megan S. C.; Dowdeswell, Robert J.; Murray, Jill; Field, Nigel; Glynn, Judith R.; Sonnenberg, Pam

    2012-01-01

    Background HIV and tuberculosis (TB) are the most common causes of death in South Africa. Antiretroviral therapy (ART) programmes should have had an impact on mortality rates. This study describes the impact of HIV, a Wellness (HIV/ART) programme and TB on population-wide trends in mortality and causes of death among South African platinum miners, from before the HIV epidemic into the ART era. Methodology/Principal Findings Retrospective analysis was conducted using routinely-collected data from an open cohort. Mortality and causes of death were determined from multiple sources, including cardiorespiratory autopsy records. All-cause and cause-specific mortality rates were calculated by calendar year. 41,665 male miners were observed for 311,938 person years (py) with 3863 deaths. The all-cause age-standardised mortality rate increased from 5.9/1000py in 1992 to 20.2/1000py in 2002. Following ART rollout in 2003, annual mortality rates fluctuated between 12.4/1000py and 19.3/1000py in the subsequent 7 years. Half of all deaths were HIV-related and 21% were caused by TB. Half (50%) of miners who died of HIV after ART rollout had never been registered on the Wellness programme. TB was the most common cause of death in HIV positive miners, increasing from 28% of deaths in the pre-ART period to 41% in the post-ART period. Conclusions/Significance This population-based cohort experienced a rapid increase in mortality from 1996 to 2003 due to increases in HIV and TB mortality. Following ART rollout there was a decrease in mortality, but a steady decrease has not been sustained. Possible explanations for these trends include the changing composition of the workforce, maturation of the HIV epidemic, insufficient uptake of ART and an increase in the proportion of deaths due to TB. In order to make a significant and sustained reduction in mortality in this population, expanding and integrating HIV and TB care and treatment is essential. PMID:22761688

  1. Prevalence and Mutation Patterns of HIV Drug Resistance from 2010 to 2011 among ART-Failure Individuals in the Yunnan Province, China

    PubMed Central

    Guo, Wei; Zhuang, Daomin; Li, Lin; Liu, Yongjian; Bao, Zuoyi; Liu, Siyang; Wang, Xiaolin; Li, Tianyi; Yang, Shaomin; Li, Jingyun

    2013-01-01

    Background Assessing the prevalence of HIV-1 drug-resistance and the mutation patterns associated with resistance in the geographical regions implementing free antiretroviral therapy (ART) in China is necessary for preventing the spread of resistant strains and designing the regimens for the subsequent therapies with limited resources. Methods Plasma samples in different cities/prefectures were collected at Yunnan Provincial Hospital of Infectious Disease from January 2010 to December 2011. Genotyping of drug-resistant individuals was conducted using an in-house assay on plasma samples. Viral load, CD4 T cell counts and demographic data were obtained from medical records and an administered questionnaire. Results A total of 609 pol sequences (515 ART-failure and 94 therapy-naïve individuals) derived from 664 samples were obtained. The prevalence of drug-resistance was 45.1% in the ART-failure individuals. Of these, 26.8% harbored HIV strains dually resistant to nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors, and 14.8% harbored HIV strains resistant to only one drug category. Mutations such as M184V/I, K103N, V106A, Y181C and G190A were common among the ART-failure individuals, and the frequencies of M184V/I, K103N and V106A were 28.2%, 19.2%, and 22.1%, respectively. The percentages of individuals exhibiting intermediate or high-level resistance to 3TC, FTC, EFV and NVP drugs were 28.4%, 28.2%, 37.3%, and 37.5%, respectively. Factors such as ethnicity, transmission route, CD4 counts, viral load and the duration of ART were significantly correlated with development of drug resistance in the ART-failure individuals. Conclusions The high prevalence of HIV drug-resistance observed among the ART-failure individuals from 2010 to 2011 in Yunnan province should be of increasing concern in regions where the implementation of ART is widespread. Education about the risk factors associated with HIV drug resistance is important for preventing and controlling the spread of HIV drug-resistant strains. PMID:24009694

  2. Plasma LL-37 correlates with vitamin D and is reduced in human immunodeficiency virus-1 infected individuals not receiving antiretroviral therapy

    PubMed Central

    Connick, Elizabeth; MaWhinney, Samantha; Chan, Edward D.; Flores, Sonia C.

    2014-01-01

    Low levels of the vitamin D-regulated antimicrobial peptide cathelicidin (LL-37) may negatively impact the immune status of human immunodeficiency virus-1 (HIV-1) infected individuals (HIV+). We compared plasma LL-37 levels in healthy controls (HIV−) and HIV+ individuals on or off antiretroviral therapies (ARTs) (ART+ and ART−, respectively), and evaluated the relationship between vitamin D and LL-37 levels. In this cross-sectional study, levels of LL-37, 25-hydroxycholecalciferol [25(OH)D3] and 1,25-dihydroxycholecalciferol [1,25(OH)2D3] were measured from an initial cohort of 18 healthy controls and 10 HIV+/ART− individuals. Because this cohort lacked HIV+/ART+ subjects, LL-37 was also quantified from a second cohort of 10 HIV+/ART− and 13 HIV+/ART+ individuals. LL-37 levels were significantly lower in the HIV+/ART− group compared to the healthy controls (P = 0.01). A direct relationship was observed between LL-37 and both 25(OH)D3 and 1,25(OH)2D3. The level of 25(OH)D3 was predictive of higher LL-37 (P = 0.04) and for any given level of 25(OH)D3, HIV+/ART− subjects averaged 20 % lower LL-37 compared to the healthy controls (P = 0.045). For any given level of 1,25(OH)2D3, HIV+/ART− subjects averaged 25 % lower LL-37 compared to the healthy controls (P = 0.018), although 1,25(OH)2D3 was not predictive of higher LL-37 (P = 0.28). Finally, LL-37 levels were significantly lower in the HIV+/ART− group compared to the HIV+/ART+ group from the second cohort (P = 0.045). Untreated HIV infection may contribute to lower LL-37 levels, independent of vitamin D levels. ART treatment may potentially mitigate this decrease in LL-37 levels. PMID:24821067

  3. Concurrent Anemia and Elevated C-Reactive Protein Predicts HIV Clinical Treatment Failure, Including Tuberculosis, After Antiretroviral Therapy Initiation

    PubMed Central

    Shivakoti, Rupak; Yang, Wei-Teng; Gupte, Nikhil; Berendes, Sima; Rosa, Alberto La; Cardoso, Sandra W.; Mwelase, Noluthando; Kanyama, Cecilia; Pillay, Sandy; Samaneka, Wadzanai; Riviere, Cynthia; Sugandhavesa, Patcharaphan; Santos, Brento; Poongulali, Selvamuthu; Tripathy, Srikanth; Bollinger, Robert C.; Currier, Judith S.; Tang, Alice M.; Semba, Richard D.; Christian, Parul; Campbell, Thomas B.; Gupta, Amita

    2015-01-01

    Background. Anemia is a known risk factor for clinical failure following antiretroviral therapy (ART). Notably, anemia and inflammation are interrelated, and recent studies have associated elevated C-reactive protein (CRP), an inflammation marker, with adverse human immunodeficiency virus (HIV) treatment outcomes, yet their joint effect is not known. The objective of this study was to assess prevalence and risk factors of anemia in HIV infection and to determine whether anemia and elevated CRP jointly predict clinical failure post-ART. Methods. A case-cohort study (N = 470 [236 cases, 234 controls]) was nested within a multinational randomized trial of ART efficacy (Prospective Evaluation of Antiretrovirals in Resource Limited Settings [PEARLS]). Cases were incident World Health Organization stage 3, 4, or death by 96 weeks of ART treatment (clinical failure). Multivariable logistic regression was used to determine risk factors for pre-ART (baseline) anemia (females: hemoglobin <12.0 g/dL; males: hemoglobin <13.0 g/dL). Association of anemia as well as concurrent baseline anemia and inflammation (CRP ≥10 mg/L) with clinical failure were assessed using multivariable Cox models. Results. Baseline anemia prevalence was 51% with 15% prevalence of concurrent anemia and inflammation. In analysis of clinical failure, multivariate-adjusted hazard ratios were 6.41 (95% confidence interval [CI], 2.82–14.57) for concurrent anemia and inflammation, 0.77 (95% CI, .37–1.58) for anemia without inflammation, and 0.45 (95% CI, .11–1.80) for inflammation without anemia compared to those without anemia and inflammation. Conclusions. ART-naive, HIV-infected individuals with concurrent anemia and inflammation are at particularly high risk of failing treatment, and understanding the pathogenesis could lead to new interventions. Reducing inflammation and anemia will likely improve HIV disease outcomes. Alternatively, concurrent anemia and inflammation could represent individuals with occult opportunistic infections in need of additional screening. PMID:25828994

  4. Determinants of virological outcome and adverse events in African children treated with paediatric nevirapine fixed-dose-combination tablets

    PubMed Central

    BIENCZAK, Andrzej; DENTI, Paolo; Adrian, COOK; WIESNER, Lubbe; MULENGA, Veronica; KITYO, Cissy; KEKITIINWA, Addy; GIBB, Diana M.; BURGER, David; WALKER, A. Sarah; MCILLERON, Helen

    2017-01-01

    Background Nevirapine is the only non-nucleoside reverse transcriptase inhibitor currently available as a paediatric fixed-dose combination tablet and is widely used in African children. Nonetheless, the number of investigations into pharmacokinetic determinants of virological suppression in African children is limited and the predictive power of the current therapeutic range was never evaluated in this population, thereby limiting treatment optimisation. Methods We analysed data from 322 African children (aged 0.3–13 years) treated with nevirapine, lamivudine, and either abacavir, stavudine, or zidovudine, and followed up to 144 weeks. Nevirapine trough concentration (Cmin) and other factors were tested for associations with viral load (VL)>100 copies/mL and transaminase increases >grade 1 using proportional hazard and logistic models in 219 initially antiretroviral treatment(ART)-naïve children. Results Pre-ART VL, adherence, and nevirapine Cmin were associated with VL non-suppression (hazard-ratio [HR]=2.08 [95% CI: 1.50–2.90, p<0.001] for 10-fold higher pre-ART VL, HR=0.78 [95% CI: 0.68–0.90, p<0.001] for 10% improvement in adherence and HR=0.94 [95% CI: 0.90–0.99, p=0.014] for a 1mg/L increase in nevirapine Cmin). There were additional effects of pre-ART CD4% and clinical site. The risk of virological non-suppression decreased with increasing nevirapine Cmin and there was no clear Cmin threshold predictive of virological non-suppression. Transient transaminase elevations >grade 1 were associated with high Cmin (>12.4 mg/L), HR=5.18 (95%CI 1.95–13.80, p<0.001). Conclusions Treatment initiation at lower pre-ART VL and higher pre-ART CD4%, increased adherence, and maintaining average Cmin higher than current target could improve virological suppression of African children treated with nevirapine without increasing toxicity. PMID:28060017

  5. The relationship between HIV and fertility in the era of antiretroviral therapy in sub-Saharan Africa: evidence from 49 Demographic and Health Surveys.

    PubMed

    Marston, M; Zaba, B; Eaton, J W

    2017-12-01

    To describe regional differences in the relative fertility of HIV-positive vs. HIV-negative women and changes as antiretroviral treatment (ART) is scaled up, to improve estimates of predicted need for and coverage of prevention of mother-to-child transmission services at national and subnational levels. We analysed 49 nationally representative household surveys in sub-Saharan Africa between 2003 and 2016 to estimate fertility rate ratios of HIV-positive and HIV-negative women by age using exponential regression and test for regional and urban/rural differences. We estimated the association between national ART coverage and the relationship between HIV and fertility. Significant regional differences exist in HIV and fertility relationships, with less HIV-associated subfertility in Southern Africa. Age patterns of relative fertility are similar. HIV impact on fertility is weaker in urban than rural areas. For women below age 30, regional and urban/rural differences are largely explained by differences in age at sexual debut. Higher levels of national ART coverage were associated with slight attenuation of the relationship between HIV and fertility. Regional differences in HIV-associated subfertility and urban-rural differences in age patterns of relative fertility should be accounted for when predicting need for and coverage of PMTCT services at national and subnational level. Although HIV impacts on fertility are somewhat reduced at higher levels of national ART coverage, differences in fertility between HIV positive and negative remain, and fertility of women on ART should not be assumed to be the same as HIV-negative women. There were few data in recent years, when ART has reached high levels, and this relationship should continue to be assessed as further evidence becomes available. © 2017 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  6. ART, Stoffenmanager, and TRA: A Systematic Comparison of Exposure Estimates Using the TREXMO Translation System.

    PubMed

    Savic, Nenad; Gasic, Bojan; Vernez, David

    2017-12-15

    Several occupational exposure models are recommended under the EU's REACH legislation. Due to limited availability of high-quality exposure data, their validation is an ongoing process. It was shown, however, that different models may calculate significantly different estimates and thus lead to potentially dangerous conclusions about chemical risk. In this paper, the between-model translation rules defined in TREXMO were used to generate 319000 different in silico exposure situations in ART, Stoffenmanager, and ECETOC TRA v3. The three models' estimates were computed and the correlation and consistency between them were investigated. The best correlated pair was Stoffenmanager-ART (R, 0.52-0.90), whereas the ART-TRA and Stoffenmanager-TRA correlations were either lower (R, 0.36-0.69) or no correlation was found. Consistency varied significantly according to different exposure types (e.g. vapour versus dust) or settings (near-field versus far-field and indoors versus outdoors). The percentages of generated situations for which estimates differed by more than a factor of 100 ranged from 14 to 97%, 37 to 99%, and 1 to 68% for Stoffenmanager-ART, TRA-ART, and TRA-Stoffenmanager, respectively. Overall, the models were more consistent for vapours than for dusts and solids, near-fields than for far-fields, and indoor than for outdoor exposure. Multiple linear regression analyses evidenced the relationship between the models' parameters and the relative differences between the models' predictions. The relative difference can be used to estimate the consistency between the models. Furthermore, the study showed that the tiered approach is not generally applicable to all exposure situations. These findings emphasize the need for a multiple-model approach to assessing critical exposure scenarios under REACH. Moreover, in combination with occupational exposure measurements, they might also be used for future studies to improve prediction accuracy. © The Author(s) 2017. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

  7. Remembered or Forgotten?—An EEG-Based Computational Prediction Approach

    PubMed Central

    Sun, Xuyun; Qian, Cunle; Chen, Zhongqin; Wu, Zhaohui; Luo, Benyan; Pan, Gang

    2016-01-01

    Prediction of memory performance (remembered or forgotten) has various potential applications not only for knowledge learning but also for disease diagnosis. Recently, subsequent memory effects (SMEs)—the statistical differences in electroencephalography (EEG) signals before or during learning between subsequently remembered and forgotten events—have been found. This finding indicates that EEG signals convey the information relevant to memory performance. In this paper, based on SMEs we propose a computational approach to predict memory performance of an event from EEG signals. We devise a convolutional neural network for EEG, called ConvEEGNN, to predict subsequently remembered and forgotten events from EEG recorded during memory process. With the ConvEEGNN, prediction of memory performance can be achieved by integrating two main stages: feature extraction and classification. To verify the proposed approach, we employ an auditory memory task to collect EEG signals from scalp electrodes. For ConvEEGNN, the average prediction accuracy was 72.07% by using EEG data from pre-stimulus and during-stimulus periods, outperforming other approaches. It was observed that signals from pre-stimulus period and those from during-stimulus period had comparable contributions to memory performance. Furthermore, the connection weights of ConvEEGNN network can reveal prominent channels, which are consistent with the distribution of SME studied previously. PMID:27973531

  8. Power and energy dissipation in subsequent return strokes as predicted by a new return stroke model

    NASA Technical Reports Server (NTRS)

    Cooray, Vernon

    1991-01-01

    Recently, Cooray introduced a new return stroke model which is capable of predicting the temporal behavior of the return stroke current and the return stroke velocity as a function of the height along the return stroke channel. The authors employed this model to calculate the power and energy dissipation in subsequent return strokes. The results of these calculations are presented here. It was concluded that a large fraction of the total energy available for the dart leader-subsequent stroke process is dissipated in the dart leader stage. The peak power per unit length dissipated in a subsequent stroke channel element decreases with increasing height of that channel element from ground level. For a given channel element, the peak power dissipation increases with increasing current in that channel element. The peak electrical power dissipation in a typical subsequent return stroke is about 1.5 times 10(exp 11) W. The energy dissipation in a subsequent stroke increases with increasing current in the return stroke channel, and for a typical subsequent stroke, the energy dissipation per unit length is about 5.0 times 10(exp 3) J/m.

  9. Quantitative prediction of drug side effects based on drug-related features.

    PubMed

    Niu, Yanqing; Zhang, Wen

    2017-09-01

    Unexpected side effects of drugs are great concern in the drug development, and the identification of side effects is an important task. Recently, machine learning methods are proposed to predict the presence or absence of interested side effects for drugs, but it is difficult to make the accurate prediction for all of them. In this paper, we transform side effect profiles of drugs as their quantitative scores, by summing up their side effects with weights. The quantitative scores may measure the dangers of drugs, and thus help to compare the risk of different drugs. Here, we attempt to predict quantitative scores of drugs, namely the quantitative prediction. Specifically, we explore a variety of drug-related features and evaluate their discriminative powers for the quantitative prediction. Then, we consider several feature combination strategies (direct combination, average scoring ensemble combination) to integrate three informative features: chemical substructures, targets, and treatment indications. Finally, the average scoring ensemble model which produces the better performances is used as the final quantitative prediction model. Since weights for side effects are empirical values, we randomly generate different weights in the simulation experiments. The experimental results show that the quantitative method is robust to different weights, and produces satisfying results. Although other state-of-the-art methods cannot make the quantitative prediction directly, the prediction results can be transformed as the quantitative scores. By indirect comparison, the proposed method produces much better results than benchmark methods in the quantitative prediction. In conclusion, the proposed method is promising for the quantitative prediction of side effects, which may work cooperatively with existing state-of-the-art methods to reveal dangers of drugs.

  10. 2[prime] and 3[prime] Carboranyl uridines and their diethyl ether adducts

    DOEpatents

    Soloway, A.H.; Barth, R.F.; Anisuzzaman, A.K.; Alam, F.; Tjarks, W.

    1992-12-15

    A process is described for preparing carboranyl uridine nucleoside compounds and their diethyl ether adducts, which exhibit a tenfold increase in boron content over prior art boron containing nucleoside compounds. The carboranyl uridine nucleoside compounds exhibit enhanced lipophilicity and hydrophilic properties adequate to enable solvation in aqueous media for subsequent incorporation of the compounds in methods for boron neutron capture therapy in mammalian tumor cells. No Drawings

  11. 2' and 3' Carboranyl uridines and their diethyl ether adducts

    DOEpatents

    Soloway, Albert H.; Barth, Rolf F.; Anisuzzaman, Abul K.; Alam, Fazlul; Tjarks, Werner

    1992-01-01

    There is disclosed a process for preparing carboranyl uridine nucleoside compounds and their diethyl ether adducts, which exhibit a tenfold increase in boron content over prior art boron containing nucleoside compounds. Said carboranyl uridine nucleoside compounds exhibit enhanced lipophilicity and hydrophilic properties adequate to enable solvation in aqueous media for subsequent incorporation of said compounds in methods for boron neutron capture therapy in mammalian tumor cells.

  12. Effectiveness of the United States Marine Corps Tiered Evaluation System

    DTIC Science & Technology

    2015-03-01

    RA Manpower and Reserve Affairs MCMAP Marine Corps Martial Arts Program MMPR Marine Corps Promotions Branch MOS military occupational specialty...STAP subsequent term alignment program TFDW Total Force Data Warehouse USMC United States Marine Corps xv THIS PAGE INTENTIONALLY LEFT BLANK...Furthermore, I would like to thank Mr. Tim Johnson at the Total Force Data Warehouse and Ms. Doreen Marucci at the Performance Evaluation Section for

  13. Vanishing twin syndrome among ART singletons and pregnancy outcomes

    PubMed Central

    Magnus, Maria C; Ghaderi, Sara; Morken, Nils-Halvdan; Magnus, Per; Bente Romundstad, Liv; Skjærven, Rolv; Wilcox, Allen J; Eldevik Håberg, Siri

    2017-01-01

    Abstract STUDY QUESTION Among babies born by ART, do singleton survivors of a vanishing twin have lower birth weight than other singletons? SUMMARY ANSWER Vanishing twin syndrome (VTS) was associated with lower birth weight among ART singletons; a sibship analysis indicated that the association was not confounded by maternal characteristics that remain stable between deliveries. WHAT IS KNOWN ALREADY Previous studies indicate that ART singletons with VTS have increased risk of adverse pregnancy outcomes, compared with other ART singletons. The potential contribution of unmeasured maternal background characteristics has been unclear. STUDY DESIGN, SIZE AND DURATION This was a Norwegian population-based registry study, including 17 368 mothers with 20 410 ART singleton deliveries between January 1984 and December 2013. PARTICIPANTS/MATERIALS, SETTING, METHODS The study population included 17 291 ART singletons without VTS, 638 ART singletons with VTS and 2418 ART singletons with uncertain vanishing twin status. We estimated differences in birth weight and gestational age comparing ART singletons with VTS first to all ART singletons without VTS, and subsequently to their ART siblings without VTS, using random- and fixed-effects linear regression, respectively. The corresponding comparisons for the associations with preterm birth and small for gestational age (SGA) were conducted using random-and fixed-effects logistic regression. The sibling analysis of preterm birth included 587 discordant siblings, while the sibling analysis of SGA included 674 discordant siblings. MAIN RESULTS AND THE ROLE OF CHANCE ART singletons with VTS had lower birth weight when compared to all ART singletons without VTS, with an adjusted mean difference (95% CI) of −116 g (−165, −67). When we compared ART singletons with VTS to their ART singletons sibling without VTS, the adjusted mean difference was −112 g (−209, −15). ART singletons with VTS also had increased risk of being born SGA, with an adjusted odds ratio (OR) (95% CI) of 1.48 (1.07, 2.03) compared to all ART singletons without VTS, and 2.79 (1.12, 6.91) in the sibship analyses. ART singletons with VTS were also more likely to be born preterm, although this difference did not reach statistical significance. LIMITATIONS REASONS FOR CAUTION We did not have information on maternal socio-economic status, but this factor is accounted for in the sibship analyses. We also had no information on whether fresh or frozen embryos were replaced. WIDER IMPLICATIONS OF THE FINDINGS The reduction in birth weight and increased risk of SGA in ART singletons with VTS may suggest the presence of harmful intrauterine factors with long-term health impact. While vanishing twins are not routinely observed in naturally conceived pregnancies, loss of a twin is potentially a risk factor for the surviving foetus in any pregnancy. This could be further explored in large samples of naturally conceived pregnancies with the necessary information. STUDY FUNDING/COMPETING INTEREST(S) The authors of this study are supported in part by the UK Medical Research Council, US National Institute of Environmental Health Sciences and the Norwegian Research Council. The authors have no conflicts of interest. TRIAL REGISTRATION NUMBER N/A. PMID:29025107

  14. L1000CDS2: LINCS L1000 characteristic direction signatures search engine.

    PubMed

    Duan, Qiaonan; Reid, St Patrick; Clark, Neil R; Wang, Zichen; Fernandez, Nicolas F; Rouillard, Andrew D; Readhead, Ben; Tritsch, Sarah R; Hodos, Rachel; Hafner, Marc; Niepel, Mario; Sorger, Peter K; Dudley, Joel T; Bavari, Sina; Panchal, Rekha G; Ma'ayan, Avi

    2016-01-01

    The library of integrated network-based cellular signatures (LINCS) L1000 data set currently comprises of over a million gene expression profiles of chemically perturbed human cell lines. Through unique several intrinsic and extrinsic benchmarking schemes, we demonstrate that processing the L1000 data with the characteristic direction (CD) method significantly improves signal to noise compared with the MODZ method currently used to compute L1000 signatures. The CD processed L1000 signatures are served through a state-of-the-art web-based search engine application called L1000CDS 2 . The L1000CDS 2 search engine provides prioritization of thousands of small-molecule signatures, and their pairwise combinations, predicted to either mimic or reverse an input gene expression signature using two methods. The L1000CDS 2 search engine also predicts drug targets for all the small molecules profiled by the L1000 assay that we processed. Targets are predicted by computing the cosine similarity between the L1000 small-molecule signatures and a large collection of signatures extracted from the gene expression omnibus (GEO) for single-gene perturbations in mammalian cells. We applied L1000CDS 2 to prioritize small molecules that are predicted to reverse expression in 670 disease signatures also extracted from GEO, and prioritized small molecules that can mimic expression of 22 endogenous ligand signatures profiled by the L1000 assay. As a case study, to further demonstrate the utility of L1000CDS 2 , we collected expression signatures from human cells infected with Ebola virus at 30, 60 and 120 min. Querying these signatures with L1000CDS 2 we identified kenpaullone, a GSK3B/CDK2 inhibitor that we show, in subsequent experiments, has a dose-dependent efficacy in inhibiting Ebola infection in vitro without causing cellular toxicity in human cell lines. In summary, the L1000CDS 2 tool can be applied in many biological and biomedical settings, while improving the extraction of knowledge from the LINCS L1000 resource.

  15. The present status and the future of missile aerodynamics

    NASA Technical Reports Server (NTRS)

    Nielsen, Jack N.

    1989-01-01

    Recent developments in the state of the art in missile aerodynamics are reviewed. Among the subjects covered are: (1) Tri-service/NASA data base, (2) wing-body interference, (3) nonlinear controls, (4) hypersonic transition, (5) vortex interference, (6) airbreathers, supersonic inlets, (7) store separation problems, (8) correlation of missile data, (9) CFD codes for complete configurations, (10) engineering prediction methods, and (11) future configurations. Suggestions are made for future research and development to advance the state of the art of missile aerodynamics.

  16. The present status and the future of missile aerodynamics

    NASA Technical Reports Server (NTRS)

    Nielsen, Jack N.

    1988-01-01

    Some recent developments in the state of the art in missile aerodynamics are reviewed. Among the subjects covered are: (1) tri-service/NASA data base, (2) wing-body interference, (3) nonlinear controls, (4) hypersonic transition, (5) vortex interference, (6) airbreathers, supersonic inlets, (7) store separation problems, (8) correlation of missile data, (9) CFD codes for complete configurations, (10) engineering prediction methods, and (11) future configurations. Suggestions are made for future research and development to advance the state of the art of missile aerodynamics.

  17. Pregnancy-specific anxiety, ART conception and infant temperament at 4 months post-partum.

    PubMed

    McMahon, C A; Boivin, J; Gibson, F L; Hammarberg, K; Wynter, K; Saunders, D; Fisher, J

    2013-04-01

    Is anxiety focused on the pregnancy outcome, known to be particularly salient in women conceiving through assisted reproductive technology (ART), related to difficult infant temperament? While trait anxiety predicts infant temperament, pregnancy-focused anxiety is not associated with more difficult infant temperament. A large body of research has provided convincing evidence that fetal exposure to maternal anxiety and stress in pregnancy has adverse consequences for child neurodevelopmental, behavioural and cognitive development, and that pregnancy-specific anxiety (concerns related to the pregnancy outcome and birth) may be of particular significance. Women conceiving through ART are of particular interest in this regard. Research over more than 20 years has consistently demonstrated that while they do not differ from spontaneously conceiving (SC) women with respect to general (state and trait) anxiety, they typically report higher pregnancy-specific anxiety. While research suggests normal behavioural and developmental outcomes for children conceived through ART, there is some evidence of more unsettled infant behaviour during the first post-natal year. The longitudinal cohort design followed 562 nulliparous women over a 7-month period, during the third trimester of pregnancy and at 4 months after birth. Approximately equal numbers of nulliparous women conceiving through ART (n = 250) and spontaneously (SC: n = 262) were recruited through ART clinics and nearby hospitals in Melbourne and Sydney, Australia. Participants completed three anxiety measures (state, trait, pregnancy specific) at time 1 in the third trimester of pregnancy and a measure of infant temperament at time 2, 4 months after birth. At time 1, relevant socio-demographic, pregnancy (maternal age, smoking, alcohol, medications, medical complications) information was recorded and at time 2, information regarding childbirth (gestation, infant birthweight, mode of delivery) and post-natal (concurrent mood) variables was recorded and controlled for in analyses. In the third trimester of pregnancy, women conceiving through ART reported lower state and trait anxiety, but higher pregnancy-focused anxiety than their SC counterparts (all Ps < 0.05). Hierarchical regression analyses including mode of conception, all anxiety variables and relevant covariates indicated that while trait anxiety in pregnancy predicted more difficult infant temperament (P < 0.001), pregnancy specific and state anxiety did not. Mode of conception predicted infant temperament; with ART women reporting less difficult infant temperament (P < 0.001) than their SC counterparts. The major limitations in the study are the reliance on a self-report measure of infant temperament and the fact that the study did not assess quality of caregiving which may moderate the effect of pregnancy anxiety on infant temperament. This study is the first to our knowledge to prospectively examine the impact of gestational stress (pregnancy anxiety) on infant temperament in women conceiving through ART. Findings confirm existing research indicating that trait anxiety in pregnancy is associated with difficult infant temperament and suggest that pregnancy-specific anxiety (measured in the third trimester) is not implicated. These findings are reassuring for women conceiving through ART whose pregnancies may be characterized by particularly intense concerns about the wellbeing of a long sought after baby. The study was funded by a grant from the Australian Research Council (ARC) and in kind and financial contributions from IVF Australia and Melbourne. N/A.

  18. Improving Flash Flood Prediction in Multiple Environments

    NASA Astrophysics Data System (ADS)

    Broxton, P. D.; Troch, P. A.; Schaffner, M.; Unkrich, C.; Goodrich, D.; Wagener, T.; Yatheendradas, S.

    2009-12-01

    Flash flooding is a major concern in many fast responding headwater catchments . There are many efforts to model and to predict these flood events, though it is not currently possible to adequately predict the nature of flash flood events with a single model, and furthermore, many of these efforts do not even consider snow, which can, by itself, or in combination with rainfall events, cause destructive floods. The current research is aimed at broadening the applicability of flash flood modeling. Specifically, we will take a state of the art flash flood model that is designed to work with warm season precipitation in arid environments, the KINematic runoff and EROSion model (KINEROS2), and combine it with a continuous subsurface flow model and an energy balance snow model. This should improve its predictive capacity in humid environments where lateral subsurface flow significantly contributes to streamflow, and it will make possible the prediction of flooding events that involve rain-on-snow or rapid snowmelt. By modeling changes in the hydrologic state of a catchment before a flood begins, we can also better understand the factors or combination of factors that are necessary to produce large floods. Broadening the applicability of an already state of the art flash flood model, such as KINEROS2, is logical because flash floods can occur in all types of environments, and it may lead to better predictions, which are necessary to preserve life and property.

  19. Maternal Nutritional Status Predicts Adverse Birth Outcomes among HIV-Infected Rural Ugandan Women Receiving Combination Antiretroviral Therapy

    PubMed Central

    Young, Sera; Murray, Katherine; Mwesigwa, Julia; Natureeba, Paul; Osterbauer, Beth; Achan, Jane; Arinaitwe, Emmanuel; Clark, Tamara; Ades, Veronica; Plenty, Albert; Charlebois, Edwin; Ruel, Theodore; Kamya, Moses; Havlir, Diane; Cohan, Deborah

    2012-01-01

    Objective Maternal nutritional status is an important predictor of birth outcomes, yet little is known about the nutritional status of HIV-infected pregnant women treated with combination antiretroviral therapy (cART). We therefore examined the relationship between maternal BMI at study enrollment, gestational weight gain (GWG), and hemoglobin concentration (Hb) among 166 women initiating cART in rural Uganda. Design Prospective cohort. Methods HIV-infected, ART-naïve pregnant women were enrolled between 12 and 28 weeks gestation and treated with a protease inhibitor or non-nucleoside reverse transcriptase inhibitor-based combination regimen. Nutritional status was assessed monthly. Neonatal anthropometry was examined at birth. Outcomes were evaluated using multivariate analysis. Results Mean GWG was 0.17 kg/week, 14.6% of women experienced weight loss during pregnancy, and 44.9% were anemic. Adverse fetal outcomes included low birth weight (LBW) (19.6%), preterm delivery (17.7%), fetal death (3.9%), stunting (21.1%), small-for-gestational age (15.1%), and head-sparing growth restriction (26%). No infants were HIV-infected. Gaining <0.1 kg/week was associated with LBW, preterm delivery, and a composite adverse obstetric/fetal outcome. Maternal weight at 7 months gestation predicted LBW. For each g/dL higher mean Hb, the odds of small-for-gestational age decreased by 52%. Conclusions In our cohort of HIV-infected women initiating cART during pregnancy, grossly inadequate GWG was common. Infants whose mothers gained <0.1 kg/week were at increased risk for LBW, preterm delivery, and composite adverse birth outcomes. cART by itself may not be sufficient for decreasing the burden of adverse birth outcomes among HIV-infected women. Trial Registration Clinicaltrials.gov NCT00993031 PMID:22879899

  20. Maternal nutritional status predicts adverse birth outcomes among HIV-infected rural Ugandan women receiving combination antiretroviral therapy.

    PubMed

    Young, Sera; Murray, Katherine; Mwesigwa, Julia; Natureeba, Paul; Osterbauer, Beth; Achan, Jane; Arinaitwe, Emmanuel; Clark, Tamara; Ades, Veronica; Plenty, Albert; Charlebois, Edwin; Ruel, Theodore; Kamya, Moses; Havlir, Diane; Cohan, Deborah

    2012-01-01

    Maternal nutritional status is an important predictor of birth outcomes, yet little is known about the nutritional status of HIV-infected pregnant women treated with combination antiretroviral therapy (cART). We therefore examined the relationship between maternal BMI at study enrollment, gestational weight gain (GWG), and hemoglobin concentration (Hb) among 166 women initiating cART in rural Uganda. Prospective cohort. HIV-infected, ART-naïve pregnant women were enrolled between 12 and 28 weeks gestation and treated with a protease inhibitor or non-nucleoside reverse transcriptase inhibitor-based combination regimen. Nutritional status was assessed monthly. Neonatal anthropometry was examined at birth. Outcomes were evaluated using multivariate analysis. Mean GWG was 0.17 kg/week, 14.6% of women experienced weight loss during pregnancy, and 44.9% were anemic. Adverse fetal outcomes included low birth weight (LBW) (19.6%), preterm delivery (17.7%), fetal death (3.9%), stunting (21.1%), small-for-gestational age (15.1%), and head-sparing growth restriction (26%). No infants were HIV-infected. Gaining <0.1 kg/week was associated with LBW, preterm delivery, and a composite adverse obstetric/fetal outcome. Maternal weight at 7 months gestation predicted LBW. For each g/dL higher mean Hb, the odds of small-for-gestational age decreased by 52%. In our cohort of HIV-infected women initiating cART during pregnancy, grossly inadequate GWG was common. Infants whose mothers gained <0.1 kg/week were at increased risk for LBW, preterm delivery, and composite adverse birth outcomes. cART by itself may not be sufficient for decreasing the burden of adverse birth outcomes among HIV-infected women. Clinicaltrials.gov NCT00993031.

  1. A baseline metabolomic signature is associated with immunological CD4+ T-cell recovery after 36 months of antiretroviral therapy in HIV-infected patients.

    PubMed

    Rodríguez-Gallego, Esther; Gómez, Josep; Pacheco, Yolanda M; Peraire, Joaquim; Viladés, Consuelo; Beltrán-Debón, Raúl; Mallol, Roger; López-Dupla, Miguel; Veloso, Sergi; Alba, Verónica; Blanco, Julià; Cañellas, Nicolau; Rull, Anna; Leal, Manuel; Correig, Xavier; Domingo, Pere; Vidal, Francesc

    2018-03-13

    Poor immunological recovery in treated HIV-infected patients is associated with greater morbidity and mortality. To date, predictive biomarkers of this incomplete immune reconstitution have not been established. We aimed to identify a baseline metabolomic signature associated with a poor immunological recovery after antiretroviral therapy (ART) to envisage the underlying mechanistic pathways that influence the treatment response. This was a multicentre, prospective cohort study in ART-naive and a pre-ART low nadir (<200 cells/μl) HIV-infected patients (n = 64). We obtained clinical data and metabolomic profiles for each individual, in which low molecular weight metabolites, lipids and lipoproteins (including particle concentrations and sizes) were measured by NMR spectroscopy. Immunological recovery was defined as reaching CD4 T-cell count at least 250 cells/μl after 36 months of virologically successful ART. We used univariate comparisons, Random Forest test and receiver-operating characteristic curves to identify and evaluate the predictive factors of immunological recovery after treatment. HIV-infected patients with a baseline metabolic pattern characterized by high levels of large high density lipoprotein (HDL) particles, HDL cholesterol and larger sizes of low density lipoprotein particles had a better immunological recovery after treatment. Conversely, patients with high ratios of non-HDL lipoprotein particles did not experience this full recovery. Medium very-low-density lipoprotein particles and glucose increased the classification power of the multivariate model despite not showing any significant differences between the two groups. In HIV-infected patients, a baseline healthier metabolomic profile is related to a better response to ART where the lipoprotein profile, mainly large HDL particles, may play a key role.

  2. Comparison of Different Risk Perception Measures in Predicting Seasonal Influenza Vaccination among Healthy Chinese Adults in Hong Kong: A Prospective Longitudinal Study

    PubMed Central

    Liao, Qiuyan; Wong, Wing Sze; Fielding, Richard

    2013-01-01

    Background Risk perception is a reported predictor of vaccination uptake, but which measures of risk perception best predict influenza vaccination uptake remain unclear. Methodology During the main influenza seasons (between January and March) of 2009 (Wave 1) and 2010 (Wave 2),505 Chinese students and employees from a Hong Kong university completed an online survey. Multivariate logistic regression models were conducted to assess how well different risk perceptions measures in Wave 1 predicted vaccination uptake against seasonal influenza in Wave 2. Principal Findings The results of the multivariate logistic regression models showed that feeling at risk (β = 0.25, p = 0.021) was the better predictor compared with probability judgment while probability judgment (β = 0.25, p = 0.029 ) was better than beliefs about risk in predicting subsequent influenza vaccination uptake. Beliefs about risk and feeling at risk seemed to predict the same aspect of subsequent vaccination uptake because their associations with vaccination uptake became insignificant when paired into the logistic regression model. Similarly, to compare the four scales for assessing probability judgment in predicting vaccination uptake, the 7-point verbal scale remained a significant and stronger predictor for vaccination uptake when paired with other three scales; the 6-point verbal scale was a significant and stronger predictor when paired with the percentage scale or the 2-point verbal scale; and the percentage scale was a significant and stronger predictor only when paired with the 2-point verbal scale. Conclusions/Significance Beliefs about risk and feeling at risk are not well differentiated by Hong Kong Chinese people. Feeling at risk, an affective-cognitive dimension of risk perception predicts subsequent vaccination uptake better than do probability judgments. Among the four scales for assessing risk probability judgment, the 7-point verbal scale offered the best predictive power for subsequent vaccination uptake. PMID:23894292

  3. Comparison of different risk perception measures in predicting seasonal influenza vaccination among healthy Chinese adults in Hong Kong: a prospective longitudinal study.

    PubMed

    Liao, Qiuyan; Wong, Wing Sze; Fielding, Richard

    2013-01-01

    Risk perception is a reported predictor of vaccination uptake, but which measures of risk perception best predict influenza vaccination uptake remain unclear. During the main influenza seasons (between January and March) of 2009 (Wave 1) and 2010 (Wave 2),505 Chinese students and employees from a Hong Kong university completed an online survey. Multivariate logistic regression models were conducted to assess how well different risk perceptions measures in Wave 1 predicted vaccination uptake against seasonal influenza in Wave 2. The results of the multivariate logistic regression models showed that feeling at risk (β = 0.25, p = 0.021) was the better predictor compared with probability judgment while probability judgment (β = 0.25, p = 0.029 ) was better than beliefs about risk in predicting subsequent influenza vaccination uptake. Beliefs about risk and feeling at risk seemed to predict the same aspect of subsequent vaccination uptake because their associations with vaccination uptake became insignificant when paired into the logistic regression model. Similarly, to compare the four scales for assessing probability judgment in predicting vaccination uptake, the 7-point verbal scale remained a significant and stronger predictor for vaccination uptake when paired with other three scales; the 6-point verbal scale was a significant and stronger predictor when paired with the percentage scale or the 2-point verbal scale; and the percentage scale was a significant and stronger predictor only when paired with the 2-point verbal scale. Beliefs about risk and feeling at risk are not well differentiated by Hong Kong Chinese people. Feeling at risk, an affective-cognitive dimension of risk perception predicts subsequent vaccination uptake better than do probability judgments. Among the four scales for assessing risk probability judgment, the 7-point verbal scale offered the best predictive power for subsequent vaccination uptake.

  4. Virological Efficacy in Cerebrospinal Fluid and Neurocognitive Status in Patients with Long-Term Monotherapy Based on Lopinavir/Ritonavir: An Exploratory Study

    PubMed Central

    Santos, José R.; Muñoz-Moreno, José A.; Moltó, José; Prats, Anna; Curran, Adrià; Domingo, Pere; Llibre, Josep M.; McClernon, Daniel R.; Bravo, Isabel; Canet, Jaume; Watson, Victoria; Back, David; Clotet, Bonaventura

    2013-01-01

    Background Data on suppression of HIV replication in the CNS and on the subsequent risk of neurocognitive impairment using monotherapy with boosted protease inhibitors are limited. Methods Ours was an exploratory cross-sectional study in patients on lopinavir/ritonavir-based monotherapy (LPV/r-MT) or standard triple therapy (LPV/r-ART) for at least 96 weeks who maintained a plasma viral load <50 copies/mL. HIV-1 RNA in CSF was determined by HIV-1 SuperLow assay (lower limit of detection, 1 copy/mL). Neurocognitive functioning was assessed using a recommended battery of neuropsychological tests covering 7 areas. Neurocognitive impairment (NCI) was determined and also a global deficit score (GDS) for study comparisons. Results Seventeen patients on LPV/r-MT and 17 on LPV/r-ART were included. Fourteen (82.4%) patients on LPV/r-MT and 16 (94.1%) on LPV/r-ART had HIV-1 RNA <1 copy/mL in CSF (p = 0.601). NCI was observed in 7 patients on LPV/r-MT and in 10 on LPV/r-ART (41% vs 59%; p = 0.494). Mean (SD) GDS was 0.22 (0.20) in patients on LPV/r-MT and 0.47 (0.34) in those on LPV/r-ART (p = 0.012). Conclusions Suppression of HIV in CSF is similar in individuals with durable plasma HIV-1 RNA suppression who are receiving LPV/r-MT or LPV/r-ART for at least 96 weeks. Findings for HIV-1 replication in CSF and neurocognitive status indicate that this strategy seems to be safe for CNS functioning. PMID:23922957

  5. Contraceptive use and pregnancy rates among women receiving antiretroviral therapy in Malawi: a retrospective cohort study.

    PubMed

    Tweya, Hannock; Feldacker, Caryl; Gugsa, Salem; Phiri, Sam

    2018-02-09

    In 2011, family planning (FP) services were integrated at Martin Preuss Centre (MPC), in urban Lilongwe, Malawi. To date, no previous study evaluated pregnancy rates among HIV-positive women after the integration of FP services into HIV care at the facility. In this study, we investigated whether integration of FP services into HIV clinical care led to increased use of contraceptives and decreased pregnancy rates. This was a retrospective cohort analysis of HIV-positive women from 15 to 49 years of age who accessed antiretroviral therapy (ART) services at MPC. Ascertainment of FP needs, contraceptive methods and pregnancy status were done at ART initiation, and at each ART follow-up visit. Women were offered a wide range of contraceptive methods. Outcomes of interest were contraceptive use and rate of pregnancy. Incident pregnancy was ascertained through patient self-reports during clinic consultation. Trends of contraceptive use and pregnancy rates were analyzed using chi-square (χ2). A total of 10,472 women were included in the analysis and contributed 15,700 person-years of observation. Contraceptive use among all women receiving ART increased from 28% in 2012 to 62% in 2016 (p < 0.001). A total of 501 pregnancies occurred, including 13 multiple pregnancies, resulting in an overall pregnancy rates of 3.2 per 100 person-years. Rates of pregnancy decreased from 6.8 per 100 person-years in 2012 to 1.3 per 100 person-years in 2016 (p < 0.001). Integration of FP services into HIV care resulted in increased contraceptive use and, subsequently, decreased pregnancy rates in women receiving ART. HIV programs should consider offering FP services to women who are receiving ART.

  6. Injecting drug use is associated with a more rapid CD4 cell decline among treatment naïve HIV-positive patients in Indonesia

    PubMed Central

    Meijerink, Hinta; Wisaksana, Rudi; Iskandar, Shelly; den Heijer, Martin; van der Ven, Andre J A M; Alisjahbana, Bachti; van Crevel, Reinout

    2014-01-01

    Background It remains unclear whether the natural course of human immunodeficiency virus (HIV) differs in subjects infected through injecting drug use (IDU) and no data have been published from low- or middle-income countries. We addressed this question in an urban cohort in Indonesia, which is experiencing a rapidly growing HIV epidemic strongly driven by IDU. Methods All antiretroviral treatment (ART) naïve HIV-positive patients who had at least two subsequent CD4 cell counts available before starting ART were included in this study. We examined the association between IDU and CD4 cell decline using a linear mixed model, with adjustment for possible confounders such as HIV viral load and hepatitis C antibodies. Results Among 284 HIV-positive ART naïve patients, the majority were male (56%) with a history of IDU (79% among men). People with a history of IDU had a statistically significant faster decline in CD4 cells (p<0.001). Based on our data, patients with a history of IDU would have an average 33% decline in CD4 cells after one year without ART, compared with a 22% decline among non-users. At two years, the decline would average 66 and 40%, respectively. No other factor was significantly associated with CD4 cell decline. Conclusions We show that a history of IDU is associated with a more rapid CD4 cell natural decline among HIV-positive individuals in Indonesia. These findings have implications for monitoring ART naïve patients with a history of IDU and for starting ART in this group. PMID:24388495

  7. Incidence and Risk Factors for Prediabetes and Diabetes Mellitus Among HIV-infected Adults on Antiretroviral Therapy: A Systematic Review and Meta-analysis.

    PubMed

    Nansseu, Jobert Richie; Bigna, Jean Joel; Kaze, Arnaud D; Noubiap, Jean Jacques

    2018-05-01

    To summarize evidence on the rates and drivers of progression from normoglycemia to prediabetes and/or diabetes mellitus (hereafter "diabetes") in antiretroviral treatment (ART)-exposed HIV-infected people. We searched EMBASE, PubMed, Web of Science, and Global Index Medicus to identify articles published from 1 January 2000 to 30 April 2017. A random-effects model produced a summary estimate of the incidence across studies and heterogeneity was assessed using Cochrane's Q statistic. We included 44 studies, whose methodologic quality was high with only 10 (30%) medium-quality studies and none of low quality. There was substantial heterogeneity between studies in estimates of the incidence of diabetes and prediabetes. The pooled incidence rate of overt diabetes and prediabetes were 13.7 per 1,000 person-years of follow-up (95% CI = 13, 20; I = 98.1%) among 396,496 person-years and 125 per 1,000 person-years (95% CI = 0, 123; I = 99.4) among 1,532 person-years, respectively. The major risk factors for diabetes and prediabetes were aging, family history of diabetes, Black or Hispanic origin, overweight/obesity, central obesity, lipodystrophy/lipoatrophy, dyslipidemia, metabolic syndrome, increased baseline fasting glycemia, and certain ART regimens. These data highlight the important and fast-increasing burden of diabetes and prediabetes among the ART-exposed HIV-infected population. More research is needed to better capture the interplay between prediabetes/diabetes and ART in HIV-infected patients, considering the increasing number of ART-exposed patients subsequent to the World Health Organization's recommendation of initiating ART at HIV infection diagnosis regardless of CD4 count and age.

  8. Status of the seamless coupled modelling system ICON-ART

    NASA Astrophysics Data System (ADS)

    Vogel, Bernhard; Rieger, Daniel; Schroeter, Jenniffer; Bischoff-Gauss, Inge; Deetz, Konrad; Eckstein, Johannes; Foerstner, Jochen; Gasch, Philipp; Ruhnke, Roland; Vogel, Heike; Walter, Carolin; Weimer, Michael

    2016-04-01

    The integrated modelling framework ICON-ART [1] (ICOsahedral Nonhydrostatic - Aerosols and Reactive Trace gases) extends the numerical weather prediction modelling system ICON by modules for gas phase chemistry, aerosol dynamics and related feedback processes. The nonhydrostatic global modelling system ICON [2] is a joint development of German Weather Service (DWD) and Max Planck Institute for Meteorology (MPI-M) with local grid refinement down to grid sizes of a few kilometers. It will be used for numerical weather prediction, climate projections and for research purposes. Since January 2016 ICON runs operationally at DWD for weather forecast on the global scale with a grid size of 13 km. Analogous to its predecessor COSMO-ART [3], ICON-ART is designed to account for feedback processes between meteorological variables and atmospheric trace substances. Up to now, ICON-ART contains the dispersion of volcanic ash, radioactive tracers, sea salt aerosol, as well as ozone-depleting stratospheric trace substances [1]. Recently, we have extended ICON-ART by a mineral dust emission scheme with global applicability and nucleation parameterizations which allow the cloud microphysics to explicitly account for prognostic aerosol distributions. Also very recently an emission scheme for volatile organic compounds was included. We present first results of the impact of natural aerosol (i.e. sea salt aerosol and mineral dust) on cloud properties and precipitation as well as the interaction of primary emitted particles with radiation. Ongoing developments are the coupling with a radiation scheme to calculate the photolysis frequencies, a coupling with the RADMKA (1) chemistry and first steps to include isotopologues of water. Examples showing the capabilities of the model system will be presented. This includes a simulation of the transport of ozone depleting short-lived trace gases from the surface into the stratosphere as well as of long-lived tracers. [1] Rieger, D., et al. (2015), ICON-ART - A new online-coupled model system from the global to regional scale, Geosci. Model Dev., doi:10.5194/gmd-8-1659-2015. [2] Zängl, G., et al. (2014), The ICON (ICOsahedral Non-hydrostatic) modelling framework of DWD MPI-M: Description of the non-hydrostatic dynamical core. Q.J.R. Meteorol. Soc., doi: 10.1002/qj.2378 [3] Vogel, B., et al. (2009), The comprehensive model system COSMO-ART - Radiative impact of aerosol on the state of the atmosphere on the regional scale, Atmos. Chem. Phys., 9, 8661-8680

  9. Arguments for the need of mining education continuity and development in Romania

    NASA Astrophysics Data System (ADS)

    Bud, I.; Duma, S.; Pasca, I.; Gusat, D.

    2018-01-01

    Mining is considered the oldest conscious man activity. In the beginning, man searched for hard rocks in the outskirts area and used it to make weapons and ornaments. Subsequently, civilizations evolved through the development of infrastructure, buildings and monuments and finally, weapons. For all these it was necessary to have mineral raw materials obtained under increasingly difficult conditions, through increasingly evolved techniques. In this way, the art of mining and metallurgy was born, which led to the formation of scientific bases. The mining activity was equally art and science. The art and the science have been learned and taught in schools since ancient times and continue today in large universities with mining engineering, metallurgy, mining topography, mining environmental protection, and geology. Lately, in Romania, the mining high school has reached a deadlock and the middle and professional school has collapsed. The development of infrastructure, construction, etc. requires the exploitation and valorisation of mineral resources based on specialists. The paper warns against the danger of losing tradition and skills in mining engineers formation and militate for the re-establishment of professional and technical schools.

  10. Weighing the evidence: risks and benefits of participatory documentary in corporatized clinics.

    PubMed

    Hansen, Helena

    2013-12-01

    This paper describes the effects of one U.S.-based public psychiatry clinic's shift to a centralized, corporate style of management, in response to pressures to cut expenditures by focusing on "evidence based" treatments. Participant observation research conducted between 2008 and 2012 for a larger study involving 127 interviews with policy makers, clinic managers, clinical practitioners and patients revealed that the shift heralded the decline of arts based therapies in the clinic, and of the social networks that had developed around them. It also inspired a participatory video self-documentary project among art group members, to portray the importance of arts-based therapies and garner public support for such therapies. Group members found a way to take action in the face of unilateral decision making, but experienced subsequent restrictions on clinic activities and discharge of core members from the clinic. The paper ends with a discussion of biopolitics, central legibility through corporate standardization, and the potential and risks of participatory documentaries to resist these trends. Copyright © 2013. Published by Elsevier Ltd.

  11. The Immune Landscape of Non-Small Cell Lung Cancer: Utility of Cytologic and Histologic Samples Obtained Through Minimally Invasive Pulmonary Procedures.

    PubMed

    Beattie, Jason; Yarmus, Lonny; Wahidi, Momen M; Rivera, M Patricia; Gilbert, Christopher; Maldonado, Fabien; Czarnecka, Kasia; Argento, Angela; Chen, Alexander; Herth, Felix; Sterman, Daniel H

    2018-05-14

    The success of immune checkpoint inhibitors and the discovery of useful biomarkers to predict response to these agents is shifting much of the focus of personalized care for non-small cell lung cancer towards harnessing the immune response. With further advancement, more effective immunotherapy options will emerge along with more useful biomarkers. Paradoxically, minimally invasive small biopsy and cytology specimens have become the primary method for diagnosis of patients with advanced disease, as well for initial diagnosis and staging in earlier stage disease. For the benefit of these patients, we will continue to learn how to do more with less. In this perspective, we review aspects of immunobiology that underlie the current state of the art of existing and emerging immunologic biomarkers that hold potential to enhance the care of patients with non-small cell lung cancer. We address practical considerations for acquiring patient samples that accurately reflect disease immune status. We also propose a paradigm shift wherein the most important sample types that need to be proven in pioneering basic science and translation work and subsequent clinical trials are the specimens most often obtained clinically.

  12. Thirty years since diffuse sound reflection by maximum length

    NASA Astrophysics Data System (ADS)

    Cox, Trevor J.; D'Antonio, Peter

    2005-09-01

    This year celebrates the 30th anniversary of Schroeder's seminal paper on sound scattering from maximum length sequences. This paper, along with Schroeder's subsequent publication on quadratic residue diffusers, broke new ground, because they contained simple recipes for designing diffusers with known acoustic performance. So, what has happened in the intervening years? As with most areas of engineering, the room acoustic diffuser has been greatly influenced by the rise of digital computing technologies. Numerical methods have become much more powerful, and this has enabled predictions of surface scattering to greater accuracy and for larger scale surfaces than previously possible. Architecture has also gone through a revolution where the forms of buildings have become more extreme and sculptural. Acoustic diffuser designs have had to keep pace with this to produce shapes and forms that are desirable to architects. To achieve this, design methodologies have moved away from Schroeder's simple equations to brute force optimization algorithms. This paper will look back at the past development of the modern diffuser, explaining how the principles of diffuser design have been devised and revised over the decades. The paper will also look at the present state-of-the art, and dreams for the future.

  13. Heart rate turbulence.

    PubMed

    Cygankiewicz, Iwona

    2013-01-01

    Heart rate turbulence (HRT) is a baroreflex-mediated biphasic reaction of heart rate in response to premature ventricular beats. Heart rate turbulence is quantified by: turbulence onset (TO) reflecting the initial acceleration of heart rate following premature beat and turbulence slope (TS) describing subsequent deceleration of heart rate. Abnormal HRT identifies patients with autonomic dysfunction or impaired baroreflex sensitivity due to variety of disorders, but also may reflect changes in autonomic nervous system induced by different therapeutic modalities such as drugs, revascularization, or cardiac resynchronization therapy. More importantly, impaired HRT has been shown to identify patients at high risk of all-cause mortality and sudden death, particularly in postinfarction and congestive heart failure patients. It should be emphasized that abnormal HRT has a well-established role in stratification of postinfarction and heart failure patients with relatively preserved left ventricular ejection fraction. The ongoing clinical trials will document whether HRT can be used to guide implantation of cardioverter-defibrillators in this subset of patients, not covered yet by ICD guidelines. This review focuses on the current state-of-the-art knowledge regarding clinical significance of HRT in detection of autonomic dysfunction and regarding the prognostic significance of this parameter in predicting all-cause mortality and sudden death. © 2013.

  14. Anti-proliferative therapy for HIV cure: a compound interest approach.

    PubMed

    Reeves, Daniel B; Duke, Elizabeth R; Hughes, Sean M; Prlic, Martin; Hladik, Florian; Schiffer, Joshua T

    2017-06-21

    In the era of antiretroviral therapy (ART), HIV-1 infection is no longer tantamount to early death. Yet the benefits of treatment are available only to those who can access, afford, and tolerate taking daily pills. True cure is challenged by HIV latency, the ability of chromosomally integrated virus to persist within memory CD4 + T cells in a non-replicative state and activate when ART is discontinued. Using a mathematical model of HIV dynamics, we demonstrate that treatment strategies offering modest but continual enhancement of reservoir clearance rates result in faster cure than abrupt, one-time reductions in reservoir size. We frame this concept in terms of compounding interest: small changes in interest rate drastically improve returns over time. On ART, latent cell proliferation rates are orders of magnitude larger than activation and new infection rates. Contingent on subtypes of cells that may make up the reservoir and their respective proliferation rates, our model predicts that coupling clinically available, anti-proliferative therapies with ART could result in functional cure within 2-10 years rather than several decades on ART alone.

  15. [Preeclampsia: A challenge also for cardiologists].

    PubMed

    Cournot, M; Lairez, O; Medzech, B

    2018-05-18

    Due to its short-term consequences on perinatal outcome, preeclampsia has been long regarded as an obstetrical disease, strictly confined to a management by OB/GYNs. It has been now widely accepted that preeclampsia is most a systemic inflammatory and systemic vascular disease during pregnancy and then a lifelong risk factor for subsequent cardiovascular event in women's life. The aim of this review is to propose an overview in the current state-of-art in definition, early identification and management of preeclampsia. We will also discuss the growing evidence that support that cardiologists must be fully involved in screening and prevention of preeclampsia during pregnancy and beyond in the subsequent medical follow-up of women who have experienced a preeclampsia. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  16. Choice of Variables and Gender Differentiated Prediction within Selected Academic Programs. Research Report #105.

    ERIC Educational Resources Information Center

    Gamache, LeAnn M.; Novick, Melvin R.

    The existence of differential prediction of two-year grade point average is reported for gender groups within programs of study at the University of Iowa. Academic records of all freshmen entering the University in 1978 in the fields of Business, Liberal Arts, Pre-Medicine, and those undecided as to major were analyzed with respect to American…

  17. Factor Structure and Predictive Utility of the 2 x 2 Achievement Goal Model in a Sample of Taiwan Students

    ERIC Educational Resources Information Center

    Chiang, Yu-Tzu; Yeh, Yu-Chen; Lin, Sunny S. J.; Hwang, Fang-Ming

    2011-01-01

    This study examined structure and predictive utility of the 2 x 2 achievement goal model among Taiwan pre-university school students (ages 10 to 16) who learned Chinese language arts. The confirmatory factor analyses of Achievement Goal Questionnaire-Chinese version provided good fitting between the factorial and dimensional structures with the…

  18. Can Statistical Modeling Increase Annual Fund Performance? An Experiment at the University of Maryland, College Park.

    ERIC Educational Resources Information Center

    Porter, Stephen R.

    Annual funds face pressures to contact all alumni to maximize participation, but these efforts are costly. This paper uses a logistic regression model to predict likely donors among alumni from the College of Arts & Humanities at the University of Maryland, College Park. Alumni were grouped according to their predicted probability of donating…

  19. Longitudinal Analysis of Adherence to First-Line Antiretroviral Therapy: Evidence of Treatment Sustainability from an Indian HIV Cohort.

    PubMed

    Shet, Anita; Kumarasamy, N; Poongulali, Selvamuthu; Shastri, Suresh; Kumar, Dodderi Sunil; Rewari, Bharath B; Arumugam, Karthika; Antony, Jimmy; De Costa, Ayesha; D'Souza, George

    2016-01-01

    Given the chronic nature of HIV infection and the need for life-long antiretroviral therapy (ART), maintaining long-term optimal adherence is an important strategy for maximizing treatment success. In order to understand better the dynamic nature of adherence behaviors in India where complex cultural and logistic features prevail, we assessed the patterns, trajectories and time-dependent predictors of adherence levels in relation to virological failure among individuals initiating first-line ART in India. Between July 2010 and August 2013, eligible ART-naïve HIV-infected individuals newly initiating first-line ART within the national program at three sites in southern India were enrolled and monitored for two years. ART included zidovudine/stavudine/tenofovir plus lamivudine plus nevirapine/efavirenz. Patients were assessed using clinical, laboratory and adherence parameters. Every three months, medication adherence was measured using pill count, and a structured questionnaire on adherence barriers was administered. Optimal adherence was defined as mean adherence ≥95%. Statistical analysis was performed using a bivariate and a multivariate model of all identified covariates. Adherence trends and determinants were modeled as rate ratios using generalized estimating equation analysis in a Poisson distribution. A total of 599 eligible ART-naïve patients participated in the study, and contributed a total of 921 person-years of observation time. Women constituted 43% and mean CD4 count prior to initiating ART was 192 cells/mm3. Overall mean adherence among all patients was 95.4%. The proportion of patients optimally adherent was 75.6%. Predictors of optimal adherence included older age (≥40 years), high school-level education and beyond, lower drug toxicity-related ART interruption, full disclosure, sense of satisfaction with one's own health and patient's perception of having good access to health-care services. Adherence was inversely proportional to virological failure (IRR 0.55, 95%CI 0.44-0.69 p<0.001). Drug toxicity and stigma-related barriers were significantly associated with virological failure, while forgetfulness was not associated with virological failure. Our study highlights the overall high level of medication adherence among individuals initiating ART within the Indian national program. Primary factors contributing towards poor adherence and subsequent virological failure in the proportion of individuals with poor adherence included drug toxicity, perceived stigma and poor access to health care services. Strategies that may contribute towards improved adherence include minimizing drug interruptions for medical reasons, use of newer ART regimens with better safety profiles and increasing access with more link ART centers that decentralize ART dispensing systems to individuals.

  20. Starting or changing therapy - a prospective study exploring antiretroviral decision-making.

    PubMed

    Fehr, J S; Nicca, D; Sendi, P; Wolf, E; Wagels, T; Kiss, A; Bregenzer, T; Vernazza, P; Jäger, H; Spirig, R; Battegay, M

    2005-08-01

    When to start or change antiretroviral treatment against HIV infection is of major importance. Patients' readiness is considered a major factor influencing such treatment decisions, in particular because no objective, absolute time point when to start antiretroviral therapy exists. We aimed at evaluating patients' readiness to start or change antiretroviral therapy (ART). HIV-infected patients starting or changing ART between July 2002 and February 2003, treating physicians and nurses participated in this prospective, observational multicenter study. We assessed shared decision-making including qualitative aspects, expected treatment decisions and treatment status after 3 months. 75 patients were included. Of 34 patients for whom starting ART was considered, 27 (79%) indicated that they were willing to start treatment. After 3 months, 21 of 27 (78%) actually started therapy, six did not. Patients with depression were less likely to be ready for ART (p < 0.05). Of 41 patients for whom changing ART was considered, 35 (85%) indicated that they were willing to change treatment. Of the latter 35 patients, 33 (94%) finally changed ART within 3 months. Physicians and nurses were too optimistic in predicting the start or change of ART. The main reason to start or change ART was the sole recommendation of the physician (52% in those starting, 61% in those changing ART). Patients mainly judged the decision as shared and were very satisfied (71%) with the process. Qualitative findings revealed the importance of a dialectic decisionmaking, described with two categories: "dealing with oneself and others"' and "understanding and being understood." Patients mainly shared the decision made during consultation. Although physicians have an essential role concerning ART, patients, physicians, and nurses all contribute to the decision. Qualitative findings indicate the importance for health-care providers to include patients' expertise and contributions.

  1. HIV viraemia and mother-to-child transmission risk after antiretroviral therapy initiation in pregnancy in Cape Town, South Africa.

    PubMed

    Myer, L; Phillips, T K; McIntyre, J A; Hsiao, N-Y; Petro, G; Zerbe, A; Ramjith, J; Bekker, L-G; Abrams, E J

    2017-02-01

    Maternal HIV viral load (VL) drives mother-to-child HIV transmission (MTCT) risk but there are few data from sub-Saharan Africa, where most MTCT occurs. We investigated VL changes during pregnancy and MTCT following antiretroviral therapy (ART) initiation in Cape Town, South Africa. We conducted a prospective study of HIV-infected women initiating ART within routine antenatal services in a primary care setting. VL measurements were taken before ART initiation and up to three more times within 7 days postpartum. Analyses examined VL changes over time, viral suppression (VS) at delivery, and early MTCT based on polymerase chain reaction (PCR) testing up to 8 weeks of age. A total of 620 ART-eligible HIV-infected pregnant women initiated ART, with 2425 VL measurements by delivery (median gestation at initiation, 20 weeks; median pre-ART VL, 4.0 log 10 HIV-1 RNA copies/mL; median time on ART before delivery, 118 days). At delivery, 91% and 73% of women had VL ≤ 1000 and ≤ 50 copies/mL, respectively. VS was strongly predicted by time on therapy and pre-ART VL. The risk of early MTCT was strongly associated with delivery VL, with risks of 0.25, 2.0 and 8.5% among women with VL < 50, 50-1000 and > 1000 copies/mL at delivery, respectively (P < 0.001). High rates of VS at delivery and low rates of MTCT can be achieved in a routine care setting in sub-Saharan Africa, indicating the effectiveness of currently recommended ART regimens. Women initiating ART late in pregnancy and with high VL appear substantially less likely to achieve VS and require targeted research and programmatic attention. © 2016 British HIV Association.

  2. Reading Ability and Print Exposure: Item Response Theory Analysis of the Author Recognition Test

    PubMed Central

    Moore, Mariah; Gordon, Peter C.

    2015-01-01

    In the Author Recognition Test (ART) participants are presented with a series of names and foils and are asked to indicate which ones they recognize as authors. The test is a strong predictor of reading skill, with this predictive ability generally explained as occurring because author knowledge is likely acquired through reading or other forms of print exposure. This large-scale study (1012 college student participants) used Item Response Theory (IRT) to analyze item (author) characteristics to facilitate identification of the determinants of item difficulty, provide a basis for further test development, and to optimize scoring of the ART. Factor analysis suggests a potential two factor structure of the ART differentiating between literary vs. popular authors. Effective and ineffective author names were identified so as to facilitate future revisions of the ART. Analyses showed that the ART is a highly significant predictor of time spent encoding words as measured using eye-tracking during reading. The relationship between the ART and time spent reading provided a basis for implementing a higher penalty for selecting foils, rather than the standard method of ART scoring (names selected minus foils selected). The findings provide novel support for the view that the ART is a valid indicator of reading volume. Further, they show that frequency data can be used to select items of appropriate difficulty and that frequency data from corpora based on particular time periods and types of text may allow test adaptation for different populations. PMID:25410405

  3. Reading ability and print exposure: item response theory analysis of the author recognition test.

    PubMed

    Moore, Mariah; Gordon, Peter C

    2015-12-01

    In the author recognition test (ART), participants are presented with a series of names and foils and are asked to indicate which ones they recognize as authors. The test is a strong predictor of reading skill, and this predictive ability is generally explained as occurring because author knowledge is likely acquired through reading or other forms of print exposure. In this large-scale study (1,012 college student participants), we used item response theory (IRT) to analyze item (author) characteristics in order to facilitate identification of the determinants of item difficulty, provide a basis for further test development, and optimize scoring of the ART. Factor analysis suggested a potential two-factor structure of the ART, differentiating between literary and popular authors. Effective and ineffective author names were identified so as to facilitate future revisions of the ART. Analyses showed that the ART is a highly significant predictor of the time spent encoding words, as measured using eyetracking during reading. The relationship between the ART and time spent reading provided a basis for implementing a higher penalty for selecting foils, rather than the standard method of ART scoring (names selected minus foils selected). The findings provide novel support for the view that the ART is a valid indicator of reading volume. Furthermore, they show that frequency data can be used to select items of appropriate difficulty, and that frequency data from corpora based on particular time periods and types of texts may allow adaptations of the test for different populations.

  4. Predicted coreceptor usage at end-stage HIV disease in tissues derived from subjects on antiretroviral therapy with an undetectable plasma viral load.

    PubMed

    Lamers, S L; Fogel, G B; Liu, E S; Nolan, D J; Salemi, M; Barbier, A E; Rose, R; Singer, E J; McGrath, M S

    2017-07-01

    HIV cure research is increasingly focused on anatomical tissues as sites for residual HIV replication during combined antiretroviral therapy (cART). Tissue-based HIV could contribute to low-level immune activation and viral rebound over the course of infection and could also influence the development of diseases, such as atherosclerosis, neurological disorders and cancers. cART-treated subjects have a decreased and irregular presence of HIV among tissues, which has resulted in a paucity of actual evidence concerning how or if HIV persists, replicates and evolves in various anatomical sites during therapy. In this study, we pooled 1806 HIV envelope V3 loop sequences from twenty-six tissue types (seventy-one total tissues) of six pre-cART subjects, four subjects with an unknown cART history who died with profound AIDS, and five subjects who died while on cART with an undetectable plasma viral load. A computational approach was used to assess sequences for their ability to utilize specific cellular coreceptors (R5, R5 and X4, or X4). We found that autopsied tissues obtained from virally suppressed cART+ subjects harbored both integrated and expressed viruses with similar coreceptor usage profiles to subjects with no or ineffective cART therapy (i.e., significant plasma viral load at death). The study suggests that tissue microenvironments provide a sanctuary for the continued evolution of HIV despite cART. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Why is past depression the best predictor of future depression? Stress generation as a mechanism of depression continuity in girls.

    PubMed

    Rudolph, Karen D; Flynn, Megan; Abaied, Jamie L; Groot, Alison; Thompson, Renee

    2009-07-01

    This study examined whether a transactional interpersonal life stress model helps to explain the continuity in depression over time in girls. Youth (86 girls, 81 boys; M age = 12.41, SD = 1.19) and their caregivers participated in a three-wave longitudinal study. Depression and episodic life stress were assessed with semistructured interviews. Path analysis provided support for a transactional interpersonal life stress model in girls but not in boys, wherein depression predicted the generation of interpersonal stress, which predicted subsequent depression. Moreover, self-generated interpersonal stress partially accounted for the continuity of depression over time. Although depression predicted noninterpersonal stress generation in girls (but not in boys), noninterpersonal stress did not predict subsequent depression.

  6. Use of assisted reproductive technology treatment as reported by mothers in comparison with registry data: the Upstate KIDS Study.

    PubMed

    Buck Louis, Germaine M; Druschel, Charlotte; Bell, Erin; Stern, Judy E; Luke, Barbara; McLain, Alexander; Sundaram, Rajeshwari; Yeung, Edwina

    2015-06-01

    To assess the validity of maternally reported assisted reproductive technologies (ART) use and to identify predictors of reporting errors. Linkage study. Not applicable. A total of 5,034 (27%) mothers enrolled, from whom 4,886 (97%) self-reported information about use of infertility treatment, including ART, for the index birth. None. Four measures of validity (sensitivity, specificity, positive and negative predictive values) and use of net reclassification improvement (NRI) methods to identify predictors associated with concordant/discordant maternal reporting. The Upstate New York Infant Development Screening Program (Update KIDS Study) was linked with the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) using a defined algorithm for 2008-2010. The sensitivity, specificity, positive and negative predictive values were high (0.93, 0.99, 0.80, and 1.00, respectively). The validity of maternal report was high, reflecting few differences by participant characteristics except for maternal age dichotomized at 29 years as identified with NRI methods. Maternally reported ART is valid, with little variation across various characteristics. No strong predictors of discordant reporting were found, supporting the utility of population-based research with SART CORS linkage. Published by Elsevier Inc.

  7. Effect of Antiretroviral Therapy on the Diagnostic Accuracy of Symptom Screening for Intensified Tuberculosis Case Finding in a South African HIV Clinic

    PubMed Central

    Rangaka, Molebogeng X.; Wilkinson, Robert J.; Glynn, Judith R.; Boulle, Andrew; van Cutsem, Gilles; Goliath, Rene; Mathee, Shaheed; Maartens, Gary

    2012-01-01

    Background. Current symptom screening algorithms for intensified tuberculosis case finding or prior to isoniazid preventive therapy (IPT) in patients infected with human immunodeficiency virus (HIV) were derived from antiretroviral-naive cohorts. There is a need to validate screening algorithms in patients on antiretroviral therapy (ART). Methods. We performed cross-sectional evaluation of the diagnostic accuracy of symptom screening, including the World Health Organization (WHO) algorithm, to rule out tuberculosis in HIV-infected individuals pre-ART and on ART undergoing screening prior to IPT. Results. A total of 1429 participants, 54% on ART, had symptom screening and a sputum culture result available. Culture-positive tuberculosis was diagnosed in 126 patients (8.8%, 95% confidence interval [CI], 7.4%–10.4%). The WHO symptom screen in the on-ART compared with the pre-ART group had a lower sensitivity (23.8% vs 47.6%), but higher specificity (94.4% vs 79.8%). The effect of ART was independent of CD4+ count in multivariable analyses. The posttest probability of tuberculosis following a negative WHO screen was 8.9% (95% CI, 7.4%–10.8%) and 4.4% (95% CI, 3.7%–5.2%) for the pre-ART and on-ART groups, respectively. Addition of body mass index to the WHO screen significantly improved discriminatory ability in both ART groups, which was further improved by adding CD4 count and ART duration. Conclusions. The WHO symptom screen has poor sensitivity, especially among patients on ART, in a clinic where regular tuberculosis screening is practiced. Consequently, a significant proportion of individuals with tuberculosis would inadvertently be placed on isoniazid monotherapy despite high negative predictive values. Until more sensitive methods of ruling out tuberculosis are established, it would be prudent to do a sputum culture prior to IPT where this is feasible. PMID:22955441

  8. Predictors of Survival among Adult Ethiopian Patients in the National ART Program at Seven University Teaching Hospitals: A Prospective Cohort Study.

    PubMed

    Fekade, Daniel; Weldegebreal, Teklu; Teklu, Alula M; Damen, Melake; Abdella, Saro; Baraki, Nega; Belayhun, Bekele; Berhan, Eyoel; Kebede, Amha; Assefa, Yibeltal

    2017-02-01

    In Ethiopia, the publicly funded antiretroviral treatment (ART) program was started in 2005. Two hundred seventy-five thousand patients were enrolled in the national ART program by 2012. However, there is limited data on mortality and predictors of death among adult patients in the ART program. The study aimed to estimate mortality and risk factors for death among adult, ART-naïve patients, started in the national ART program from January 2009 to July 2013. Multi-site, prospective, observational cohort study of adult, age > 18 years, ART-naïve patients, started in the national ART program at seven university-affiliated hospitals from January 2009 - July 2013. Kaplan-Meier and Cox regression analyses were used to estimate survival and determine risk factors for death. A total of 976 patients, 594 females (60.9 %), were enrolled into the study. Median age of the cohort was 33years. The median CD4 count at start of ART was 144 cells/µl (interquartile range (IQR) 78-205), and 34.2% (330/965) had CD4 < 100. Sixty-three percent (536/851) had viral load greater than 5 log copies/ml (IQR 4.7-5.7) at base line. One hundred and one deaths were recorded during follow-up period, all-cause mortality rate 10.3%; 5.4 deaths/100 person years of observation, 95% confidence interval 4.4-6.5. Seventy percent of the deaths occurred within six months of starting ART. Cox regression analyses showed that the following measures independently predicted mortality: age >51 years, (Adjusted Hazard Ratio (AHR) 4.01, P=0.003), WHO stages III&IV, (AHR 1.76, p = 0.025), CD4 count, <100, (AHR 2.36, p =0.006), and viral load >5 log copies /ml (CHR 1.71, p = 0.037). There is high early on- ART mortality in patients presenting with advanced immunodeficiency. Detecting cases and initiating ART before onset of advanced immunodeficiency might improve survival.

  9. Predictors of accessing antiretroviral therapy among HIV-positive drug users in China's National Methadone Maintenance Treatment Programme.

    PubMed

    Zhao, Yan; Shi, Cynthia X; McGoogan, Jennifer M; Rou, Keming; Zhang, Fujie; Wu, Zunyou

    2015-01-01

    The objective of this study was to examine factors that predict antiretroviral therapy (ART) access among eligible, HIV-positive methadone maintenance treatment (MMT) clients. We also tested the hypothesis that sustained MMT participation increases the likelihood of accessing ART. A nation-wide cohort study conducted from 1 March 2004 to 31 December 2011. MMT clients were followed from the time of their enrolment in China's national MMT programme until their death or the study end date. Our cohort comprised 7111 ART-eligible, HIV-positive MMT clients, 49.2% of whom remained ART-naive and 50.8% of whom received ART. Demographic variables, drug use history, MMT programme participation and HIV-related clinical characteristics of study participants who remained naive to ART and those who accessed ART were compared by univariate and multivariable analysis. Predictors of accessing ART among this cohort included being retained in MMT at the time of first meeting ART eligibility [adjusted odds ratio (AOR)=1.84, confidence interval (CI)=1.54-2.21, P<0.001] compared to meeting ART eligibility before entering MMT (AOR=0.98, CI=0.80-1.21, P=0.849) or previously entering MMT and dropping out before meeting ART eligibility. Additional predictors were CD4≤200 cells/μl when ART-eligibility requirement was first met (AOR=1.81, CI=1.61-2.05, P<0.001 compared to CD4=201-350 cells/μl), and being in a stable partner relationship (married/cohabitating: AOR=1.14, CI=1.01-1.28, P=0.030). Retained participation in methadone maintenance treatment increases the likelihood that eligible clients will access antiretroviral therapy. These results highlight the potential benefit of colocalization of methadone maintenance treatment and antiretroviral therapy services in a 'one-stop-shop' model. © 2014 Society for the Study of Addiction.

  10. Pre-cART Elevation of CRP and CD4+ T-Cell Immune Activation Associated With HIV Clinical Progression in a Multinational Case-Cohort Study.

    PubMed

    Balagopal, Ashwin; Asmuth, David M; Yang, Wei-Teng; Campbell, Thomas B; Gupte, Nikhil; Smeaton, Laura; Kanyama, Cecilia; Grinsztejn, Beatriz; Santos, Breno; Supparatpinyo, Khuanchai; Badal-Faesen, Sharlaa; Lama, Javier R; Lalloo, Umesh G; Zulu, Fatima; Pawar, Jyoti S; Riviere, Cynthia; Kumarasamy, Nagalingeswaran; Hakim, James; Li, Xiao-Dong; Pollard, Richard B; Semba, Richard D; Thomas, David L; Bollinger, Robert C; Gupta, Amita

    2015-10-01

    Despite the success of combination antiretroviral therapy (cART), a subset of HIV-infected patients who initiate cART develop early clinical progression to AIDS; therefore, some cART initiators are not fully benefitted by cART. Immune activation pre-cART may predict clinical progression in cART initiators. A case-cohort study (n = 470) within the multinational Prospective Evaluation of Antiretrovirals in Resource-Limited Settings clinical trial (1571 HIV treatment-naive adults who initiated cART; CD4 T-cell count <300 cells/mm; 9 countries) was conducted. A subcohort of 30 participants per country was randomly selected; additional cases were added from the main cohort. Cases [n = 236 (random subcohort 36; main cohort 200)] had clinical progression (incident WHO stage 3/4 event or death) within 96 weeks after cART initiation. Immune activation biomarkers were quantified pre-cART. Associations between biomarkers and clinical progression were examined using weighted multivariable Cox-proportional hazards models. Median age was 35 years, 45% were women, 49% black, 31% Asian, and 9% white. Median CD4 T-cell count was 167 cells per cubic millimeter. In multivariate analysis, highest quartile C-reactive protein concentration [adjusted hazard ratio (aHR), 2.53; 95% confidence interval (CI): 1.02 to 6.28] and CD4 T-cell activation (aHR, 5.18; 95% CI: 1.09 to 24.47) were associated with primary outcomes, compared with lowest quartiles. sCD14 had a trend toward association with clinical failure (aHR, 2.24; 95% CI: 0.96 to 5.21). Measuring C-reactive protein and CD4 T-cell activation may identify patients with CD4 T-cell counts <300 cells per cubic millimeter at risk for early clinical progression when initiating cART. Additional vigilance and symptom-based screening may be required in this subset of patients even after beginning cART.

  11. Pre-cART Elevation of CRP and CD4+ T-cell Immune Activation Associated with HIV Clinical Progression in a Multinational Case-Cohort Study

    PubMed Central

    Balagopal, Ashwin; Asmuth, David M.; Yang, Wei-Teng; Campbell, Thomas B.; Gupte, Nikhil; Smeaton, Laura; Kanyama, Cecilia; Grinsztejn, Beatriz; Santos, Breno; Supparatpinyo, Khuanchai; Badal-Faesen, Sharlaa; Lama, Javier R.; Lalloo, Umesh G.; Zulu, Fatima; Pawar, Jyoti S; Riviere, Cynthia; Kumarasamy, Nagalingeswaran; Hakim, James; Li, Xiao-Dong; Pollard, Richard B.; Semba, Richard D.; Thomas, David L.; Bollinger, Robert C.; Gupta, Amita

    2015-01-01

    Background Despite the success of combination antiretroviral therapy (cART), a subset of HIV-infected patients who initiate cART develop early clinical progression to AIDS; therefore some cART initiators are not fully benefitted by cART. Immune activation pre-cART may predict clinical progression in cART initiators. Methods A case-cohort study (n=470) within the multinational Prospective Evaluation of Antiretrovirals in Resource-Limited Settings (PEARLS) clinical trial (1571 HIV treatment-naïve adults who initiated cART; CD4+ T cell count <300 cells/mm3; nine countries) was conducted. A subcohort of 30 participants/country was randomly selected; additional cases were added from the main cohort. Cases (n=236 [random subcohort–36; main cohort–200]) had clinical progression (incident WHO Stage 3/4 event or death) within 96 weeks following cART initiation. Immune activation biomarkers were quantified pre-cART. Associations between biomarkers and clinical progression were examined using weighted multivariable Cox-proportional hazards models. Results Median age was 35 years, 45% were women, 49% black, 31% Asian, and 9% white. Median CD4+ T-cell count was 167 cells/mm3. In multivariate analysis, highest quartile CRP concentration (adjusted hazards ratio [aHR] 2.53, 95%CI 1.02-6.28) and CD4+ T-cell activation (aHR 5.18, 95CI 1.09-24.47) were associated with primary outcomes, compared to lowest quartiles. sCD14 had a trend towards association with clinical failure (aHR 2.24, 95%CI 0.96–5.21). Conclusions Measuring CRP and CD4+ T-cell activation may identify patients with CD4+ T cell counts < 300 cells/mm3 at risk for early clinical progression when initiating cART. Additional vigilance and symptom-based screening may be required in this subset of patients even after beginning cART. PMID:26017661

  12. Bucking social norms: Examining anomalous fertility aspirations in the face of HIV in Lusaka, Zambia

    PubMed Central

    Moore, Ann M.; Keogh, Sarah; Kavanaugh, Megan; Bankole, Akinrinola; Mulambia, Chishimba; Mutombo, Namuunda

    2014-01-01

    In settings of high fertility and high HIV prevalence, individuals are making fertility decisions while simultaneously trying to avoid or manage HIV. We sought to increase our understanding of how individuals dually manage HIV risk while attempting to achieve their fertility goals as part of the project entitled HIV Status and Achieving Fertility Desires conducted in Zambia in 2011. Using multivariate regression to predict fertility patterns based on socio-demographic characteristics for respondents from facility-based and community-based surveys, we employed Anomalous Case Analysis (ACA) whereby in-depth interview respondents were selected from the groups of outliers amongst the survey respondents who reported lower or higher fertility preferences than predicted as well as those who adhered to predicted patterns, and lived in Lusaka (n=45). All of the facility-based respondents were HIV-positive. We utilize the Theory of Conjunctural Action (TCA) to categorize domains of influence on individuals’ preferences and behavior. Both community-based and facility-based right-tail respondents (outliers whose fertility intentions indicated that they wanted a/nother child when we predicted that they did not) expressed comparatively less control over their fertility and gave more weight to pressures from others to continue childbearing. Partner communication about fertility desires was greater among left-tail respondents (outliers whose fertility intentions indicated that they did not want a/nother child when we predicted that they did). HIV-positive right-tail respondents were more likely to see anti-retroviral therapies (ARTs) which prevent mother to child transmission of HIV as highly effective, mitigating inhibitions to further childbearing. Drug interactions between ARTs and contraceptives were identified as a limitation to HIV-positive individuals’ contraceptive options on both sides of the distribution. Factors that should be taken into account in the future to understand fertility behavior in high HIV-prevalent settings include couples’ communication around fertility and perception of the efficacy of ARTs. PMID:25150655

  13. Loss to follow-up trends in HIV-positive patients receiving antiretroviral treatment in Asia from 2003 to 2013

    PubMed Central

    De La Mata, Nicole L.; Ly, Penh Sun; Van Nguyen, Kinh; Merati, Tuti Parwati; Pham, Thuy Thanh; Lee, Man Po; Choi, Jun Yong; Ross, Jeremy; Law, Matthew G.; Ng, Oon Tek

    2017-01-01

    Introduction Over time there has been substantial improvement in antiretroviral treatment (ART) programmes, including expansion of services and increased patient engagement. We describe time trends in, and factors associated with, loss to follow-up (LTFU) in HIV-positive patients receiving ART in Asia. Methods Analysis included HIV-positive adults initiating ART in 2003-2013 at seven ART programmes in Asia. Patients LTFU had not attended the clinic for ≥180 days, had not died or transferred to another clinic. Patients were censored at recent clinic visit, follow-up to January 2014. We used cumulative incidence to compare LTFU and mortality between years of ART initiation. Factors associated with LTFU were evaluated using a competing risks regression model, adjusted for clinical site. Results A total of 8,305 patients were included. There were 743 patients LTFU and 352 deaths over 26,217 person-years (pys), a crude LTFU and mortality rate of 2.83 (2.64-3.05) per 100 pys and 1.34 (1.21-1.49) per 100 pys, respectively. At 24 months, the cumulative LTFU incidence increased from 4.3%(2.9-6.1%) in 2003-05 to 8.1%(7.1-9.2%) in 2006-09, then decreased to 6.7%(5.9-7.5%) in 2010-13. Concurrently, the cumulative mortality incidence decreased from 6.2%(4.5-8.2%) in 2003-05 to 3.3%(2.8-3.9%) in 2010-13. The risk of LTFU reduced in 2010-13 compared to 2006-09 (adjusted subhazard ratio=0.73, 0.69-0.99). Conclusions LTFU rates in HIV-positive patients receiving ART in our clinical sites have varied by the year of ART initiation, with rates declining in recent years while mortality rates have remained stable. Further increases in site-level resources are likely to contribute to additional reductions in LTFU for patients initiating in subsequent years. PMID:28129256

  14. The Role of Substance Use Initiation in Adolescent Development of Subsequent Substance-Related Problems

    ERIC Educational Resources Information Center

    Magid, Viktoriya; Moreland, Angela D.

    2014-01-01

    A systematic review was conducted on the role of substance use initiation in subsequent use and substance-related problems among adolescents. Specifically, we examine previous studies to identify whether age of onset predicts subsequent levels of misuse; we also posit reasons for this association that have been suggested within the literature. In…

  15. Prediction of subacute infarct size in acute middle cerebral artery stroke: comparison of perfusion-weighted imaging and apparent diffusion coefficient maps.

    PubMed

    Drier, Aurélie; Tourdias, Thomas; Attal, Yohan; Sibon, Igor; Mutlu, Gurkan; Lehéricy, Stéphane; Samson, Yves; Chiras, Jacques; Dormont, Didier; Orgogozo, Jean-Marc; Dousset, Vincent; Rosso, Charlotte

    2012-11-01

    To compare perfusion-weighted (PW) imaging and apparent diffusion coefficient (ADC) maps in prediction of infarct size and growth in patients with acute middle cerebral artery infarct. This study was approved by the local institutional review board. Written informed consent was obtained from all 80 patients. Subsequent infarct volume and growth on follow-up magnetic resonance (MR) images obtained within 6 days were compared with the predictions based on PW images by using a time-to-peak threshold greater than 4 seconds and ADC maps obtained less than 12 hours after middle cerebral artery infarct. ADC- and PW imaging-predicted infarct growth areas and infarct volumes were correlated with subsequent infarct growth and follow-up diffusion-weighted (DW) imaging volumes. The impact of MR imaging time delay on the correlation coefficient between the predicted and subsequent infarct volumes and individual predictions of infarct growth by using receiver operating characteristic curves were assessed. The infarct volume measurements were highly reproducible (concordance correlation coefficient [CCC] of 0.965 and 95% confidence interval [CI]: 0.949, 0.976 for acute DW imaging; CCC of 0.995 and 95% CI: 0.993, 0.997 for subacute DW imaging). The subsequent infarct volume correlated (P<.0001) with ADC- (ρ=0.853) and PW imaging- (ρ=0.669) predicted volumes. The correlation was higher for ADC-predicted volume than for PW imaging-predicted volume (P<.005), but not when the analysis was restricted to patients without recanalization (P=.07). The infarct growth correlated (P<.0001) with PW imaging-DW imaging mismatch (ρ=0.470) and ADC-DW imaging mismatch (ρ=0.438), without significant differences between both methods (P=.71). The correlations were similar among time delays with ADC-predicted volumes but decreased with PW imaging-based volumes beyond the therapeutic window. Accuracies of ADC- and PW imaging-based predictions of infarct growth in an individual prediction were similar (area under the receiver operating characteristic curve [AUC] of 0.698 and 95% CI: 0.585, 0.796 vs AUC of 0.749 and 95% CI: 0.640, 0.839; P=.48). The ADC-based method was as accurate as the PW imaging-based method for evaluating infarct growth and size in the subacute phase. © RSNA, 2012

  16. Challenging the state of the art in protein structure prediction: Highlights of experimental target structures for the 10th Critical Assessment of Techniques for Protein Structure Prediction Experiment CASP10.

    PubMed

    Kryshtafovych, Andriy; Moult, John; Bales, Patrick; Bazan, J Fernando; Biasini, Marco; Burgin, Alex; Chen, Chen; Cochran, Frank V; Craig, Timothy K; Das, Rhiju; Fass, Deborah; Garcia-Doval, Carmela; Herzberg, Osnat; Lorimer, Donald; Luecke, Hartmut; Ma, Xiaolei; Nelson, Daniel C; van Raaij, Mark J; Rohwer, Forest; Segall, Anca; Seguritan, Victor; Zeth, Kornelius; Schwede, Torsten

    2014-02-01

    For the last two decades, CASP has assessed the state of the art in techniques for protein structure prediction and identified areas which required further development. CASP would not have been possible without the prediction targets provided by the experimental structural biology community. In the latest experiment, CASP10, more than 100 structures were suggested as prediction targets, some of which appeared to be extraordinarily difficult for modeling. In this article, authors of some of the most challenging targets discuss which specific scientific question motivated the experimental structure determination of the target protein, which structural features were especially interesting from a structural or functional perspective, and to what extent these features were correctly reproduced in the predictions submitted to CASP10. Specifically, the following targets will be presented: the acid-gated urea channel, a difficult to predict transmembrane protein from the important human pathogen Helicobacter pylori; the structure of human interleukin (IL)-34, a recently discovered helical cytokine; the structure of a functionally uncharacterized enzyme OrfY from Thermoproteus tenax formed by a gene duplication and a novel fold; an ORFan domain of mimivirus sulfhydryl oxidase R596; the fiber protein gene product 17 from bacteriophage T7; the bacteriophage CBA-120 tailspike protein; a virus coat protein from metagenomic samples of the marine environment; and finally, an unprecedented class of structure prediction targets based on engineered disulfide-rich small proteins. Copyright © 2013 The Authors. Wiley Periodicals, Inc.

  17. Adverse Pregnancy Outcomes after Abnormal First Trimester Screening for Aneuploidy

    PubMed Central

    Goetzl, Laura

    2010-01-01

    Women with abnormal first trimester screening but with a normal karyotype are at risk for adverse pregnancy outcomes. A nuchal translucency >3.5mm is associated with an increased risk of subsequent pregnancy loss, fetal infection, fetal heart abnormalities and other structural abnormalities. Abnormal first trimester analytes are also associated with adverse pregnancy outcomes but the predictive value is less impressive. As a single marker, PAPP-A <1st%ile has a good predictive value for subsequent fetal growth restriction. Women with PAPP-A<5th%ile should undergo subsequent risk assessment with routine MSAFP screening with the possible addition of uterine artery PI assessment in the midtrimester. PMID:20638576

  18. Does subsequent criminal justice involvement predict foster care and termination of parental rights for children born to incarcerated women?

    PubMed

    Kubiak, Sheryl Pimlott; Kasiborski, Natalie; Karim, Nidal; Schmittel, Emily

    2012-01-01

    This longitudinal study of 83 incarcerated women, who gave birth during incarceration and retained their parental rights through brief sentences, examines the intersection between subsequent criminal justice involvement postrelease and child welfare outcomes. Ten years of multiple state-level administrative data sets are used to determine if arrest or conviction predict foster care and/or termination of parental rights. Findings indicate that only felony arrest is a significant predictor of foster care involvement. Additionally, 69% of mothers retained legal custody, despite subsequent criminal involvement for many, suggesting supportive parenting programs and resources need to be available to these women throughout and after incarceration.

  19. Rapid evaluation of soluble HLA-G levels in supernatants of in vitro fertilized embryos.

    PubMed

    Rebmann, Vera; Switala, Magdalena; Eue, Ines; Schwahn, Eva; Merzenich, Markus; Grosse-Wilde, Hans

    2007-04-01

    Human leukocyte antigen G (HLA-G) molecules are crucial for the maternal tolerance against the fetus during pregnancy. Thus, the presence of soluble HLA-G (sHLA-G) in embryo cultures is thought to be correlated to a successful pregnancy after assisted reproductive techniques (ART). Here, we established a rapid detection assay based on Luminex technology, which can be integrated into ART proceedings, allowing sHLA-G quantification in sample volumes of only 10 microl within 1.5 hours. Using this method, sHLA-G levels of 526 single-embryo cultures, 47 two-embryo cultures, and 15 three-embryo cultures were analyzed corresponding to 313 ART cycles. In 117 embryo cultures, sHLA-G was detectable. In single-embryo cultures, the sHLA-G levels were positively correlated to embryo quality (p = 0.048, r = 0.20, n = 100). The presence of sHLA-G in embryo cultures was significantly (p < 0.0001) associated with clinical pregnancy after intracytoplasmatic sperm injections (ICSI), especially in couples with male factor infertility, but not after in vitro fertilization (IVF) or in couples with female infertility. Importantly, in sHLA-G negative embryos, the abortion rate was increased threefold (p = 0.04). In conclusion, the results obtained by our novel method support strongly the diagnostic relevance of sHLA-G for predicting pregnancy outcome after ART. The ultimate conditions for this prediction have to be further investigated in a multicenter study.

  20. Adrian Stokes and the portrait of Melanie Klein.

    PubMed

    Sayers, Janet

    2015-08-01

    This paper focuses on the offer by the art writer Adrian Stokes to commission and pay for a portrait of the psychoanalyst Melanie Klein by the artist William Coldstream. It details some of the precursors of this offer in Stokes's preceding involvement first with Klein and then with Coldstream; her response to this offer; and its outcome and aftermath in Stokes's subsequent writing about Klein and Coldstream. Copyright © 2015 Institute of Psychoanalysis.

  1. The Charitable Trust Model: An Alternative Approach For Department Of Defense Accounting

    DTIC Science & Technology

    2016-12-01

    Constitution declares, “No Money shall be drawn from the Treasury, but in Consequence of Appropriations made by Law; and a regular Statement and Account...of all public Money shall be published from time to time” (U.S. Const. art. I, § 9). This provision represents the basis for federal financial... money . In the 200 years since the founders established this nation, various statutes have subsequently mandated additional accounting and reporting

  2. The Impact of Standards-Based Reforms on the Art of Teaching: A Narrative Case Study of the Perceptions of Highly Effective Teachers in Grades 7-12

    ERIC Educational Resources Information Center

    Thornton, Susan W.

    2013-01-01

    In the 12 years subsequent to the passing of No Child Left Behind (NCLB), the ensuing standards-based reforms (SBRs) have created multiple effects that have permeated every aspect of the educational process, and teachers have reported specific constraints being placed upon them as a result. Grounded in Eisner's (2002b) theory of aesthetic teaching…

  3. Hopelessness, individualism, collectivism, and substance use among young rural-to-urban migrants in China.

    PubMed

    Du, Hongfei; Li, Xiaoming; Lin, Danhua; Tam, Cheuk Chi

    2014-01-01

    The current study aimed to investigate the impact of individualism, collectivism, and hopelessness on substance use. Hopelessness was hypothesized as a mediator between individualism and substance use, and between collectivism and substance use. We tested the hypothesis using a survey of 641 young rural-to-urban migrants in China. Consistent with our hypotheses, individualistic orientation predicted increased hopelessness and subsequently predicted more substance use, whereas collectivistic orientation was associated with decreased hopelessness and subsequently predicted less substance use. Hopelessness fully mediated the relations between individualism and substance use and between collectivism and substance use. The theoretical and practical implications of these findings were discussed.

  4. Development of an engineering analysis of progressive damage in composites during low velocity impact

    NASA Technical Reports Server (NTRS)

    Humphreys, E. A.

    1981-01-01

    A computerized, analytical methodology was developed to study damage accumulation during low velocity lateral impact of layered composite plates. The impact event was modeled as perfectly plastic with complete momentum transfer to the plate structure. A transient dynamic finite element approach was selected to predict the displacement time response of the plate structure. Composite ply and interlaminar stresses were computed at selected time intervals and subsequently evaluated to predict layer and interlaminar damage. The effects of damage on elemental stiffness were then incorporated back into the analysis for subsequent time steps. Damage predicted included fiber failure, matrix ply failure and interlaminar delamination.

  5. Assessing Craving and its Relationship to Subsequent Prescription Opioid Use Among Treatment-Seeking Prescription Opioid Dependent Patients

    PubMed Central

    McHugh, R. Kathryn; Fitzmaurice, Garrett M.; Carroll, Kathleen M.; Griffin, Margaret L.; Hill, Kevin P.; Wasan, Ajay D.; Weiss, Roger D.

    2014-01-01

    Background Craving is viewed as a core feature of substance use disorders and has been shown to predict future drug use, particularly over the short term. Accordingly, craving is often assessed in treatment settings as a marker of risk for subsequent drug use. The identification of the briefest measure that maintains predictive validity is of particular value for both clinical and research settings to minimize assessment burden while maintaining utility for the prediction of use. Methods Data from a multi-site clinical trial of treatment for prescription opioid dependence were examined to evaluate whether a brief, 3-item craving scale administered each week predicted urine-confirmed self report of prescription opioid use in the subsequent week. Logistic regression models examining the association between craving and presence or absence of opioid use in the following week were conducted, controlling for opioid use in the previous week, treatment condition, and lifetime history of heroin use. Results Greater craving was associated with a higher odds of prescription opioid use in the following week. For each one-unit increase on this 10-point scale, the odds of using opioids in the subsequent week was 17% higher. In addition to an item assessing urges, items assessing cue-induced craving and perceived likelihood of relapse in an environment where drugs were previously used contributed uniquely to this association. Conclusions A brief measure of prescription opioid craving predicted prescription opioid use among individuals in treatment. This measure offers an efficient strategy to inform the assessment of risk for use in this population. PMID:25454409

  6. Investigating atmospheric transport processes of trace gases with ICON-ART on different scales

    NASA Astrophysics Data System (ADS)

    Schröter, Jennifer; Ruhnke, Roland; Rieger, Daniel; Vogel, Heike; Vogel, Bernhard

    2016-04-01

    We have extended the global ICON [1] (ICOsahedral Nonhydrostatic) modelling framework by introducing ICON-ART [2]. ICON is jointly developed by the German Weather Service (DWD) and Max-Planck-Institute for Meteorology (MPI-M), and is used for numerical weather prediction as well as for future climate predictions. ICON-ART is developed at the KIT with the goal to simulate interactions between trace substances and the state of the atmosphere. For the dynamics (transport and diffusion) of gaseous tracers, the original ICON tracer framework is used. A process splitting approach separates the physical processes. In this study, we present results of the ICON-ART extension, including the full gas-phase chemistry module. This module uses the kpp formalism [3] to generate chemistry modules and the photolysis module is based on Cloud-J7.3 [4]. Photolysis rates are calculated online based on the meteorological state of the atmosphere, as well as on the actual ozone profile and cloud optical parameters. Two simulations are performed with ICON-ART. The first one with physics parameterisations for the numerical weather prediction (NWP) and the second one with that for climate simulation in order to investigate the dynamical influence on the distribution of long-lived as well as of short-lived species by comparing both simulations. The results are evaluated with other model results and with observation. In addition to that, we use aircraft campaign data to validate the results on the regional scale for short term simulations by using the NWP physics. [1] Zängl, G., Reinert, D., Ripodas, P., and Baldauf, M.: The ICON (ICOsahedral Non-hydrostatic) modelling framework of DWD and MPI-M: Description of the non-hydrostatic dynamicalcore, Q. J. Roy. Meteor. Soc,141, 563-579, doi:10.1002/qj.2378, 2015 [2] Rieger, D., Bangert, M., Bischoff-Gauss, I., Förstner, J., Lundgren, K., Reinert, D., Schröter, J., Vogel, H., Zängl, G., Ruhnke, R., and Vogel, B.: ICON-ART 1.0 - a new online-coupled model system from the global to regional scale, Geosci. Model Dev., 8, 1659-1676, doi:10.5194/gmd-8-1659-2015, 2015 [3] Sandu, A. and Sander, R.: Technical note: Simulating chemical systems in Fortran90 and Matlab with the Kinetic PreProcessor KPP-2.1, Atmos. Chem. Phys., 6, 187-195, doi:10.5194/acp-6-187-2006, 2006 [4] Prather, M. J.: Photolysis rates in correlated overlapping cloud fields: Cloud-J 7.3c, Geosci. Model Dev., 8, 2587-2595, doi:10.5194/gmd-8-2587-2015, 2015

  7. Rumination, anxiety, depressive symptoms and subsequent depression in adolescents at risk for psychopathology: a longitudinal cohort study

    PubMed Central

    2013-01-01

    Background A ruminative style of responding to low mood is associated with subsequent high depressive symptoms and depressive disorder in children, adolescents and adults. Scores on self-report rumination scales correlate strongly with scores on anxiety and depression symptom scales. This may confound any associations between rumination and subsequent depression. Methods Our sample comprised 658 healthy adolescents at elevated risk for psychopathology. This study applied ordinal item (non-linear) factor analysis to pooled items from three self-report questionnaires to explore whether there were separate, but correlated, constructs of rumination, depression and anxiety. It then tested whether rumination independently predicted depressive disorder and depressive symptoms over the subsequent 12 months, after adjusting for confounding variables. Results We identified a single rumination factor, which was correlated with factors representing cognitive symptoms of depression, somatic symptoms of depression and anxiety symptoms; and one factor representing adaptive responses to low mood. Elevated rumination scores predicted onset of depressive disorders over the subsequent year (p = 0.035), and levels of depressive symptoms 12 months later (p < 0.0005), after adjustment for prior levels of depressive and anxiety symptoms. Conclusion High rumination predicts onset of depressive disorder in healthy adolescents. Therapy that reduces rumination and increases distraction/problem-solving may reduce onset and relapse rates of depression. PMID:24103296

  8. An assessment of the relationship between the World Health Organization HIV drug resistance early warning indicators and HIV drug resistance acquisition.

    PubMed

    St-Jean, M; Harrigan, P R; Sereda, P; Montaner, Jsg; Lima, V D

    2017-05-01

    The World Health Organization (WHO)'s HIV drug resistance (HIVDR) early warning indicators (EWIs) measure antiretroviral therapy (ART)-site factors associated with HIVDR prevention, without HIVDR laboratory testing. We assessed the relationship between EWIs and HIVDR acquisition using data from British Columbia, Canada. Eligible patients were ART-naïve, were ≥ 19 years old, had initiated ART between 1 January 2000 and 31 December 2012, had ≥ 15 months of follow-up, and were without transmitted HIVDR. Patients were followed for acquired HIVDR until 31 March 2014, the last contact date, or death. We built logistic regression models to assess the associations and predictive ability of individual indicators and of the EWI Score (the number of indicators for which a patient did not meet the criteria) on HIVDR acquisition (to any class of HIVDR, lamivudine (3TC)/emtricitabine (FTC), nonnucleoside reverse transcriptase inhibitors (NNRTIs), nucleoside reverse transcriptase inhibitors (NRTIs) or protease inhibitors (PIs)]). All explored EWIs were associated with at least one class of HIVDR, with the exception of 'ART prescribing practices'. We observed a dose-response relationship between acquiring HIVDR to any antiretroviral class and an increasing EWI score in our predictive logistic regression model. The area under the curve was 0.848 (excellent discrimination). The adjusted odds ratios for acquiring any class of HIVDR for an EWI score of 1, 2 and ≥ 3 versus 0 were 2.30 [95% confidence Interval (CI) 1.21-4.38], 3.35 (95% CI: 1.86-6.03) and 7.26 (95% CI: 4.18-12.61), respectively. Several EWIs were associated with and predictive of HIVDR, supporting the WHO EWIs as a component of the HIVDR prevention method in settings where HIVDR testing is not routinely or widely available. © 2016 British HIV Association.

  9. Prediction of recovery of motor function after stroke.

    PubMed

    Stinear, Cathy

    2010-12-01

    Stroke is a leading cause of disability. The ability to live independently after stroke depends largely on the reduction of motor impairment and the recovery of motor function. Accurate prediction of motor recovery assists rehabilitation planning and supports realistic goal setting by clinicians and patients. Initial impairment is negatively related to degree of recovery, but inter-individual variability makes accurate prediction difficult. Neuroimaging and neurophysiological assessments can be used to measure the extent of stroke damage to the motor system and predict subsequent recovery of function, but these techniques are not yet used routinely. The use of motor impairment scores and neuroimaging has been refined by two recent studies in which these investigations were used at multiple time points early after stroke. Voluntary finger extension and shoulder abduction within 5 days of stroke predicted subsequent recovery of upper-limb function. Diffusion-weighted imaging within 7 days detected the effects of stroke on caudal motor pathways and was predictive of lasting motor impairment. Thus, investigations done soon after stroke had good prognostic value. The potential prognostic value of cortical activation and neural plasticity has been explored for the first time by two recent studies. Functional MRI detected a pattern of cortical activation at the acute stage that was related to subsequent reduction in motor impairment. Transcranial magnetic stimulation enabled measurement of neural plasticity in the primary motor cortex, which was related to subsequent disability. These studies open interesting new lines of enquiry. WHERE NEXT?: The accuracy of prediction might be increased by taking into account the motor system's capacity for functional reorganisation in response to therapy, in addition to the extent of stroke-related damage. Improved prognostic accuracy could also be gained by combining simple tests of motor impairment with neuroimaging, genotyping, and neurophysiological assessment of neural plasticity. The development of algorithms to guide the sequential combinations of these assessments could also further increase accuracy, in addition to improving rehabilitation planning and outcomes. Copyright © 2010 Elsevier Ltd. All rights reserved.

  10. The associations of earlier trauma exposures and history of mental disorders with PTSD after subsequent traumas.

    PubMed

    Kessler, R C; Aguilar-Gaxiola, S; Alonso, J; Bromet, E J; Gureje, O; Karam, E G; Koenen, K C; Lee, S; Liu, H; Pennell, B-E; Petukhova, M V; Sampson, N A; Shahly, V; Stein, D J; Atwoli, L; Borges, G; Bunting, B; de Girolamo, G; Gluzman, S F; Haro, J M; Hinkov, H; Kawakami, N; Kovess-Masfety, V; Navarro-Mateu, F; Posada-Villa, J; Scott, K M; Shalev, A Y; Ten Have, M; Torres, Y; Viana, M C; Zaslavsky, A M

    2017-09-19

    Although earlier trauma exposure is known to predict posttraumatic stress disorder (PTSD) after subsequent traumas, it is unclear whether this association is limited to cases where the earlier trauma led to PTSD. Resolution of this uncertainty has important implications for research on pretrauma vulnerability to PTSD. We examined this issue in the World Health Organization (WHO) World Mental Health (WMH) Surveys with 34 676 respondents who reported lifetime trauma exposure. One lifetime trauma was selected randomly for each respondent. DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition) PTSD due to that trauma was assessed. We reported in a previous paper that four earlier traumas involving interpersonal violence significantly predicted PTSD after subsequent random traumas (odds ratio (OR)=1.3-2.5). We also assessed 14 lifetime DSM-IV mood, anxiety, disruptive behavior and substance disorders before random traumas. We show in the current report that only prior anxiety disorders significantly predicted PTSD in a multivariate model (OR=1.5-4.3) and that these disorders interacted significantly with three of the earlier traumas (witnessing atrocities, physical violence victimization and rape). History of witnessing atrocities significantly predicted PTSD after subsequent random traumas only among respondents with prior PTSD (OR=5.6). Histories of physical violence victimization (OR=1.5) and rape after age 17 years (OR=17.6) significantly predicted only among respondents with no history of prior anxiety disorders. Although only preliminary due to reliance on retrospective reports, these results suggest that history of anxiety disorders and history of a limited number of earlier traumas might usefully be targeted in future prospective studies as distinct foci of research on individual differences in vulnerability to PTSD after subsequent traumas.Molecular Psychiatry advance online publication, 19 September 2017; doi:10.1038/mp.2017.194.

  11. NREL Projects Awarded More Than $3 Million to Advance Novel Solar

    Science.gov Websites

    in Grid Operations," evaluating a research solution to better integrate solar power generation funding program, which advances state-of-the-art techniques for predicting solar power generation to Office to advance predictive modeling of solar power as part of its Solar Forecasting 2 funding program

  12. Antiretroviral therapy CNS penetration and HIV-1-associated CNS disease.

    PubMed

    Garvey, L; Winston, A; Walsh, J; Post, F; Porter, K; Gazzard, B; Fisher, M; Leen, C; Pillay, D; Hill, T; Johnson, M; Gilson, R; Anderson, J; Easterbrook, P; Bansi, L; Orkin, C; Ainsworth, J; Palfreeman, A; Gompels, M; Phillips, A N; Sabin, C A

    2011-02-22

    The impact of different antiretroviral agents on the risk of developing or surviving CNS disease remains unknown. The aim of this study was to investigate whether using antiretroviral regimens with higher CNS penetration effectiveness (CPE) scores was associated with reduced incidence of CNS disease and improved survival in the UK Collaborative HIV Cohort (CHIC) Study. Adults without previous CNS disease, who commenced combination antiretroviral therapy (cART) between 1996 and 2008, were included (n = 22,356). Initial and most recent cART CPE scores were calculated. CNS diseases were HIV encephalopathy (HIVe), progressive multifocal leukoencephalopathy (PML), cerebral toxoplasmosis (TOXO), and cryptococcal meningitis (CRYPTO). Incidence rates and overall survival were stratified by CPE score. A multivariable Poisson regression model was used to identify independent associations. The median (interquartile range) CPE score for initial cART regimen increased from 7 (5-8) in 1996-1997 to 9 (8-10) in 2000-2001 and subsequently declined to 6 (7-8) in 2006-2008. Differences in gender, HIV acquisition risk group, and ethnicity existed between CPE score strata. A total of 251 subjects were diagnosed with a CNS disease (HIVe 80; TOXO 59; CRYPTO 56; PML 54). CNS diseases occurred more frequently in subjects prescribed regimens with CPE scores ≤ 4, and less frequently in those with scores ≥ 10; however, these differences were nonsignificant. Initial and most recent cART CPE scores ≤ 4 were independently associated with increased risk of death. Clinical status at time of commencing cART influences antiretroviral selection and CPE score. This information should be considered when utilizing CPE scores for retrospective analyses.

  13. A Bushelful of Science.

    ERIC Educational Resources Information Center

    Van De Walle, Carol

    1988-01-01

    Describes a multidisciplinary unit which uses 12 varieties of apples. Explains activities for observing, predicting decay, art and science, the process of fermentation, and group and individual projects. Information on description of apples and labeled diagrams are included. (RT)

  14. Cytomegalovirus retinitis and HIV: Case reviews from KwaZulu-Natal Province, South Africa.

    PubMed

    Hassan-Moosa, R; Chinappa, T; Jeena, L; Visser, L; Naidoo, K

    2017-09-22

    Retinal cytomegalovirus (CMV) infection is a common opportunistic infection and remains a significant contributor to visual loss in patients with AIDS. We highlight the poor outcomes of CMV retinitis in three HIV-infected patients who were initiated on antiretroviral therapy (ART). We conducted a retrospective chart review of advanced stage HIV-infected patients with known CMV retinitis.Case 1. A 37-year-old man, with a CD4+ cell count of 35 cells/µL, presented for ART initiation with a 5-month history of visual loss in his left eye. Fundoscopy showed left eye CMV retinitis and right eye HIV retinopathy. ART and 5 months of weekly intravitreal ganciclovir injections (left eye) were commenced. Six-month outcomes included virological suppression, and visual acuity in the right eye of 6/6 and in the left eye of 3/60.Case 2. A 31-year-old woman, with a CD4+ cell count of 39 cells/µL and on tuberculosis therapy, presented for ART initiation. She presented with a 2-month history of decreased visual acuity. Fundoscopy showed bilateral CMV retinitis, which was more pronounced in the left eye. ART and 8 months of intravitreal ganciclovir injections were commenced. Six-month outcomes included virological suppression and visual acuity in the right eye of 6/9, and in the left eye of 6/24.Case 3. A 29-year-old woman, with a CD4+ cell count of 24 cells/µL, who was on tuberculosis therapy and ART, complained of blurred vision at her 2-month ART follow-up visit. Fundoscopy showed bilateral retinal detachment secondary to CMV retinitis. While silicone oil tamponade and subsequent retinectomy successfully repaired the right eye, extensive damage rendered the left eye irreparable. Six-month outcomes included virological suppression, with 6/120 visual acuity in the right eye and complete blindness in the left eye. CMV retinitis causes debilitating, permanent sequelae, which is preventable by ART initiation at higher CD4+ cell counts. Despite achieving virological suppression, vision could not be completely restored in these patients, irrespective of the severity of CMV retinitis.

  15. One year survival of ART and conventional restorations in patients with disability

    PubMed Central

    2014-01-01

    Background Providing restorative treatment for persons with disability may be challenging and has been related to the patient’s ability to cope with the anxiety engendered by treatment and to cooperate fully with the demands of the clinical situation. The aim of the present study was to assess the survival rate of ART restorations compared to conventional restorations in people with disability referred for special care dentistry. Methods Three treatment protocols were distinguished: ART (hand instruments/high-viscosity glass-ionomer); conventional restorative treatment (rotary instrumentation/resin composite) in the clinic (CRT/clinic) and under general anaesthesia (CRT/GA). Patients were referred for restorative care to a special care centre and treated by one of two specialists. Patients and/or their caregivers were provided with written and verbal information regarding the proposed techniques, and selected the type of treatment they were to receive. Treatment was provided as selected but if this option proved clinically unfeasible one of the alternative techniques was subsequently proposed. Evaluation of restoration survival was performed by two independent trained and calibrated examiners using established ART restoration assessment codes at 6 months and 12 months. The Proportional Hazard model with frailty corrections was applied to calculate survival estimates over a one year period. Results 66 patients (13.6 ± 7.8 years) with 16 different medical disorders participated. CRT/clinic proved feasible for 5 patients (7.5%), the ART approach for 47 patients (71.2%), and 14 patients received CRT/GA (21.2%). In all, 298 dentine carious lesions were restored in primary and permanent teeth, 182 (ART), 21 (CRT/clinic) and 95 (CRT/GA). The 1-year survival rates and jackknife standard error of ART and CRT restorations were 97.8 ± 1.0% and 90.5 ± 3.2%, respectively (p = 0.01). Conclusions These short-term results indicate that ART appears to be an effective treatment protocol for treating patients with disability restoratively, many of whom have difficulty coping with the conventional restorative treatment. Trial registration number Netherlands Trial Registration: NTR 4400 PMID:24885938

  16. Patients present earlier and survival has improved, but pre-ART attrition is high in a six-year HIV cohort data from Ethiopia.

    PubMed

    Mulissa, Zewdie; Jerene, Degu; Lindtjørn, Bernt

    2010-10-11

    Previous studies showed higher early mortality rates among patients treated with antiretroviral drugs in settings with limited resources. One of the reasons was late presentation of patients to care. With improved access to HIV services, we expect improvements in disease stage at presentation. Our objective was to assess the effect of improved availability of HIV services on patient presentation to care and subsequent pre-ART and on-ART outcomes. At Arba Minch Hospital in Ethiopia, we reviewed baseline characteristics and outcomes of 2191 adult HIV patients. Nearly a half were in WHO stage III at presentation. About two-thirds of the patients (1428) started ART. Patients enrolled in the early phase (OR = 4.03, 95% CI 3.07-5.27), men (OR = 1.78, 95%CI 1.47-2.16), and those aged 45 years and above (OR = 2.04, 95%CI 1.48-2.82) were at higher risk of being in advanced clinical stage at presentation. The pre-treatment mortality rate was 13.1 per 100 PYO, ranging from 1.4 in the rapid scale-up phase to 25.9 per 100 PYO in the early phase. A quarter of the patients were lost to follow-up before starting treatment. Being in less advanced stage (HR = 1.9, 95% CI = 1.6, 2.2), being in the recent cohort (HR = 2.0, 95% CI = 1.6, 2.6), and rural residence (HR = 1.8, 95% CI = 1.5, 2.2) were independent predictors of pre-ART loss to follow-up. Of those who started ART, 13.4% were lost to follow-up and 15.4% died. The survival improved during the study. Patients with advanced disease, men and older people had higher death rates. Patients started to present at earlier stages of their illness and death has decreased among adult HIV patients visiting Arba Minch Hospital. However, many patients were lost from pre-treatment follow-up. Early treatment start contributed to improved survival. Both pre-ART and on-ART patient retention mechanisms should be strengthened.

  17. [HIV drug resistance in ART-experienced patients in Cali, Colombia, 2008-2010].

    PubMed

    Martínez-Cajas, Jorge L; Mueses-Marín, Héctor F; Galindo-Orrego, Pablo; Agudelo, Juan F; Galindo-Quintero, Jaime

    2013-01-01

    Little has been published in Colombia on HIV drug resistance in patients taking antiretroviral treatment (ART). Currently, the Colombian guidelines do not recommend the use of genotypic antiretroviral resistance tests (GART) for treatment-naive patients or for those experiencing a first therapeutic failure. To determine the frequency of relevant resistance mutations and the degree of susceptibility/ resistance of HIV to antiretroviral drugs (ARVs) in ART-experienced patients. A non-random sample of 170 ART-experienced HIV patients with virologic failure and who underwent GART was recruited. A study of HIV drug resistance was carried out in two groups of patients: one group that underwent early GART and the other group that received late GART testing. The most frequent type of resistance affected the non-nucleoside class (76%). The late-GART group had higher risk of nucleoside analog and protease inhibitor drug resistance, a higher number of resistance mutations and more complex mutational profiles than the early-GART group. A high cross resistance level (30%) was found in the nucleoside analog class. The least affected medications were tenofovir and darunavir. Our results suggest that performing GART late is associated with levels of ARV resistance that could restrict the use of an important number of essential ARV in subsequent regimens. There is a need to revise the current recommendations to include GART prior to start of treatment and after the first virologic failure.

  18. High Levels of Dual-Class Drug Resistance in HIV-Infected Children Failing First-Line Antiretroviral Therapy in Southern Ethiopia

    PubMed Central

    Kinloch, Natalie N.; Lapointe, Hope R.; Cobarrubias, Kyle D.; Foster, Byron A.; Jerene, Degu; Makonnen, Eyasu; Brumme, Zabrina L.

    2018-01-01

    Clinical monitoring of pediatric HIV treatment remains a major challenge in settings where drug resistance genotyping is not routinely available. As a result, our understanding of drug resistance, and its impact on subsequent therapeutic regimens available in these settings, remains limited. We investigate the prevalence and correlates of HIV-1 drug resistance among 94 participants of the Ethiopia Pediatric HIV Cohort failing first-line combination antiretroviral therapy (cART) using dried blood spot-based genotyping. Overall, 81% (73/90) of successfully genotyped participants harbored resistance mutations, including 69% (62/90) who harbored resistance to both Nucleoside Reverse Transcriptase Inhibitors (NRTIs) and Non-nucleoside Reverse Transcriptase Inhibitors (NNRTIs). Strikingly, 42% of resistant participants harbored resistance to all four NRTIs recommended for second-line use in this setting, meaning that there are effectively no remaining cART options for these children. Longer cART duration and prior regimen changes were significantly associated with detection of drug resistance mutations. Replicate genotyping increased the breadth of drug resistance detected in 34% of cases, and thus is recommended for consideration when typing from blood spots. Implementation of timely drug resistance testing and access to newer antiretrovirals and drug classes are urgently needed to guide clinical decision-making and improve outcomes for HIV-infected children on first-line cART in Ethiopia. PMID:29389912

  19. Identical vs. Conceptual repetition FN400 and Parietal Old/New ERP components occur during encoding and predict subsequent memory

    PubMed Central

    Griffin, Michael; DeWolf, Melissa; Keinath, Alexander; Liu, Xiaonan; Reder, Lynne

    2013-01-01

    This Event-Related Potential (ERP) study investigated whether components commonly measured at test, such as the FN400 and the parietal old/new components, could be observed during encoding and, if so, whether they would predict different levels of accuracy on a subsequent memory test. ERPs were recorded while subjects classified pictures of objects as man-made or natural. Some objects were only classified once while others were classified twice during encoding, sometimes with an identical picture, and other times with a different exemplar from the same category. A subsequent surprise recognition test required subjects to judge whether each probe word corresponded to a picture shown earlier, and if so whether there were two identical pictures that corresponded to the word probe, two different pictures, or just one picture. When the second presentation showed a duplicate of an earlier picture, the FN400 effect (a significantly less negative deflection on the second presentation) was observed regardless of subsequent memory response; however, when the second presentation showed a different exemplar of the same concept, the FN400 effect was only marginally significant. In contrast, the parietal old/new effect was robust for the second presentation of conceptual repetitions when the test probe was subsequently recognized, but not for identical repetitions. These findings suggest that ERP components that are typically observed during an episodic memory test can be observed during an incidental encoding task, and that they are predictive of the degree of subsequent memory performance. PMID:23528265

  20. Image-Based Predictive Modeling of Heart Mechanics.

    PubMed

    Wang, V Y; Nielsen, P M F; Nash, M P

    2015-01-01

    Personalized biophysical modeling of the heart is a useful approach for noninvasively analyzing and predicting in vivo cardiac mechanics. Three main developments support this style of analysis: state-of-the-art cardiac imaging technologies, modern computational infrastructure, and advanced mathematical modeling techniques. In vivo measurements of cardiac structure and function can be integrated using sophisticated computational methods to investigate mechanisms of myocardial function and dysfunction, and can aid in clinical diagnosis and developing personalized treatment. In this article, we review the state-of-the-art in cardiac imaging modalities, model-based interpretation of 3D images of cardiac structure and function, and recent advances in modeling that allow personalized predictions of heart mechanics. We discuss how using such image-based modeling frameworks can increase the understanding of the fundamental biophysics behind cardiac mechanics, and assist with diagnosis, surgical guidance, and treatment planning. Addressing the challenges in this field will require a coordinated effort from both the clinical-imaging and modeling communities. We also discuss future directions that can be taken to bridge the gap between basic science and clinical translation.

  1. Why is Past Depression the Best Predictor of Future Depression? Stress Generation as a Mechanism of Depression Continuity in Girls

    PubMed Central

    Rudolph, Karen D.; Flynn, Megan; Abaied, Jamie; Groot, Alison; Thompson, Renee

    2009-01-01

    This study examined whether a transactional interpersonal life stress model helps to explain the continuity in depression over time in girls. Youth (86 girls, 81 boys; M age = 12.41, SD = 1.19) and their caregivers participated in a three-wave longitudinal study. Depression and episodic life stress were assessed with semi-structured interviews. Path analysis provided support for a transactional interpersonal life stress model in girls but not in boys, wherein depression predicted the generation of interpersonal stress, which predicted subsequent depression. Moreover, self-generated interpersonal stress partially accounted for the continuity of depression over time. Although depression predicted noninterpersonal stress generation in girls (but not in boys), noninterpersonal stress did not predict subsequent depression. PMID:20183635

  2. Assessing the population health impact of market interventions to improve access to antiretroviral treatment

    PubMed Central

    Bärnighausen, Till; Kyle, Margaret; Salomon, Joshua A; Waning, Brenda

    2012-01-01

    Despite extraordinary global progress in increasing coverage of antiretroviral treatment (ART), the majority of people needing ART currently are not receiving treatment. Both the number of people needing ART and the average ART price per patient-year are expected to increase in coming years, which will dramatically raise funding needs for ART. Several international organizations are using interventions in ART markets to decrease ART price or to improve ART quality, delivery and innovation, with the ultimate goal of improving population health. These organizations need to select those market interventions that are most likely to substantially affect population health outcomes (ex ante assessment) and to evaluate whether implemented interventions have improved health outcomes (ex post assessment). We develop a framework to structure ex ante and ex post assessment of the population health impact of market interventions, which is transmitted through effects in markets and health systems. Ex ante assessment should include evaluation of the safety and efficacy of the ART products whose markets will be affected by the intervention; theoretical consideration of the mechanisms through which the intervention will affect population health; and predictive modelling to estimate the potential population health impact of the intervention. For ex post assessment, analysts need to consider which outcomes to estimate empirically and which to model based on empirical findings and understanding of the economic and biological mechanisms along the causal pathway from market intervention to population health. We discuss methods for ex post assessment and analyse assessment issues (unintended intervention effects, interaction effects between different interventions, and assessment impartiality and cost). We offer seven recommendations for ex ante and ex post assessment of population health impact of market interventions. PMID:21914713

  3. Perception and predictors of quality of life among HIV patients attending art clinics in northwest Ethiopia: a prospective longitudinal study.

    PubMed

    Wubshet, Mamo; Berhane, Yemane; Worku, Alemayehu; Kebede, Yigzaw

    2014-07-01

    In treating HIV as a chronic disease, monitoring changes of quality of life of patient's overtime is important for clinicians and policy makers. However, to our knowledge little research attention has been directed towards examining the longitudinal change of quality of life overtime in sub-Saharan Africa. To examine longitudinal changes in quality of life among patients initiated ART METHOD: A prospective longitudinal follow-up study was conducted from December 2009 to August 2011 to evaluate the changes in quality of life and how this relates with baseline socio-demographic and clinical characteristics among consecutive adult ART naïve patients attending ART clinic. Quality of life was measured by WHOQOL-HIV BREF. All quality of life domain scores improved significantly during 12 month follow-up in the ART program. At each follow-up visit, scores were significantly higher than baseline scores (p < 0.001). Predictors of improved quality of life were male gender, disclosure of HIV status, starting ART at higher CD4, > 200 cells/μL, and good baseline overall quality of life, whereas predictors of poor quality of life were starting ART with advanced disease stage and tuberculosis co-infection. This study demonstrated that the quality of life improved overtime for HIV-infected individuals receiving ART which is consistent with previous studies. It also provided information regarding the predictive effects of baseline socio-demographic and clinical factors on the changes in quality of life at the 12-month follow-up time. The finding of the study has implications of starting ART at a higher CD4 and early stage of the disease for better quality of life outcomes.

  4. Impaired lipoprotein processing in HIV patients on antiretroviral therapy: aberrant high-density lipoprotein lipids, stability, and function.

    PubMed

    Gillard, Baiba K; Raya, Joe L; Ruiz-Esponda, Raul; Iyer, Dinakar; Coraza, Ivonne; Balasubramanyam, Ashok; Pownall, Henry J

    2013-07-01

    HIV patients on antiretroviral therapy (HIV/ART) exhibit a unique atherogenic dyslipidemic profile with hypertriglyceridemia (HTG) and low plasma concentrations of high-density lipoprotein (HDL) cholesterol. In the Heart Positive Study of HIV/ART patients, a hypolipidemic therapy of fenofibrate, niacin, diet, and exercise reduced HTG and plasma non-HDL cholesterol concentrations and raised plasma HDL cholesterol and adiponectin concentrations. We tested the hypothesis that HIV/ART HDL have abnormal structures and properties and are dysfunctional. Hypolipidemic therapy reduced the TG contents of low-density lipoprotein and HDL. At baseline, HIV/ART low-density lipoproteins were more triglyceride (TG)-rich and HDL were more TG- and cholesteryl ester-rich than the corresponding lipoproteins from normolipidemic (NL) subjects. Very-low-density lipoproteins, low-density lipoprotein, and HDL were larger than the corresponding lipoproteins from NL subjects; HIV/ART HDL were less stable than NL HDL. HDL-[(3)H]cholesteryl ester uptake by Huh7 hepatocytes was used to assess HDL functionality. HIV/ART plasma were found to contain significantly less competitive inhibition activity for hepatocyte HDL-cholesteryl ester uptake than NL plasma were found to contain (P<0.001). Compared with NL subjects, lipoproteins from HIV/ART patients are larger and more neutral lipid-rich, and their HDL are less stable and less receptor-competent. On the basis of this work and previous studies of lipase activity in HIV, we present a model in which plasma lipolytic activities or hepatic cholesteryl ester uptake are impaired in HIV/ART patients. These findings provide a rationale to determine whether the distinctive lipoprotein structure, properties, and function of HIV/ART HDL predict atherosclerosis as assessed by carotid artery intimal medial thickness.

  5. Roles and functions of social networks among men who use drugs in ART initiation in Vietnam

    PubMed Central

    Latkin, Carl A.; Smith, M. Kumi; Ha, Tran Viet; Mo, Tran Thi; Zelaya, Carla; Sripaipan, Teerada; Le Minh, Nguyen; Quan, Vu Minh; Go, Vivian F.

    2016-01-01

    Support from social network members may help to facilitate access to HIV medical care, especially in low resourced communities. As part of a randomized clinical trial of a community-level stigma and risk reduction intervention in Thai Nguyen, Vietnam for people living with HIV who inject drugs (PWID), 341 participants were administered a baseline social network inventory. Network predictors of antiretroviral therapy (ART) initiation at the six-month follow-up were assessed. The social networks of PWID were sparse. Few participants who reported injectors in their networks also reported family members, whereas those who did not have injectors were more likely to report family members and network members providing emotional support and medical advice. In multivariate models, having at least one network member who provided medical advice predicted ART initiation at six months (OR=2.74, CI=1.20–6.28). These results suggest the importance of functional social support and network support mobilization for ART initiation among PWID. PMID:27125243

  6. Roles and Functions of Social Networks Among Men Who Use Drugs in ART Initiation in Vietnam.

    PubMed

    Latkin, Carl A; Smith, M Kumi; Ha, Tran Viet; Mo, Tran Thi; Zelaya, Carla; Sripaipan, Teerada; Le Minh, Nguyen; Quan, Vu Minh; Go, Vivian F

    2016-11-01

    Support from social network members may help to facilitate access to HIV medical care, especially in low resourced communities. As part of a randomized clinical trial of a community-level stigma and risk reduction intervention in Thai Nguyen, Vietnam for people living with HIV who inject drugs (PWID), 341 participants were administered a baseline social network inventory. Network predictors of antiretroviral therapy (ART) initiation at the 6-month follow-up were assessed. The social networks of PWID were sparse. Few participants who reported injectors in their networks also reported family members, whereas those who did not have injectors were more likely to report family members and network members providing emotional support and medical advice. In multivariate models, having at least one network member who provided medical advice predicted ART initiation at 6 months (OR 2.74, CI 1.20-6.28). These results suggest the importance of functional social support and network support mobilization for ART initiation among PWID.

  7. From art to science: a new epistemological status for medicine? On expectations regarding personalized medicine.

    PubMed

    Wiesing, Urban

    2017-12-20

    Personalized medicine plays an important role in the development of current medicine. Among the numerous statements regarding the future of personalized medicine, some can be found that accord medicine a new scientific status. Medicine will be transformed from an art to a science due to personalized medicine. This prognosis is supported by references to models of historical developments. The article examines what is meant by this prognosis, what consequences it entails, and how feasible it is. It refers to the long tradition of epistemological thinking in medicine and the use of historical models for the development of medicine. The possible answers to the question "art or science" are systematized with respect to the core question about the relationship between knowledge and action. The prediction for medicine to develop from an 'empirical healing art' to a 'rational, molecular science' is nonsensical from an epistemological point of view. The historical models employed to substantiate the development of personalized medicine are questionable.

  8. The forgotten artist: Why to consider intentions and interaction in a model of aesthetic experience. Comment on "Move me, astonish me... delight my eyes and brain: The Vienna Integrated Model of top-down and bottom-up processes in Art Perception (VIMAP) and corresponding affective, evaluative, and neurophysiological correlates" by Matthew Pelowski et al.

    NASA Astrophysics Data System (ADS)

    Brattico, Elvira; Brattico, Pauli; Vuust, Peter

    2017-07-01

    In their target article published in this journal issue, Pelowski et al. [1] address the question of how humans experience, and respond to, visual art. They propose a multi-layered model of the representations and processes involved in assessing visual art objects that, furthermore, involves both bottom-up and top-down elements. Their model provides predictions for seven different outcomes of human aesthetic experience, based on few distinct features (schema congruence, self-relevance, and coping necessity), and connects the underlying processing stages to ;specific correlates of the brain; (a similar attempt was previously done for music by [2-4]). In doing this, the model aims to account for the (often profound) experience of an individual viewer in front of an art object.

  9. The First Prediction of a Rift Valley Fever Outbreak

    NASA Technical Reports Server (NTRS)

    Anyamba, Assaf; Chretien, Jean-Paul; Small, Jennifer; Tucker, Compton J.; Formenty, Pierre; Richardson, Jason H.; Britch, Seth C.; Schnabel, David C.; Erickson, Ralph L.; Linthicum, Kenneth J.

    2009-01-01

    El Nino/Southern Oscillation (ENSO) related anomalies were analyzed using a combination of satellite measurements of elevated sea surface temperatures, and subsequent elevated rainfall and satellite derived normalized difference vegetation index data. A Rift Valley fever risk mapping model using these climate data predicted areas where outbreaks of Rift Valley fever in humans and animals were expected and occurred in the Horn of Africa from December 2006 to May 2007. The predictions were subsequently confirmed by entomological and epidemiological field investigations of virus activity in the areas identified as at risk. Accurate spatial and temporal predictions of disease activity, as it occurred first in southern Somalia and then through much of Kenya before affecting northern Tanzania, provided a 2 to 6 week period of warning for the Horn of Africa that facilitated disease outbreak response and mitigation activities. This is the first prospective prediction of a Rift Valley fever outbreak.

  10. Prediction of a Rift Valley fever outbreak

    PubMed Central

    Anyamba, Assaf; Chretien, Jean-Paul; Small, Jennifer; Tucker, Compton J.; Formenty, Pierre B.; Richardson, Jason H.; Britch, Seth C.; Schnabel, David C.; Erickson, Ralph L.; Linthicum, Kenneth J.

    2009-01-01

    El Niño/Southern Oscillation related climate anomalies were analyzed by using a combination of satellite measurements of elevated sea-surface temperatures and subsequent elevated rainfall and satellite-derived normalized difference vegetation index data. A Rift Valley fever (RVF) risk mapping model using these climate data predicted areas where outbreaks of RVF in humans and animals were expected and occurred in the Horn of Africa from December 2006 to May 2007. The predictions were subsequently confirmed by entomological and epidemiological field investigations of virus activity in the areas identified as at risk. Accurate spatial and temporal predictions of disease activity, as it occurred first in southern Somalia and then through much of Kenya before affecting northern Tanzania, provided a 2 to 6 week period of warning for the Horn of Africa that facilitated disease outbreak response and mitigation activities. To our knowledge, this is the first prospective prediction of a RVF outbreak. PMID:19144928

  11. Early follow-up data from seizure diaries can be used to predict subsequent seizures in same cohort by borrowing strength across participants

    PubMed Central

    Hall, Charles B.; Lipton, Richard B.; Tennen, Howard; Haut, Sheryl R.

    2014-01-01

    Accurate prediction of seizures in persons with epilepsy offers opportunities for both precautionary measures and preemptive treatment. Previously identified predictors of seizures include patient-reported seizure anticipation, as well as stress, anxiety, and decreased sleep. In this study, we developed three models using 30 days of nightly seizure diary data in a cohort of 71 individuals with a history of uncontrolled seizures to predict subsequent seizures in the same cohort over a 30-day follow-up period. The best model combined the individual’s seizure history with that of the remainder of the cohort, resulting in 72% sensitivity for 80% specificity, and 0.83 area under the receiver operating characteristic curve. The possibility of clinically relevant prediction should be examined through electronic data capture and more specific and more frequent sampling, and with patient training to improve prediction. PMID:19138755

  12. MQAPRank: improved global protein model quality assessment by learning-to-rank.

    PubMed

    Jing, Xiaoyang; Dong, Qiwen

    2017-05-25

    Protein structure prediction has achieved a lot of progress during the last few decades and a greater number of models for a certain sequence can be predicted. Consequently, assessing the qualities of predicted protein models in perspective is one of the key components of successful protein structure prediction. Over the past years, a number of methods have been developed to address this issue, which could be roughly divided into three categories: single methods, quasi-single methods and clustering (or consensus) methods. Although these methods achieve much success at different levels, accurate protein model quality assessment is still an open problem. Here, we present the MQAPRank, a global protein model quality assessment program based on learning-to-rank. The MQAPRank first sorts the decoy models by using single method based on learning-to-rank algorithm to indicate their relative qualities for the target protein. And then it takes the first five models as references to predict the qualities of other models by using average GDT_TS scores between reference models and other models. Benchmarked on CASP11 and 3DRobot datasets, the MQAPRank achieved better performances than other leading protein model quality assessment methods. Recently, the MQAPRank participated in the CASP12 under the group name FDUBio and achieved the state-of-the-art performances. The MQAPRank provides a convenient and powerful tool for protein model quality assessment with the state-of-the-art performances, it is useful for protein structure prediction and model quality assessment usages.

  13. Attributing heart attack and stroke to "Old Age": Implications for subsequent health outcomes among older adults.

    PubMed

    Stewart, Tara L; Chipperfield, Judith G; Perry, Raymond P; Hamm, Jeremy M

    2016-01-01

    This study assessed the extent to which older adults attribute a recent heart attack/stroke to "old age," and examined consequences for subsequent lifestyle behavior and health-care service utilization. Community-dwelling adults (N = 57, ages 73-98 years) were interviewed about their heart attack/stroke, and an objective health registry provided data on health-care utilization over a 3-year period. Endorsement of "old age" as a cause of heart attack/stroke negatively predicted lifestyle behavior change, and positively predicted frequency of physician visits and likelihood of hospitalization over the subsequent 3 years. Findings suggest the importance of considering "old age" attributions in the context of cardiovascular health events. © The Author(s) 2014.

  14. AERIS : eco-driving application development and testing.

    DOT National Transportation Integrated Search

    2012-06-01

    This exploratory study investigates the potential of developing an Eco-Driving application that utilizes an eco-cruise control (ECC) system within state-of-the-art car-following models. The research focuses on integrating predictive cruise control an...

  15. Safety Picks up "STEAM"

    ERIC Educational Resources Information Center

    Roy, Ken

    2016-01-01

    This column shares safety information for the classroom. STEAM subjects--science, technology, engineering, art, and mathematics--are essential for fostering students' 21st-century skills. STEAM promotes critical-thinking skills, including analysis, assessment, categorization, classification, interpretation, justification, and prediction, and are…

  16. Using Single-trial EEG to Predict and Analyze Subsequent Memory

    PubMed Central

    Noh, Eunho; Herzmann, Grit; Curran, Tim; de Sa, Virginia R.

    2013-01-01

    We show that it is possible to successfully predict subsequent memory performance based on single-trial EEG activity before and during item presentation in the study phase. Two-class classification was conducted to predict subsequently remembered vs. forgotten trials based on subjects’ responses in the recognition phase. The overall accuracy across 18 subjects was 59.6 % by combining pre- and during-stimulus information. The single-trial classification analysis provides a dimensionality reduction method to project the high-dimensional EEG data onto a discriminative space. These projections revealed novel findings in the pre- and during-stimulus period related to levels of encoding. It was observed that the pre-stimulus information (specifically oscillatory activity between 25–35Hz) −300 to 0 ms before stimulus presentation and during-stimulus alpha (7–12 Hz) information between 1000–1400 ms after stimulus onset distinguished between recollection and familiarity while the during-stimulus alpha information and temporal information between 400–800 ms after stimulus onset mapped these two states to similar values. PMID:24064073

  17. Pretraining Cortical Thickness Predicts Subsequent Perceptual Learning Rate in a Visual Search Task.

    PubMed

    Frank, Sebastian M; Reavis, Eric A; Greenlee, Mark W; Tse, Peter U

    2016-03-01

    We report that preexisting individual differences in the cortical thickness of brain areas involved in a perceptual learning task predict the subsequent perceptual learning rate. Participants trained in a motion-discrimination task involving visual search for a "V"-shaped target motion trajectory among inverted "V"-shaped distractor trajectories. Motion-sensitive area MT+ (V5) was functionally identified as critical to the task: after 3 weeks of training, activity increased in MT+ during task performance, as measured by functional magnetic resonance imaging. We computed the cortical thickness of MT+ from anatomical magnetic resonance imaging volumes collected before training started, and found that it significantly predicted subsequent perceptual learning rates in the visual search task. Participants with thicker neocortex in MT+ before training learned faster than those with thinner neocortex in that area. A similar association between cortical thickness and training success was also found in posterior parietal cortex (PPC). © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  18. Endometriosis fertility index predicts live births following surgical resection of moderate and severe endometriosis.

    PubMed

    Maheux-Lacroix, S; Nesbitt-Hawes, E; Deans, R; Won, H; Budden, A; Adamson, D; Abbott, J A

    2017-11-01

    Can live birth be accurately predicted following surgical resection of moderate-severe (Stage III-IV) endometriosis? Live births can accurately be predicted with the endometriosis fertility index (EFI), with adnexal function being the most important factor to predict non-assisted reproductive technology (non-ART) fertility or the requirement for ART (www.endometriosisefi.com). Fertility prognosis is important to many women with severe endometriosis. Controversy persists regarding optimal post-operative management to achieve pregnancy and the counselling of patients regarding duration of conventional treatments before undergoing ART. The EFI is reported to correlate with expectant management pregnancy rate, although external validation has been performed without specifically addressing fertility in women with moderate and severe endometriosis. Retrospective cohort study of 279 women from September 2001 to June 2016. We included women undergoing laparoscopic resection of Stage III-IV endometriosis who attempted pregnancy post-operatively. The EFI was calculated based on detailed operative reports and surgical images. Fertility outcomes were obtained by direct patient contact. Kaplan-Meier model, log rank test and Cox regression were used for analyses. The follow-up rate was 84% with a mean duration of 4.1 years. A total of 147 women (63%) had a live birth following surgery, 94 of them (64%) without ART. The EFI was highly associated with live births (P < 0.001): for women with an EFI of 0-2 the estimated cumulative non-ART live birth rate at five years was 0% and steadily increased up to 91% with an EFI of 9-10, while the proportion of women who attempted ART and had a live birth, steadily increased from 38 to 71% among the same EFI strata (P = 0.1). A low least function score was the most significant predictor of failure (P = 0.003), followed by having had a previous resection (P = 0.019) or incomplete resection (P = 0.028), being older than 40 compared to <35 years of age (P = 0.027), and having leiomyomas (P = 0.037). The main limitation of this study is its retrospective design. Imprecision was higher with low EFI due to smaller sample size in this subgroup. Finally, the EFI is somewhat subjective and could be prone to intra- and inter-observer variations. Women with a high EFI score have excellent fertility prognosis and may be advised to try to become pregnant with timed intercourse compared to women with a low score, for which prompt referral to ART seems more reasonable. Other prognostic factors can be used to guide the management of women with an intermediate EFI score. These data follow women over many years post-resection and represent longitudinal fertility data rarely demonstrated in such a cohort. The location and impact of lesions on the ability of the adnexa to function seems crucial for the fertility prognosis and should be further investigated. This study was funded by the GRACE Research funds. S.M.-L. is the recipient of a Training Award from the Fonds de Recherche Quebec-Sante. D.A. is the primary author of the Endometriosis Fertility Index. All authors have no conflicts of interest to declare. N/A. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  19. Modeling, Measurements, and Fundamental Database Development for Nonequilibrium Hypersonic Aerothermodynamics

    NASA Technical Reports Server (NTRS)

    Bose, Deepak

    2012-01-01

    The design of entry vehicles requires predictions of aerothermal environment during the hypersonic phase of their flight trajectories. These predictions are made using computational fluid dynamics (CFD) codes that often rely on physics and chemistry models of nonequilibrium processes. The primary processes of interest are gas phase chemistry, internal energy relaxation, electronic excitation, nonequilibrium emission and absorption of radiation, and gas-surface interaction leading to surface recession and catalytic recombination. NASAs Hypersonics Project is advancing the state-of-the-art in modeling of nonequilibrium phenomena by making detailed spectroscopic measurements in shock tube and arcjets, using ab-initio quantum mechanical techniques develop fundamental chemistry and spectroscopic databases, making fundamental measurements of finite-rate gas surface interactions, implementing of detailed mechanisms in the state-of-the-art CFD codes, The development of new models is based on validation with relevant experiments. We will present the latest developments and a roadmap for the technical areas mentioned above

  20. Cardiac tissue engineering: state of the art.

    PubMed

    Hirt, Marc N; Hansen, Arne; Eschenhagen, Thomas

    2014-01-17

    The engineering of 3-dimensional (3D) heart muscles has undergone exciting progress for the past decade. Profound advances in human stem cell biology and technology, tissue engineering and material sciences, as well as prevascularization and in vitro assay technologies make the first clinical application of engineered cardiac tissues a realistic option and predict that cardiac tissue engineering techniques will find widespread use in the preclinical research and drug development in the near future. Tasks that need to be solved for this purpose include standardization of human myocyte production protocols, establishment of simple methods for the in vitro vascularization of 3D constructs and better maturation of myocytes, and, finally, thorough definition of the predictive value of these methods for preclinical safety pharmacology. The present article gives an overview of the present state of the art, bottlenecks, and perspectives of cardiac tissue engineering for cardiac repair and in vitro testing.

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