Acute Radiation Risk and BRYNTRN Organ Dose Projection Graphical User Interface

NASA Technical Reports Server (NTRS)

Cucinotta, Francis A.; Hu, Shaowen; Nounu, Hateni N.; Kim, Myung-Hee

2011-01-01

The integration of human space applications risk projection models of organ dose and acute radiation risk has been a key problem. NASA has developed an organ dose projection model using the BRYNTRN with SUM DOSE computer codes, and a probabilistic model of Acute Radiation Risk (ARR). The codes BRYNTRN and SUM DOSE are a Baryon transport code and an output data processing code, respectively. The risk projection models of organ doses and ARR take the output from BRYNTRN as an input to their calculations. With a graphical user interface (GUI) to handle input and output for BRYNTRN, the response models can be connected easily and correctly to BRYNTRN. A GUI for the ARR and BRYNTRN Organ Dose (ARRBOD) projection code provides seamless integration of input and output manipulations, which are required for operations of the ARRBOD modules. The ARRBOD GUI is intended for mission planners, radiation shield designers, space operations in the mission operations directorate (MOD), and space biophysics researchers. BRYNTRN code operation requires extensive input preparation. Only a graphical user interface (GUI) can handle input and output for BRYNTRN to the response models easily and correctly. The purpose of the GUI development for ARRBOD is to provide seamless integration of input and output manipulations for the operations of projection modules (BRYNTRN, SLMDOSE, and the ARR probabilistic response model) in assessing the acute risk and the organ doses of significant Solar Particle Events (SPEs). The assessment of astronauts radiation risk from SPE is in support of mission design and operational planning to manage radiation risks in future space missions. The ARRBOD GUI can identify the proper shielding solutions using the gender-specific organ dose assessments in order to avoid ARR symptoms, and to stay within the current NASA short-term dose limits. The quantified evaluation of ARR severities based on any given shielding configuration and a specified EVA or other mission scenario can be made to guide alternative solutions for attaining determined objectives set by mission planners. The ARRBOD GUI estimates the whole-body effective dose, organ doses, and acute radiation sickness symptoms for astronauts, by which operational strategies and capabilities can be made for the protection of astronauts from SPEs in the planning of future lunar surface scenarios, exploration of near-Earth objects, and missions to Mars.

Identifying Falls Risk Screenings Not Documented with Administrative Codes Using Natural Language Processing

PubMed Central

Zhu, Vivienne J; Walker, Tina D; Warren, Robert W; Jenny, Peggy B; Meystre, Stephane; Lenert, Leslie A

2017-01-01

Quality reporting that relies on coded administrative data alone may not completely and accurately depict providers’ performance. To assess this concern with a test case, we developed and evaluated a natural language processing (NLP) approach to identify falls risk screenings documented in clinical notes of patients without coded falls risk screening data. Extracting information from 1,558 clinical notes (mainly progress notes) from 144 eligible patients, we generated a lexicon of 38 keywords relevant to falls risk screening, 26 terms for pre-negation, and 35 terms for post-negation. The NLP algorithm identified 62 (out of the 144) patients who falls risk screening documented only in clinical notes and not coded. Manual review confirmed 59 patients as true positives and 77 patients as true negatives. Our NLP approach scored 0.92 for precision, 0.95 for recall, and 0.93 for F-measure. These results support the concept of utilizing NLP to enhance healthcare quality reporting. PMID:29854264

RMP Guidance for Warehouses - Appendix A/B: 40 CFR part 68/Selected NAICS Codes

EPA Pesticide Factsheets

These appendices contain the full text of 40 Code of Federal Regulations Part 68, Chemical Accident Prevention Provisions; which includes hazard assessment, emergency response, substance thresholds, reporting requirements, and the Risk Management Plan.

Qualitative evaluation of suicide and overdose risk assessment procedures among veterans in substance use disorder treatment clinics.

PubMed

Webster, Linda; Eisenberg, Anna; Bohnert, Amy S B; Kleinberg, Felicia; Ilgen, Mark A

2012-01-01

The objective of this study was to examine risk assessment practices for suicide and unintentional overdose to inform ongoing care in substance use disorder clinics. Focus groups were conducted via telephone among a random sample of treatment providers (N = 19) from Veterans Health Administration substance use disorder clinics across the nation. Themes were coded by research staff. Treatment providers reported consistent and clear guidelines for risk assessment of suicide among patients. Unintentional overdose questions elicited dissimilar responses which indicated a lack of cohesion and uniformity in risk assessment practices across clinics. Suicide risk assessment protocols are cohesively implemented by treatment providers. Unintentional overdose risk, however, may be less consistently assessed in clinics.

The SERGISAI procedure for seismic risk assessment

NASA Astrophysics Data System (ADS)

Zonno, G.; Garcia-Fernandez, M.; Jimenez, M.J.; Menoni, S.; Meroni, F.; Petrini, V.

The European project SERGISAI developed a computational tool where amethodology for seismic risk assessment at different geographical scales hasbeen implemented. Experts of various disciplines, including seismologists,engineers, planners, geologists, and computer scientists, co-operated in anactual multidisciplinary process to develop this tool. Standard proceduralcodes, Geographical Information Systems (GIS), and Artificial Intelligence(AI) techniques compose the whole system, that will enable the end userto carry out a complete seismic risk assessment at three geographical scales:regional, sub-regional and local. At present, single codes or models thathave been incorporated are not new in general, but the modularity of theprototype, based on a user-friendly front-end, offers potential users thepossibility of updating or replacing any code or model if desired. Theproposed procedure is a first attempt to integrate tools, codes and methodsfor assessing expected earthquake damage, and it was mainly designedto become a useful support for civil defence and land use planning agencies.Risk factors have been treated in the most suitable way for each one, interms of level of detail, kind of parameters and units of measure.Identifying various geographical scales is not a mere question of dimension;since entities to be studied correspond to areas defined by administrativeand geographical borders. The procedure was applied in the following areas:Toscana in Italy, for the regional scale, the Garfagnana area in Toscana, forthe sub-regional scale, and a part of Barcelona city, Spain, for the localscale.

Development of probabilistic multimedia multipathway computer codes.

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

Yu, C.; LePoire, D.; Gnanapragasam, E.

2002-01-01

The deterministic multimedia dose/risk assessment codes RESRAD and RESRAD-BUILD have been widely used for many years for evaluation of sites contaminated with residual radioactive materials. The RESRAD code applies to the cleanup of sites (soils) and the RESRAD-BUILD code applies to the cleanup of buildings and structures. This work describes the procedure used to enhance the deterministic RESRAD and RESRAD-BUILD codes for probabilistic dose analysis. A six-step procedure was used in developing default parameter distributions and the probabilistic analysis modules. These six steps include (1) listing and categorizing parameters; (2) ranking parameters; (3) developing parameter distributions; (4) testing parameter distributionsmore » for probabilistic analysis; (5) developing probabilistic software modules; and (6) testing probabilistic modules and integrated codes. The procedures used can be applied to the development of other multimedia probabilistic codes. The probabilistic versions of RESRAD and RESRAD-BUILD codes provide tools for studying the uncertainty in dose assessment caused by uncertain input parameters. The parameter distribution data collected in this work can also be applied to other multimedia assessment tasks and multimedia computer codes.« less

Description of Transport Codes for Space Radiation Shielding

NASA Technical Reports Server (NTRS)

Kim, Myung-Hee Y.; Wilson, John W.; Cucinotta, Francis A.

2011-01-01

This slide presentation describes transport codes and their use for studying and designing space radiation shielding. When combined with risk projection models radiation transport codes serve as the main tool for study radiation and designing shielding. There are three criteria for assessing the accuracy of transport codes: (1) Ground-based studies with defined beams and material layouts, (2) Inter-comparison of transport code results for matched boundary conditions and (3) Comparisons to flight measurements. These three criteria have a very high degree with NASA's HZETRN/QMSFRG.

Micrometeoroid and Orbital Debris Threat Assessment: Mars Sample Return Earth Entry Vehicle

NASA Technical Reports Server (NTRS)

Christiansen, Eric L.; Hyde, James L.; Bjorkman, Michael D.; Hoffman, Kevin D.; Lear, Dana M.; Prior, Thomas G.

2011-01-01

This report provides results of a Micrometeoroid and Orbital Debris (MMOD) risk assessment of the Mars Sample Return Earth Entry Vehicle (MSR EEV). The assessment was performed using standard risk assessment methodology illustrated in Figure 1-1. Central to the process is the Bumper risk assessment code (Figure 1-2), which calculates the critical penetration risk based on geometry, shielding configurations and flight parameters. The assessment process begins by building a finite element model (FEM) of the spacecraft, which defines the size and shape of the spacecraft as well as the locations of the various shielding configurations. This model is built using the NX I-deas software package from Siemens PLM Software. The FEM is constructed using triangular and quadrilateral elements that define the outer shell of the spacecraft. Bumper-II uses the model file to determine the geometry of the spacecraft for the analysis. The next step of the process is to identify the ballistic limit characteristics for the various shield types. These ballistic limits define the critical size particle that will penetrate a shield at a given impact angle and impact velocity. When the finite element model is built, each individual element is assigned a property identifier (PID) to act as an index for its shielding properties. Using the ballistic limit equations (BLEs) built into the Bumper-II code, the shield characteristics are defined for each and every PID in the model. The final stage of the analysis is to determine the probability of no penetration (PNP) on the spacecraft. This is done using the micrometeoroid and orbital debris environment definitions that are built into the Bumper-II code. These engineering models take into account orbit inclination, altitude, attitude and analysis date in order to predict an impacting particle flux on the spacecraft. Using the geometry and shielding characteristics previously defined for the spacecraft and combining that information with the environment model calculations, the Bumper-II code calculates a probability of no penetration for the spacecraft.

Moral Hazard: How The National Flood Insurance Program Is Limiting Risk Reduction

DTIC Science & Technology

2016-12-01

Management and Budget, Paperwork Reduction Project (0704-0188) Washington DC 20503. 1. AGENCY USE ONLY (Leave blank) 2. REPORT DATE December...assessment, floodplain management , and flood insurance. A study of the NFIP concludes that aspects of the program limit risk reduction...floodplain management , risk assessment, disaster recovery, flood insurance claim, pre-flood insurance rate map 15. NUMBER OF PAGES 123 16. PRICE CODE

78 FR 23497 - Propiconazole; Pesticide Tolerances

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-19

...). Animal production (NAICS code 112). Food manufacturing (NAICS code 311). Pesticide manufacturing (NAICS.... Aggregate Risk Assessment and Determination of Safety Section 408(b)(2)(A)(i) of FFDCA allows EPA to... dose at which adverse effects of concern are identified (the LOAEL). Uncertainty/safety factors are...

General RMP Guidance - Appendix A: 40 CFR 68

EPA Pesticide Factsheets

Here the full text of Chemical Accident Prevention Provisions and Risk Management Program is transcribed directly from the Code of Federal Regulations. Subparts include hazard assessment, regulated substances and thresholds, and risk management plan.

RESRAD for Radiological Risk Assessment. Comparison with EPA CERCLA Tools - PRG and DCC Calculators

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

Yu, C.; Cheng, J. -J.; Kamboj, S.

The purpose of this report is two-fold. First, the risk assessment methodology for both RESRAD and the EPA’s tools is reviewed. This includes a review of the EPA’s justification for 2 using a dose-to-risk conversion factor to reduce the dose-based protective ARAR from 15 to 12 mrem/yr. Second, the models and parameters used in RESRAD and the EPA PRG and DCC Calculators are compared in detail, and the results are summarized and discussed. Although there are suites of software tools in the RESRAD family of codes and the EPA Calculators, the scope of this report is limited to the RESRADmore » (onsite) code for soil contamination and the EPA’s PRG and DCC Calculators also for soil contamination.« less

An open-source textbook for teaching climate-related risk analysis using the R computing environment

NASA Astrophysics Data System (ADS)

Applegate, P. J.; Keller, K.

2015-12-01

Greenhouse gas emissions lead to increased surface air temperatures and sea level rise. In turn, sea level rise increases the risks of flooding for people living near the world's coastlines. Our own research on assessing sea level rise-related risks emphasizes both Earth science and statistics. At the same time, the free, open-source computing environment R is growing in popularity among statisticians and scientists due to its flexibility and graphics capabilities, as well as its large library of existing functions. We have developed a set of laboratory exercises that introduce students to the Earth science and statistical concepts needed for assessing the risks presented by climate change, particularly sea-level rise. These exercises will be published as a free, open-source textbook on the Web. Each exercise begins with a description of the Earth science and/or statistical concepts that the exercise teaches, with references to key journal articles where appropriate. Next, students are asked to examine in detail a piece of existing R code, and the exercise text provides a clear explanation of how the code works. Finally, students are asked to modify the existing code to produce a well-defined outcome. We discuss our experiences in developing the exercises over two separate semesters at Penn State, plus using R Markdown to interweave explanatory text with sample code and figures in the textbook.

Usefulness of Canadian Public Health Insurance Administrative Databases to Assess Breast and Ovarian Cancer Screening Imaging Technologies for BRCA1/2 Mutation Carriers.

PubMed

Larouche, Geneviève; Chiquette, Jocelyne; Plante, Marie; Pelletier, Sylvie; Simard, Jacques; Dorval, Michel

2016-11-01

In Canada, recommendations for clinical management of hereditary breast and ovarian cancer among individuals carrying a deleterious BRCA1 or BRCA2 mutation have been available since 2007. Eight years later, very little is known about the uptake of screening and risk-reduction measures in this population. Because Canada's public health care system falls under provincial jurisdictions, using provincial health care administrative databases appears a valuable option to assess management of BRCA1/2 mutation carriers. The objective was to explore the usefulness of public health insurance administrative databases in British Columbia, Ontario, and Quebec to assess management after BRCA1/2 genetic testing. Official public health insurance documents were considered potentially useful if they had specific procedure codes, and pertained to procedures performed in the public and private health care systems. All 3 administrative databases have specific procedures codes for mammography and breast ultrasounds. Only Quebec and Ontario have a specific procedure code for breast magnetic resonance imaging. It is impossible to assess, on an individual basis, the frequency of others screening exams, with the exception of CA-125 testing in British Columbia. Screenings done in private practice are excluded from the administrative databases unless covered by special agreements for reimbursement, such as all breast imaging exams in Ontario and mammograms in British Columbia and Quebec. There are no specific procedure codes for risk-reduction surgeries for breast and ovarian cancer. Population-based assessment of breast and ovarian cancer risk management strategies other than mammographic screening, using only administrative data, is currently challenging in the 3 Canadian provinces studied. Copyright © 2016 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

77 FR 20817 - Integrated Risk Information System (IRIS); Announcement of Availability of Literature Searches...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-06

... quantitative and qualitative risk information on effects that may result from exposure to specific chemical... Deputy Director, National Center for Environmental Assessment, (mail code: 8601D), Office of Research and... program that evaluates quantitative and qualitative risk information on effects that may result from...

The grout/glass performance assessment code system (GPACS) with verification and benchmarking

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

Piepho, M.G.; Sutherland, W.H.; Rittmann, P.D.

1994-12-01

GPACS is a computer code system for calculating water flow (unsaturated or saturated), solute transport, and human doses due to the slow release of contaminants from a waste form (in particular grout or glass) through an engineered system and through a vadose zone to an aquifer, well and river. This dual-purpose document is intended to serve as a user`s guide and verification/benchmark document for the Grout/Glass Performance Assessment Code system (GPACS). GPACS can be used for low-level-waste (LLW) Glass Performance Assessment and many other applications including other low-level-waste performance assessments and risk assessments. Based on all the cses presented, GPACSmore » is adequate (verified) for calculating water flow and contaminant transport in unsaturated-zone sediments and for calculating human doses via the groundwater pathway.« less

Testing and refining the Science in Risk Assessment and Policy (SciRAP) web-based platform for evaluating the reliability and relevance of in vivo toxicity studies.

PubMed

Beronius, Anna; Molander, Linda; Zilliacus, Johanna; Rudén, Christina; Hanberg, Annika

2018-05-28

The Science in Risk Assessment and Policy (SciRAP) web-based platform was developed to promote and facilitate structure and transparency in the evaluation of ecotoxicity and toxicity studies for hazard and risk assessment of chemicals. The platform includes sets of criteria and a colour-coding tool for evaluating the reliability and relevance of individual studies. The SciRAP method for evaluating in vivo toxicity studies was first published in 2014 and the aim of the work presented here was to evaluate and develop that method further. Toxicologists and risk assessors from different sectors and geographical areas were invited to test the SciRAP criteria and tool on a specific set of in vivo toxicity studies and to provide feedback concerning the scientific soundness and user-friendliness of the SciRAP approach. The results of this expert assessment were used to refine and improve both the evaluation criteria and the colour-coding tool. It is expected that the SciRAP web-based platform will continue to be developed and enhanced to keep up to date with the needs of end-users. Copyright © 2018 John Wiley & Sons, Ltd.

Risk of Guillain-Barré syndrome after seasonal influenza vaccination and influenza health-care encounters: a self-controlled study.

PubMed

Kwong, Jeffrey C; Vasa, Priya P; Campitelli, Michael A; Hawken, Steven; Wilson, Kumanan; Rosella, Laura C; Stukel, Therese A; Crowcroft, Natasha S; McGeer, Allison J; Zinman, Lorne; Deeks, Shelley L

2013-09-01

The possible risk of Guillain-Barré syndrome from influenza vaccines remains a potential obstacle to achieving high vaccination coverage. However, influenza infection might also be associated with Guillain-Barré syndrome. We aimed to assess the risk of Guillain-Barré syndrome after seasonal influenza vaccination and after influenza-coded health-care encounters. We used the self-controlled risk interval design and linked universal health-care system databases from Ontario, Canada, with data obtained between 1993 and 2011. We used physician billing claims for influenza vaccination and influenza-coded health-care encounters to ascertain exposures. Using fixed-effects conditional Poisson regression, we estimated the relative incidence of hospitalisation for primary-coded Guillain-Barré syndrome during the risk interval compared with the control interval. We identified 2831 incident admissions for Guillain-Barré syndrome; 330 received an influenza vaccine and 109 had an influenza-coded health-care encounter within 42 weeks before hospitalisation. The risk of Guillain-Barré syndrome within 6 weeks of vaccination was 52% higher than in the control interval of 9-42 weeks (relative incidence 1·52; 95% CI 1·17-1·99), with the greatest risk during weeks 2-4 after vaccination. The risk of Guillain-Barré syndrome within 6 weeks of an influenza-coded health-care encounter was greater than for vaccination (15·81; 10·28-24·32). The attributable risks were 1·03 Guillain-Barré syndrome admissions per million vaccinations, compared with 17·2 Guillain-Barré syndrome admissions per million influenza-coded health-care encounters. The relative and attributable risks of Guillain-Barré syndrome after seasonal influenza vaccination are lower than those after influenza illness. Patients considering immunisation should be fully informed of the risks of Guillain-Barré syndrome from both influenza vaccines and influenza illness. Canadian Institutes of Health Research. Copyright © 2013 Elsevier Ltd. All rights reserved.

Micrometeoroid and Orbital Debris Risk Assessment With Bumper 3

NASA Technical Reports Server (NTRS)

Hyde, J.; Bjorkman, M.; Christiansen, E.; Lear, D.

2017-01-01

The Bumper 3 computer code is the primary tool used by NASA for micrometeoroid and orbital debris (MMOD) risk analysis. Bumper 3 (and its predecessors) have been used to analyze a variety of manned and unmanned spacecraft. The code uses NASA's latest micrometeoroid (MEM-R2) and orbital debris (ORDEM 3.0) environment definition models and is updated frequently with ballistic limit equations that describe the hypervelocity impact performance of spacecraft materials. The Bumper 3 program uses these inputs along with a finite element representation of spacecraft geometry to provide a deterministic calculation of the expected number of failures. The Bumper 3 software is configuration controlled by the NASA/JSC Hypervelocity Impact Technology (HVIT) Group. This paper will demonstrate MMOD risk assessment techniques with Bumper 3 used by NASA's HVIT Group. The Permanent Multipurpose Module (PMM) was added to the International Space Station in 2011. A Bumper 3 MMOD risk assessment of this module will show techniques used to create the input model and assign the property IDs. The methodology used to optimize the MMOD shielding for minimum mass while still meeting structural penetration requirements will also be demonstrated.

Predicting Risk of Suicide Attempt Using History of Physical Illnesses From Electronic Medical Records

PubMed Central

Luo, Wei; Tran, Truyen; Berk, Michael; Venkatesh, Svetha

2016-01-01

Background Although physical illnesses, routinely documented in electronic medical records (EMR), have been found to be a contributing factor to suicides, no automated systems use this information to predict suicide risk. Objective The aim of this study is to quantify the impact of physical illnesses on suicide risk, and develop a predictive model that captures this relationship using EMR data. Methods We used history of physical illnesses (except chapter V: Mental and behavioral disorders) from EMR data over different time-periods to build a lookup table that contains the probability of suicide risk for each chapter of the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) codes. The lookup table was then used to predict the probability of suicide risk for any new assessment. Based on the different lengths of history of physical illnesses, we developed six different models to predict suicide risk. We tested the performance of developed models to predict 90-day risk using historical data over differing time-periods ranging from 3 to 48 months. A total of 16,858 assessments from 7399 mental health patients with at least one risk assessment was used for the validation of the developed model. The performance was measured using area under the receiver operating characteristic curve (AUC). Results The best predictive results were derived (AUC=0.71) using combined data across all time-periods, which significantly outperformed the clinical baseline derived from routine risk assessment (AUC=0.56). The proposed approach thus shows potential to be incorporated in the broader risk assessment processes used by clinicians. Conclusions This study provides a novel approach to exploit the history of physical illnesses extracted from EMR (ICD-10 codes without chapter V-mental and behavioral disorders) to predict suicide risk, and this model outperforms existing clinical assessments of suicide risk. PMID:27400764

An implementation framework for the feedback of individual research results and incidental findings in research.

PubMed

Thorogood, Adrian; Joly, Yann; Knoppers, Bartha Maria; Nilsson, Tommy; Metrakos, Peter; Lazaris, Anthoula; Salman, Ayat

2014-12-23

This article outlines procedures for the feedback of individual research data to participants. This feedback framework was developed in the context of a personalized medicine research project in Canada. Researchers in this domain have an ethical obligation to return individual research results and/or material incidental findings that are clinically significant, valid and actionable to participants. Communication of individual research data must proceed in an ethical and efficient manner. Feedback involves three procedural steps: assessing the health relevance of a finding, re-identifying the affected participant, and communicating the finding. Re-identification requires researchers to break the code in place to protect participant identities. Coding systems replace personal identifiers with a numerical code. Double coding systems provide added privacy protection by separating research data from personal identifying data with a third "linkage" database. A trusted and independent intermediary, the "keyholder", controls access to this linkage database. Procedural guidelines for the return of individual research results and incidental findings are lacking. This article outlines a procedural framework for the three steps of feedback: assessment, re-identification, and communication. This framework clarifies the roles of the researcher, Research Ethics Board, and keyholder in the process. The framework also addresses challenges posed by coding systems. Breaking the code involves privacy risks and should only be carried out in clearly defined circumstances. Where a double coding system is used, the keyholder plays an important role in balancing the benefits of individual feedback with the privacy risks of re-identification. Feedback policies should explicitly outline procedures for the assessment of findings, and the re-identification and contact of participants. The responsibilities of researchers, the Research Ethics Board, and the keyholder must be clearly defined. We provide general guidelines for keyholders involved in feedback. We also recommend that Research Ethics Boards should not be directly involved in the assessment of individual findings. Hospitals should instead establish formal, interdisciplinary clinical advisory committees to help researchers determine whether or not an uncertain finding should be returned.

Modeling Terrorism Risk to the Air Transportation System: An Independent Assessment of TSA’s Risk Management Analysis Tool and Associated Methods

DTIC Science & Technology

2012-01-01

our own work for this discussion. DoD Instruction 5000.61 defines model validation as “the pro - cess of determining the degree to which a model and its... determined that RMAT is highly con - crete code, potentially leading to redundancies in the code itself and making RMAT more difficult to maintain...system con - ceptual models valid, and are the data used to support them adequate? (Chapters Two and Three) 2. Are the sources and methods for populating

Non-coding RNAs in crop genetic modification: considerations and predictable environmental risk assessments (ERA).

PubMed

Ramesh, S V

2013-09-01

Of late non-coding RNAs (ncRNAs)-mediated gene silencing is an influential tool deliberately deployed to negatively regulate the expression of targeted genes. In addition to the widely employed small interfering RNA (siRNA)-mediated gene silencing approach, other variants like artificial miRNA (amiRNA), miRNA mimics, and artificial transacting siRNAs (tasiRNAs) are being explored and successfully deployed in developing non-coding RNA-based genetically modified plants. The ncRNA-based gene manipulations are typified with mobile nature of silencing signals, interference from viral genome-derived suppressor proteins, and an obligation for meticulous computational analysis to prevaricate any inadvertent effects. In a broad sense, risk assessment inquiries for genetically modified plants based on the expression of ncRNAs are competently addressed by the environmental risk assessment (ERA) models, currently in vogue, designed for the first generation transgenic plants which are based on the expression of heterologous proteins. Nevertheless, transgenic plants functioning on the foundation of ncRNAs warrant due attention with respect to their unique attributes like off-target or non-target gene silencing effects, small RNAs (sRNAs) persistence, food and feed safety assessments, problems in detection and tracking of sRNAs in food, impact of ncRNAs in plant protection measures, effect of mutations etc. The role of recent developments in sequencing techniques like next generation sequencing (NGS) and the ERA paradigm of the different countries in vogue are also discussed in the context of ncRNA-based gene manipulations.

76 FR 17163 - Submission for OMB Review-Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-28

...: Application for Political Risk Insurance. Form Number: OPIC-52. Frequency of Use: Once per investor per... Industrial Classification Codes: All. Description of Affected Public: U.S. companies or citizens investing... OPIC to determine the investor's and the project's eligibility for political risk insurance, assess the...

Predicting the Mobility and Burial of Underwater Unexploded Ordnance (UXO) Using the UXO Mobility Model (ESTCP) 200417

DTIC Science & Technology

2009-11-01

Abbreviations and Acronyms Acronym Definition ADCP Acoustic Doppler Current Profiler AGD Applications Guidance Document ARAMS Army Risk Assessment Modeling...Center iv NESDI Navy Environmental Sustainability Development to Integration NOS National Ocean Service NS Naval Station NWS Naval Weapons...Plan QAS Quality Assurance Specialist RAC Risk Assessment Code REF/DIF Refraction/Diffraction ROI Return on Investment SAJ Dr. Scott A. Jenkins

Precursors of Reading Difficulties in Czech and Slovak Children At-Risk of Dyslexia.

PubMed

Moll, Kristina; Thompson, Paul A; Mikulajova, Marina; Jagercikova, Zuzana; Kucharska, Anna; Franke, Helena; Hulme, Charles; Snowling, Margaret J

2016-05-01

Children with preschool language difficulties are at high risk of literacy problems; however, the nature of the relationship between delayed language development and dyslexia is not understood. Three hundred eight Slovak and Czech children were recruited into three groups: family risk of dyslexia, speech/language difficulties and controls, and were assessed three times from kindergarten until Grade 1. There was a twofold increase in probability of reading problems in each risk group. Precursors of 'dyslexia' included difficulties in oral language and code-related skills (phoneme awareness, letter-knowledge and rapid automatized naming); poor performance in phonological memory and vocabulary was observed in both affected and unaffected high-risk peers. A two-group latent variable path model shows that early language skills predict code-related skills, which in turn predict literacy skills. Findings suggest that dyslexia in Slavic languages has its origins in early language deficits, and children who succumb to reading problems show impaired code-related skills before the onset of formal reading instruction. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Application of miRNAs as Biomarkers of Exposure and Effects in Risk Evaluation

EPA Science Inventory

Of the known epigenetic mechanisms, non-coding RNA and more specifically, microRNA (miRNA), offer the most immediate promise for risk assessment applications because these molecules can serve as excellent biomarkers of toxicity. The advantages of miRNA versus more classical prot...

Adolescent Girls' Assessment and Management of Sexual Risks: Insights from Focus Group Research

ERIC Educational Resources Information Center

Bay-Cheng, Laina Y.; Livingston, Jennifer A.; Fava, Nicole M.

2011-01-01

We conducted focus groups with girls ages 14 to 17 (N = 43) to study how the dominant discourse of sexual risk shapes young women's understanding of the sexual domain and their management of these presumably pervasive threats. Through inductive analysis, we developed a coding scheme focused on three themes: (a) "types of sexual risk,"…

Clinician Perceptions of Childhood Risk Factors for Future Antisocial Behavior

ERIC Educational Resources Information Center

Koegl, Christopher J.; Farrington, David P.; Augimeri, Leena K.

2009-01-01

We asked 176 mental health clinicians to list factors that place a child at risk for engaging in future antisocial behavior. Participants were randomly assigned to do this in relationship to boys and girls. Listed factors were then coded into broad item categories using the Early Assessment Risk Lists (EARL). Of the 1,695 factors listed, 1,476…

Coding of obesity in administrative hospital discharge abstract data: accuracy and impact for future research studies.

PubMed

Martin, Billie-Jean; Chen, Guanmin; Graham, Michelle; Quan, Hude

2014-02-13

Obesity is a pervasive problem and a popular subject of academic assessment. The ability to take advantage of existing data, such as administrative databases, to study obesity is appealing. The objective of our study was to assess the validity of obesity coding in an administrative database and compare the association between obesity and outcomes in an administrative database versus registry. This study was conducted using a coronary catheterization registry and an administrative database (Discharge Abstract Database (DAD)). A Body Mass Index (BMI) ≥30 kg/m2 within the registry defined obesity. In the DAD obesity was defined by diagnosis codes E65-E68 (ICD-10). The sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) of an obesity diagnosis in the DAD was determined using obesity diagnosis in the registry as the referent. The association between obesity and outcomes was assessed. The study population of 17380 subjects was largely male (68.8%) with a mean BMI of 27.0 kg/m2. Obesity prevalence was lower in the DAD than registry (2.4% vs. 20.3%). A diagnosis of obesity in the DAD had a sensitivity 7.75%, specificity 98.98%, NPV 80.84% and PPV 65.94%. Obesity was associated with decreased risk of death or re-hospitalization, though non-significantly within the DAD. Obesity was significantly associated with an increased risk of cardiac procedure in both databases. Overall, obesity was poorly coded in the DAD. However, when coded, it was coded accurately. Administrative databases are not an optimal datasource for obesity prevalence and incidence surveillance but could be used to define obese cohorts for follow-up.

Risk of Cerebrovascular Events in Elderly Patients After Radiation Therapy Versus Surgery for Early-Stage Glottic Cancer

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

Hong, Julian C.; Kruser, Tim J.; Gondi, Vinai

Purpose: Comprehensive neck radiation therapy (RT) has been shown to increase cerebrovascular disease (CVD) risk in advanced-stage head-and-neck cancer. We assessed whether more limited neck RT used for early-stage (T1-T2 N0) glottic cancer is associated with increased CVD risk, using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Methods and Materials: We identified patients ≥66 years of age with early-stage glottic laryngeal cancer from SEER diagnosed from 1992 to 2007. Patients treated with combined surgery and RT were excluded. Medicare CPT codes for carotid interventions, Medicare ICD-9 codes for cerebrovascular events, and SEER data for stroke as the causemore » of death were collected. Similarly, Medicare CPT and ICD-9 codes for peripheral vascular disease (PVD) were assessed to serve as an internal control between treatment groups. Results: A total of 1413 assessable patients (RT, n=1055; surgery, n=358) were analyzed. The actuarial 10-year risk of CVD was 56.5% (95% confidence interval 51.5%-61.5%) for the RT cohort versus 48.7% (41.1%-56.3%) in the surgery cohort (P=.27). The actuarial 10-year risk of PVD did not differ between the RT (52.7% [48.1%-57.3%]) and surgery cohorts (52.6% [45.2%-60.0%]) (P=.89). Univariate analysis showed an increased association of CVD with more recent diagnosis (P=.001) and increasing age (P=.001). On multivariate Cox analysis, increasing age (P<.001) and recent diagnosis (P=.002) remained significantly associated with a higher CVD risk, whereas the association of RT and CVD remained not statistically significant (HR=1.11 [0.91-1.37,] P=.31). Conclusions: Elderly patients with early-stage laryngeal cancer have a high burden of cerebrovascular events after surgical management or RT. RT and surgery are associated with comparable risk for subsequent CVD development after treatment in elderly patients.« less

Assessment of Risk Communication about Undercooked Hamburgers by Restaurant Servers.

PubMed

Thomas, Ellen M; Binder, Andrew R; McLAUGHLIN, Anne; Jaykus, Lee-Ann; Hanson, Dana; Powell, Douglas; Chapman, Benjamin

2016-12-01

According to the U.S. Food and Drug Administration 2013 Model Food Code, it is the duty of a food establishment to disclose and remind consumers of risk when ordering undercooked food such as ground beef. The purpose of this study was to explore actual risk communication behaviors of food establishment servers. Secret shoppers visited 265 restaurants in seven geographic locations across the United States, ordered medium rare burgers, and collected and coded risk information from chain and independent restaurant menus and from server responses. The majority of servers reported an unreliable method of doneness (77%) or other incorrect information (66%) related to burger doneness and safety. These results indicate major gaps in server knowledge and risk communication, and the current risk communication language in the Model Food Code does not sufficiently fill these gaps. The question is "should servers even be acting as risk communicators?" There are numerous challenges associated with this practice, including high turnover rates, limited education, and the high stress environment based on pleasing a customer. If servers are designated as risk communicators, food establishment staff should be adequately trained and provided with consumer advisory messages that are accurate, audience appropriate, and delivered in a professional manner so that customers can make informed food safety decisions.

Making sense of Arctic maritime traffic using the Polar Operational Limits Assessment Risk Indexing System (POLARIS)

NASA Astrophysics Data System (ADS)

Stoddard, M. A.; Etienne, L.; Fournier, M.; Pelot, R.; Beveridge, L.

2016-04-01

Maritime traffic volume in the Arctic is growing for several reasons: climate change is resulting in less ice in extent, duration, and thickness; economic drivers are inducing growth in resource extraction traffic, community size (affecting resupply) and adventure tourism. This dynamic situation, coupled with harsh weather, variable operating conditions, remoteness, and lack of straightforward emergency response options, demand robust risk management processes. The requirements for risk management for polar ship operations are specified in the new International Maritime Organization (IMO) International Code for Ships Operating in Polar Waters (Polar Code). The goal of the Polar Code is to provide for safe ship operations and protection of the polar environment by addressing the risk present in polar waters. Risk management is supported by evidence-based models, including threat identification (types and frequency of hazards), exposure levels, and receptor characterization. Most of the information used to perform risk management in polar waters is attained in-situ, but increasingly is being augmented with open-access remote sensing information. In this paper we focus on the use of open-access historical ice charts as an integral part of northern navigation, especially for route planning and evaluation.

Risk Informed Design and Analysis Criteria for Nuclear Structures

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

Salmon, Michael W.

2015-06-17

Target performance can be achieved by defining design basis ground motion from results of a probabilistic seismic hazards assessment, and introducing known levels of conservatism in the design above the DBE. ASCE 4, 43, DOE-STD-1020 defined the DBE at 4x10-4 and introduce only slight levels of conservatism in response. ASCE 4, 43, DOE-STD-1020 assume code capacities shoot for about 98% NEP. There is a need to have a uniform target (98% NEP) for code developers (ACI, AISC, etc.) to aim for. In considering strengthening options, one must also consider cost/risk reduction achieved.

Using Dynamic Risk and Protective Factors to Predict Inpatient Aggression: Reliability and Validity of START Assessments

PubMed Central

Desmarais, Sarah L.; Nicholls, Tonia L.; Wilson, Catherine M.; Brink, Johann

2012-01-01

The Short-Term Assessment of Risk and Treatability (START) is a relatively new structured professional judgment guide for the assessment and management of short-term risks associated with mental, substance use, and personality disorders. The scheme may be distinguished from other violence risk instruments because of its inclusion of 20 dynamic factors that are rated in terms of both vulnerability and strength. This study examined the reliability and validity of START assessments in predicting inpatient aggression. Research assistants completed START assessments for 120 male forensic psychiatric patients through review of hospital files. They additionally completed Historical-Clinical-Risk Management – 20 (HCR-20) and the Hare Psychopathy Checklist: Screening Version (PCL:SV) assessments. Outcome data was coded from hospital files for a 12-month follow-up period using the Overt Aggression Scale (OAS). START assessments evidenced excellent interrater reliability and demonstrated both predictive and incremental validity over the HCR-20 Historical subscale scores and PCL:SV total scores. Overall, results support the reliability and validity of START assessments, and use of the structured professional judgment approach more broadly, as well as the value of using dynamic risk and protective factors to assess violence risk. PMID:22250595

A site-specific approach for assessing the fire risk to structures at the wildland/urban interface

Treesearch

Jack Cohen

1991-01-01

The essence of the wildland/urban interface fire problem is the loss of homes. The problem is not new, but is becoming increasingly important as more homes with inadequate adherence to safety codes are built at the wildland/urban interface. Current regulatory codes are inflexible. Specifications for building and site characteristics cannot be adjusted to accommodate...

Validation study in four health-care databases: upper gastrointestinal bleeding misclassification affects precision but not magnitude of drug-related upper gastrointestinal bleeding risk.

PubMed

Valkhoff, Vera E; Coloma, Preciosa M; Masclee, Gwen M C; Gini, Rosa; Innocenti, Francesco; Lapi, Francesco; Molokhia, Mariam; Mosseveld, Mees; Nielsson, Malene Schou; Schuemie, Martijn; Thiessard, Frantz; van der Lei, Johan; Sturkenboom, Miriam C J M; Trifirò, Gianluca

2014-08-01

To evaluate the accuracy of disease codes and free text in identifying upper gastrointestinal bleeding (UGIB) from electronic health-care records (EHRs). We conducted a validation study in four European electronic health-care record (EHR) databases such as Integrated Primary Care Information (IPCI), Health Search/CSD Patient Database (HSD), ARS, and Aarhus, in which we identified UGIB cases using free text or disease codes: (1) International Classification of Disease (ICD)-9 (HSD, ARS); (2) ICD-10 (Aarhus); and (3) International Classification of Primary Care (ICPC) (IPCI). From each database, we randomly selected and manually reviewed 200 cases to calculate positive predictive values (PPVs). We employed different case definitions to assess the effect of outcome misclassification on estimation of risk of drug-related UGIB. PPV was 22% [95% confidence interval (CI): 16, 28] and 21% (95% CI: 16, 28) in IPCI for free text and ICPC codes, respectively. PPV was 91% (95% CI: 86, 95) for ICD-9 codes and 47% (95% CI: 35, 59) for free text in HSD. PPV for ICD-9 codes in ARS was 72% (95% CI: 65, 78) and 77% (95% CI: 69, 83) for ICD-10 codes (Aarhus). More specific definitions did not have significant impact on risk estimation of drug-related UGIB, except for wider CIs. ICD-9-CM and ICD-10 disease codes have good PPV in identifying UGIB from EHR; less granular terminology (ICPC) may require additional strategies. Use of more specific UGIB definitions affects precision, but not magnitude, of risk estimates. Copyright © 2014 Elsevier Inc. All rights reserved.

Identification of Potential Hazard using Hazard Identification and Risk Assessment

NASA Astrophysics Data System (ADS)

Sari, R. M.; Syahputri, K.; Rizkya, I.; Siregar, I.

2017-03-01

This research was conducted in the paper production’s company. These Paper products will be used as a cigarette paper. Along in the production’s process, Company provides the machines and equipment that operated by workers. During the operations, all workers may potentially injured. It known as a potential hazard. Hazard identification and risk assessment is one part of a safety and health program in the stage of risk management. This is very important as part of efforts to prevent occupational injuries and diseases resulting from work. This research is experiencing a problem that is not the identification of potential hazards and risks that would be faced by workers during the running production process. The purpose of this study was to identify the potential hazards by using hazard identification and risk assessment methods. Risk assessment is done using severity criteria and the probability of an accident. According to the research there are 23 potential hazard that occurs with varying severity and probability. Then made the determination Risk Assessment Code (RAC) for each potential hazard, and gained 3 extreme risks, 10 high risks, 6 medium risks and 3 low risks. We have successfully identified potential hazard using RAC.

RMP Guidance for Chemical Distributors - Appendix A: 40 CFR part 68/Selected NAICS Codes

EPA Pesticide Factsheets

The full text of Part 68, Chemical Accident Prevention provisions, includes hazard assessment, emergency response, threshold quantities for regulated substances, reporting requirements, and the Risk Management Plan.

An innovative expression model of human health risk based on the quantitative analysis of soil metals sources contribution in different spatial scales.

PubMed

Zhang, Yimei; Li, Shuai; Wang, Fei; Chen, Zhuang; Chen, Jie; Wang, Liqun

2018-09-01

Toxicity of heavy metals from industrialization poses critical concern, and analysis of sources associated with potential human health risks is of unique significance. Assessing human health risk of pollution sources (factored health risk) concurrently in the whole and the sub region can provide more instructive information to protect specific potential victims. In this research, we establish a new expression model of human health risk based on quantitative analysis of sources contribution in different spatial scales. The larger scale grids and their spatial codes are used to initially identify the level of pollution risk, the type of pollution source and the sensitive population at high risk. The smaller scale grids and their spatial codes are used to identify the contribution of various sources of pollution to each sub region (larger grid) and to assess the health risks posed by each source for each sub region. The results of case study show that, for children (sensitive populations, taking school and residential area as major region of activity), the major pollution source is from the abandoned lead-acid battery plant (ALP), traffic emission and agricultural activity. The new models and results of this research present effective spatial information and useful model for quantifying the hazards of source categories and human health a t complex industrial system in the future. Copyright © 2018 Elsevier Ltd. All rights reserved.

Nuclear Power Plant Cyber Security Discrete Dynamic Event Tree Analysis (LDRD 17-0958) FY17 Report

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

Wheeler, Timothy A.; Denman, Matthew R.; Williams, R. A.

Instrumentation and control of nuclear power is transforming from analog to modern digital assets. These control systems perform key safety and security functions. This transformation is occurring in new plant designs as well as in the existing fleet of plants as the operation of those plants is extended to 60 years. This transformation introduces new and unknown issues involving both digital asset induced safety issues and security issues. Traditional nuclear power risk assessment tools and cyber security assessment methods have not been modified or developed to address the unique nature of cyber failure modes and of cyber security threat vulnerabilities.more » iii This Lab-Directed Research and Development project has developed a dynamic cyber-risk in- formed tool to facilitate the analysis of unique cyber failure modes and the time sequencing of cyber faults, both malicious and non-malicious, and impose those cyber exploits and cyber faults onto a nuclear power plant accident sequence simulator code to assess how cyber exploits and cyber faults could interact with a plants digital instrumentation and control (DI&C) system and defeat or circumvent a plants cyber security controls. This was achieved by coupling an existing Sandia National Laboratories nuclear accident dynamic simulator code with a cyber emulytics code to demonstrate real-time simulation of cyber exploits and their impact on automatic DI&C responses. Studying such potential time-sequenced cyber-attacks and their risks (i.e., the associated impact and the associated degree of difficulty to achieve the attack vector) on accident management establishes a technical risk informed framework for developing effective cyber security controls for nuclear power.« less

Identifying Subtypes of Spousal Assaulters Using the B-SAFER

ERIC Educational Resources Information Center

Thijssen, Jill; de Ruiter, Corine

2011-01-01

In the present study, a structured risk assessment instrument for intimate partner violence, the Brief Spousal Assault Form for the Evaluation of Risk (B-SAFER), was coded for 146 files of spousal assault cases from the Dutch probation service, dating from 2004 and 2005. The aim of the study was twofold: (a) to validate Holtzworth-Munroe and…

Development of code evaluation criteria for assessing predictive capability and performance

NASA Technical Reports Server (NTRS)

Lin, Shyi-Jang; Barson, S. L.; Sindir, M. M.; Prueger, G. H.

1993-01-01

Computational Fluid Dynamics (CFD), because of its unique ability to predict complex three-dimensional flows, is being applied with increasing frequency in the aerospace industry. Currently, no consistent code validation procedure is applied within the industry. Such a procedure is needed to increase confidence in CFD and reduce risk in the use of these codes as a design and analysis tool. This final contract report defines classifications for three levels of code validation, directly relating the use of CFD codes to the engineering design cycle. Evaluation criteria by which codes are measured and classified are recommended and discussed. Criteria for selecting experimental data against which CFD results can be compared are outlined. A four phase CFD code validation procedure is described in detail. Finally, the code validation procedure is demonstrated through application of the REACT CFD code to a series of cases culminating in a code to data comparison on the Space Shuttle Main Engine High Pressure Fuel Turbopump Impeller.

The effect of clustering on lot quality assurance sampling: a probabilistic model to calculate sample sizes for quality assessments

PubMed Central

2013-01-01

Background Traditional Lot Quality Assurance Sampling (LQAS) designs assume observations are collected using simple random sampling. Alternatively, randomly sampling clusters of observations and then individuals within clusters reduces costs but decreases the precision of the classifications. In this paper, we develop a general framework for designing the cluster(C)-LQAS system and illustrate the method with the design of data quality assessments for the community health worker program in Rwanda. Results To determine sample size and decision rules for C-LQAS, we use the beta-binomial distribution to account for inflated risk of errors introduced by sampling clusters at the first stage. We present general theory and code for sample size calculations. The C-LQAS sample sizes provided in this paper constrain misclassification risks below user-specified limits. Multiple C-LQAS systems meet the specified risk requirements, but numerous considerations, including per-cluster versus per-individual sampling costs, help identify optimal systems for distinct applications. Conclusions We show the utility of C-LQAS for data quality assessments, but the method generalizes to numerous applications. This paper provides the necessary technical detail and supplemental code to support the design of C-LQAS for specific programs. PMID:24160725

The effect of clustering on lot quality assurance sampling: a probabilistic model to calculate sample sizes for quality assessments.

PubMed

Hedt-Gauthier, Bethany L; Mitsunaga, Tisha; Hund, Lauren; Olives, Casey; Pagano, Marcello

2013-10-26

Traditional Lot Quality Assurance Sampling (LQAS) designs assume observations are collected using simple random sampling. Alternatively, randomly sampling clusters of observations and then individuals within clusters reduces costs but decreases the precision of the classifications. In this paper, we develop a general framework for designing the cluster(C)-LQAS system and illustrate the method with the design of data quality assessments for the community health worker program in Rwanda. To determine sample size and decision rules for C-LQAS, we use the beta-binomial distribution to account for inflated risk of errors introduced by sampling clusters at the first stage. We present general theory and code for sample size calculations.The C-LQAS sample sizes provided in this paper constrain misclassification risks below user-specified limits. Multiple C-LQAS systems meet the specified risk requirements, but numerous considerations, including per-cluster versus per-individual sampling costs, help identify optimal systems for distinct applications. We show the utility of C-LQAS for data quality assessments, but the method generalizes to numerous applications. This paper provides the necessary technical detail and supplemental code to support the design of C-LQAS for specific programs.

Risk assessment during transport of radioactive materials through the Suez Canal

NASA Astrophysics Data System (ADS)

Sabek, M. G.; El-Shinawy, R. M. K.; Gomaa, M.

1997-03-01

In this paper a study for risk assessment of the impact of transporting radioactive materials, during the period 1986-1992, through the Suez Canal of Egypt is given. The code RADTRAN-IV was used for this study. The results of the code, for a normal case, show that the transportation of low activity materials such as uranium (U 3O 8) represent the main items that contribute significantly to the collective dose within the Suez Canal area (Port-Said, Ismailia and Suez). The values of the annual collective dose due to transportation of all radionuclide materials was found to be at a maximum in Suez town and is equal to 5.04 × 10 -8 Man-Sv for the whole populations. If we only consider the workder at the harbour (estimated to be 50 persons), the value of the annual collective dose is about 3.33 × 10 -4 Man-Sv. These values are less than the exemption value of 1 Man-Sv recommended by the IAEA. For the accident case, the following pathways are considered by the code: ground-shine, direct inhalation, inhalation of resuspended material and cloud-shine. The total values of the estimated risks for each radionuclide material are presented in table form and, in addition, health effects (genetic effects, GE, and latent cancer fatality), LCF) are discussed. The calculated values of the radiological risks are very low for the three towns, showing that no radiation-induced early deaths are to be expected.

Using Prospect Theory to Investigate Decision-Making Bias Within an Information Security Context

DTIC Science & Technology

2005-12-01

risk was acceptable, 5 when to the CA the risk was so bad...Population Proportion Lower Tail: Risk Averse (A) Coded as 0. Risk Seeking (B) Coded as 1. Ho (indifferent in risk behavior): p = . 5 Ha ( risk averse...Averse (A) Coded as 0. Risk Seeking (B) Coded as 1. Ho (indifferent in risk behavior): p = . 5 Ha ( risk averse thus significantly below . 5 ): p < . 5

Physics and biophysics experiments needed for improved risk assessment in space

NASA Astrophysics Data System (ADS)

Sihver, L.

To improve the risk assessment of radiation carcinogenesis, late degenerative tissue effects, acute syndromes, synergistic effects of radiation and microgravity or other spacecraft factors, and hereditary effects, on future LEO and interplanetary space missions, the radiobiological effects of cosmic radiation before and after shielding must be well understood. However, cosmic radiation is very complex and includes low and high LET components of many different neutral and charged particles. The understanding of the radiobiology of the heavy ions, from GCRs and SPEs, is still a subject of great concern due to the complicated dependence of their biological effects on the type of ion and energy, and its interaction with various targets both outside and within the spacecraft and the human body. In order to estimate the biological effects of cosmic radiation, accurate knowledge of the physics of the interactions of both charged and non-charged high-LET particles is necessary. Since it is practically impossible to measure all primary and secondary particles from all projectile-target-energy combinations needed for a correct risk assessment in space, accurate particle and heavy ion transport codes might be a helpful instrument to overcome those difficulties. These codes have to be carefully validated to make sure they fulfill preset accuracy criteria, e.g. to be able to predict particle fluence and energy distributions within a certain accuracy. When validating the accuracy of the transport codes, both space and ground-based accelerator experiments are needed. In this paper current and future physics and biophysics experiments needed for improved risk assessment in space will be discussed. The cyclotron HIRFL (heavy ion research facility in Lanzhou) and the new synchrotron CSR (cooling storage ring), which can be used to provide ion beams for space related experiments at the Institute of Modern Physics, Chinese Academy of Sciences (IMP-CAS), will be presented together with the physical and biomedical research performed at IMP-CAS.

Model based verification of the Secure Socket Layer (SSL) Protocol for NASA systems

NASA Technical Reports Server (NTRS)

Powell, John D.; Gilliam, David

2004-01-01

The National Aeronautics and Space Administration (NASA) has tens of thousands of networked computer systems and applications. Software Security vulnerabilities present risks such as lost or corrupted data, information theft, and unavailability of critical systems. These risks represent potentially enormous costs to NASA. The NASA Code Q research initiative 'Reducing Software Security Risk (RSSR) Trough an Integrated Approach' offers formal verification of information technology (IT), through the creation of a Software Security Assessment Instrument (SSAI), to address software security risks.

Assessment of Literature Related to Combustion Appliance Venting Systems

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

Rapp, V. H.; Less, B. D.; Singer, B. C.

In many residential building retrofit programs, air tightening to increase energy efficiency is often constrained by safety concerns with naturally vented combustion appliances. Tighter residential buildings more readily depressurize when exhaust equipment is operated, making combustion appliances more prone to backdraft or spill combustion exhaust into the living space. Several measures, such as installation guidelines, vent sizing codes, and combustion safety diagnostics, are in place with the intent to prevent backdrafting and combustion spillage, but the diagnostics conflict and the risk mitigation objective is inconsistent. This literature review summarizes the metrics and diagnostics used to assess combustion safety, documents theirmore » technical basis, and investigates their risk mitigations. It compiles information from the following: codes for combustion appliance venting and installation; standards and guidelines for combustion safety diagnostics; research evaluating combustion safety diagnostics; research investigating wind effects on building depressurization and venting; and software for simulating vent system performance.« less

Assessing and managing breast cancer risk: clinicians' current practice and future needs.

PubMed

Collins, Ian M; Steel, Emma; Mann, G Bruce; Emery, Jon D; Bickerstaffe, Adrian; Trainer, Alison; Butow, Phyllis; Pirotta, Marie; Antoniou, Antonis C; Cuzick, Jack; Hopper, John; Phillips, Kelly-Anne; Keogh, Louise A

2014-10-01

Decision support tools for the assessment and management of breast cancer risk may improve uptake of prevention strategies. End-user input in the design of such tools is critical to increase clinical use. Before developing such a computerized tool, we examined clinicians' practice and future needs. Twelve breast surgeons, 12 primary care physicians and 5 practice nurses participated in 4 focus groups. These were recorded, coded, and analyzed to identify key themes. Participants identified difficulties assessing risk, including a lack of available tools to standardize practice. Most expressed confidence identifying women at potentially high risk, but not moderate risk. Participants felt a tool could especially reassure young women at average risk. Desirable features included: evidence-based, accessible (e.g. web-based), and displaying absolute (not relative) risks in multiple formats. The potential to create anxiety was a concern. Development of future tools should address these issues to optimize translation of knowledge into clinical practice. Copyright © 2014 Elsevier Ltd. All rights reserved.

Physical Activity and Influenza-Coded Outpatient Visits, a Population-Based Cohort Study

PubMed Central

Siu, Eric; Campitelli, Michael A.; Kwong, Jeffrey C.

2012-01-01

Background Although the benefits of physical activity in preventing chronic medical conditions are well established, its impacts on infectious diseases, and seasonal influenza in particular, are less clearly defined. We examined the association between physical activity and influenza-coded outpatient visits, as a proxy for influenza infection. Methodology/Principal Findings We conducted a cohort study of Ontario respondents to Statistics Canada’s population health surveys over 12 influenza seasons. We assessed physical activity levels through survey responses, and influenza-coded physician office and emergency department visits through physician billing claims. We used logistic regression to estimate the risk of influenza-coded outpatient visits during influenza seasons. The cohort comprised 114,364 survey respondents who contributed 357,466 person-influenza seasons of observation. Compared to inactive individuals, moderately active (OR 0.83; 95% CI 0.74–0.94) and active (OR 0.87; 95% CI 0.77–0.98) individuals were less likely to experience an influenza-coded visit. Stratifying by age, the protective effect of physical activity remained significant for individuals <65 years (active OR 0.86; 95% CI 0.75–0.98, moderately active: OR 0.85; 95% CI 0.74–0.97) but not for individuals ≥65 years. The main limitations of this study were the use of influenza-coded outpatient visits rather than laboratory-confirmed influenza as the outcome measure, the reliance on self-report for assessing physical activity and various covariates, and the observational study design. Conclusion/Significance Moderate to high amounts of physical activity may be associated with reduced risk of influenza for individuals <65 years. Future research should use laboratory-confirmed influenza outcomes to confirm the association between physical activity and influenza. PMID:22737242

A methodological pilot: parenting among women in substance abuse treatment.

PubMed

Lewin, Linda; Farkas, Kathleen; Niazi, Maryam

2014-01-01

Mothers who abuse substances are likely to have insecure emotional attachment with their children, placing their children at risk for social-emotional and psychiatric conditions. Sobriety does not inevitably improve parenting. We tested recruitment methods, audiovisual (AV) recording procedures, the protocol for identifying child abuse risk, the coding of mother-child interactions, and retention of the sample for repeated measures as the first phase in examining mother-child relational quality of women in substance abuse treatment. This innovative study involved AV recordings to capture the in-vivo mother-child interactional behaviors that were later coded and analyzed for mean scores on the 64-item Parent-Child Relational Quality Assessment. Repeated measurement was planned during treatment and two months after discharge from treatment. The pilot involved a small sample (n = 11) of mother-child (<6 years) dyads. Highest and lowest ratings of interaction behaviors were identified. Mothers showed less enthusiasm and creativity but matched their child's emotional state. The children showed appropriate motor skill items and attachment behaviors. The dyad coding showed less mutual enjoyment between the mother and child. Eight of the participants could not be located for the second measurement despite multiple contact methods. AV recordings capture rich, descriptive information that can be coded for interactional quality analysis. Repeated measurement with this cohort was not feasible, thus needing to assess for additional/more frequent contacts to maintain the sample.

European Code against Cancer 4th Edition: Process of reviewing the scientific evidence and revising the recommendations.

PubMed

Minozzi, Silvia; Armaroli, Paola; Espina, Carolina; Villain, Patricia; Wiseman, Martin; Schüz, Joachim; Segnan, Nereo

2015-12-01

The European Code Against Cancer is a set of recommendations to give advice on cancer prevention. Its 4th edition is an update of the 3rd edition, from 2003. Working Groups of independent experts from different fields of cancer prevention were appointed to review the recommendations, supported by a Literature Group to provide scientific and technical support in the assessment of the scientific evidence, through systematic reviews of the literature. Common procedures were developed to guide the experts in identifying, retrieving, assessing, interpreting and summarizing the scientific evidence in order to revise the recommendations. The Code strictly followed the concept of providing advice to European Union citizens based on the current best available science. The advice, if followed, would be expected to reduce cancer risk, referring both to avoiding or reducing exposure to carcinogenic agents or changing behaviour related to cancer risk and to participating in medical interventions able to avert specific cancers or their consequences. The information sources and procedures for the review of the scientific evidence are described here in detail. The 12 recommendations of the 4th edition of the European Code Against Cancer were ultimately approved by a Scientific Committee of leading European cancer and public health experts. Copyright © 2015 International Agency for Research on Cancer. Published by Elsevier Ltd. All rights reserved.

Modification of the SAS4A Safety Analysis Code for Integration with the ADAPT Discrete Dynamic Event Tree Framework.

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

Jankovsky, Zachary Kyle; Denman, Matthew R.

It is difficult to assess the consequences of a transient in a sodium-cooled fast reactor (SFR) using traditional probabilistic risk assessment (PRA) methods, as numerous safety-related sys- tems have passive characteristics. Often there is significant dependence on the value of con- tinuous stochastic parameters rather than binary success/failure determinations. One form of dynamic PRA uses a system simulator to represent the progression of a transient, tracking events through time in a discrete dynamic event tree (DDET). In order to function in a DDET environment, a simulator must have characteristics that make it amenable to changing physical parameters midway through themore » analysis. The SAS4A SFR system analysis code did not have these characteristics as received. This report describes the code modifications made to allow dynamic operation as well as the linking to a Sandia DDET driver code. A test case is briefly described to demonstrate the utility of the changes.« less

Development of innovative methods for risk assessment in high-rise construction based on clustering of risk factors

NASA Astrophysics Data System (ADS)

Okolelova, Ella; Shibaeva, Marina; Shalnev, Oleg

2018-03-01

The article analyses risks in high-rise construction in terms of investment value with account of the maximum probable loss in case of risk event. The authors scrutinized the risks of high-rise construction in regions with various geographic, climatic and socio-economic conditions that may influence the project environment. Risk classification is presented in general terms, that includes aggregated characteristics of risks being common for many regions. Cluster analysis tools, that allow considering generalized groups of risk depending on their qualitative and quantitative features, were used in order to model the influence of the risk factors on the implementation of investment project. For convenience of further calculations, each type of risk is assigned a separate code with the number of the cluster and the subtype of risk. This approach and the coding of risk factors makes it possible to build a risk matrix, which greatly facilitates the task of determining the degree of impact of risks. The authors clarified and expanded the concept of the price risk, which is defined as the expected value of the event, 105 which extends the capabilities of the model, allows estimating an interval of the probability of occurrence and also using other probabilistic methods of calculation.

Choices in the use of ICD-9 codes to identify stroke risk factors can affect the apparent population-level risk factor prevalence and distribution of CHADS2 scores

PubMed Central

Rothendler, James A; Rose, Adam J; Reisman, Joel I; Berlowitz, Dan R; Kazis, Lewis E

2012-01-01

While developed for managing individuals with atrial fibrillation, risk stratification schemes for stroke, such as CHADS2, may be useful in population-based studies, including those assessing process of care. We investigated how certain decisions in identifying diagnoses from administrative data affect the apparent prevalence of CHADS2-associated diagnoses and distribution of scores. Two sets of ICD-9 codes (more restrictive/ more inclusive) were defined for each CHADS2-associated diagnosis. For stroke/transient ischemic attack (TIA), the more restrictive set was applied to only inpatient data. We varied the number of years (1-3) in searching for relevant codes, and, except for stroke/TIA, the number of instances (1 vs. 2) that diagnoses were required to appear. The impact of choices on apparent disease prevalence varied by type of choice and condition, but was often substantial. Choices resulting in substantial changes in prevalence also tended to be associated with more substantial effects on the distribution of CHADS2 scores. PMID:22937488

Aging, Counterfeiting Configuration Control (AC3)

DTIC Science & Technology

2010-01-31

SARA continuously polls contributing data sources on a data specific refresh cycle. SARA supports a continuous risk topology assessment by the program...function was demonstrated at the bread -board level based on comparison of North American Industrialization Classification System (NAICS) codes. Other

[Forensic-psychiatric assessment of pedophilia].

PubMed

Nitschke, J; Osterheider, M; Mokros, A

2011-09-01

The present paper illustrates the approach of a forensic psychiatric expert witness regarding the assessment of pedophilia. In a first step it is inevitable to differentiate if the defendant is suffering from pedophilia or if the alleged crime might have been committed because of other motivations (antisociality, sexual activity as redirection, impulsivity). A sound diagnostic assessment is indispendable for this task. In a second step the level of severity needs to be gauged in order to clarify whether the requirement of the entry criteria of §§ 20, 21 of the German penal code are fulfilled. In a third step, significant impairments of self-control mechanisms need to be elucidated. The present article reviews indicators of such impairments regarding pedophilia. With respect to a mandatory treatment order (§ 63 German penal code) or preventive detention (§ 66 German penal code) the legal prognosis of the defendant needs to be considered. The present paper gives an overview of the current state of risk assessment research and discusses the transfer to an individual prognosis critically. © Georg Thieme Verlag KG Stuttgart · New York.

Assessing attachment in school-aged children: Do the School-Age Assessment of Attachment and Family Drawings work together as complementary tools?

PubMed

Carr-Hopkins, Rebecca; De Burca, Calem; Aldridge, Felicity A

2017-07-01

Our goal was to identify an assessment package that could improve treatment planning for troubled children and their families. To assess the validity of our tools, we tested the relations among the School-Age Assessment of Attachment, the Family Drawing and children's risk status. We used the Dynamic-Maturational Model of Attachment and Adaptation to interpret the assessments in the hope of identifying a gradient of risk, and explore whether a new coding method improved the validity of Family Drawings and their utility as a tool to complement the School-Age Assessment of Attachment. The participants were 89 children, aged between 5 and 12 years; 32 children were involved with mental health services or child protection. Each child completed a School-Age Assessment of Attachment and a Family Drawing. Both assessments differentiated between clinical and normative referrals with moderate effect sizes when dichotomizing risk versus non-risk attachment. When the analysis incorporated a gradient of six attachment classifications, the effect sizes decreased, but specificity of risk increased. The School-Age Assessment of Attachment had greater validity for discriminating risk, and type of risk, than the Family Drawings. With a School-Age Assessment of Attachment and family history, the Family Drawing can provide information about distress that some children do not provide verbally. Integration of the two assessment tools alongside information about parental and family functioning appears to be the key to formulating children's problems.

Comparison of cystatin C and creatinine to determine the incidence of composite adverse outcomes in HIV-infected individuals.

PubMed

Yanagisawa, Naoki; Sasaki, Shugo; Suganuma, Akihiko; Imamura, Akifumi; Ajisawa, Atsushi; Ando, Minoru

2015-02-01

Cystatin C is an overall biomarker of pathophysiologic abnormalities that accompany chronic kidney disease (CKD). The utility of cystatin C is not fully understood in an HIV-infected population. This prospective study investigated 661 HIV-infected individuals for 4 years to determine the incidence of adverse outcomes, including all-cause mortality, cardiovascular disease, and renal dysfunction. The risk of developing the outcomes was discriminated with a 4 color-coded classification in a 3 × 6 contingency table, that combined 3 grades of dipstick proteinuria with 6 grades of estimated glomerular filtration rate (eGFR) calculated using either serum creatinine (eGFRcr) or cystatin C (eGFRcy): green, low risk; yellow, moderately increased risk; orange, high risk; and red, very high risk. The cumulative incidence of the outcomes was assessed by the Kaplan-Meier method, and the association between color-coded risk and the time to outcome was evaluated using multivariate proportional hazards analysis. Compared with eGFRcr, the use of eGFRcy reduced the prevalence of risk ≥ orange by 0.8%. The adverse outcomes were significantly more likely to occur to the patients with baseline risk category ≥orange than those with ≤ yellow, independent of risk categories based on eGFRcr or eGFRcy. However, in multivariate analysis, risk category ≥orange with eGFRcy-based classification was significantly associated with adverse outcomes, but not the one with eGFRcr. Replacing creatinine by cystatin C in the CKD color-coded risk classification may be appropriate to discriminate HIV-infected patients at increased risk of a poor prognosis. Copyright © 2014 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

NESTEM-QRAS: A Tool for Estimating Probability of Failure

NASA Technical Reports Server (NTRS)

Patel, Bhogilal M.; Nagpal, Vinod K.; Lalli, Vincent A.; Pai, Shantaram; Rusick, Jeffrey J.

2002-01-01

An interface between two NASA GRC specialty codes, NESTEM and QRAS has been developed. This interface enables users to estimate, in advance, the risk of failure of a component, a subsystem, and/or a system under given operating conditions. This capability would be able to provide a needed input for estimating the success rate for any mission. NESTEM code, under development for the last 15 years at NASA Glenn Research Center, has the capability of estimating probability of failure of components under varying loading and environmental conditions. This code performs sensitivity analysis of all the input variables and provides their influence on the response variables in the form of cumulative distribution functions. QRAS, also developed by NASA, assesses risk of failure of a system or a mission based on the quantitative information provided by NESTEM or other similar codes, and user provided fault tree and modes of failure. This paper will describe briefly, the capabilities of the NESTEM, QRAS and the interface. Also, in this presentation we will describe stepwise process the interface uses using an example.

NESTEM-QRAS: A Tool for Estimating Probability of Failure

NASA Astrophysics Data System (ADS)

Patel, Bhogilal M.; Nagpal, Vinod K.; Lalli, Vincent A.; Pai, Shantaram; Rusick, Jeffrey J.

2002-10-01

An interface between two NASA GRC specialty codes, NESTEM and QRAS has been developed. This interface enables users to estimate, in advance, the risk of failure of a component, a subsystem, and/or a system under given operating conditions. This capability would be able to provide a needed input for estimating the success rate for any mission. NESTEM code, under development for the last 15 years at NASA Glenn Research Center, has the capability of estimating probability of failure of components under varying loading and environmental conditions. This code performs sensitivity analysis of all the input variables and provides their influence on the response variables in the form of cumulative distribution functions. QRAS, also developed by NASA, assesses risk of failure of a system or a mission based on the quantitative information provided by NESTEM or other similar codes, and user provided fault tree and modes of failure. This paper will describe briefly, the capabilities of the NESTEM, QRAS and the interface. Also, in this presentation we will describe stepwise process the interface uses using an example.

Chemical speciation and risk assessment of cadmium in soils around a typical coal mining area of China.

PubMed

Cheng, Siwei; Liu, Guijian; Zhou, Chuncai; Sun, Ruoyu

2018-05-21

The distribution characteristics of Cadmium (Cd) fractions in soils around a coal mining area of Huaibei coalfield were investigated, with the aim to assess its ecological risk. The total Cd concentrations in soils ranged from 0.05 to 0.87 mg/kg. The high percentage of phyto-available Cd (58%) when redox or base-acid equilibria changed. Soil pH was found to be a crucial factor affecting soil Cd fraction, and carbonate-bound Cd can be significantly affected by both organic matter and pH of soils. The static ecological evaluation models, including potential ecological risk index (PERI), geo-accumulation index (I geo ) and risk assessment code (RAC), revealed a moderate soil Cd contamination and prensented high Cd exposure risk in studied soils. However, the dynamic evaluation of Cd risk, determined using a delayed geochemical hazard (DGH), suggested that our studied soils can be classified as median-risk with a mean probability of 24.79% for Cd DGH. These results provide a better assessment for the risk development of Cd contamination in coal mining areas. Copyright © 2018 Elsevier Inc. All rights reserved.

The development of an observational screening tool to assess safe, effective and appropriate walking aid use in people with multiple sclerosis.

PubMed

Eitzen, Abby; Finlayson, Marcia; Carolan-Laing, Leanne; Nacionales, Arthur Junn; Walker, Christie; O'Connor, Josephine; Asano, Miho; Coote, Susan

2017-08-01

The purpose of this study was to identify potential items for an observational screening tool to assess safe, effective and appropriate walking aid use among people with multiple sclerosis (MS). Such a tool is needed because of the association between fall risk and mobility aid use in this population. Four individuals with MS were videotaped using a one or two straight canes, crutches or a rollator in different settings. Seventeen health care professionals from Canada, Ireland and the United States were recruited, and viewed the videos, and were then interviewed about the use of the devices by the individuals in the videos. Interview questions addressed safety, effectiveness and appropriateness of the device in the setting. Data were analyzed qualitatively. Coding consistency across raters was evaluated and confirmed. Nineteen codes were identified as possible items for the screening tool. The most frequent issues raised regardless of setting and device were "device used for duration/abandoned", "appropriate device", "balance and stability", "device technique", "environmental modification" and "hands free." With the identification of a number of potential tool items, researchers can now move forward with the development of the tool. This will involve consultation with both healthcare professionals and people with MS. Implications for rehabilitation Falls among people with multiple sclerosis are associated with mobility device use and use of multiple devices is associated with greater falls risk. The ability to assess for safe, effective and efficient use of walking aids is therefore important, no tools currently exist for this purpose. The codes arising from this study will be used to develop a screening tool for safe, effective and efficient walking aid use with the aim of reducing falls risk.

Ecological risk of heavy metals in sediments of the Luan River source water.

PubMed

Liu, Jingling; Li, Yongli; Zhang, Bao; Cao, Jinling; Cao, Zhiguo; Domagalski, Joseph

2009-08-01

Distribution and characteristics of heavy metals enrichment in sediment were surveyed including the bio-available form analyzed for assessment of the Luan River source water quality. The approaches of sediment quality guidelines (SQG), risk assessment code and Hakanson potential ecological risk index were used for the ecological risk assessment. According to SQG, The results show that in animal bodies, Hg at the sampling site of Wuliehexia was 1.39 mg/kg, Cr at Sandaohezi was 152.37 mg/kg and Cu at Hanjiaying was 178.61 mg/kg exceeding the severe effect screening level. There were 90% of sampling sites of Cr and Pb and 50% sites of Cu exceeded the lowest effect screening level. At Boluonuo and Wuliehexia, the exchangeable and carbonate fractions for above 50% of sites were at high risk levels and that for above 30% of sites at Xiahenan and Wulieheshang were also at high risk levels. Other sites were at medium risk level. Compared to soil background values of China, Hg and Cd showed very strong ecological risk, and the seven heavy metals of Hg, Cd, Cu, As, Pb, Cr, Zn at ecological risk levels were in the descending order. The results could give insight into risk assessment of environmental pollution and decision-making for water source security.

Evaluation of severe accident risks: Quantification of major input parameters: MAACS (MELCOR Accident Consequence Code System) input

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

Sprung, J.L.; Jow, H-N; Rollstin, J.A.

1990-12-01

Estimation of offsite accident consequences is the customary final step in a probabilistic assessment of the risks of severe nuclear reactor accidents. Recently, the Nuclear Regulatory Commission reassessed the risks of severe accidents at five US power reactors (NUREG-1150). Offsite accident consequences for NUREG-1150 source terms were estimated using the MELCOR Accident Consequence Code System (MACCS). Before these calculations were performed, most MACCS input parameters were reviewed, and for each parameter reviewed, a best-estimate value was recommended. This report presents the results of these reviews. Specifically, recommended values and the basis for their selection are presented for MACCS atmospheric andmore » biospheric transport, emergency response, food pathway, and economic input parameters. Dose conversion factors and health effect parameters are not reviewed in this report. 134 refs., 15 figs., 110 tabs.« less

USER MANUAL FOR EXPRESS, THE EXAMS-PRZM EXPOSURE SIMULATION SHELL

EPA Science Inventory

The Environmental Fate and Effects Division (EFED) of EPA's Office of Pesticide Programs(OPP) uses a suite of ORD simulation models for the exposure analysis portion of regulatory risk assessments. These models (PRZM, EXAMS, AgDisp) are complex, process-based simulation codes tha...

Software analysis handbook: Software complexity analysis and software reliability estimation and prediction

NASA Technical Reports Server (NTRS)

Lee, Alice T.; Gunn, Todd; Pham, Tuan; Ricaldi, Ron

1994-01-01

This handbook documents the three software analysis processes the Space Station Software Analysis team uses to assess space station software, including their backgrounds, theories, tools, and analysis procedures. Potential applications of these analysis results are also presented. The first section describes how software complexity analysis provides quantitative information on code, such as code structure and risk areas, throughout the software life cycle. Software complexity analysis allows an analyst to understand the software structure, identify critical software components, assess risk areas within a software system, identify testing deficiencies, and recommend program improvements. Performing this type of analysis during the early design phases of software development can positively affect the process, and may prevent later, much larger, difficulties. The second section describes how software reliability estimation and prediction analysis, or software reliability, provides a quantitative means to measure the probability of failure-free operation of a computer program, and describes the two tools used by JSC to determine failure rates and design tradeoffs between reliability, costs, performance, and schedule.

Risk assessment of heavy metals from combustion of pelletized municipal sewage sludge.

PubMed

Xiao, Zhihua; Yuan, Xingzhong; Leng, Lijian; Jiang, Longbo; Chen, Xiaohong; Zhibin, Wu; Xin, Peng; Jiachao, Zhang; Zeng, Guangming

2016-02-01

Fly ash and slag are important by-products obtained from combustion of municipal sewage sludge (MSS) after pelletization. The quantitative environmental impact assessment of heavy metals in fly ash and slag, compared to MSS, were performed in accordance with bioavailability and eco-toxicity, geo-accumulation index (GAI), risk assessment code (RAC), and potential ecological risk index (PERI). The results demonstrated that not only direct but also long-term bioavailability and eco-toxicity of heavy metals in fly ash and slag decreased except direct bioavailability and eco-toxicity of Pb in fly ash. The GAI demonstrated that combustion significantly weakened (P < 0.05) the pollution levels of heavy metals. PERI indicated that all risks attributed to heavy metals were significantly lowered (P < 0.05) from 777.07 (very high risk) in MSS to 288.72 (moderate risk) and 64.55 (low risk) in fly ash and slag, respectively. In terms of the RAC, seven heavy metals had low even no risk to the environments after combustion besides As in slag. The environmental risk of heavy metals in fly ash and slag was decreased compared with MSS. However, the results of PERI showed that fly ash had a moderate risk.

Distribution and risk assessment of heavy metals in sewage sludge after ozonation.

PubMed

Zhang, Jian; Tian, Yu; Zhang, Jun; Li, Ning; Kong, Lingchao; Yu, Ming; Zuo, Wei

2017-02-01

In this paper, transformation of chemical forms of heavy metals (Cu, Zn, Ni, Pb, Cr, Cd, Mn, and Mg) in sewage sludge (SS) during ozonation was investigated. Meanwhile, the risk of heavy metals to environment in ozonated sludge (OS) and SS was estimated according to risk assessment code (RAC). The residual rates of heavy metals were over 72.8 %, which demonstrated that the heavy metals in SS were mainly existed in the OS after ozonation. The results indicated that the ozonation had an effect on the redistribution of heavy metals. The comparisons of the RAC between OS and SS indicated that the environmental risk of heavy metals in OS was aggravated compared to SS, except for Mg. Consequently, it was suggested that the OS should be pretreated before application.

Improving the safety of street-vended food.

PubMed

Moy, G; Hazzard, A; Käferstein, F

1997-01-01

An integrated plan of action for improving street food involving health and other regulatory authorities, vendors and consumers should address not only food safety, but also environmental health management, including consideration of inadequate sanitation and waste management, possible environmental pollution, congestion and disturbances to traffic. However, WHO cautions that, in view of their importance in the diets of urban populations, particularly the socially disadvantaged, every effort should be made to preserve the benefits provided by varied, inexpensive and often nutritious street food. Therefore, authorities concerned with street food management must balance efforts aimed at reducing the negative aspects on the environment with the benefits of street food and its important role in the community. Health authorities charged with responsibility for food safety control should match risk management action to the level of assessed risk. The rigorous application of codes and enforcement of regulations more suited to larger and permanent food service establishments is unlikely to be justifiable. Such rigorous application of codes and regulations may result in disappearance of the trade with consequent aggravation of hunger and malnutrition. Moreover, most codes and regulations have not been based on any systematic identification and assessment of health hazards associated with different types of foods and operations as embodied in the HACCP approach which has been recognized by Codex as the most cost-effective means for promoting food safety. WHO encourages the development of regulations that empower vendors to take greater responsibility for the preparation of safe food, and of codes of practice based on the HACCP system.

Nonlinear response of lipid-shelled microbubbles to coded excitation: implications for noninvasive atherosclerosis imaging

NASA Astrophysics Data System (ADS)

Shekhar, Himanshu; Doyley, Marvin M.

2013-03-01

Nonlinear (subharmonic/harmonic) imaging with ultrasound contrast agents (UCA) could characterize the vasa vasorum, which could help assess the risk associated with atherosclerosis. However, the sensitivity and specificity of high-frequency nonlinear imaging must be improved to enable its clinical translation. The current excitation scheme employs sine-bursts — a strategy that requires high-peak pressures to produce strong nonlinear response from UCA. In this paper, chirp-coded excitation was evaluated to assess its ability to enhance the subharmonic and harmonic response of UCA. Acoustic measurements were conducted with a pair of single-element transducers at 10-MHz transmit frequencies to evaluate the subharmonic and harmonic response of Targestar-P® (Targeson Inc., San Diego, CA, USA), a commercially available phospholipid-encapsulated contrast agent. The results of this study demonstrated a 2 - 3 fold reduction in the subharmonic threshold, and a 4 - 14 dB increase in nonlinear signal-to-noise ratio, with chirp-coded excitation. Therefore, chirp-coded excitation could be well suited for improving the imaging performance of high-frequency harmonic and subharmonic imaging.

Estimate of Space Radiation-Induced Cancer Risks for International Space Station Orbits

NASA Technical Reports Server (NTRS)

Wu, Honglu; Atwell, William; Cucinotta, Francis A.; Yang, Chui-hsu

1996-01-01

Excess cancer risks from exposures to space radiation are estimated for various orbits of the International Space Station (ISS). Organ exposures are computed with the transport codes, BRYNTRN and HZETRN, and the computerized anatomical male and computerized anatomical female models. Cancer risk coefficients in the National Council on Radiation Protection and Measurements report No. 98 are used to generate lifetime excess cancer incidence and cancer mortality after a one-month mission to ISS. The generated data are tabulated to serve as a quick reference for assessment of radiation risk to astronauts on ISS missions.

Infornut® Process; improves accessibility to diagnosis and nutritional support for the malnourished hospitalized patient; impact on management indicators; two-year assessment.

PubMed

Villalobos Gámez, Juan Luis; González Pérez, Cristina; García-Almeida, José Manuel; Martínez Reina, Alfonso; Del Río Mata, José; Márquez Fernández, Efrén; Rioja Vázquez, Rosalía; Barranco Pérez, Joaquín; Enguix Armada, Alfredo; Rodríguez García, Luis Miguel; Bernal Losada, Olga; Osorio Fernández, Diego; Mínguez Mañanes, Alfredo; Lara Ramos, Carlos; Dani, Laila; Vallejo Báez, Antonio; Martínez Martín, Jesús; Fernández Ovies, José Manuel; Tinahones Madueño, Francisco Javier; Fernández-Crehuet Navajas, Joaquín

2014-06-01

The high prevalence of disease-related hospital malnutrition justifies the need for screening tools and early detection in patients at risk for malnutrition, followed by an assessment targeted towards diagnosis and treatment. At the same time there is clear undercoding of malnutrition diagnoses and the procedures to correct it Objectives: To describe the INFORNUT program/ process and its development as an information system. To quantify performance in its different phases. To cite other tools used as a coding source. To calculate the coding rates for malnutrition diagnoses and related procedures. To show the relationship to Mean Stay, Mortality Rate and Urgent Readmission; as well as to quantify its impact on the hospital Complexity Index and its effect on the justification of Hospitalization Costs. The INFORNUT® process is based on an automated screening program of systematic detection and early identification of malnourished patients on hospital admission, as well as their assessment, diagnoses, documentation and reporting. Of total readmissions with stays longer than three days incurred in 2008 and 2010, we recorded patients who underwent analytical screening with an alert for a medium or high risk of malnutrition, as well as the subgroup of patients in whom we were able to administer the complete INFORNUT® process, generating a report for each. Other documentary coding sources are cited. From the Minimum Basic Data Set, codes defined in the SEDOMSENPE consensus were analyzed. The data were processed with the Alcor-DRG program. Rates in ‰ of discharges for 2009 and 2010 of diagnoses of malnutrition, procedure and procedures-related diagnoses were calculated. These rates were compared with the mean rates in Andalusia. The contribution of these codes to the Complexity Index was estimated and, from the cost accounting data, the fraction of the hospitalization cost seen as justified by this activity was estimated. RESULTS are summarized for both study years. With respect to process performance, more than 3,600 patients per year (30% of admissions with a stay > 3 days) underwent analytical screening. Half of these patients were at medium or high risk and a nutritional assessment using INFORNUT® was completed for 55% of them, generating approximately 1,000 reports/year. Our coding rates exceeded the mean rates in Andalusia, being 3.5 times higher for diagnoses (35‰); 2.5 times higher for procedures (50‰) and five times the rate of procedurerelated diagnoses in the same patient (25‰). The Mean Stay of patients coded with malnutrition at discharge was 31.7 days, compared to 9.5 for the overall hospital stay. The Mortality Rate for the same patients (21.8%) was almost five times higher than the mean and Urgent Readmissions (5.5%) were 1.9 times higher. The impact of this coding on the hospital Complexity Index was four hundredths (from 2.08 to 2.12 in 2009 and 2.15 to 2.19 in 2010). This translates into a hospitalization cost justification of 2,000,000; five to six times the cost of artificial nutrition. The process facilitated access to the diagnosis of malnutrition and to understanding the risk of developing it, as well as to the prescription of procedures and/or supplements to correct it. The interdisciplinary team coordination, the participatory process and the tools used improved coding rates to give results far above the Andalusian mean. These results help to upwardly adjust the hospital Complexity Index or Case Mix-, as well as to explain hospitalization costs. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Assessing risk for violence among male and female civil psychiatric patients: the HCR-20, PCL:SV, and VSC.

PubMed

Nicholls, Tonia L; Ogloff, James R P; Douglas, Kevin S

2004-01-01

This study evaluated the predictive validity of violence risk assessments conducted using the HCR-20, the Psychopathy Checklist: Screening Version (PCL:SV), and by the Violence Screening Checklist (VSC) in a sample of 268 involuntarily hospitalized male and female psychiatric patients. Information pertaining to violence and crime was coded from medical charts and correctional records. The HCR-20/PCL:SV evidenced modest non-significant associations in postdictive assessments of inpatient violence among men. Moderate to strong significant associations were found between the HCR-20/PCL:SV and inpatient violence among women. Pseudo-prospective assessments using the HCR-20 and PCL:SV resulted in moderate to large relationships with violence and crime in men and women following community discharge. It is concluded that the VSC is a promising tool for assessing acute inpatient violence risk with men. Findings offer preliminary validation of the predictive validity of the HCR-20 and PCL:SV with female civil psychiatric patients. Copyright 2004 John Wiley & Sons, Ltd.

Fracture Analysis of Vessels. Oak Ridge FAVOR, v06.1, Computer Code: Theory and Implementation of Algorithms, Methods, and Correlations

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

Williams, P. T.; Dickson, T. L.; Yin, S.

The current regulations to insure that nuclear reactor pressure vessels (RPVs) maintain their structural integrity when subjected to transients such as pressurized thermal shock (PTS) events were derived from computational models developed in the early-to-mid 1980s. Since that time, advancements and refinements in relevant technologies that impact RPV integrity assessment have led to an effort by the NRC to re-evaluate its PTS regulations. Updated computational methodologies have been developed through interactions between experts in the relevant disciplines of thermal hydraulics, probabilistic risk assessment, materials embrittlement, fracture mechanics, and inspection (flaw characterization). Contributors to the development of these methodologies include themore » NRC staff, their contractors, and representatives from the nuclear industry. These updated methodologies have been integrated into the Fracture Analysis of Vessels -- Oak Ridge (FAVOR, v06.1) computer code developed for the NRC by the Heavy Section Steel Technology (HSST) program at Oak Ridge National Laboratory (ORNL). The FAVOR, v04.1, code represents the baseline NRC-selected applications tool for re-assessing the current PTS regulations. This report is intended to document the technical bases for the assumptions, algorithms, methods, and correlations employed in the development of the FAVOR, v06.1, code.« less

Ecological risk of heavy metals in sediments of the luan river source water

USGS Publications Warehouse

Liu, J.; Li, Y.; Zhang, B.; Cao, J.; Cao, Z.; Domagalski, Joseph L.

2009-01-01

Distribution and characteristics of heavy metals enrichment in sediment were surveyed including the bio-available form analyzed for assessment of the Luan River source water quality. The approaches of sediment quality guidelines (SQG), risk assessment code and Hakanson potential ecological risk index were used for the ecological risk assessment. According to SQG, The results show that in animal bodies, Hg at the sampling site of Wuliehexia was 1.39 mg/kg, Cr at Sandaohezi was 152.37 mg/kg and Cu at Hanjiaying was 178.61 mg/kg exceeding the severe effect screening level. There were 90% of sampling sites of Cr and Pb and 50% sites of Cu exceeded the lowest effect screening level. At Boluonuo and Wuliehexia, the exchangeable and carbonate fractions for above 50% of sites were at high risk levels and that for above 30% of sites at Xiahenan and Wulieheshang were also at high risk levels. Other sites were at medium risk level. Compared to soil background values of China, Hg and Cd showed very strong ecological risk, and the seven heavy metals of Hg, Cd, Cu, As, Pb, Cr, Zn at ecological risk levels were in the descending order. The results could give insight into risk assessment of environmental pollution and decision-making for water source security. ?? 2009 Springer Science+Business Media, LLC.

PRA and Risk Informed Analysis

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

Bernsen, Sidney A.; Simonen, Fredric A.; Balkey, Kenneth R.

2006-01-01

The Boiler and Pressure Vessel Code (BPVC) of the American Society of Mechanical Engineers (ASME) has introduced a risk based approach into Section XI that covers Rules for Inservice Inspection of Nuclear Power Plant Components. The risk based approach requires application of the probabilistic risk assessments (PRA). Because no industry consensus standard existed for PRAs, ASME has developed a standard to evaluate the quality level of an available PRA needed to support a given risk based application. The paper describes the PRA standard, Section XI application of PRAs, and plans for broader applications of PRAs to other ASME nuclear codesmore » and standards. The paper addresses several specific topics of interest to Section XI. Important consideration are special methods (surrogate components) used to overcome the lack of PRA treatments of passive components in PRAs. The approach allows calculations of conditional core damage probabilities both for component failures that cause initiating events and failures in standby systems that decrease the availability of these systems. The paper relates the explicit risk based methods of the new Section XI code cases to the implicit consideration of risk used in the development of Section XI. Other topics include the needed interactions of ISI engineers, plant operating staff, PRA specialists, and members of expert panels that review the risk based programs.« less

Comparison of ORSAT and SCARAB Reentry Analysis Tools for a Generic Satellite Test Case

NASA Technical Reports Server (NTRS)

Kelley, Robert L.; Hill, Nicole M.; Rochelle, W. C.; Johnson, Nicholas L.; Lips, T.

2010-01-01

Reentry analysis is essential to understanding the consequences of the full life cycle of a spacecraft. Since reentry is a key factor in spacecraft development, NASA and ESA have separately developed tools to assess the survivability of objects during reentry. Criteria such as debris casualty area and impact energy are particularly important to understanding the risks posed to people on Earth. Therefore, NASA and ESA have undertaken a series of comparison studies of their respective reentry codes for verification and improvements in accuracy. The NASA Object Reentry Survival Analysis Tool (ORSAT) and the ESA Spacecraft Atmospheric Reentry and Aerothermal Breakup (SCARAB) reentry analysis tools serve as standard codes for reentry survivability assessment of satellites. These programs predict whether an object will demise during reentry and calculate the debris casualty area of objects determined to survive, establishing the reentry risk posed to the Earth's population by surviving debris. A series of test cases have been studied for comparison and the most recent uses "Testsat," a conceptual satellite composed of generic parts, defined to use numerous simple shapes and various materials for a better comparison of the predictions of these two codes. This study is an improvement on the others in this series because of increased consistency in modeling techniques and variables. The overall comparison demonstrated that the two codes arrive at similar results. Either most objects modeled resulted in close agreement between the two codes, or if the difference was significant, the variance could be explained as a case of semantics in the model definitions. This paper presents the main results of ORSAT and SCARAB for the Testsat case and discusses the sources of any discovered differences. Discussion of the results of previous comparisons is made for a summary of differences between the codes and lessons learned from this series of tests.

Residential building codes, affordability, and health protection: a risk-tradeoff approach.

PubMed

Hammitt, J K; Belsky, E S; Levy, J I; Graham, J D

1999-12-01

Residential building codes intended to promote health and safety may produce unintended countervailing risks by adding to the cost of construction. Higher construction costs increase the price of new homes and may increase health and safety risks through "income" and "stock" effects. The income effect arises because households that purchase a new home have less income remaining for spending on other goods that contribute to health and safety. The stock effect arises because suppression of new-home construction leads to slower replacement of less safe housing units. These countervailing risks are not presently considered in code debates. We demonstrate the feasibility of estimating the approximate magnitude of countervailing risks by combining the income effect with three relatively well understood and significant home-health risks. We estimate that a code change that increases the nationwide cost of constructing and maintaining homes by $150 (0.1% of the average cost to build a single-family home) would induce offsetting risks yielding between 2 and 60 premature fatalities or, including morbidity effects, between 20 and 800 lost quality-adjusted life years (both discounted at 3%) each year the code provision remains in effect. To provide a net health benefit, the code change would need to reduce risk by at least this amount. Future research should refine these estimates, incorporate quantitative uncertainty analysis, and apply a full risk-tradeoff approach to real-world case studies of proposed code changes.

[The hospital perspective: disease management and integrated health care].

PubMed

Schrappe, Matthias

2003-06-01

Disease Management is a transsectoral, population-based form of health care, which addresses groups of patients with particular clinical entities and risk factors. It refers both to an evidence-based knowledge base and corresponding guidelines, evaluates outcome as a continuous quality improvement process and usually includes active participation of patients. In Germany, the implementation of disease management is associated with financial transactions for risk adjustment between health care assurances [para. 137 f, Book V of Social Code (SGB V)] and represents the second kind of transsectoral care, besides a program designed as integrated health care according to para. 140 a ff f of Book V of Social Code. While in the USA and other countries disease management programs are made available by several institutions involved in health care, in Germany these programs are offered by health care insurers. Assessment of disease management from the hospital perspective will have to consider three questions: How large is the risk to compensate inadequate quality in outpatient care? Are there synergies in internal organisational development? Can the risk of inadequate funding of the global "integrated" budget be tolerated? Transsectoral quality assurance by valid performance indicators and implementation of a quality improvement process are essential. Internal organisational changes can be supported, particularly in the case of DRG introduction. The economic risk and financial output depends on the kind of disease being focussed by the disease management program. In assessing the underlying scientific evidence of their cost effectiveness, societal costs will have to be precisely differentiated from hospital-associated costs.

Postoperative complications following colectomy for ulcerative colitis: A validation study

PubMed Central

2012-01-01

Background Ulcerative colitis (UC) patients failing medical management require colectomy. This study compares risk estimates for predictors of postoperative complication derived from administrative data against that of chart review and evaluates the accuracy of administrative coding for this population. Methods Hospital administrative databases were used to identify adults with UC undergoing colectomy from 1996–2007. Medical charts were reviewed and regression analyses comparing chart versus administrative data were performed to assess the effect of age, emergent operation, and Charlson comorbidities on the occurrence of postoperative complications. Sensitivity, specificity, and positive/negative predictive values of administrative coding for identifying the study population, Charlson comorbidities, and postoperative complications were assessed. Results Compared to chart review, administrative data estimated a higher magnitude of effect for emergent admission (OR 2.52 [95% CI: 1.80–3.52] versus 1.49 [1.06–2.09]) and Charlson comorbidities (OR 2.91 [1.86–4.56] versus 1.50 [1.05–2.15]) as predictors of postoperative complications. Administrative data correctly identified UC and colectomy in 85.9% of cases. The administrative database was 37% sensitive in identifying patients with ≥ 1Charlson comorbidity. Restricting analysis to active comorbidities increased the sensitivity to 63%. The sensitivity of identifying patients with at least one postoperative complication was 68%; restricting analysis to more severe complications improved the sensitivity to 84%. Conclusions Administrative data identified the same risk factors for postoperative complications as chart review, but overestimated the magnitude of risk. This discrepancy may be explained by coding inaccuracies that selectively identifying the most serious complications and comorbidities. PMID:22943760

Speciation and environmental risk assessment of heavy metal in bio-oil from liquefaction/pyrolysis of sewage sludge.

PubMed

Yuan, Xingzhong; Leng, Lijian; Huang, Huajun; Chen, Xiaohong; Wang, Hou; Xiao, Zhihua; Zhai, Yunbo; Chen, Hongmei; Zeng, Guangming

2015-02-01

Liquefaction bio-oil (LBO) produced with ethanol (or acetone) as the solvent and pyrolysis bio-oil (PBO) produced at 550°C (or 850°C) from sewage sludge (SS) were produced, and were characterized and evaluated in terms of their heavy metal (HM) composition. The total concentration, speciation and leaching characteristic of HMs (Cu, Cr, Pb, Zn, Cd, and Ni) in both LBO and PBO were investigated. The total concentration and exchangeable fraction of Zn and Ni in bio-oils were at surprisingly high levels. Quantitative risk assessment of HM in bio-oils was performed by the method of risk assessment code (RAC), potential ecological risk index (PERI) and geo-accumulation index (GAI). Ni in bio-oil produced by pyrolysis at 850°C (PBO850) and Zn in bio-oil by liquefaction at 360°C with ethanol as solvent (LBO-360E) were evaluated to possess very high risk to the environment according to RAC. Additionally, Cd in PBO850 and LBO-360E were evaluated by PERI to have very high risk and high risk, respectively, while Cd in all bio-oils was assessed moderately contaminated according to GAI. Copyright © 2014 Elsevier Ltd. All rights reserved.

Maternal exposure to neighborhood soil Pb and eclampsia risk in New Orleans, Louisiana (USA): evidence from a natural experiment in flooding.

PubMed

Zahran, Sammy; Magzamen, Sheryl; Breunig, Ian M; Mielke, Howard W

2014-08-01

Previous studies link maternal blood lead (Pb) levels and pregnancy-related hypertensive disorders. Assess the relationship between neighborhood soil Pb and maternal eclampsia risk. Zip code summarized high density soil survey data of New Orleans collected before and after Hurricanes Katrina and Rita (HKR) were merged with pregnancy outcome data on 75,501 mothers from the Louisiana office of public health. Cross-sectional logistic regression analyses are performed testing the association between pre-HKR accumulation of Pb in soils in thirty-two neighborhoods and eclampsia risk. Then we examine whether measured declines in soil Pb following the flooding of the city resulted in corresponding reductions of eclampsia risk. Cross-sectional analyses show that a one standard deviation increase in soil Pb increases the odds of eclampsia by a factor of 1.48 (95% CI: 1.31, 1.66). Mothers in zip code areas with soil Pb>333 mg/kg were 4.00 (95% CI: 3.00, 5.35) times more likely to experience eclampsia than mothers residing in neighborhoods with soil Pb<50mg/kg. Difference-in-differences analyses capturing the exogenous reduction in soil Pb following the 2005 flooding of New Orleans indicate that mothers residing in zip codes experiencing decrease in soil Pb (-387.9 to -33.6 mg/kg) experienced a significant decline in eclampsia risk (OR=0.619; 95% CI: 0.397, 0.963). Mothers residing in neighborhoods with high accumulation of Pb in soils are at heightened risk of experiencing eclampsia. Copyright © 2014 Elsevier Inc. All rights reserved.

Subcritical water treatment of explosive and heavy metals co-contaminated soil: Removal of the explosive, and immobilization and risk assessment of heavy metals.

PubMed

Islam, Mohammad Nazrul; Jung, Ho-Young; Park, Jeong-Hun

2015-11-01

Co-contamination of explosives and heavy metals (HMs) in soil, particularly army shooting range soil, has received increasing environmental concern due to toxicity and risks to ecological systems. In this study, a subcritical water (SCW) extraction process was used to remediate the explosives-plus-HMs-co-contaminated soil. A quantitative evaluation of explosives in the treated soil, compared with untreated soil, was applied to assess explosive removal. The immobilization of HMs was assessed by toxicity characteristic leaching procedure tests, and by investigating the migration of HMs fractions. The environmental risk of HMs in the soil residue was assessed according to the risk assessment code (RAC) and ecological risk indices (Er and RI). The results indicated that SCW treatment could eliminate the explosives, >99%, during the remediation, while the HM was effectively immobilized. The effect of water temperature on reducing the explosives and the risk of HMs in soil was observed. A marked increase in the non-bioavailable concentration of each HM was observed, and the leaching rate of HMs was decreased by 70-97% after SCW treatment at 250 °C, showing the effective immobilization of HMs. According to the RAC or RI, each tested HM showed no or low risk to the environment after treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

Assessing Differences in Risk Perceptions About Obesity Among "Normal-Weight" and "Overweight" Adolescents--A Qualitative Study.

PubMed

Gavaravarapu, SubbaRao M; Rao, K Mallikarjuna; Nagalla, Balakrishna; Avula, Laxmaiah

2015-01-01

To assess the differences in risk perceptions of overweight/obese and normal-weight adolescents about obesity and associated risk factors. Qualitative study using focus group discussions (FGDs). Five randomly selected schools from the South Indian city of Hyderabad. Seventy-nine adolescents (ages 11-14 years) participated in 10 FGDs (5 each with overweight/obese and normal-weight groups). Whether obesity-related risk perceptions differ with actual weight status or not. FGDs were recorded, transcribed, and manually coded for thematic analysis. Results were presented according to 6 themes. At each stage of coding and analysis, reports were read independently by 2-3 researchers and the inter-coder reliability was high (ratio of number of agreements against the sum of agreements plus disagreements was over 90%). Adolescents across the groups had limited understanding of nutrition during adolescence as well as causes and consequences of obesity. The optimistic bias that they were less vulnerable compared to others to the risks of obesity was evident from perceptions of overweight groups. While overweight adolescents argued that obesity was hereditary, the normal-weight participants perceived "faulty food habits" and laziness as the reasons. Adolescents across the groups considered fruits and vegetables as healthy foods. There were clear differences in perceptions of adolescents of different weight status. Employing the risk perception analysis framework, this study identified the following adolescent traits: responsive, avoidance, and indifference, which may be useful for developing nutrition communication programs. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

TERRA: a computer code for simulating the transport of environmentally released radionuclides through agriculture

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

Baes, C.F. III; Sharp, R.D.; Sjoreen, A.L.

1984-11-01

TERRA is a computer code which calculates concentrations of radionuclides and ingrowing daughters in surface and root-zone soil, produce and feed, beef, and milk from a given deposition rate at any location in the conterminous United States. The code is fully integrated with seven other computer codes which together comprise a Computerized Radiological Risk Investigation System, CRRIS. Output from either the long range (> 100 km) atmospheric dispersion code RETADD-II or the short range (<80 km) atmospheric dispersion code ANEMOS, in the form of radionuclide air concentrations and ground deposition rates by downwind location, serves as input to TERRA. User-definedmore » deposition rates and air concentrations may also be provided as input to TERRA through use of the PRIMUS computer code. The environmental concentrations of radionuclides predicted by TERRA serve as input to the ANDROS computer code which calculates population and individual intakes, exposures, doses, and risks. TERRA incorporates models to calculate uptake from soil and atmospheric deposition on four groups of produce for human consumption and four groups of livestock feeds. During the environmental transport simulation, intermediate calculations of interception fraction for leafy vegetables, produce directly exposed to atmospherically depositing material, pasture, hay, and silage are made based on location-specific estimates of standing crop biomass. Pasture productivity is estimated by a model which considers the number and types of cattle and sheep, pasture area, and annual production of other forages (hay and silage) at a given location. Calculations are made of the fraction of grain imported from outside the assessment area. TERRA output includes the above calculations and estimated radionuclide concentrations in plant produce, milk, and a beef composite by location.« less

Structured parenting of toddlers at high versus low genetic risk: two pathways to child problems.

PubMed

Leve, Leslie D; Harold, Gordon T; Ge, Xiaojia; Neiderhiser, Jenae M; Shaw, Daniel; Scaramella, Laura V; Reiss, David

2009-11-01

Little is known about how parenting might offset genetic risk to prevent the onset of child problems during toddlerhood. We used a prospective adoption design to separate genetic and environmental influences and test whether associations between structured parenting and toddler behavior problems were conditioned by genetic risk for psychopathology. The sample included 290 linked sets of adoptive families and birth mothers and 95 linked birth fathers. Genetic risk was assessed via birth mother and birth father psychopathology (anxiety, depression, antisociality, and drug use). Structured parenting was assessed via microsocial coding of adoptive mothers' behavior during a cleanup task. Toddler behavior problems were assessed with the Child Behavior Checklist. Controlling for temperamental risk at 9 months, there was an interaction between birth mother psychopathology and adoptive mothers' parenting on toddler behavior problems at 18 months. The interaction indicated two pathways to child problems: structured parenting was beneficial for toddlers at high genetic risk but was related to behavior problems for toddlers at low genetic risk. This crossover interaction pattern was replicated with birth father psychopathology as the index of genetic risk. The effects of structured parenting on toddler behavior problems varied as a function of genetic risk. Children at genetic risk might benefit from parenting interventions during toddlerhood that enhance structured parenting.

Risk reduction in pediatric procedural sedation by application of an American Academy of Pediatrics/American Society of Anesthesiologists process model.

PubMed

Hoffman, George M; Nowakowski, Rhonda; Troshynski, Todd J; Berens, Richard J; Weisman, Steven J

2002-02-01

Guidelines for risk reduction during procedural sedation from the American Academy of Pediatrics (AAP) and the American Society of Anesthesiologists (ASA) rely on expert opinion and consensus. In this article, we tested the hypothesis that application of an AAP/ASA-structured model would reduce the risk of sedation-related adverse events. Prospectively coded sedation records were abstracted by a hospital quality improvement specialist with practical and administrative experience in pediatric sedation. Process variables included notation of nulla per os (NPO) status, performance of a guided risk assessment, assignment of ASA physical status score, obtaining informed consent, generation of a sedation plan, and assessment of sedation level using a quantitative scoring system. Content variables included adherence to AAP NPO guidelines, ASA class, target sedation level, actual sedation level, age, procedure, and drugs used. Complication risk was assessed by logistic regression and Mantel-Haenszel odds ratios (OR). Complications were identified in 40 of 960 records (4.2%). The complication rate was 34 of 895 (3.8%) with planned conscious sedation and 6 of 65 (9.2%) with planned deep sedation ([DS]; OR: 2.6). Complications were reduced by performance of structured risk assessment (OR: 0.10), adherence to all process guidelines (OR: 0), and avoiding actual DS (OR: 0.4). The only drug associated with higher risk was chloral hydrate (OR: 2.1). Failure to adhere to NPO guidelines did not increase risk in this assessment; however, the adverse event rate was 0 if all process guidelines were followed. Presedation assessment reduces complications of DS. Repeated assessment of sedation score reduces the risk of inadvertent DS. The data provide direct evidence that AAP/ASA guidelines can reduce the risk of pediatric procedural sedation.

A new approach to the characterization of subtle errors in everyday action: implications for mild cognitive impairment.

PubMed

Seligman, Sarah C; Giovannetti, Tania; Sestito, John; Libon, David J

2014-01-01

Mild functional difficulties have been associated with early cognitive decline in older adults and increased risk for conversion to dementia in mild cognitive impairment, but our understanding of this decline has been limited by a dearth of objective methods. This study evaluated the reliability and validity of a new system to code subtle errors on an established performance-based measure of everyday action and described preliminary findings within the context of a theoretical model of action disruption. Here 45 older adults completed the Naturalistic Action Test (NAT) and neuropsychological measures. NAT performance was coded for overt errors, and subtle action difficulties were scored using a novel coding system. An inter-rater reliability coefficient was calculated. Validity of the coding system was assessed using a repeated-measures ANOVA with NAT task (simple versus complex) and error type (overt versus subtle) as within-group factors. Correlation/regression analyses were conducted among overt NAT errors, subtle NAT errors, and neuropsychological variables. The coding of subtle action errors was reliable and valid, and episodic memory breakdown predicted subtle action disruption. Results suggest that the NAT can be useful in objectively assessing subtle functional decline. Treatments targeting episodic memory may be most effective in addressing early functional impairment in older age.

Do expert assessments converge? An exploratory case study of evaluating and managing a blood supply risk.

PubMed

Eyles, John; Heddle, Nancy; Webert, Kathryn; Arnold, Emmy; McCurdy, Bronwen

2011-08-24

Examining professional assessments of a blood product recall/withdrawal and its implications for risk and public health, the paper introduces ideas about perceptions of minimal risk and its management. It also describes the context of publicly funded blood transfusion in Canada and the withdrawal event that is the basis of this study. Interviews with 45 experts from administration, medicine, blood supply, laboratory services and risk assessment took place using a multi-level sampling framework in the aftermath of the recall. These experts either directly dealt with the withdrawal or were involved in the management of the blood supply at the national level. Data from these interviews were coded in NVivo for analysis and interpretation. Analytically, data were interpreted to derive typifications to relate interview responses to risk management heuristics. While all those interviewed agreed on the importance of patient safety, differences in the ways in which the risk was contextualized and explicated were discerned. Risk was seen in terms of patient safety, liability or precaution. These different risk logics are illustrated by selected quotations. Expert assessments did not fully converge and it is possible that these different risk logics and discourses may affect the risk management process more generally, although not necessarily in a negative way. Patient safety is not to be compromised but management of blood risk in publicly funded systems may vary. We suggest ways of managing blood risk using formal and safety case approaches.

Do expert assessments converge? An exploratory case study of evaluating and managing a blood supply risk

PubMed Central

2011-01-01

Background Examining professional assessments of a blood product recall/withdrawal and its implications for risk and public health, the paper introduces ideas about perceptions of minimal risk and its management. It also describes the context of publicly funded blood transfusion in Canada and the withdrawal event that is the basis of this study. Methods Interviews with 45 experts from administration, medicine, blood supply, laboratory services and risk assessment took place using a multi-level sampling framework in the aftermath of the recall. These experts either directly dealt with the withdrawal or were involved in the management of the blood supply at the national level. Data from these interviews were coded in NVivo for analysis and interpretation. Analytically, data were interpreted to derive typifications to relate interview responses to risk management heuristics. Results While all those interviewed agreed on the importance of patient safety, differences in the ways in which the risk was contextualized and explicated were discerned. Risk was seen in terms of patient safety, liability or precaution. These different risk logics are illustrated by selected quotations. Conclusions Expert assessments did not fully converge and it is possible that these different risk logics and discourses may affect the risk management process more generally, although not necessarily in a negative way. Patient safety is not to be compromised but management of blood risk in publicly funded systems may vary. We suggest ways of managing blood risk using formal and safety case approaches. PMID:21864330

Are College Students' Assessments of Threat Shaped by the Dangers of Their Childhood Environment?

PubMed

Sherman, Amanda K; Minich, Steven H; Langen, Tom A; Skufca, Joseph; Wilke, Andreas

2016-07-01

Humans internalize environmental cues of mortality risk at an early age, which influences subsequent risk perceptions and behavior. In this respect, an individual's current risk assessment may be viewed as an adaptive response to the dangers present within his or her early local environment. Here we examine the relationship between several variables indicating threat within an individual's early environment (e.g., prevalence of violent and property crimes, registered sex offenders) and their perception of crime risk within both the childhood and current adult environments. We recruited a group of 657 students who hail from diverse geographic backgrounds to provide the zip code location of their childhood residence along with subjective ratings of danger of that and their current location, which enabled us to compare their ratings of risk/danger with the federally reported crime statistics of each setting. Our results indicate that the early prevalence of registered sex offenders indeed influences an individual's risk perception in adulthood, and that these factors have a differential effect on males and females. Our findings provide support for the theory that early environmental factors signaling danger affect how individuals assess risk within their adult environment. © The Author(s) 2015.

Assessment of radiological protection systems among diagnostic radiology facilities in North East India.

PubMed

Singh, Thokchom Dewan; Jayaraman, T; Arunkumar Sharma, B

2017-03-01

This study aims to assess the adequacy level of radiological protection systems available in the diagnostic radiology facilities located in three capital cities of North East (NE) India. It further attempts to understand, using a multi-disciplinary approach, how the safety codes/standards in diagnostic radiology framed by the Atomic Energy Regulatory Board (AERB) and the International Atomic Energy Agency (IAEA) to achieve adequate radiological protection in facilities, have been perceived, conceptualized, and applied accordingly in these facilities. About 30 diagnostic radiology facilities were randomly selected from three capitals of states in NE India; namely Imphal (Manipur), Shillong (Meghalaya) and Guwahati (Assam). A semi-structured questionnaire developed based on a multi-disciplinary approach was used for this study. It was observed that radiological practices undertaken in these facilities were not exactly in line with safety codes/standards in diagnostic radiology of the AERB and the IAEA. About 50% of the facilities had registered/licensed x-ray equipment with the AERB. More than 80% of the workers did not use radiation protective devices, although these devices were available in the facilities. About 85% of facilities had no institutional risk management system. About 70% of the facilities did not carry out periodic quality assurance testing of their x-ray equipment or surveys of radiation leakage around the x-ray room, and did not display radiation safety indicators in the x-ray rooms. Workers in these facilities exhibited low risk perception about the risks associated with these practices. The majority of diagnostic radiology facilities in NE India did not comply with the radiological safety codes/standards framed by the AERB and IAEA. The study found inadequate levels of radiological protection systems in the majority of facilities. This study suggests a need to establish firm measures that comply with the radiological safety codes/standards of the AERB and IAEA to protect patients, workers and the public of this region.

Societal and observational problems in earthquake risk assessments and their delivery to those most at risk

NASA Astrophysics Data System (ADS)

Bilham, Roger

2013-01-01

Losses from earthquakes continue to rise despite increasingly sophisticated methods to estimate seismic risk throughout the world. This article discusses five specific reasons why this should be. Loss of life is most pronounced in the developing nations where three factors - poverty, corruption and ignorance - conspire to reduce the effective application of seismic resistant codes. A fourth reason is that in many developing nations the application of seismic resistant construction is inadvertently restricted to wealthy, or civil segments of the community, and is either unobtainable or irrelevant to the most vulnerable segment of the public — the owner/occupiers of substandard dwellings. A fifth flaw in current seismic hazard studies is that sophisticated methodologies to evaluate risk are inappropriate in regions where strain rates are low, and where historical data are short compared to the return time of damaging earthquakes. The scientific community has remained largely unaware of the importance of these impediments to the development and application of appropriate seismic resistant code, and is ill-equipped to address them.

Preliminary risks associated with postulated tritium release from production reactor operation

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

O'Kula, K.R.; Horton, W.H.

1988-01-01

The Probabilistic Risk Assessment (PRA) of Savannah River Plant (SRP) reactor operation is assessing the off-site risk due to tritium releases during postulated full or partial loss of heavy water moderator accidents. Other sources of tritium in the reactor are less likely to contribute to off-site risk in non-fuel melting accident scenarios. Preliminary determination of the frequency of average partial moderator loss (including incidents with leaks as small as .5 kg) yields an estimate of /approximately/1 per reactor year. The full moderator loss frequency is conservatively chosen as 5 /times/ 10/sup /minus/3/ per reactor year. Conditional consequences, determined with amore » version of the MACCS code modified to handle tritium, are found to be insignificant. The 95th percentile individual cancer risk is 4 /times/ 10/sup /minus/8/ per reactor year within 16 km of the release point. The full moderator loss accident contributes about 75% of the evaluated risks. 13 refs., 4 figs., 5 tabs.« less

Radiological Risk Assessments for Occupational Exposure at Fuel Fabrication Facility in AlTuwaitha Site Baghdad – Iraq by using RESRAD Computer Code

NASA Astrophysics Data System (ADS)

Ibrahim, Ziadoon H.; Ibrahim, S. A.; Mohammed, M. K.; Shaban, A. H.

2018-05-01

The purpose of this study is to evaluate the radiological risks for workers for one year of their activities at Fuel Fabrication Facility (FFF) so as to make the necessary protection to prevent or minimize risks resulted from these activities this site now is under the Iraqi decommissioning program (40). Soil samples surface and subsurface were collected from different positions of this facility and analyzed by gamma rays spectroscopy technique High Purity Germanium detector (HPGe) was used. It was found out admixture of radioactive isotopes (232Th 40K 238U 235U137Cs) according to the laboratory results the highest values were (975758) for 238U (21203) for 235U (218) for 232Th (4046) for 40K and (129) for 137Cs in (Bqkg1) unit. The annual total radiation dose and risks were estimated by using RESRAD (onsite) 70 computer code. The highest total radiation dose was (5617μSv/year) in area that represented by soil sample (S7) and the radiological risks morbidity and mortality (118E02 8661E03) respectively in the same area

Applicability of drinking water treatment residue for lake restoration in relation to metal/metalloid risk assessment

PubMed Central

Yuan, Nannan; Wang, Changhui; Pei, Yuansheng; Jiang, Helong

2016-01-01

Drinking water treatment residue (DWTR), a byproduct generated during potable water production, exhibits a high potential for recycling to control eutrophication. However, this beneficial recycling is hampered by unclear metal/metalloid pollution risks related to DWTR. In this study, the pollution risks of Al, As, Ba, Be, Cd, Co, Cr, Cu, Fe, Mn, Mo, Ni, Pb, and Zn due to DWTR application were first evaluated for lake water based on human health risk assessment models and comparison of regulatory standards. The risks of DWTR were also evaluated for sediments on the basis of toxicity characteristics leaching procedure and fractionation in relation to risk assessment code. Variations in the biological behaviors of metal/metalloid in sediments caused by DWTR were assessed using Chironomus plumosus larvae and Hydrilla verticillata. Kinetic luminescent bacteria test (using Aliivibrio fischeri) was conducted to analyze the possibility of acute and chronic detrimental effects of sediment with DWTR application. According to the obtained results, we identify a potential undesirable effect of DWTR related to Fe and Mn (typically under anaerobic conditions); roughly present a dosage threshold calculation model; and recommend a procedure for DWTR prescreening to ensure safe application. Overall, managed DWTR application is necessary for successful eutrophication control. PMID:27929083

Applicability of drinking water treatment residue for lake restoration in relation to metal/metalloid risk assessment

NASA Astrophysics Data System (ADS)

Yuan, Nannan; Wang, Changhui; Pei, Yuansheng; Jiang, Helong

2016-12-01

Drinking water treatment residue (DWTR), a byproduct generated during potable water production, exhibits a high potential for recycling to control eutrophication. However, this beneficial recycling is hampered by unclear metal/metalloid pollution risks related to DWTR. In this study, the pollution risks of Al, As, Ba, Be, Cd, Co, Cr, Cu, Fe, Mn, Mo, Ni, Pb, and Zn due to DWTR application were first evaluated for lake water based on human health risk assessment models and comparison of regulatory standards. The risks of DWTR were also evaluated for sediments on the basis of toxicity characteristics leaching procedure and fractionation in relation to risk assessment code. Variations in the biological behaviors of metal/metalloid in sediments caused by DWTR were assessed using Chironomus plumosus larvae and Hydrilla verticillata. Kinetic luminescent bacteria test (using Aliivibrio fischeri) was conducted to analyze the possibility of acute and chronic detrimental effects of sediment with DWTR application. According to the obtained results, we identify a potential undesirable effect of DWTR related to Fe and Mn (typically under anaerobic conditions); roughly present a dosage threshold calculation model; and recommend a procedure for DWTR prescreening to ensure safe application. Overall, managed DWTR application is necessary for successful eutrophication control.

Including Health in Environmental Assessments of Major Transport Infrastructure Projects: A Documentary Analysis

PubMed Central

Riley, Emily; Harris, Patrick; Kent, Jennifer; Sainsbury, Peter; Lane, Anna; Baum, Fran

2018-01-01

Background: Transport policy and practice impacts health. Environmental Impact Assessments (EIAs) are regulated public policy mechanisms that can be used to consider the health impacts of major transport projects before they are approved. The way health is considered in these environmental assessments (EAs) is not well known. This research asked: How and to what extent was human health considered in EAs of four major transport projects in Australia. Methods: We developed a comprehensive coding framework to analyse the Environmental Impact Statements (EISs) of four transport infrastructure projects: three road and one light rail. The coding framework was designed to capture how health was directly and indirectly included. Results: We found that health was partially considered in all four EISs. In the three New South Wales (NSW) projects, but not the one South Australian project, this was influenced by the requirements issued to proponents by the government which directed the content of the EIS. Health was assessed using human health risk assessment (HHRA). We found this to be narrow in focus and revealed a need for a broader social determinants of health approach, using multiple methods. The road assessments emphasised air quality and noise risks, concluding these were minimal or predicted to improve. The South Australian project was the only road project not to include health data explicitly. The light rail EIS considered the health benefits of the project whereas the others focused on risk. Only one project considered mental health, although in less detail than air quality or noise. Conclusion: Our findings suggest EIAs lag behind the known evidence linking transport infrastructure to health. If health is to be comprehensively included, a more complete model of health is required, as well as a shift away from health risk assessment as the main method used. This needs to be mandatory for all significant developments. We also found that considering health only at the EIA stage may be a significant limitation, and there is a need for health issues to be considered when earlier, fundamental decisions about the project are being made. PMID:29524938

Heavy metal contamination and risk assessment in water, paddy soil, and rice around an electroplating plant.

PubMed

Liu, Jie; Zhang, Xue-Hong; Tran, Henry; Wang, Dun-Qiu; Zhu, Yi-Nian

2011-11-01

The objective of this paper is to assess the impact of long-term electroplating industrial activities on heavy metal contamination in agricultural soils and potential health risks for local residents. Water, soil, and rice samples were collected from sites upstream (control) and downstream of the electroplating wastewater outlet. The concentrations of heavy metals were determined by an atomic absorption spectrophotometer. Fractionation and risk assessment code (RAC) were used to evaluate the environmental risks of heavy metals in soils. The health risk index (HRI) and hazard index (HI) were calculated to assess potential health risks to local populations through rice consumption. Hazardous levels of Cu, Cr, and Ni were observed in water and paddy soils at sites near the plant. According to the RAC analysis, the soils showed a high risk for Ni and a medium risk for Cu and Cr at certain sites. The rice samples were primarily contaminated with Ni, followed by Cr and Cu. HRI values >1 were not found for any heavy metal. However, HI values for adults and children were 2.075 and 1.808, respectively. Water, paddy soil, and rice from the studied area have been contaminated by Cu, Cr, and Ni. The contamination of these elements is related to the electroplating wastewater. Although no single metal poses health risks for local residents through rice consumption, the combination of several metals may threaten the health of local residents. Cu and Ni are the key components contributing to the potential health risks.

Thinking through cancer risk: characterizing smokers' process of risk determination.

PubMed

Hay, Jennifer; Shuk, Elyse; Cruz, Gustavo; Ostroff, Jamie

2005-10-01

The perception of cancer risk motivates cancer risk reduction behaviors. However, common measurement strategies for cancer risk perceptions, which involve numerical likelihood estimates, do not adequately capture individuals' thoughts and feelings about cancer risk. To guide the development of novel measurement strategies, the authors used semistructured interviews to examine the thought processes used by smokers (N = 15) as they considered their cancer risk. They used grounded theory to guide systematic data coding and develop a heuristic model describing smokers' risk perception process that includes a cognitive, primarily rational process whereby salient personal risk factors for cancer are considered and combined, and an affective/attitudinal process, which shifts risk perceptions either up or down. The model provides a tentative explanation concerning how people hold cancer risk perceptions that diverge from rational assessment of their risks and will be useful in guiding the development of non-numerical measurements strategies for cancer risk perceptions.

Analyzing simulation-based PRA data through traditional and topological clustering: A BWR station blackout case study

DOE PAGES

Maljovec, D.; Liu, S.; Wang, B.; ...

2015-07-14

Here, dynamic probabilistic risk assessment (DPRA) methodologies couple system simulator codes (e.g., RELAP and MELCOR) with simulation controller codes (e.g., RAVEN and ADAPT). Whereas system simulator codes model system dynamics deterministically, simulation controller codes introduce both deterministic (e.g., system control logic and operating procedures) and stochastic (e.g., component failures and parameter uncertainties) elements into the simulation. Typically, a DPRA is performed by sampling values of a set of parameters and simulating the system behavior for that specific set of parameter values. For complex systems, a major challenge in using DPRA methodologies is to analyze the large number of scenarios generated,more » where clustering techniques are typically employed to better organize and interpret the data. In this paper, we focus on the analysis of two nuclear simulation datasets that are part of the risk-informed safety margin characterization (RISMC) boiling water reactor (BWR) station blackout (SBO) case study. We provide the domain experts a software tool that encodes traditional and topological clustering techniques within an interactive analysis and visualization environment, for understanding the structures of such high-dimensional nuclear simulation datasets. We demonstrate through our case study that both types of clustering techniques complement each other for enhanced structural understanding of the data.« less

Ovarian Cancer Incidence Corrected for Oophorectomy

PubMed Central

Baldwin, Lauren A.; Chen, Quan; Tucker, Thomas C.; White, Connie G.; Ore, Robert N.; Huang, Bin

2017-01-01

Current reported incidence rates for ovarian cancer may significantly underestimate the true rate because of the inclusion of women in the calculations who are not at risk for ovarian cancer due to prior benign salpingo-oophorectomy (SO). We have considered prior SO to more realistically estimate risk for ovarian cancer. Kentucky Health Claims Data, International Classification of Disease 9 (ICD-9) codes, Current Procedure Terminology (CPT) codes, and Kentucky Behavioral Risk Factor Surveillance System (BRFSS) Data were used to identify women who have undergone SO in Kentucky, and these women were removed from the at-risk pool in order to re-assess incidence rates to more accurately represent ovarian cancer risk. The protective effect of SO on the population was determined on an annual basis for ages 5–80+ using data from the years 2009–2013. The corrected age-adjusted rates of ovarian cancer that considered SO ranged from 33% to 67% higher than age-adjusted rates from the standard population. Correction of incidence rates for ovarian cancer by accounting for women with prior SO gives a better understanding of risk for this disease faced by women. The rates of ovarian cancer were substantially higher when SO was taken into consideration than estimates from the standard population. PMID:28368298

Relativity Screens for Misvalued Medical Services: Impact on Noninvasive Diagnostic Radiology.

PubMed

Rosenkrantz, Andrew B; Silva, Ezequiel; Hawkins, C Matthew

2017-11-01

In 2006, the AMA/Specialty Society Relative Value Scale Update Committee (RUC) introduced ongoing relativity screens to identify potentially misvalued medical services for payment adjustments. We assess the impact of these screens upon the valuation of noninvasive diagnostic radiology services. Data regarding relativity screens and relative value unit (RVU) changes were obtained from the 2016 AMA Relativity Assessment Status Report. All global codes in the 2016 Medicare Physician Fee Schedule with associated work RVUs were classified as noninvasive diagnostic radiology services versus remaining services. The frequency of having ever undergone a screen was compared between the two groups. Screened radiology codes were further evaluated regarding the RVU impact of subsequent revaluation. Of noninvasive diagnostic radiology codes, 46.0% (201 of 437) were screened versus 22.2% (1,460 of 6,575) of remaining codes (P < .001). Most common screens for which radiology codes were identified as potentially misvalued were (1) high expenditures (27.5%) and (2) high utilization (25.6%). The modality and body region most likely to be identified in a screen were CT (82.1%) and breast (90.9%), respectively. Among screened radiology codes, work RVUs, practice expense RVUs, and nonfacility total RVUs decreased in 20.3%, 65.9%, and 75.3%, respectively. All screened CT, MRI, brain, and spine codes exhibited decreased total RVUs. Policymakers' ongoing search for potentially misvalued medical services has disproportionately impacted noninvasive diagnostic radiology services, risking the introduction of unintended or artificial shifts in physician practice. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Reliability of routinely collected hospital data for child maltreatment surveillance.

PubMed

McKenzie, Kirsten; Scott, Debbie A; Waller, Garry S; Campbell, Margaret

2011-01-05

Internationally, research on child maltreatment-related injuries has been hampered by a lack of available routinely collected health data to identify cases, examine causes, identify risk factors and explore health outcomes. Routinely collected hospital separation data coded using the International Classification of Diseases and Related Health Problems (ICD) system provide an internationally standardised data source for classifying and aggregating diseases, injuries, causes of injuries and related health conditions for statistical purposes. However, there has been limited research to examine the reliability of these data for child maltreatment surveillance purposes. This study examined the reliability of coding of child maltreatment in Queensland, Australia. A retrospective medical record review and recoding methodology was used to assess the reliability of coding of child maltreatment. A stratified sample of hospitals across Queensland was selected for this study, and a stratified random sample of cases was selected from within those hospitals. In 3.6% of cases the coders disagreed on whether any maltreatment code could be assigned (definite or possible) versus no maltreatment being assigned (unintentional injury), giving a sensitivity of 0.982 and specificity of 0.948. The review of these cases where discrepancies existed revealed that all cases had some indications of risk documented in the records. 15.5% of cases originally assigned a definite or possible maltreatment code, were recoded to a more or less definite strata. In terms of the number and type of maltreatment codes assigned, the auditor assigned a greater number of maltreatment types based on the medical documentation than the original coder assigned (22% of the auditor coded cases had more than one maltreatment type assigned compared to only 6% of the original coded data). The maltreatment types which were the most 'under-coded' by the original coder were psychological abuse and neglect. Cases coded with a sexual abuse code showed the highest level of reliability. Given the increasing international attention being given to improving the uniformity of reporting of child-maltreatment related injuries and the emphasis on the better utilisation of routinely collected health data, this study provides an estimate of the reliability of maltreatment-specific ICD-10-AM codes assigned in an inpatient setting.

Reliability of Routinely Collected Hospital Data for Child Maltreatment Surveillance

PubMed Central

2011-01-01

Background Internationally, research on child maltreatment-related injuries has been hampered by a lack of available routinely collected health data to identify cases, examine causes, identify risk factors and explore health outcomes. Routinely collected hospital separation data coded using the International Classification of Diseases and Related Health Problems (ICD) system provide an internationally standardised data source for classifying and aggregating diseases, injuries, causes of injuries and related health conditions for statistical purposes. However, there has been limited research to examine the reliability of these data for child maltreatment surveillance purposes. This study examined the reliability of coding of child maltreatment in Queensland, Australia. Methods A retrospective medical record review and recoding methodology was used to assess the reliability of coding of child maltreatment. A stratified sample of hospitals across Queensland was selected for this study, and a stratified random sample of cases was selected from within those hospitals. Results In 3.6% of cases the coders disagreed on whether any maltreatment code could be assigned (definite or possible) versus no maltreatment being assigned (unintentional injury), giving a sensitivity of 0.982 and specificity of 0.948. The review of these cases where discrepancies existed revealed that all cases had some indications of risk documented in the records. 15.5% of cases originally assigned a definite or possible maltreatment code, were recoded to a more or less definite strata. In terms of the number and type of maltreatment codes assigned, the auditor assigned a greater number of maltreatment types based on the medical documentation than the original coder assigned (22% of the auditor coded cases had more than one maltreatment type assigned compared to only 6% of the original coded data). The maltreatment types which were the most 'under-coded' by the original coder were psychological abuse and neglect. Cases coded with a sexual abuse code showed the highest level of reliability. Conclusion Given the increasing international attention being given to improving the uniformity of reporting of child-maltreatment related injuries and the emphasis on the better utilisation of routinely collected health data, this study provides an estimate of the reliability of maltreatment-specific ICD-10-AM codes assigned in an inpatient setting. PMID:21208411

Flexible, secure agent development framework

DOEpatents

Goldsmith,; Steven, Y [Rochester, MN

2009-04-07

While an agent generator is generating an intelligent agent, it can also evaluate the data processing platform on which it is executing, in order to assess a risk factor associated with operation of the agent generator on the data processing platform. The agent generator can retrieve from a location external to the data processing platform an open site that is configurable by the user, and load the open site into an agent substrate, thereby creating a development agent with code development capabilities. While an intelligent agent is executing a functional program on a data processing platform, it can also evaluate the data processing platform to assess a risk factor associated with performing the data processing function on the data processing platform.

Fractionation profile and mobility pattern of metals in sediments from the Mediterranean Coast, Libya.

PubMed

Nasr, Samir M; Okbah, Mohamed A; El Haddad, Huda S; Soliman, Naglaa F

2015-07-01

A five-step sequential extraction technique, following Tessier's protocol, has been applied to determine the chemical association of Cd, Cu, Fe, Pb, and Zn with major sedimentary phases (exchangeable, carbonate, manganese and iron oxides, organic and residual fraction) in surface sediments from 14 stations off the Libyan Mediterranean coast. This study is a first approach of chemical fractionation of these metals in one of the most economically important area of the Libyan coastline in Mediterranean Sea. The total metal content was also determined. The total concentration of metals ranged from 5-10.5 mg/kg for Cd, 9.1-22.7 mg/kg for Cu, 141.8-1056.8 mg/kg for Fe, 18.9-56.9 mg/kg for Pb, and 11.6-30.5 mg/kg for Zn. The results of the partitioning study showed that the residual form was the dominant fraction of the selected metals among most of the studied locations. The degree of surface sediment contamination was computed for risk assessment code (RAC), individual contamination factor (ICF), and Global contamination factor (GCF). Risk assessment code classification showed that the relative amounts of easily dissolved phase of trace metals in the sediments are in the order of Pb>Zn>Cd>Cu>Fe. The results of ICF and GCF showed that Sirt and Abu Kammashand had higher GCF than other sites indicating higher environmental risk. In terms of ICF value, a decrease order in environmental risk by trace metals was Pb>Zn>Cu>Cd>Fe. Therefore, Pb had highest risk to water body.

Overview of Graphical User Interface for ARRBOD (Acute Radiation Risk and BRYNTRN Organ Dose Projection)

NASA Technical Reports Server (NTRS)

Kim, Myung-Hee Y.; Hu, Shaowen; Nounu, Hatem N.; Cucinotta, Francis A.

2010-01-01

Solar particle events (SPEs) pose the risk of acute radiation sickness (ARS) to astronauts, because organ doses from large SPEs may reach critical levels during extra vehicular activities (EVAs) or lightly shielded spacecraft. NASA has developed an organ dose projection model of Baryon transport code (BRYNTRN) with an output data processing module of SUMDOSE, and a probabilistic model of acute radiation risk (ARR). BRYNTRN code operation requires extensive input preparation, and the risk projection models of organ doses and ARR take the output from BRYNTRN as an input to their calculations. With a graphical user interface (GUI) to handle input and output for BRYNTRN, these response models can be connected easily and correctly to BRYNTRN in a user friendly way. The GUI for the Acute Radiation Risk and BRYNTRN Organ Dose (ARRBOD) projection code provides seamless integration of input and output manipulations required for operations of the ARRBOD modules: BRYNTRN, SUMDOSE, and the ARR probabilistic response model. The ARRBOD GUI is intended for mission planners, radiation shield designers, space operations in the mission operations directorate (MOD), and space biophysics researchers. Assessment of astronauts organ doses and ARS from the exposure to historically large SPEs is in support of mission design and operation planning to avoid ARS and stay within the current NASA short-term dose limits. The ARRBOD GUI will serve as a proof-of-concept for future integration of other risk projection models for human space applications. We present an overview of the ARRBOD GUI product, which is a new self-contained product, for the major components of the overall system, subsystem interconnections, and external interfaces.

Stereotyped Motor Behaviors Associated with Autism in High-Risk Infants: A Pilot Videotape Analysis of a Sibling Sample

ERIC Educational Resources Information Center

Loh, Alvin; Soman, Teesta; Brian, Jessica; Bryson, Susan E.; Roberts, Wendy; Szatmari, Peter; Smith, Isabel M.; Zwaigenbaum, Lonnie

2007-01-01

This study examined motor behaviors in a longitudinal cohort of infant siblings of children with autism. Stereotypic movements and postures occurring during standardized observational assessments at 12 and 18 months were coded from videotapes. Participants included eight infant siblings later diagnosed with autism spectrum disorder (ASD), a random…

78 FR 1196 - Codex Alimentarius Commission: Meeting of the Ad Hoc Codex Intergovernmental Task Force on Animal...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-08

... related to the 7th Session of the AFTF will be accessible via the World Wide Web at the following address... World Health Organization (WHO). Through adoption of food standards, codes of practice, and other... animals. The guidelines should include specific science-based risk assessment criteria to apply to feed...

Physical basis of radiation protection in space travel

NASA Astrophysics Data System (ADS)

Durante, Marco; Cucinotta, Francis A.

2011-10-01

The health risks of space radiation are arguably the most serious challenge to space exploration, possibly preventing these missions due to safety concerns or increasing their costs to amounts beyond what would be acceptable. Radiation in space is substantially different from Earth: high-energy (E) and charge (Z) particles (HZE) provide the main contribution to the equivalent dose in deep space, whereas γ rays and low-energy α particles are major contributors on Earth. This difference causes a high uncertainty on the estimated radiation health risk (including cancer and noncancer effects), and makes protection extremely difficult. In fact, shielding is very difficult in space: the very high energy of the cosmic rays and the severe mass constraints in spaceflight represent a serious hindrance to effective shielding. Here the physical basis of space radiation protection is described, including the most recent achievements in space radiation transport codes and shielding approaches. Although deterministic and Monte Carlo transport codes can now describe well the interaction of cosmic rays with matter, more accurate double-differential nuclear cross sections are needed to improve the codes. Energy deposition in biological molecules and related effects should also be developed to achieve accurate risk models for long-term exploratory missions. Passive shielding can be effective for solar particle events; however, it is limited for galactic cosmic rays (GCR). Active shielding would have to overcome challenging technical hurdles to protect against GCR. Thus, improved risk assessment and genetic and biomedical approaches are a more likely solution to GCR radiation protection issues.

Automation of a high risk medication regime algorithm in a home health care population.

PubMed

Olson, Catherine H; Dierich, Mary; Westra, Bonnie L

2014-10-01

Create an automated algorithm for predicting elderly patients' medication-related risks for readmission and validate it by comparing results with a manual analysis of the same patient population. Outcome and Assessment Information Set (OASIS) and medication data were reused from a previous, manual study of 911 patients from 15 Medicare-certified home health care agencies. The medication data was converted into standardized drug codes using APIs managed by the National Library of Medicine (NLM), and then integrated in an automated algorithm that calculates patients' high risk medication regime scores (HRMRs). A comparison of the results between algorithm and manual process was conducted to determine how frequently the HRMR scores were derived which are predictive of readmission. HRMR scores are composed of polypharmacy (number of drugs), Potentially Inappropriate Medications (PIM) (drugs risky to the elderly), and Medication Regimen Complexity Index (MRCI) (complex dose forms, instructions or administration). The algorithm produced polypharmacy, PIM, and MRCI scores that matched with 99%, 87% and 99% of the scores, respectively, from the manual analysis. Imperfect match rates resulted from discrepancies in how drugs were classified and coded by the manual analysis vs. the automated algorithm. HRMR rules lack clarity, resulting in clinical judgments for manual coding that were difficult to replicate in the automated analysis. The high comparison rates for the three measures suggest that an automated clinical tool could use patients' medication records to predict their risks of avoidable readmissions. Copyright © 2014 Elsevier Inc. All rights reserved.

Calculation of out-of-field dose distribution in carbon-ion radiotherapy by Monte Carlo simulation.

PubMed

Yonai, Shunsuke; Matsufuji, Naruhiro; Namba, Masao

2012-08-01

Recent radiotherapy technologies including carbon-ion radiotherapy can improve the dose concentration in the target volume, thereby not only reducing side effects in organs at risk but also the secondary cancer risk within or near the irradiation field. However, secondary cancer risk in the low-dose region is considered to be non-negligible, especially for younger patients. To achieve a dose estimation of the whole body of each patient receiving carbon-ion radiotherapy, which is essential for risk assessment and epidemiological studies, Monte Carlo simulation plays an important role because the treatment planning system can provide dose distribution only in∕near the irradiation field and the measured data are limited. However, validation of Monte Carlo simulations is necessary. The primary purpose of this study was to establish a calculation method using the Monte Carlo code to estimate the dose and quality factor in the body and to validate the proposed method by comparison with experimental data. Furthermore, we show the distributions of dose equivalent in a phantom and identify the partial contribution of each radiation type. We proposed a calculation method based on a Monte Carlo simulation using the PHITS code to estimate absorbed dose, dose equivalent, and dose-averaged quality factor by using the Q(L)-L relationship based on the ICRP 60 recommendation. The values obtained by this method in modeling the passive beam line at the Heavy-Ion Medical Accelerator in Chiba were compared with our previously measured data. It was shown that our calculation model can estimate the measured value within a factor of 2, which included not only the uncertainty of this calculation method but also those regarding the assumptions of the geometrical modeling and the PHITS code. Also, we showed the differences in the doses and the partial contributions of each radiation type between passive and active carbon-ion beams using this calculation method. These results indicated that it is essentially important to include the dose by secondary neutrons in the assessment of the secondary cancer risk of patients receiving carbon-ion radiotherapy with active as well as passive beams. We established a calculation method with a Monte Carlo simulation to estimate the distribution of dose equivalent in the body as a first step toward routine risk assessment and an epidemiological study of carbon-ion radiotherapy at NIRS. This method has the advantage of being verifiable by the measurement.

Integrating risk assessment and life cycle assessment: a case study of insulation.

PubMed

Nishioka, Yurika; Levy, Jonathan I; Norris, Gregory A; Wilson, Andrew; Hofstetter, Patrick; Spengler, John D

2002-10-01

Increasing residential insulation can decrease energy consumption and provide public health benefits, given changes in emissions from fuel combustion, but also has cost implications and ancillary risks and benefits. Risk assessment or life cycle assessment can be used to calculate the net impacts and determine whether more stringent energy codes or other conservation policies would be warranted, but few analyses have combined the critical elements of both methodologies In this article, we present the first portion of a combined analysis, with the goal of estimating the net public health impacts of increasing residential insulation for new housing from current practice to the latest International Energy Conservation Code (IECC 2000). We model state-by-state residential energy savings and evaluate particulate matter less than 2.5 microm in diameter (PM2.5), NOx, and SO2 emission reductions. We use past dispersion modeling results to estimate reductions in exposure, and we apply concentration-response functions for premature mortality and selected morbidity outcomes using current epidemiological knowledge of effects of PM2.5 (primary and secondary). We find that an insulation policy shift would save 3 x 10(14) British thermal units or BTU (3 x 10(17) J) over a 10-year period, resulting in reduced emissions of 1,000 tons of PM2.5, 30,000 tons of NOx, and 40,000 tons of SO2. These emission reductions yield an estimated 60 fewer fatalities during this period, with the geographic distribution of health benefits differing from the distribution of energy savings because of differences in energy sources, population patterns, and meteorology. We discuss the methodology to be used to integrate life cycle calculations, which can ultimately yield estimates that can be compared with costs to determine the influence of external costs on benefit-cost calculations.

Addressing medical coding and billing part II: a strategy for achieving compliance. A risk management approach for reducing coding and billing errors.

PubMed Central

Adams, Diane L.; Norman, Helen; Burroughs, Valentine J.

2002-01-01

Medical practice today, more than ever before, places greater demands on physicians to see more patients, provide more complex medical services and adhere to stricter regulatory rules, leaving little time for coding and billing. Yet, the need to adequately document medical records, appropriately apply billing codes and accurately charge insurers for medical services is essential to the medical practice's financial condition. Many physicians rely on office staff and billing companies to process their medical bills without ever reviewing the bills before they are submitted for payment. Some physicians may not be receiving the payment they deserve when they do not sufficiently oversee the medical practice's coding and billing patterns. This article emphasizes the importance of monitoring and auditing medical record documentation and coding application as a strategy for achieving compliance and reducing billing errors. When medical bills are submitted with missing and incorrect information, they may result in unpaid claims and loss of revenue to physicians. Addressing Medical Audits, Part I--A Strategy for Achieving Compliance--CMS, JCAHO, NCQA, published January 2002 in the Journal of the National Medical Association, stressed the importance of preparing the medical practice for audits. The article highlighted steps the medical practice can take to prepare for audits and presented examples of guidelines used by regulatory agencies to conduct both medical and financial audits. The Medicare Integrity Program was cited as an example of guidelines used by regulators to identify coding errors during an audit and deny payment to providers when improper billing occurs. For each denied claim, payments owed to the medical practice are are also denied. Health care is, no doubt, a costly endeavor for health care providers, consumers and insurers. The potential risk to physicians for improper billing may include loss of revenue, fraud investigations, financial sanction, disciplinary action and exclusion from participation in government programs. Part II of this article recommends an approach for assessing potential risk, preventing improper billing, and improving financial management of the medical practice. Images p432-a PMID:12078924

ACSNSQIP Risk Calculator in Indian Patients Undergoing Surgery for Head and Neck Cancers: Is It Valid?

PubMed

Subramaniam, Narayana; Balasubramanian, Deepak; Rka, Pradeep; Murthy, Samskruthi; Rathod, Priyank; Vidhyadharan, Sivakumar; Thankappan, Krishnakumar; Iyer, Subramania

2018-06-01

Pre-operative assessment is vital to determine patient-specific risks and minimize them in order to optimize surgical outcomes. The American College of Surgeons National Surgical Quality Improvement Program (ACSNSQIP) Surgical Risk Calculator is the most comprehensive surgical risk assessment tool available. We performed this study to determine the validity of ACSNSQIP calculator when used to predict surgical complications in a cohort of patients with head and neck cancer treated in an Indian tertiary care center. Retrospective data was collected for 150 patients with head and neck cancer who were operated in the Department of Head and Neck Oncology, Amrita Institute of Medical Sciences, Kochi, in the year 2016. The predicted outcome data was compared with actual documented outcome data for the variables mentioned. Brier's score was used to estimate the predictive value of the risk assessment generated. Pearson's r coefficient was utilized to validate the prediction of length of hospital stay. Brier's score for the entire calculator was 0.32 (not significant). Additionally, when the score was determined for individual parameters (surgical site infection, pneumonia, etc.), none were significant. Pearson's r value for length of stay was also not significant ( p  = .632). The ACSNSQIP risk assessment tool did not accurately reflect surgical outcomes in our cohort of Indian patients. Although it is the most comprehensive tool available at present, modifications that may improve accuracy are allowing for input of multiple procedure codes, risk stratifying for previous radiation or surgery, and better risk assessment for microvascular flap reconstruction.

Use of Medicare claims to rank hospitals by surgical site infection risk following coronary artery bypass graft surgery.

PubMed

Huang, Susan S; Placzek, Hilary; Livingston, James; Ma, Allen; Onufrak, Fallon; Lankiewicz, Julie; Kleinman, Ken; Bratzler, Dale; Olsen, Margaret A; Lyles, Rosie; Khan, Yosef; Wright, Paula; Yokoe, Deborah S; Fraser, Victoria J; Weinstein, Robert A; Stevenson, Kurt; Hooper, David; Vostok, Johanna; Datta, Rupak; Nsa, Wato; Platt, Richard

2011-08-01

To evaluate whether longitudinal insurer claims data allow reliable identification of elevated hospital surgical site infection (SSI) rates. We conducted a retrospective cohort study of Medicare beneficiaries who underwent coronary artery bypass grafting (CABG) in US hospitals performing at least 80 procedures in 2005. Hospitals were assigned to deciles by using case mix-adjusted probabilities of having an SSI-related inpatient or outpatient claim code within 60 days of surgery. We then reviewed medical records of randomly selected patients to assess whether chart-confirmed SSI risk was higher in hospitals in the worst deciles compared with the best deciles. Fee-for-service Medicare beneficiaries who underwent CABG in these hospitals in 2005. We evaluated 114,673 patients who underwent CABG in 671 hospitals. In the best decile, 7.8% (958/12,307) of patients had an SSI-related code, compared with 24.8% (2,747/11,068) in the worst decile ([Formula: see text]). Medical record review confirmed SSI in 40% (388/980) of those with SSI-related codes. In the best decile, the chart-confirmed annual SSI rate was 3.2%, compared with 9.4% in the worst decile, with an adjusted odds ratio of SSI of 2.7 (confidence interval, 2.2-3.3; [Formula: see text]) for CABG performed in a worst-decile hospital compared with a best-decile hospital. Claims data can identify groups of hospitals with unusually high or low post-CABG SSI rates. Assessment of claims is more reproducible and efficient than current surveillance methods. This example of secondary use of routinely recorded electronic health information to assess quality of care can identify hospitals that may benefit from prevention programs.

Hypertension is Associated With Increased Mortality in Children Hospitalized With Arterial Ischemic Stroke.

PubMed

Adil, Malik M; Beslow, Lauren A; Qureshi, Adnan I; Malik, Ahmed A; Jordan, Lori C

2016-03-01

Recently a single-center study suggested that hypertension after stroke in children was a risk factor for mortality. Our goal was to assess the association between hypertension and outcome after arterial ischemic stroke in children from a large national sample. Using the Healthcare Cost and Utilization Project Kids' Inpatient Database, children (1-18 years) with a primary diagnosis of ischemic stroke (International Classification of Diseases, Ninth Revision [ICD-9] codes 433-437.1) who also had a diagnosis of elevated blood pressure (ICD-9 code 796.2) or hypertension (ICD-9 codes 401 and 405) from 2003, 2006, and 2009 were identified. Clinical characteristics, discharge outcomes, and length of stay were assessed. Multivariable logistic regression was used to assess the relationship between hypertension and in-hospital mortality or discharge outcomes. Of 2590 children admitted with arterial ischemic stroke, 156 (6%) also had a diagnosis of hypertension. Ten percent of children with hypertension also had renal failure. Among patients with arterial ischemic stroke, hypertension was associated with increased mortality (7.4% vs. 2.8%; P = 0.01) and increased length of stay (mean 11 ± 17 vs. 7 ± 12 days; P = 0.004) compared with those without hypertension. After adjusting for age, sex, intubation, presence of a fluid and electrolyte disorder, and renal failure, children with hypertension had an increased odds of in-hospital death (odds ratio 1.2, 95% confidence interval [1.1-3.3, P = 0.04]). Hypertension was associated with an increased risk of in-hospital death for children presenting with arterial ischemic stroke. Further prospective study of blood pressure in children with stroke is needed. Copyright © 2016 Elsevier Inc. All rights reserved.

Historical cancer incidence and mortality assessment in an Illinois community proximal to a former manufactured gas plant

PubMed Central

Alexander, Dominik D; Jiang, Xiaohui; Bylsma, Lauren C; Garabrant, David H; Irvin, Sarah R; Fryzek, Jon P

2014-01-01

Objectives Concern has been raised that the occurrence of cancer may be increased in neighbourhoods around a former manufactured gas plant in Champaign, Illinois, USA. Thus, we compared historical rates of cancer in this area to comparison communities as well as with nationally standardised rates. Design Retrospective population-based community cancer assessment during 1990–2010. Setting Champaign County, Illinois, USA, and zip codes encompassing the location of the former manufactured gas plant to counties that were similar demographically. Participants Residents of the counties and zip codes studied between 1990 and 2010. Main outcome measures The relative risk (RR) and 95% CI were used to compare cancer incidence and mortality in the areas near the gas compression site to the comparison counties. Standardised incidence ratios (SIRs) were calculated to compare rates in the areas near the gas compression site to expected rates based on overall US cancer rates. Results Total cancer mortality (RR=0.91, 95% CI 0.88 to 0.94) and incidence (RR=0.95, 95% CI 0.94 to 0.97) were reduced significantly in Champaign County versus the comparison counties. Similarly, a reduced rate of total cancer was observed in analyses by zip code (proximal to the former gas plant) when compared with either similar counties (RR=0.89, 95% CI 0.86 to 0.93) or national standardised rates of cancer (SIR=0.88, 95% CI 0.85 to 0.91). Conclusions This historical cancer assessment did not find an increased risk of total cancer or specific cancer types in communities near a former manufactured gas plant site. PMID:25534215

Hydrogen quantitative risk assessment workshop proceedings.

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

Groth, Katrina M.; Harris, Aaron P.

2013-09-01

The Quantitative Risk Assessment (QRA) Toolkit Introduction Workshop was held at Energetics on June 11-12. The workshop was co-hosted by Sandia National Laboratories (Sandia) and HySafe, the International Association for Hydrogen Safety. The objective of the workshop was twofold: (1) Present a hydrogen-specific methodology and toolkit (currently under development) for conducting QRA to support the development of codes and standards and safety assessments of hydrogen-fueled vehicles and fueling stations, and (2) Obtain feedback on the needs of early-stage users (hydrogen as well as potential leveraging for Compressed Natural Gas [CNG], and Liquefied Natural Gas [LNG]) and set priorities for %E2%80%9CVersionmore » 1%E2%80%9D of the toolkit in the context of the commercial evolution of hydrogen fuel cell electric vehicles (FCEV). The workshop consisted of an introduction and three technical sessions: Risk Informed Development and Approach; CNG/LNG Applications; and Introduction of a Hydrogen Specific QRA Toolkit.« less

Novel Threat-risk Index Using Probabilistic Risk Assessment and Human Reliability Analysis - Final Report

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

George A. Beitel

2004-02-01

In support of a national need to improve the current state-of-the-art in alerting decision makers to the risk of terrorist attack, a quantitative approach employing scientific and engineering concepts to develop a threat-risk index was undertaken at the Idaho National Engineering and Environmental Laboratory (INEEL). As a result of this effort, a set of models has been successfully integrated into a single comprehensive model known as Quantitative Threat-Risk Index Model (QTRIM), with the capability of computing a quantitative threat-risk index on a system level, as well as for the major components of the system. Such a threat-risk index could providemore » a quantitative variant or basis for either prioritizing security upgrades or updating the current qualitative national color-coded terrorist threat alert.« less

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

A. Alfonsi; C. Rabiti; D. Mandelli

The Reactor Analysis and Virtual control ENviroment (RAVEN) code is a software tool that acts as the control logic driver and post-processing engine for the newly developed Thermal-Hydraulic code RELAP-7. RAVEN is now a multi-purpose Probabilistic Risk Assessment (PRA) software framework that allows dispatching different functionalities: Derive and actuate the control logic required to simulate the plant control system and operator actions (guided procedures), allowing on-line monitoring/controlling in the Phase Space Perform both Monte-Carlo sampling of random distributed events and Dynamic Event Tree based analysis Facilitate the input/output handling through a Graphical User Interface (GUI) and a post-processing data miningmore » module« less

Effect of pyrolysis temperature on chemical form, behavior and environmental risk of Zn, Pb and Cd in biochar produced from phytoremediation residue.

PubMed

Huang, Hui; Yao, Wenlin; Li, Ronghua; Ali, Amjad; Du, Juan; Guo, Di; Xiao, Ran; Guo, Zhanyu; Zhang, Zengqiang; Awasthi, Mukesh Kumar

2018-02-01

This study aimed to evaluate the chemical forms, behavior and environmental risk of heavy metal (HMs) Zn, Pb and Cd in phytoremediation residue (PMR) pyrolyzed at 350 °C, 550 °C and 750 °C, respectively. The behavior of HMs variation during the PMR pyrolysis process was analyzed and the potential HMs environmental risk of phytoremediation residue biochars (PMB) was assessed which was seldom investigated before. The results showed that the pyrolysis temperature increase decreased the soluble/exchangeable HMs fraction and alleviated the HMs bioavailability. When the temperature was over 550 °C, the adsorbed Zn(II), Pb(II) and Cd(II) were turned into oxides forms and concentrated in PMB with more stable forms exhibiting lower risk assessment code and potential ecological risk index. The ecotoxicity test showed higher pyrolysis temperature favored the reduction of PMB ecotoxicity. It is suggested that pyrolysis temperature above 550°C may be suitable for thermal treatment of PMR with acceptable environmental risk. Copyright © 2017 Elsevier Ltd. All rights reserved.

Influence of sewage sludge-based activated carbon and temperature on the liquefaction of sewage sludge: yield and composition of bio-oil, immobilization and risk assessment of heavy metals.

PubMed

Zhai, Yunbo; Chen, Hongmei; Xu, Bibo; Xiang, Bobin; Chen, Zhong; Li, Caiting; Zeng, Guangming

2014-05-01

The influence of sewage sludge-based activated carbons (SSAC) on sewage sludge liquefaction has been carried out at 350 and 400°C. SSAC increased the yield and energy density of bio-oil at 350°C. The metallic compounds were the catalytic factor of SSAC obtained at 550°C (SSAC-550), while carbon was the catalytic factor of SSAC obtained at 650°C. Liquefaction with SSAC redistributed the species of heavy metals in solid residue (SR). With the addition of SSAC, the risk of Cu, Zn and Pb decreased at 350°C, while at 400°C the risk of Cd, Cu, and Zn were decreased. Ecological risk index indicated that 400°C was preferable for the toxicity decrement of SR, while risk assessment code indicated that SR obtained at 350°C contained lower risk. Considering the bio-oil yield, liquefaction at 350°C with SSAC-550 was preferable. Copyright © 2014 Elsevier Ltd. All rights reserved.

Coding update of the SMFM definition of low risk for cesarean delivery from ICD-9-CM to ICD-10-CM.

PubMed

Armstrong, Joanne; McDermott, Patricia; Saade, George R; Srinivas, Sindhu K

2017-07-01

In 2015, the Society for Maternal-Fetal Medicine developed a low risk for cesarean delivery definition based on administrative claims-based diagnosis codes described by the International Classification of Diseases, Ninth Revision, Clinical Modification. The Society for Maternal-Fetal Medicine definition is a clinical enrichment of 2 available measures from the Joint Commission and the Agency for Healthcare Research and Quality measures. The Society for Maternal-Fetal Medicine measure excludes diagnosis codes that represent clinically relevant risk factors that are absolute or relative contraindications to vaginal birth while retaining diagnosis codes such as labor disorders that are discretionary risk factors for cesarean delivery. The introduction of the International Statistical Classification of Diseases, 10th Revision, Clinical Modification in October 2015 expanded the number of available diagnosis codes and enabled a greater depth and breadth of clinical description. These coding improvements further enhance the clinical validity of the Society for Maternal-Fetal Medicine definition and its potential utility in tracking progress toward the goal of safely lowering the US cesarean delivery rate. This report updates the Society for Maternal-Fetal Medicine definition of low risk for cesarean delivery using International Statistical Classification of Diseases, 10th Revision, Clinical Modification coding. Copyright © 2017. Published by Elsevier Inc.

The 9th international symposium on the packaging and transportation of radioactive materials

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

None

1989-06-01

This three-volume document contains the papers and poster sessions presented at the symposium. Volume 3 contains 87 papers on topics such as structural codes and benchmarking, shipment of plutonium by air, spent fuel shipping, planning, package design and risk assessment, package testing, OCRWN operations experience and regulations. Individual papers were processed separately for the data base. (TEM)

Teaching Ethical Decision Making Using Dual Relationship Principles as a Case Example

ERIC Educational Resources Information Center

Boland-Prom, Kim; Anderson, Sandra C.

2005-01-01

When the National Association of Social Workers (1999) ratified the Code of Ethics in 2000, it was an acknowledgement that dual relationships can be part of sound social work practice. The educational materials that are available to educators do not move sufficiently beyond a risk-reduction approach to dual relationships to an assessment of how a…

Protecting groundwater resources at biosolids recycling sites.

PubMed

McFarland, Michael J; Kumarasamy, Karthik; Brobst, Robert B; Hais, Alan; Schmitz, Mark D

2013-01-01

In developing the national biosolids recycling rule (Title 40 of the Code of Federal Regulation Part 503 or Part 503), the USEPA conducted deterministic risk assessments whose results indicated that the probability of groundwater impairment associated with biosolids recycling was insignificant. Unfortunately, the computational capabilities available for performing risk assessments of pollutant fate and transport at that time were limited. Using recent advances in USEPA risk assessment methodology, the present study evaluates whether the current national biosolids pollutant limits remain protective of groundwater quality. To take advantage of new risk assessment approaches, a computer-based groundwater risk characterization screening tool (RCST) was developed using USEPA's Multimedia, Multi-pathway, Multi-receptor Exposure and Risk Assessment program. The RCST, which generates a noncarcinogenic human health risk estimate (i.e., hazard quotient [HQ] value), has the ability to conduct screening-level risk characterizations. The regulated heavy metals modeled in this study were As, Cd, Ni, Se, and Zn. Results from RCST application to biosolids recycling sites located in Yakima County, Washington, indicated that biosolids could be recycled at rates as high as 90 Mg ha, with no negative human health effects associated with groundwater consumption. Only under unrealistically high biosolids land application rates were public health risks characterized as significant (HQ ≥ 1.0). For example, by increasing the biosolids application rate and pollutant concentrations to 900 Mg ha and 10 times the regulatory limit, respectively, the HQ values varied from 1.4 (Zn) to 324.0 (Se). Since promulgation of Part 503, no verifiable cases of groundwater contamination by regulated biosolids pollutants have been reported. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

The 2014 United States National Seismic Hazard Model

USGS Publications Warehouse

Petersen, Mark D.; Moschetti, Morgan P.; Powers, Peter; Mueller, Charles; Haller, Kathleen; Frankel, Arthur; Zeng, Yuehua; Rezaeian, Sanaz; Harmsen, Stephen; Boyd, Oliver; Field, Edward; Chen, Rui; Rukstales, Kenneth S.; Luco, Nicolas; Wheeler, Russell; Williams, Robert; Olsen, Anna H.

2015-01-01

New seismic hazard maps have been developed for the conterminous United States using the latest data, models, and methods available for assessing earthquake hazard. The hazard models incorporate new information on earthquake rupture behavior observed in recent earthquakes; fault studies that use both geologic and geodetic strain rate data; earthquake catalogs through 2012 that include new assessments of locations and magnitudes; earthquake adaptive smoothing models that more fully account for the spatial clustering of earthquakes; and 22 ground motion models, some of which consider more than double the shaking data applied previously. Alternative input models account for larger earthquakes, more complicated ruptures, and more varied ground shaking estimates than assumed in earlier models. The ground motions, for levels applied in building codes, differ from the previous version by less than ±10% over 60% of the country, but can differ by ±50% in localized areas. The models are incorporated in insurance rates, risk assessments, and as input into the U.S. building code provisions for earthquake ground shaking.

Orbital Debris Research in the United States

NASA Technical Reports Server (NTRS)

Stansbery, Gene

2009-01-01

The presentation includes information about growth of the satellite population, the U.S. Space Surveillance Network, tracking and catalog maintenance, Haystack and HAX radar observation, Goldstone radar, the Michigan Orbital Debris Survey Telescope (MODEST), spacecraft surface examinations and sample of space shuttle impacts. GEO/LEO observations from Kwajalein Atoll, NASA s Orbital Debris Engineering Model (ORDEM2008), a LEO-to-GEO Environment Debris Model (LEGEND), Debris Assessment Software (DAS) 2.0, the NASA/JSC BUMPER-II meteoroid/debris threat assessment code, satellite reentry risk assessment, optical size and shape determination, work on more complicated fragments, and spectral studies.

Measuring coding intensity in the Medicare Advantage program.

PubMed

Kronick, Richard; Welch, W Pete

2014-01-01

In 2004, Medicare implemented a system of paying Medicare Advantage (MA) plans that gave them greater incentive than fee-for-service (FFS) providers to report diagnoses. Risk scores for all Medicare beneficiaries 2004-2013 and Medicare Current Beneficiary Survey (MCBS) data, 2006-2011. Change in average risk score for all enrollees and for stayers (beneficiaries who were in either FFS or MA for two consecutive years). Prevalence rates by Hierarchical Condition Category (HCC). Each year the average MA risk score increased faster than the average FFS score. Using the risk adjustment model in place in 2004, the average MA score as a ratio of the average FFS score would have increased from 90% in 2004 to 109% in 2013. Using the model partially implemented in 2014, the ratio would have increased from 88% to 102%. The increase in relative MA scores appears to largely reflect changes in diagnostic coding, not real increases in the morbidity of MA enrollees. In survey-based data for 2006-2011, the MA-FFS ratio of risk scores remained roughly constant at 96%. Intensity of coding varies widely by contract, with some contracts coding very similarly to FFS and others coding much more intensely than the MA average. Underpinning this relative growth in scores is particularly rapid relative growth in a subset of HCCs. Medicare has taken significant steps to mitigate the effects of coding intensity in MA, including implementing a 3.4% coding intensity adjustment in 2010 and revising the risk adjustment model in 2013 and 2014. Given the continuous relative increase in the average MA risk score, further policy changes will likely be necessary.

Safety Issues with Hydrogen as a Vehicle Fuel

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

Cadwallader, Lee Charles; Herring, James Stephen

1999-10-01

This report is an initial effort to identify and evaluate safety issues associated with the use of hydrogen as a vehicle fuel in automobiles. Several forms of hydrogen have been considered: gas, liquid, slush, and hydrides. The safety issues have been discussed, beginning with properties of hydrogen and the phenomenology of hydrogen combustion. Safety-related operating experiences with hydrogen vehicles have been summarized to identify concerns that must be addressed in future design activities and to support probabilistic risk assessment. Also, applicable codes, standards, and regulations pertaining to hydrogen usage and refueling have been identified and are briefly discussed. This reportmore » serves as a safety foundation for any future hydrogen safety work, such as a safety analysis or a probabilistic risk assessment.« less

Safety Issues with Hydrogen as a Vehicle Fuel

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

L. C. Cadwallader; J. S. Herring

1999-09-01

This report is an initial effort to identify and evaluate safety issues associated with the use of hydrogen as a vehicle fuel in automobiles. Several forms of hydrogen have been considered: gas, liquid, slush, and hydrides. The safety issues have been discussed, beginning with properties of hydrogen and the phenomenology of hydrogen combustion. Safety-related operating experiences with hydrogen vehicles have been summarized to identify concerns that must be addressed in future design activities and to support probabilistic risk assessment. Also, applicable codes, standards, and regulations pertaining to hydrogen usage and refueling have been identified and are briefly discussed. This reportmore » serves as a safety foundation for any future hydrogen safety work, such as a safety analysis or a probabilistic risk assessment.« less

Cardiovascular risk factor assessment after pre-eclampsia in primary care

PubMed Central

2009-01-01

Background Pre-eclampsia is associated with an increased risk of development of cardiovascular disease later in life. It is not known how general practitioners in the Netherlands care for these women after delivery with respect to cardiovascular risk factor management. Methods Review of medical records of 1196 women in four primary health care centres, who were registered from January 2000 until July 2007 with an International Classification of Primary Care (ICPC) code indicating pregnancy. Records were searched for indicators of pre-eclampsia. Of those who experienced pre-eclampsia and of a random sample of 150 women who did not, the following information on cardiovascular risk factor management after pregnancy was extracted from the records: frequency and timing of blood pressure, cholesterol and glucose measurements - and vascular diagnoses. Additionally the sensitivity and specificity of ICPC coding for pre-eclampsia were determined. Results 35 women experienced pre-eclampsia. Blood pressure was more often checked after pregnancy in these women than in controls (57.1% vs. 12.0%, p < 0.001). In 50% of the cases blood pressure was measured within 3 months after delivery with no further follow-up visit. A check for glucose and cholesterol levels was rare, and equally frequent in PE and control women. 20% of the previously normotensive women in the PE group had hypertension at one or more occasions after three months post partum versus none in the control group. The ICPC coding for pre-eclampsia showed a sensitivity of 51.4% and a specificity of 100.0%. Conclusion Despite the evidence of increased risk of future cardiovascular disease in women with a history of pre-eclampsia, follow-up of these women is insufficient and undeveloped in primary care in the Netherlands. PMID:19995418

Including Health in Environmental Assessments of Major Transport Infrastructure Projects: A Documentary Analysis.

PubMed

Riley, Emily; Harris, Patrick; Kent, Jennifer; Sainsbury, Peter; Lane, Anna; Baum, Fran

2018-05-10

Transport policy and practice impacts health. Environmental Impact Assessments (EIAs) are regulated public policy mechanisms that can be used to consider the health impacts of major transport projects before they are approved. The way health is considered in these environmental assessments (EAs) is not well known. This research asked: How and to what extent was human health considered in EAs of four major transport projects in Australia. We developed a comprehensive coding framework to analyse the Environmental Impact Statements (EISs) of four transport infrastructure projects: three road and one light rail. The coding framework was designed to capture how health was directly and indirectly included. We found that health was partially considered in all four EISs. In the three New South Wales (NSW) projects, but not the one South Australian project, this was influenced by the requirements issued to proponents by the government which directed the content of the EIS. Health was assessed using human health risk assessment (HHRA). We found this to be narrow in focus and revealed a need for a broader social determinants of health approach, using multiple methods. The road assessments emphasised air quality and noise risks, concluding these were minimal or predicted to improve. The South Australian project was the only road project not to include health data explicitly. The light rail EIS considered the health benefits of the project whereas the others focused on risk. Only one project considered mental health, although in less detail than air quality or noise. Our findings suggest EIAs lag behind the known evidence linking transport infrastructure to health. If health is to be comprehensively included, a more complete model of health is required, as well as a shift away from health risk assessment as the main method used. This needs to be mandatory for all significant developments. We also found that considering health only at the EIA stage may be a significant limitation, and there is a need for health issues to be considered when earlier, fundamental decisions about the project are being made. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Dynamic event tree analysis with the SAS4A/SASSYS-1 safety analysis code

DOE PAGES

Jankovsky, Zachary K.; Denman, Matthew R.; Aldemir, Tunc

2018-02-02

The consequences of a transient in an advanced sodium-cooled fast reactor are difficult to capture with the traditional approach to probabilistic risk assessment (PRA). Numerous safety-relevant systems are passive and may have operational states that cannot be represented by binary success or failure. In addition, the specific order and timing of events may be crucial which necessitates the use of dynamic PRA tools such as ADAPT. The modifications to the SAS4A/SASSYS-1 sodium-cooled fast reactor safety analysis code for linking it to ADAPT to perform a dynamic PRA are described. A test case is used to demonstrate the linking process andmore » to illustrate the type of insights that may be gained with this process. Finally, newly-developed dynamic importance measures are used to assess the significance of reactor parameters/constituents on calculated consequences of initiating events.« less

Dynamic event tree analysis with the SAS4A/SASSYS-1 safety analysis code

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

Jankovsky, Zachary K.; Denman, Matthew R.; Aldemir, Tunc

The consequences of a transient in an advanced sodium-cooled fast reactor are difficult to capture with the traditional approach to probabilistic risk assessment (PRA). Numerous safety-relevant systems are passive and may have operational states that cannot be represented by binary success or failure. In addition, the specific order and timing of events may be crucial which necessitates the use of dynamic PRA tools such as ADAPT. The modifications to the SAS4A/SASSYS-1 sodium-cooled fast reactor safety analysis code for linking it to ADAPT to perform a dynamic PRA are described. A test case is used to demonstrate the linking process andmore » to illustrate the type of insights that may be gained with this process. Finally, newly-developed dynamic importance measures are used to assess the significance of reactor parameters/constituents on calculated consequences of initiating events.« less

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

McKenzie-Carter, M.A.; Lyon, R.E.; Rope, S.K.

This report contains information to support the Environmental Assessment for the Burning Plasma Experiment (BPX) Project proposed for the Princeton Plasma Physics Laboratory (PPPL). The assumptions and methodology used to assess the impact to members of the public from operational and accidental releases of radioactive material from the proposed BPX during the operational period of the project are described. A description of the tracer release tests conducted at PPPL by NOAA is included; dispersion values from these tests are used in the dose calculations. Radiological releases, doses, and resulting health risks are calculated and summarized. The computer code AIRDOS- EPA,more » which is part of the computer code system CAP-88, is used to calculate the individual and population doses for routine releases; FUSCRAC3 is used to calculate doses resulting from off-normal releases where direct application of the NOAA tracer test data is not practical. Where applicable, doses are compared to regulatory limits and guideline values. 48 refs., 16 tabs.« less

The NASA Space Radiobiology Risk Assessment Project

NASA Astrophysics Data System (ADS)

Cucinotta, Francis A.; Huff, Janice; Ponomarev, Artem; Patel, Zarana; Kim, Myung-Hee

The current first phase (2006-2011) has the three major goals of: 1) optimizing the conventional cancer risk models currently used based on the double-detriment life-table and radiation quality functions; 2) the integration of biophysical models of acute radiation syndromes; and 3) the development of new systems radiation biology models of cancer processes. The first-phase also includes continued uncertainty assessment of space radiation environmental models and transport codes, and relative biological effectiveness factors (RBE) based on flight data and NSRL results, respectively. The second phase of the (2012-2016) will: 1) develop biophysical models of central nervous system risks (CNS); 2) achieve comphrensive systems biology models of cancer processes using data from proton and heavy ion studies performed at NSRL; and 3) begin to identify computational models of biological countermeasures. Goals for the third phase (2017-2021) include: 1) the development of a systems biology model of cancer risks for operational use at NASA; 2) development of models of degenerative risks, 2) quantitative models of counter-measure impacts on cancer risks; and 3) indiviudal based risk assessments. Finally, we will support a decision point to continue NSRL research in support of NASA's exploration goals beyond 2021, and create an archival of NSRL research results for continued analysis. Details on near term goals, plans for a WEB based data resource of NSRL results, and a space radiation Wikepedia are described.

Earth-Observation based mapping and monitoring of exposure change in the megacity of Istanbul: open-source tools from the MARSITE project

NASA Astrophysics Data System (ADS)

De Vecchi, Daniele; Dell'Acqua, Fabio

2016-04-01

The EU FP7 MARSITE project aims at assessing the "state of the art" of seismic risk evaluation and management at European level, as a starting point to move a "step forward" towards new concepts of risk mitigation and management by long-term monitoring activities carried out both on land and at sea. Spaceborne Earth Observation (EO) is one of the means through which MARSITE is accomplishing this commitment, whose importance is growing as a consequence of the operational unfolding of the Copernicus initiative. Sentinel-2 data, with its open-data policy, represents an unprecedented opportunity to access global spaceborne multispectral data for various purposes including risk monitoring. In the framework of EU FP7 projects MARSITE, RASOR and SENSUM, our group has developed a suite of geospatial software tools to automatically extract risk-related features from EO data, especially on the exposure and vulnerability side of the "risk equation" [1]. These are for example the extension of a built-up area or the distribution of building density. These tools are available open-source as QGIS plug-ins [2] and their source code can be freely downloaded from GitHub [3]. A test case on the risk-prone mega city of Istanbul has been set up, and preliminary results will be presented in this paper. The output of the algorithms can be incorporated into a risk modeling process, whose output is very useful to stakeholders and decision makers who intend to assess and mitigate the risk level across the giant urban agglomerate. Keywords - Remote Sensing, Copernicus, Istanbul megacity, seismic risk, multi-risk, exposure, open-source References [1] Harb, M.M.; De Vecchi, D.; Dell'Acqua, F., "Physical Vulnerability Proxies from Remotes Sensing: Reviewing, Implementing and Disseminating Selected Techniques," Geoscience and Remote Sensing Magazine, IEEE , vol.3, no.1, pp.20,33, March 2015. doi: 10.1109/MGRS.2015.2398672 [2] SENSUM QGIS plugin, 2016, available online at: https://plugins.qgis.org/plugins/sensum_eo_tools/ [3] SENSUM QGIS code repository, 2016, available online at: https://github.com/SENSUM-project/sensum_rs_qgis

Conducting Retrospective Ontological Clinical Trials in ICD-9-CM in the Age of ICD-10-CM.

PubMed

Venepalli, Neeta K; Shergill, Ardaman; Dorestani, Parvaneh; Boyd, Andrew D

2014-01-01

To quantify the impact of International Classification of Disease 10th Revision Clinical Modification (ICD-10-CM) transition in cancer clinical trials by comparing coding accuracy and data discontinuity in backward ICD-10-CM to ICD-9-CM mapping via two tools, and to develop a standard ICD-9-CM and ICD-10-CM bridging methodology for retrospective analyses. While the transition to ICD-10-CM has been delayed until October 2015, its impact on cancer-related studies utilizing ICD-9-CM diagnoses has been inadequately explored. Three high impact journals with broad national and international readerships were reviewed for cancer-related studies utilizing ICD-9-CM diagnoses codes in study design, methods, or results. Forward ICD-9-CM to ICD-10-CM mapping was performing using a translational methodology with the Motif web portal ICD-9-CM conversion tool. Backward mapping from ICD-10-CM to ICD-9-CM was performed using both Centers for Medicare and Medicaid Services (CMS) general equivalence mappings (GEMs) files and the Motif web portal tool. Generated ICD-9-CM codes were compared with the original ICD-9-CM codes to assess data accuracy and discontinuity. While both methods yielded additional ICD-9-CM codes, the CMS GEMs method provided incomplete coverage with 16 of the original ICD-9-CM codes missing, whereas the Motif web portal method provided complete coverage. Of these 16 codes, 12 ICD-9-CM codes were present in 2010 Illinois Medicaid data, and accounted for 0.52% of patient encounters and 0.35% of total Medicaid reimbursements. Extraneous ICD-9-CM codes from both methods (Centers for Medicare and Medicaid Services general equivalent mapping [CMS GEMs, n = 161; Motif web portal, n = 246]) in excess of original ICD-9-CM codes accounted for 2.1% and 2.3% of total patient encounters and 3.4% and 4.1% of total Medicaid reimbursements from the 2010 Illinois Medicare database. Longitudinal data analyses post-ICD-10-CM transition will require backward ICD-10-CM to ICD-9-CM coding, and data comparison for accuracy. Researchers must be aware that all methods for backward coding are not comparable in yielding original ICD-9-CM codes. The mandated delay is an opportunity for organizations to better understand areas of financial risk with regards to data management via backward coding. Our methodology is relevant for all healthcare-related coding data, and can be replicated by organizations as a strategy to mitigate financial risk.

Methodology, status and plans for development and assessment of Cathare code

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

Bestion, D.; Barre, F.; Faydide, B.

1997-07-01

This paper presents the methodology, status and plans for the development, assessment and uncertainty evaluation of the Cathare code. Cathare is a thermalhydraulic code developed by CEA (DRN), IPSN, EDF and FRAMATOME for PWR safety analysis. First, the status of the code development and assessment is presented. The general strategy used for the development and the assessment of the code is presented. Analytical experiments with separate effect tests, and component tests are used for the development and the validation of closure laws. Successive Revisions of constitutive laws are implemented in successive Versions of the code and assessed. System tests ormore » integral tests are used to validate the general consistency of the Revision. Each delivery of a code Version + Revision is fully assessed and documented. A methodology is being developed to determine the uncertainty on all constitutive laws of the code using calculations of many analytical tests and applying the Discrete Adjoint Sensitivity Method (DASM). At last, the plans for the future developments of the code are presented. They concern the optimization of the code performance through parallel computing - the code will be used for real time full scope plant simulators - the coupling with many other codes (neutronic codes, severe accident codes), the application of the code for containment thermalhydraulics. Also, physical improvements are required in the field of low pressure transients and in the modeling for the 3-D model.« less

Adult attachment interviews of women from low-risk, poverty, and maltreatment risk samples: comparisons between the hostile/helpless and traditional AAI coding systems.

PubMed

Frigerio, Alessandra; Costantino, Elisabetta; Ceppi, Elisa; Barone, Lavinia

2013-01-01

The main aim of this study was to investigate the correlates of a Hostile-Helpless (HH) state of mind among 67 women belonging to a community sample and two different at-risk samples matched on socio-economic indicators, including 20 women from low-SES population (poverty sample) and 15 women at risk for maltreatment being monitored by the social services for the protection of juveniles (maltreatment risk sample). The Adult Attachment Interview (AAI) protocols were reliably coded blind to the samples' group status. The rates of HH classification increased in relation to the risk status of the three samples, ranging from 9% for the low-risk sample to 60% for the maltreatment risk sample to 75% for mothers in the maltreatment risk sample who actually maltreated their infants. In terms of the traditional AAI classification system, 88% of the interviews from the maltreating mothers were classified Unresolved/Cannot Classify (38%) or Preoccupied (50%). Partial overlapping between the 2 AAI coding systems was found, and discussion concerns the relevant contributions of each AAI coding system to understanding of the intergenerational transmission of maltreatment.

Group A Streptococcal Infections Are Associated With Increased Risk of Pediatric Neuropsychiatric Disorders: A Taiwanese Population-Based Cohort Study.

PubMed

Wang, Han-Cheng; Lau, Chi-Ieong; Lin, Che-Chen; Chang, Anna; Kao, Chia-Hung

2016-07-01

This study evaluated the association between group A streptococcal (GAS) infections and the risks of developing tic disorders, obsessive-compulsive disorder (OCD), and attention-deficit/hyperactivity disorder (ADHD). We conducted a follow-up cohort study in 2014 using Taiwan's National Health Insurance Research Database. The study cohort consisted of patients younger than 18 years with newly diagnosed GAS infection (ICD-9-CM codes 034 [streptococcal sore throat and scarlet fever] and 482.31 [pneumonia due to Streptococcus, group A]) from 2001 to 2010. All patients having GAS infection codes between 1996 and 2000 were excluded. We assessed the patients' risks of developing tic disorders, OCD, and ADHD (ICD-9-CM codes 300.3 [obsessive-compulsive disorders], 301.4 [obsessive-compulsive personality disorder], 307.2 [tic disorder, unspecified], and 314 [attention deficit disorder]) and compared these risks with those of a control cohort. The primary outcomes of this study were the overall neuropsychiatric disorder occurrence and the occurrence of separate subtypes. We examined 2,596 patients and 25,960 controls. The incidence of neuropsychiatric disorders in the GAS infection cohort (60.42 per 10,000 person-years) was significantly higher than that in the comparison cohort (49.32 per 10,000 person-years) (hazard ratio [HR] = 1.22; 95% CI, 1.00-1.49). The largest increased risk was for tic disorders (HR = 1.63; 95% CI, 1.02-2.62). Patients hospitalized for GAS infection had a 1.96-fold higher risk of neuropsychiatric disorders than did people without GAS infection (HR = 1.96; 95% CI, 1.23-3.12), and there was no difference in risk between outpatients with GAS infection and people without GAS infection (HR = 1.14; 95% CI, 0.92-1.41). Patients with moderate or high frequencies of GAS infection-related clinic visits had much higher risks of developing a neuropsychiatric disorder and, specifically, tic disorders and ADHD (all P values for trend < .05). These risks were not increased in patients with a low frequency of clinic visits. Our results confirmed an association between previous group A streptococcal infection and neuropsychiatric disorders. © Copyright 2016 Physicians Postgraduate Press, Inc.

ANEMOS: A computer code to estimate air concentrations and ground deposition rates for atmospheric nuclides emitted from multiple operating sources

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

Miller, C.W.; Sjoreen, A.L.; Begovich, C.L.

This code estimates concentrations in air and ground deposition rates for Atmospheric Nuclides Emitted from Multiple Operating Sources. ANEMOS is one component of an integrated Computerized Radiological Risk Investigation System (CRRIS) developed for the US Environmental Protection Agency (EPA) for use in performing radiological assessments and in developing radiation standards. The concentrations and deposition rates calculated by ANEMOS are used in subsequent portions of the CRRIS for estimating doses and risks to man. The calculations made in ANEMOS are based on the use of a straight-line Gaussian plume atmospheric dispersion model with both dry and wet deposition parameter options. Themore » code will accommodate a ground-level or elevated point and area source or windblown source. Adjustments may be made during the calculations for surface roughness, building wake effects, terrain height, wind speed at the height of release, the variation in plume rise as a function of downwind distance, and the in-growth and decay of daughter products in the plume as it travels downwind. ANEMOS can also accommodate multiple particle sizes and clearance classes, and it may be used to calculate the dose from a finite plume of gamma-ray-emitting radionuclides passing overhead. The output of this code is presented for 16 sectors of a circular grid. ANEMOS can calculate both the sector-average concentrations and deposition rates at a given set of downwind distances in each sector and the average of these quantities over an area within each sector bounded by two successive downwind distances. ANEMOS is designed to be used primarily for continuous, long-term radionuclide releases. This report describes the models used in the code, their computer implementation, the uncertainty associated with their use, and the use of ANEMOS in conjunction with other codes in the CRRIS. A listing of the code is included in Appendix C.« less

Implications of Supermarket Access, Neighborhood Walkability, and Poverty Rates for Diabetes Risk in an Employee Population

PubMed Central

Herrick, Cynthia J.; Yount, Byron W.; Eyler, Amy A.

2016-01-01

Objective Diabetes is a growing public health problem, and the environment in which people live and work may affect diabetes risk. The goal of this study was to examine the association between multiple aspects of environment and diabetes risk in an employee population. Design This was a retrospective cross-sectional analysis. Home environment variables were derived using employee zip code. Descriptive statistics were run on all individual and zip code level variables, stratified by diabetes risk and worksite. A multivariable logistic regression analysis was then conducted to determine the strongest associations with diabetes risk. Setting Data was collected from employee health fairs in a Midwestern health system 2009–2012. Subjects The dataset contains 25,227 unique individuals across four years of data. From this group, using an individual’s first entry into the database, 15,522 individuals had complete data for analysis. Results The prevalence of high diabetes risk in this population was 2.3%. There was significant variability in individual and zip code level variables across worksites. From the multivariable analysis, living in a zip code with higher percent poverty and higher walk score was positively associated with high diabetes risk, while living in a zip code with higher supermarket density was associated with a reduction in high diabetes risk. Conclusions Our study underscores the important relationship between poverty, home neighborhood environment, and diabetes risk, even in a relatively healthy employed population, and suggests a role for the employer in promoting health. PMID:26638995

Implications of supermarket access, neighbourhood walkability and poverty rates for diabetes risk in an employee population.

PubMed

Herrick, Cynthia J; Yount, Byron W; Eyler, Amy A

2016-08-01

Diabetes is a growing public health problem, and the environment in which people live and work may affect diabetes risk. The goal of the present study was to examine the association between multiple aspects of environment and diabetes risk in an employee population. This was a retrospective cross-sectional analysis. Home environment variables were derived using employees' zip code. Descriptive statistics were run on all individual- and zip-code-level variables, stratified by diabetes risk and worksite. A multivariable logistic regression analysis was then conducted to determine the strongest associations with diabetes risk. Data were collected from employee health fairs in a Midwestern health system, 2009-2012. The data set contains 25 227 unique individuals across four years of data. From this group, using an individual's first entry into the database, 15 522 individuals had complete data for analysis. The prevalence of high diabetes risk in this population was 2·3 %. There was significant variability in individual- and zip-code-level variables across worksites. From the multivariable analysis, living in a zip code with higher percentage of poverty and higher walk score was positively associated with high diabetes risk, while living in a zip code with higher supermarket density was associated with a reduction in high diabetes risk. Our study underscores the important relationship between poverty, home neighbourhood environment and diabetes risk, even in a relatively healthy employed population, and suggests a role for the employer in promoting health.

Child Maltreatment and Risky Sexual Behavior.

PubMed

Thompson, Richard; Lewis, Terri; Neilson, Elizabeth C; English, Diana J; Litrownik, Alan J; Margolis, Benyamin; Proctor, Laura; Dubowitz, Howard

2017-02-01

Risky sexual behavior is a serious public health problem. Child sexual abuse is an established risk factor, but other forms of maltreatment appear to elevate risky behavior. The mechanisms by which child maltreatment influence risk are not well understood. This study used data from 859 high-risk youth, followed through age 18. Official reports of each form of maltreatment were coded. At age 16, potential mediators (trauma symptoms and substance use) were assessed. At age 18, risky sexual behavior (more than four partners, unprotected sex, unassertiveness in sexual refusal) was assessed. Neglect significantly predicted unprotected sex. Substance use predicted unprotected sex and four or more partners but did not mediate the effects of maltreatment. Trauma symptoms predicted unprotected sex and mediated effects of emotional maltreatment on unprotected sex and on assertiveness in sexual refusal and the effects of sexual abuse on unprotected sex. Both neglect and emotional maltreatment emerged as important factors in risky sexual behavior. Trauma symptoms appear to be an important pathway by which maltreatment confers risk for risky sexual behavior. Interventions to reduce risky sexual behavior should include assessment and treatment for trauma symptoms and for history of child maltreatment in all its forms.

Community health center provider ability to identify, treat and account for the social determinants of health: a card study.

PubMed

Lewis, Joy H; Whelihan, Kate; Navarro, Isaac; Boyle, Kimberly R

2016-08-27

The social determinants of health (SDH) are conditions that shape the overall health of an individual on a continuous basis. As momentum for addressing social factors in primary care settings grows, provider ability to identify, treat and assess these factors remains unknown. Community health centers care for over 20-million of America's highest risk populations. This study at three centers evaluates provider ability to identify, treat and code for the SDH. Investigators utilized a pre-study survey and a card study design to obtain evidence from the point of care. The survey assessed providers' perceptions of the SDH and their ability to address them. Then providers filled out one anonymous card per patient on four assigned days over a 4-week period, documenting social factors observed during encounters. The cards allowed providers to indicate if they were able to: provide counseling or other interventions, enter a diagnosis code and enter a billing code for identified factors. The results of the survey indicate providers were familiar with the SDH and were comfortable identifying social factors at the point of care. A total of 747 cards were completed. 1584 factors were identified and 31 % were reported as having a service provided. However, only 1.2 % of factors were associated with a billing code and 6.8 % received a diagnosis code. An obvious discrepancy exists between the number of identifiable social factors, provider ability to address them and documentation with billing and diagnosis codes. This disparity could be related to provider inability to code for social factors and bill for related time and services. Health care organizations should seek to implement procedures to document and monitor social factors and actions taken to address them. Results of this study suggest simple methods of identification may be sufficient. The addition of searchable codes and reimbursements may improve the way social factors are addressed for individuals and populations.

Disease-Specific Trends of Comorbidity Coding and Implications for Risk Adjustment in Hospital Administrative Data.

PubMed

Nimptsch, Ulrike

2016-06-01

To investigate changes in comorbidity coding after the introduction of diagnosis related groups (DRGs) based prospective payment and whether trends differ regarding specific comorbidities. Nationwide administrative data (DRG statistics) from German acute care hospitals from 2005 to 2012. Observational study to analyze trends in comorbidity coding in patients hospitalized for common primary diseases and the effects on comorbidity-related risk of in-hospital death. Comorbidity coding was operationalized by Elixhauser diagnosis groups. The analyses focused on adult patients hospitalized for the primary diseases of heart failure, stroke, and pneumonia, as well as hip fracture. When focusing the total frequency of diagnosis groups per record, an increase in depth of coding was observed. Between-hospital variations in depth of coding were present throughout the observation period. Specific comorbidity increases were observed in 15 of the 31 diagnosis groups, and decreases in comorbidity were observed for 11 groups. In patients hospitalized for heart failure, shifts of comorbidity-related risk of in-hospital death occurred in nine diagnosis groups, in which eight groups were directed toward the null. Comorbidity-adjusted outcomes in longitudinal administrative data analyses may be biased by nonconstant risk over time, changes in completeness of coding, and between-hospital variations in coding. Accounting for such issues is important when the respective observation period coincides with changes in the reimbursement system or other conditions that are likely to alter clinical coding practice. © Health Research and Educational Trust.

Risk Assessment of Potentially Toxic Elements (PTEs) Pollution at a Rural Industrial Wasteland in an Abandoned Metallurgy Factory in North China

PubMed Central

Chen, Jiajun

2018-01-01

The potential toxic elements (PTEs) pollution problems in many rural industrial wastelands have been observed to be conspicuous. Therefore, 40 top soil samples were collected from the wasteland of a typical rural metallurgy factory in Baoding, China. The total concentrations of six key PTEs were measured. The soil properties and speciation of the PTEs were also identified. Extremely high concentrations of As, Cd, Pb, and Zn were observed in the surface soils. Using the PTEs concentration in the top soils of the rural industrial wasteland, the following indices of pollution were calculated: the pollution load index (PLI), the geo-accumulation Index (Igeo), the risk assessment code (RAC), and the health risk assessment (HRA). The analysis of the PLI and Igeo indicated that site #1 was relatively clean, while sites #2 and #3 were heavily polluted. The results of the RAC showed that PTEs in top soils at sites #2 and #3 were significantly increased (p  <  0.05) for Cd and Zn. The HRA indicated that both As and Pb presented non-carcinogenic risks to children and adults at sites #2 and #3. Our findings can be a reference for risk prevention of industrially abandoned land in rural China. PMID:29316642

Risk Assessment of Potentially Toxic Elements (PTEs) Pollution at a Rural Industrial Wasteland in an Abandoned Metallurgy Factory in North China.

PubMed

Sun, Zheng; Chen, Jiajun

2018-01-06

The potential toxic elements (PTEs) pollution problems in many rural industrial wastelands have been observed to be conspicuous. Therefore, 40 top soil samples were collected from the wasteland of a typical rural metallurgy factory in Baoding, China. The total concentrations of six key PTEs were measured. The soil properties and speciation of the PTEs were also identified. Extremely high concentrations of As, Cd, Pb, and Zn were observed in the surface soils. Using the PTEs concentration in the top soils of the rural industrial wasteland, the following indices of pollution were calculated: the pollution load index (PLI), the geo-accumulation Index (I geo ), the risk assessment code (RAC), and the health risk assessment (HRA). The analysis of the PLI and I geo indicated that site #1 was relatively clean, while sites #2 and #3 were heavily polluted. The results of the RAC showed that PTEs in top soils at sites #2 and #3 were significantly increased ( p <  0.05) for Cd and Zn. The HRA indicated that both As and Pb presented non-carcinogenic risks to children and adults at sites #2 and #3. Our findings can be a reference for risk prevention of industrially abandoned land in rural China.

HIV Risk and Perceptions of Masculinity among Young Black MSM

PubMed Central

Fields, Errol L.; Bogart, Laura M.; Smith, Katherine C.; Malebranche, David J.; Ellen, Jonathan; Schuster, Mark A.

2011-01-01

Purpose Young Black men who have sex with men (MSM) have among the highest rates of HIV infection in the US. Although reported rates of unprotected anal intercourse are similar to MSM of other racial/ethnic backgrounds, young Black MSM (YBMSM) aged 15–22 are 5 times more likely than comparably aged white MSM to be HIV-infected. We explored contextual social-environmental factors that may influence how YBMSM assess risk, choose partners, and make decisions about condom use. Methods We analyzed semi-structured interviews with 35 YBMSM (18–24) in New York City, upstate NY, and Atlanta. We used structured analytic coding based on a theoretical scheme that emerged from the data. Results Perception of masculinity was the primary contextual factor influencing partner selection, risk assessment, and condom decision-making. Four primary themes emerged: 1) greater preference for partners perceived as masculine; 2) discomfort with allowing men perceived as feminine to be the insertive partner in anal intercourse; 3) a power dynamic such that partners perceived as more masculine made condom-use decisions within the dyad; and 4) use of potential partners’ perceived masculinity to assess HIV risk. Conclusions Perceived masculinity may play a significant role in HIV risk for YBMSM and may be an important concept to consider in prevention strategies directed towards this population. PMID:22325136

Effects of malnutrition on complication rates, length of hospital stay, and revenue in elective surgical patients in the G-DRG-system.

PubMed

Thomas, Michael N; Kufeldt, Johannes; Kisser, Ulrich; Hornung, Hans-Martin; Hoffmann, Jessica; Andraschko, Monika; Werner, Jens; Rittler, Peter

2016-02-01

Malnutrition is known to independently affect patient outcomes. The aim of this study was to investigate the prevalence of patients at risk for malnutrition in an elective surgery patient cohort and to analyze the effects of malnutrition on morbidity, mortality, and hospital length of hospital (LOS). Furthermore, we aimed to evaluate the economic effect of a diligent coding of malnutrition, as a side diagnosis, in a simulation of the German Diagnosis-Related Group system. The nutritional status of 1244 patients undergoing elective surgery was standardized on the day of admission by the Nutritional Risk Screening (NRS) 2002. To quantify the influence of malnutrition on revenue, the real DRGs of all patients were grouped. In simulation, an appropriate International Classification of Diseases code was used as a secondary diagnosis for all malnourished patients based on the NRS rating. A multivariate logistic regression analysis and a Cox regression were performed to identify potential confounders and to determine the adjusted effect of nutritional status on the occurrence of complications and hospital LOS. The prevalence of patients at risk for malnutrition (NRS ≥3) was 24.1% (300 of 1244). These patients showed a significant increase in hospital LOS (13 versus 7 d). Additionally, postoperative complications were significantly higher in this group (7.23% versus 6.91%). Including malnutrition in the Diagnosis-Related Group coding system resulted in a reimbursement of €1979.67 per patient at risk for malnutrition and a total reimbursement of €79,186.73 for all patients at risk for malnutrition in the present study. Establishment of a structured, comprehensive assessment of the nutritional status of hospitalized patients can repetitiously identify patients at risk for malnutrition. Additionally, the diligent codification of malnutrition can lead to cost compensation in the German Diagnosis-Related Group system. Copyright © 2016 Elsevier Inc. All rights reserved.

Cancer risk coefficient for patient undergoing kyphoplasty surgery using Monte Carlo method

NASA Astrophysics Data System (ADS)

Santos, Felipe A.; Santos, William S.; Galeano, Diego C.; Cavalcante, Fernanda R.; Silva, Ademir X.; Souza, Susana O.; Júnior, Albérico B. Carvalho

2017-11-01

Kyphoplasty surgery is widely used for pain relief in patients with vertebral compression fracture (VCF). For this surgery, an X-ray emitter that provides real-time imaging is employed to guide the medical instruments and the surgical cement used to fill and strengthen the vertebra. Equivalent and effective doses related to high temporal resolution equipment has been studied to assess the damage and more recently cancer risk. For this study, a virtual scenario was prepared using MCNPX code and a pair of UF family simulators. Two projections with seven tube voltages for each one were simulated. The organ in the abdominal region were those who had higher cancer risk because they receive the primary beam. The risk of lethal cancer is on average 20% higher in AP projection than in LL projection. This study aims at estimating the risk of cancer in organs and the risk of lethal cancer for patient submitted to kyphoplasty surgery.

Occupational risk identification using hand-held or laptop computers.

PubMed

Naumanen, Paula; Savolainen, Heikki; Liesivuori, Jyrki

2008-01-01

This paper describes the Work Environment Profile (WEP) program and its use in risk identification by computer. It is installed into a hand-held computer or a laptop to be used in risk identification during work site visits. A 5-category system is used to describe the identified risks in 7 groups, i.e., accidents, biological and physical hazards, ergonomic and psychosocial load, chemicals, and information technology hazards. Each group contains several qualifying factors. These 5 categories are colour-coded at this stage to aid with visualization. Risk identification produces visual summary images the interpretation of which is facilitated by colours. The WEP program is a tool for risk assessment which is easy to learn and to use both by experts and nonprofessionals. It is especially well adapted to be used both in small and in larger enterprises. Considerable time is saved as no paper notes are needed.

Development of a claims-based risk score to identify obese individuals.

PubMed

Clark, Jeanne M; Chang, Hsien-Yen; Bolen, Shari D; Shore, Andrew D; Goodwin, Suzanne M; Weiner, Jonathan P

2010-08-01

Obesity is underdiagnosed, hampering system-based health promotion and research. Our objective was to develop and validate a claims-based risk model to identify obese persons using medical diagnosis and prescription records. We conducted a cross-sectional analysis of de-identified claims data from enrollees of 3 Blue Cross Blue Shield plans who completed a health risk assessment capturing height and weight. The final sample of 71,057 enrollees was randomly split into 2 subsamples for development and validation of the obesity risk model. Using the Johns Hopkins Adjusted Clinical Groups case-mix/predictive risk methodology, we categorized study members' diagnosis (ICD) codes. Logistic regression was used to determine which claims-based risk markers were associated with a body mass index (BMI) > or = 35 kg/m(2). The sensitivities of the scores > or =90(th) percentile to detect obesity were 26% to 33%, while the specificities were >90%. The areas under the receiver operator curve ranged from 0.67 to 0.73. In contrast, a diagnosis of obesity or an obesity medication alone had very poor sensitivity (10% and 1%, respectively); the obesity risk model identified an additional 22% of obese members. Varying the percentile cut-point from the 70(th) to the 99(th) percentile resulted in positive predictive values ranging from 15.5 to 59.2. An obesity risk score was highly specific for detecting a BMI > or = 35 kg/m(2) and substantially increased the detection of obese members beyond a provider-coded obesity diagnosis or medication claim. This model could be used for obesity care management and health promotion or for obesity-related research.

The Family Socialization Interview-Revised (FSI-R): a Comprehensive Assessment of Parental Disciplinary Behaviors.

PubMed

O'Dor, Sarah L; Grasso, Damion J; Forbes, Danielle; Bates, John E; McCarthy, Kimberly J; Wakschlag, Lauren S; Briggs-Gowan, Margaret J

2017-04-01

Elucidating the complex mechanisms by which harsh parenting increases risk of child psychopathology is key to targeted prevention. This requires nuanced methods that capture the varied perceptions and experiences of diverse families. The Family Socialization Interview-Revised (FSI-R), adapted from an interview developed by Dodge et al. (Child Development, 65, 649-665, 1994), is a comprehensive, semi-structured interview for characterizing methods of parental discipline used with young children. The FSI-R coding system systematically rates parenting style, usual discipline techniques, and most intense physical and psychological discipline based on rater judgment across two eras: (1) birth to the previous year, and (2) the previous year to present. The current study examined the psychometric properties of the FSI-R in a diverse, high-risk community sample of 386 mothers and their children, ages 3 to 6 years. Interrater reliability was good to excellent for codes capturing physically and psychologically harsh parenting, and restrictive/punitive parenting styles. Findings supported the FSI-R's convergent and incremental validity. Importantly, the FSI-R demonstrated incremental utility, explaining unique variance in children's externalizing and internalizing symptoms beyond that explained by traditional surveys and observed parenting. The FSI-R appeared particularly promising for capturing risk associated with young children's depressive symptoms, as these were generally not significantly associated with other measures of harsh parenting. Overall, findings support the added value of the FSI-R within a multi-method assessment of disciplinary practices across early child development. Future implications for prevention are discussed.

It's Only a Phase: Applying the 5 Phases of Clinical Trials to the NSCR Model Improvement Process

NASA Technical Reports Server (NTRS)

Elgart, S. R.; Milder, C. M.; Chappell, L. J.; Semones, E. J.

2017-01-01

NASA limits astronaut radiation exposures to a 3% risk of exposure-induced death from cancer (REID) at the upper 95% confidence level. Since astronauts approach this limit, it is important that the estimate of REID be as accurate as possible. The NASA Space Cancer Risk 2012 (NSCR-2012) model has been the standard for NASA's space radiation protection guidelines since its publication in 2013. The model incorporates elements from U.S. baseline statistics, Japanese atomic bomb survivor research, animal models, cellular studies, and radiation transport to calculate astronaut baseline risk of cancer and REID. The NSCR model is under constant revision to ensure emerging research is incorporated into radiation protection standards. It is important to develop guidelines, however, to determine what new research is appropriate for integration. Certain standards of transparency are necessary in order to assess data quality, statistical quality, and analytical quality. To this effect, all original source code and any raw data used to develop the code are required to confirm there are no errors which significantly change reported outcomes. It is possible to apply a clinical trials approach to select and assess the improvement concepts that will be incorporated into future iterations of NSCR. This poster describes the five phases of clinical trials research, pre-clinical research, and clinical research phases I-IV, explaining how each step can be translated into an appropriate NSCR model selection guideline.

The aerospace plane design challenge: Credible computational fluid dynamics results

NASA Technical Reports Server (NTRS)

Mehta, Unmeel B.

1990-01-01

Computational fluid dynamics (CFD) is necessary in the design processes of all current aerospace plane programs. Single-stage-to-orbit (STTO) aerospace planes with air-breathing supersonic combustion are going to be largely designed by means of CFD. The challenge of the aerospace plane design is to provide credible CFD results to work from, to assess the risk associated with the use of those results, and to certify CFD codes that produce credible results. To establish the credibility of CFD results used in design, the following topics are discussed: CFD validation vis-a-vis measurable fluid dynamics (MFD) validation; responsibility for credibility; credibility requirement; and a guide for establishing credibility. Quantification of CFD uncertainties helps to assess success risk and safety risks, and the development of CFD as a design tool requires code certification. This challenge is managed by designing the designers to use CFD effectively, by ensuring quality control, and by balancing the design process. For designing the designers, the following topics are discussed: how CFD design technology is developed; the reasons Japanese companies, by and large, produce goods of higher quality than the U.S. counterparts; teamwork as a new way of doing business; and how ideas, quality, and teaming can be brought together. Quality control for reducing the loss imparted to the society begins with the quality of the CFD results used in the design process, and balancing the design process means using a judicious balance of CFD and MFD.

Development and evaluation of an office ergonomic risk checklist: ROSA--rapid office strain assessment.

PubMed

Sonne, Michael; Villalta, Dino L; Andrews, David M

2012-01-01

The Rapid Office Strain Assessment (ROSA) was designed to quickly quantify risks associated with computer work and to establish an action level for change based on reports of worker discomfort. Computer use risk factors were identified in previous research and standards on office design for the chair, monitor, telephone, keyboard and mouse. The risk factors were diagrammed and coded as increasing scores from 1 to 3. ROSA final scores ranged in magnitude from 1 to 10, with each successive score representing an increased presence of risk factors. Total body discomfort and ROSA final scores for 72 office workstations were significantly correlated (R = 0.384). ROSA final scores exhibited high inter- and intra-observer reliability (ICCs of 0.88 and 0.91, respectively). Mean discomfort increased with increasing ROSA scores, with a significant difference occurring between scores of 3 and 5 (out of 10). A ROSA final score of 5 might therefore be useful as an action level indicating when immediate change is necessary. ROSA proved to be an effective and reliable method for identifying computer use risk factors related to discomfort. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Progress of IRSN R&D on ITER Safety Assessment

NASA Astrophysics Data System (ADS)

Van Dorsselaere, J. P.; Perrault, D.; Barrachin, M.; Bentaib, A.; Gensdarmes, F.; Haeck, W.; Pouvreau, S.; Salat, E.; Seropian, C.; Vendel, J.

2012-08-01

The French "Institut de Radioprotection et de Sûreté Nucléaire" (IRSN), in support to the French "Autorité de Sûreté Nucléaire", is analysing the safety of ITER fusion installation on the basis of the ITER operator's safety file. IRSN set up a multi-year R&D program in 2007 to support this safety assessment process. Priority has been given to four technical issues and the main outcomes of the work done in 2010 and 2011 are summarized in this paper: for simulation of accident scenarios in the vacuum vessel, adaptation of the ASTEC system code; for risk of explosion of gas-dust mixtures in the vacuum vessel, adaptation of the TONUS-CFD code for gas distribution, development of DUST code for dust transport, and preparation of IRSN experiments on gas inerting, dust mobilization, and hydrogen-dust mixtures explosion; for evaluation of the efficiency of the detritiation systems, thermo-chemical calculations of tritium speciation during transport in the gas phase and preparation of future experiments to evaluate the most influent factors on detritiation; for material neutron activation, adaptation of the VESTA Monte Carlo depletion code. The first results of these tasks have been used in 2011 for the analysis of the ITER safety file. In the near future, this R&D global programme may be reoriented to account for the feedback of the latter analysis or for new knowledge.

Current and anticipated uses of the thermal hydraulics codes at the NRC

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

Caruso, R.

1997-07-01

The focus of Thermal-Hydraulic computer code usage in nuclear regulatory organizations has undergone a considerable shift since the codes were originally conceived. Less work is being done in the area of {open_quotes}Design Basis Accidents,{close_quotes}, and much more emphasis is being placed on analysis of operational events, probabalistic risk/safety assessment, and maintenance practices. All of these areas need support from Thermal-Hydraulic computer codes to model the behavior of plant fluid systems, and they all need the ability to perform large numbers of analyses quickly. It is therefore important for the T/H codes of the future to be able to support thesemore » needs, by providing robust, easy-to-use, tools that produce easy-to understand results for a wider community of nuclear professionals. These tools need to take advantage of the great advances that have occurred recently in computer software, by providing users with graphical user interfaces for both input and output. In addition, reduced costs of computer memory and other hardware have removed the need for excessively complex data structures and numerical schemes, which make the codes more difficult and expensive to modify, maintain, and debug, and which increase problem run-times. Future versions of the T/H codes should also be structured in a modular fashion, to allow for the easy incorporation of new correlations, models, or features, and to simplify maintenance and testing. Finally, it is important that future T/H code developers work closely with the code user community, to ensure that the code meet the needs of those users.« less

Methodology for fast detection of false sharing in threaded scientific codes

DOEpatents

Chung, I-Hsin; Cong, Guojing; Murata, Hiroki; Negishi, Yasushi; Wen, Hui-Fang

2014-11-25

A profiling tool identifies a code region with a false sharing potential. A static analysis tool classifies variables and arrays in the identified code region. A mapping detection library correlates memory access instructions in the identified code region with variables and arrays in the identified code region while a processor is running the identified code region. The mapping detection library identifies one or more instructions at risk, in the identified code region, which are subject to an analysis by a false sharing detection library. A false sharing detection library performs a run-time analysis of the one or more instructions at risk while the processor is re-running the identified code region. The false sharing detection library determines, based on the performed run-time analysis, whether two different portions of the cache memory line are accessed by the generated binary code.

Gout and the Risk of Non-vertebral Fracture

PubMed Central

Kim, Seoyoung C.; Paik, Julie M.; Liu, Jun; Curhan, Gary C.; Solomon, Daniel H.

2016-01-01

Prior studies suggest an association between osteoporosis, systemic inflammation and pro-inflammatory cytokines such as IL-1 and IL-6. Conflicting findings exist on the association between hyperuricemia and osteoporosis. Furthermore, it remains unknown whether gout, a common inflammatory arthritis, affects fracture risk. Using data from a US commercial health plan (2004–2013), we evaluated the risk of non-vertebral fracture (i.e. forearm, wrist, hip and pelvis) in patients with gout versus those without. Gout patients were identified with ≥2 diagnosis codes and ≥1 dispensing for a gout-related drug. Non-gout patients, identified with ≥2 visits coded for any diagnosis and ≥1 dispensing for any prescription drugs, were free of gout diagnosis and received no gout-related drugs. Hip fracture was the secondary outcome. Fractures were identified with a combination of diagnosis and procedure codes. Cox proportional hazards models compared the risk of non-vertebral fracture in gout patients versus non-gout, adjusting for over 40 risk factors for osteoporotic fracture. Among gout patients with baseline serum uric acid (sUA) measurements available, we assessed the risk of non-vertebral fracture associated with sUA. We identified 73,202 gout and 219,606 non-gout patients, matched on age, sex, and the date of study entry. The mean age was 60 years and 82% were men. Over the mean 2-year follow-up, the incidence rate of non-vertebral fracture per 1,000 person-years was 2.92 in gout and 2.66 in non-gout. The adjusted hazard ratio (HR) was 0.98 (95%CI 0.85–1.12) for non-vertebral fracture and 0.83 (95%CI 0.65–1.07) for hip fracture in gout versus non-gout. Subgroup analysis (n=15,079) showed no association between baseline sUA and non-vertebral fracture (HR 1.03, 95%CI 0.93–1.15), adjusted for age, sex, comorbidity score and number of any prescription drugs. Gout was not associated with a risk of non-vertebral fracture. Among patients with gout, sUA was not associated with the risk of non-vertebral fracture. PMID:27541696

User Instructions for the Systems Assessment Capability, Rev. 1, Computer Codes Volume 3: Utility Codes

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

Eslinger, Paul W.; Aaberg, Rosanne L.; Lopresti, Charles A.

2004-09-14

This document contains detailed user instructions for a suite of utility codes developed for Rev. 1 of the Systems Assessment Capability. The suite of computer codes for Rev. 1 of Systems Assessment Capability performs many functions.

Estimates of radiological risk from depleted uranium weapons in war scenarios.

PubMed

Durante, Marco; Pugliese, Mariagabriella

2002-01-01

Several weapons used during the recent conflict in Yugoslavia contain depleted uranium, including missiles and armor-piercing incendiary rounds. Health concern is related to the use of these weapons, because of the heavy-metal toxicity and radioactivity of uranium. Although chemical toxicity is considered the more important source of health risk related to uranium, radiation exposure has been allegedly related to cancers among veterans of the Balkan conflict, and uranium munitions are a possible source of contamination in the environment. Actual measurements of radioactive contamination are needed to assess the risk. In this paper, a computer simulation is proposed to estimate radiological risk related to different exposure scenarios. Dose caused by inhalation of radioactive aerosols and ground contamination induced by Tomahawk missile impact are simulated using a Gaussian plume model (HOTSPOT code). Environmental contamination and committed dose to the population resident in contaminated areas are predicted by a food-web model (RESRAD code). Small values of committed effective dose equivalent appear to be associated with missile impacts (50-y CEDE < 5 mSv), or population exposure by water-independent pathways (50-y CEDE < 80 mSv). The greatest hazard is related to the water contamination in conditions of effective leaching of uranium in the groundwater (50-y CEDE < 400 mSv). Even in this worst case scenario, the chemical toxicity largely predominates over radiological risk. These computer simulations suggest that little radiological risk is associated to the use of depleted uranium weapons.

The relationship between oral health risk and disease status and age, and the significance for general dental practice funding by capitation.

PubMed

Busby, M; Martin, J A; Matthews, R; Burke, F J T; Chapple, I

2014-11-01

The aim of this paper was to review the oral health and future disease risk scores compiled in the Denplan Excel/Previser Patient Assessment (DEPPA) data base by patient age group, and to consider the significance of these outcomes to general practice funding by capitation payments. Between September 2013 and January 2014 7,787 patient assessments were conducted by about 200 dentists from across the UK using DEPPA. A population study was conducted on this data at all life stages. The composite Denplan Excel Oral Health Score (OHS) element of DEPPA reduced in a linear fashion with increasing age from a mean value of 85.0 in the 17-24 age group to a mean of 72.6 in patients aged over 75 years. Both periodontal health and tooth health aspects declined with age in an almost linear pattern. DEPPA capitation fee code recommendations followed this trend by advising higher fee codes as patients aged. As is the case with general health, these contemporary data suggest that the cost of providing oral health care tends to rise significantly with age. Where capitation is used as a method for funding, these costs either need to be passed onto those patients, or a conscious decision made to subsidise older age groups.

Improving the coding and classification of ambulance data through the application of International Classification of Disease 10th revision.

PubMed

Cantwell, Kate; Morgans, Amee; Smith, Karen; Livingston, Michael; Dietze, Paul

2014-02-01

This paper aims to examine whether an adaptation of the International Classification of Disease (ICD) coding system can be applied retrospectively to final paramedic assessment data in an ambulance dataset with a view to developing more fine-grained, clinically relevant case definitions than are available through point-of-call data. Over 1.2 million case records were extracted from the Ambulance Victoria data warehouse. Data fields included dispatch code, cause (CN) and final primary assessment (FPA). Each FPA was converted to an ICD-10-AM code using word matching or best fit. ICD-10-AM codes were then converted into Major Diagnostic Categories (MDC). CN was aligned with the ICD-10-AM codes for external cause of morbidity and mortality. The most accurate results were obtained when ICD-10-AM codes were assigned using information from both FPA and CN. Comparison of cases coded as unconscious at point-of-call with the associated paramedic assessment highlighted the extra clinical detail obtained when paramedic assessment data are used. Ambulance paramedic assessment data can be aligned with ICD-10-AM and MDC with relative ease, allowing retrospective coding of large datasets. Coding of ambulance data using ICD-10-AM allows for comparison of not only ambulance service users but also with other population groups. WHAT IS KNOWN ABOUT THE TOPIC? There is no reliable and standard coding and categorising system for paramedic assessment data contained in ambulance service databases. WHAT DOES THIS PAPER ADD? This study demonstrates that ambulance paramedic assessment data can be aligned with ICD-10-AM and MDC with relative ease, allowing retrospective coding of large datasets. Representation of ambulance case types using ICD-10-AM-coded information obtained after paramedic assessment is more fine grained and clinically relevant than point-of-call data, which uses caller information before ambulance attendance. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? This paper describes a model of coding using an internationally recognised standard coding and categorising system to support analysis of paramedic assessment. Ambulance data coded using ICD-10-AM allows for reliable reporting and comparison within the prehospital setting and across the healthcare industry.

The California Multimedia Risk Assessment Protocol for Alternative Fuels

NASA Astrophysics Data System (ADS)

Hatch, T.; Ginn, T. R.; McKone, T. E.; Rice, D. W.

2013-12-01

Any new fuel in California requires approval by the state agencies overseeing human and environmental health. In order to provide a systematic evaluation of new fuel impacts, California now requires a multimedia risk assessment (MMRA) for fuel approval. The fuel MMRA involves all relevant state agencies including: the California Air Resources Board (CARB), the State Water Resources Control Board (SWRCB), the Office of Environmental Health Hazards Assessment (OEHHA), and the Department of Toxic Substances Control (DTSC) overseen by the California Environmental Protection Agency (CalEPA). The lead agency for MMRAs is the CARB. The original law requiring a multimedia assessment is California Health and Safety Code 43830.8. In addition, the low carbon fuel standard (LCFS), the Global Warming Solutions Act (AB32), and the Verified Diesel Emission Control Strategy (VDECS) have provisions that can require a multimedia assessment. In this presentation, I give an overview of the California multimedia risk assessment (MMRA) for new fuels that has been recently developed and applied to several alternative fuels. The objective of the California MMRA is to assess risk of potential impacts of new fuels to multiple environmental media including: air, water, and soil. Attainment of this objective involves many challenges, including varying levels of uncertainty, relative comparison of incommensurate risk factors, and differing levels of priority assigned to risk factors. The MMRA is based on a strategy of relative risk assessment and flexible accommodation of distinct and diverse fuel formulations. The approach is tiered by design, in order to allow for sequentially more sophisticated investigations as knowledge gaps are identified and re-prioritized by the ongoing research. The assessment also involves peer review in order to provide coupling between risk assessment and stakeholder investment, as well as constructive or confrontational feedback. The multimedia assessment framework has been implemented for a number of alternative fuels to date. MMRAs for Biodiesel, Ethanol blended Gasoline, Renewable Diesel, and Biobutanol have been submitted to California for regulatory approval. Currently, assessments are being conducted for natural gasoline (alkanes blended with natural gas) and DiMethyl Ether. With each new fuel MMRA, lessons are learned on how to perform a MMRA better. As a result, the multimedia assessment guidelines are being slightly revised based on lessons learned from the MMRAs completed to date.

Analyses in support of risk-informed natural gas vehicle maintenance facility codes and standards :

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

Ekoto, Isaac W.; Blaylock, Myra L.; LaFleur, Angela Christine

2014-03-01

Safety standards development for maintenance facilities of liquid and compressed gas fueled large-scale vehicles is required to ensure proper facility design and operation envelopes. Standard development organizations are utilizing risk-informed concepts to develop natural gas vehicle (NGV) codes and standards so that maintenance facilities meet acceptable risk levels. The present report summarizes Phase I work for existing NGV repair facility code requirements and highlights inconsistencies that need quantitative analysis into their effectiveness. A Hazardous and Operability study was performed to identify key scenarios of interest. Finally, scenario analyses were performed using detailed simulations and modeling to estimate the overpressure hazardsmore » from HAZOP defined scenarios. The results from Phase I will be used to identify significant risk contributors at NGV maintenance facilities, and are expected to form the basis for follow-on quantitative risk analysis work to address specific code requirements and identify effective accident prevention and mitigation strategies.« less

Dental health of 6-year-old children in Alpes Maritimes, France.

PubMed

Joseph, C; Velley, A M; Pierre, A; Bourgeois, D; Muller-Bolla, M

2011-10-01

To describe the dental health status of 6-year-old children using the ICDAS-II advanced method and to evaluate the association between the known caries risk factors with the cavitated caries lesion (WHO basic method) or with both non-cavitated and cavitated caries lesion caries (ICDAS II). In this cross-sectional study, a questionnaire was used to evaluate oral health and dietary habits of children. A clinical examination and a Cario analysis test (Pierre Fabre Oral care) were performed. Logistic regression analyses were used to assess the association between caries and daily tooth-brushing, dietary habits, visible plaque and salivary factors. There were 341 children (52% female and 6.25+/-0.46 years of age) in this study. Using the ICDAS-II advanced method, 39% of the children were caries-free. This proportion was larger (67.2%) using the WHO method. In multivariate models, visible dental plaque and Streptococcus mutans count were associated with caries experience registered as ICDAS-II codes 1-6 or codes 3-6. The absence of daily tooth-brushing with fluoridated toothpaste was associated only with caries experience ICDAS-II codes 3-6. The use of WHO or ICDAS-II method changed the proportion of caries-free children but not the clinical caries risk factors associated with caries experience.

Drinking Water Residence Time in Distribution Networks and Emergency Department Visits for Gastrointestinal Illness in Metro Atlanta, Georgia

PubMed Central

Moe, Christine L.; Klein, Mitchel; Flanders, W. Dana; Uber, Jim; Amirtharajah, Appiah; Singer, Philip; Tolbert, Paige E.

2013-01-01

We examined whether the average water residence time, the time it takes water to travel from the treatment plant to the user, for a zip code was related to the proportion of emergency department (ED) visits for gastrointestinal (GI) illness among residents of that zip code. Individual-level ED data were collected from all hospitals located in the five-county metro Atlanta area from 1993 to 2004. Two of the largest water utilities in the area, together serving 1.7 million people, were considered. People served by these utilities had almost three million total ED visits, 164,937 of them for GI illness. The relationship between water residence time and risk for GI illness was assessed using logistic regression, controlling for potential confounding factors, including patient age and markers of socioeconomic status (SES). We observed a modestly increased risk for GI illness for residents of zip codes with the longest water residence times compared to intermediate residence times (odds ratio (OR) for Utility 1 = 1.07, 95% confidence interval (CI) = 1.03, 1.10; OR for Utility 2 = 1.05, 95% CI = 1.02, 1.08). The results suggest that drinking water contamination in the distribution system may contribute to the burden of endemic GI illness. PMID:19240359

Drinking water residence time in distribution networks and emergency department visits for gastrointestinal illness in Metro Atlanta, Georgia.

PubMed

Tinker, Sarah C; Moe, Christine L; Klein, Mitchel; Flanders, W Dana; Uber, Jim; Amirtharajah, Appiah; Singer, Philip; Tolbert, Paige E

2009-06-01

We examined whether the average water residence time, the time it takes water to travel from the treatment plant to the user, for a zip code was related to the proportion of emergency department (ED) visits for gastrointestinal (GI) illness among residents of that zip code. Individual-level ED data were collected from all hospitals located in the five-county metro Atlanta area from 1993 to 2004. Two of the largest water utilities in the area, together serving 1.7 million people, were considered. People served by these utilities had almost 3 million total ED visits, 164,937 of them for GI illness. The relationship between water residence time and risk for GI illness was assessed using logistic regression, controlling for potential confounding factors, including patient age and markers of socioeconomic status (SES). We observed a modestly increased risk for GI illness for residents of zip codes with the longest water residence times compared with intermediate residence times (odds ratio (OR) for Utility 1 = 1.07, 95% confidence interval (CI) = 1.03, 1.10; OR for Utility 2 = 1.05, 95% CI = 1.02, 1.08). The results suggest that drinking water contamination in the distribution system may contribute to the burden of endemic GI illness.

[Speciation Distribution and Risk Assessment of Heavy Metals in Typical Material Roof Dusts].

PubMed

Li, Dun-zhu; Guan, Yun-tao; Liu, An; Li, Si-yuan

2015-09-01

With the modified BCR sequential extraction procedure, the chemical speciation and risk for 10 heavy metals (Ba, Co, Cr, Cu, Mn, Ni, Pb, Sb, Sr and Zn) in roof dusts were investigated. The subjects of this study were collected from four typical material paved roofs (i. e., ceramic tile, concrete, metal and asphalt) in southeast China. The results indicated that the average contents of heavy metals in roof dust significantly exceeded road dust. The analysis of chemical fraction showed that the acid soluble/exchangeable fraction of Zn was much higher than other elements, the existence of Pb and Cu was mainly in oxidization fraction, while other heavy metals dominated by the residual fraction. The mobility sequence percentages for all roof dust samples decreased in the order of Pb > Zn > Cu >Mn > Co >Sr > Sb > Ni > Ba > Cr, and it should be noted that Pb, Zn, Cu, Mn and Co all have more than 50% proportion in mobility sequence. Based on environmental risk assessment, the highest values of contamination factors (Cf) and risk assessment code (RAC) consistently was observed in Zn, which indicated that Zn had relatively high ecological risk. Health risk assessment showed that the non-carcinogenic hazard indexes (HI) of heavy metals decreased in the order of Pb > Cr > Sb > Zn > Mn > Cu > Ba > Ni > Co > Sr, the HI of heavy metals for adults were lower than safe value while the HI of Pb for children was higher than safe value, suggesting that they will not harm the adult's health except Pb for children. The carcinogenic risk for Cr, Co and Ni were all below the threshold values, which indicated that there was no carcinogenic risk.

Predictive Modeling of Risk Factors and Complications of Cataract Surgery

PubMed Central

Gaskin, Gregory L; Pershing, Suzann; Cole, Tyler S; Shah, Nigam H

2016-01-01

Purpose To quantify the relationship between aggregated preoperative risk factors and cataract surgery complications, as well as to build a model predicting outcomes on an individual-level—given a constellation of demographic, baseline, preoperative, and intraoperative patient characteristics. Setting Stanford Hospital and Clinics between 1994 and 2013. Design Retrospective cohort study Methods Patients age 40 or older who received cataract surgery between 1994 and 2013. Risk factors, complications, and demographic information were extracted from the Electronic Health Record (EHR), based on International Classification of Diseases, 9th edition (ICD-9) codes, Current Procedural Terminology (CPT) codes, drug prescription information, and text data mining using natural language processing. We used a bootstrapped least absolute shrinkage and selection operator (LASSO) model to identify highly-predictive variables. We built random forest classifiers for each complication to create predictive models. Results Our data corroborated existing literature on postoperative complications—including the association of intraoperative complications, complex cataract surgery, black race, and/or prior eye surgery with an increased risk of any postoperative complications. We also found a number of other, less well-described risk factors, including systemic diabetes mellitus, young age (<60 years old), and hyperopia as risk factors for complex cataract surgery and intra- and post-operative complications. Our predictive models based on aggregated outperformed existing published models. Conclusions The constellations of risk factors and complications described here can guide new avenues of research and provide specific, personalized risk assessment for a patient considering cataract surgery. The predictive capacity of our models can enable risk stratification of patients, which has utility as a teaching tool as well as informing quality/value-based reimbursements. PMID:26692059

Enrichment and assessment of the health risks posed by heavy metals in PM1 in Changji, Xinjiang, China.

PubMed

Liu, Yu Y; Shen, Ya X; Liu, Cheng; Liu, Hao F

2017-04-16

The present study aims to investigate the influence of human activity on heavy metals in a typical arid urban area of China and assess human health risks posed by heavy metals in PM 1 (particles <1.0 μm in diameter) for different people. In this paper, Changji (Xinjiang, China) was selected as the study area, and samples were collected from March 2014 to March 2015. A total 14 elements in PM 1 were quantified using ICP-MS. An enrichment factor (EF) was used to assess the influence of human activity on the contamination of these metals. The results indicated that Mn was not enriched; Co, Cu, Cr, Ni, Tl, and V were slightly enriched; Mo, Pb, and Sb were moderately enriched; and Ag, As, and Cd were strongly enriched. To assess the health risks associated with inhaling PM 1 , the risk assessment code and loss in life expectancy based on the individual metals were calculated. The results showed that the elements Ag, Cu, Mo, Pb, Sb, Tl, and V in PM 1 posed low levels of non-carcinogenic risks, but these metals may still pose risks to certain susceptible populations. In addition, the results also showed that As, Co, and Cr posed an appreciable carcinogenic risk, while Cd and Ni posed low levels of carcinogenic risk. The total predicted loss of life expectancy caused by the three metals As, Co, and Ni was 63.67 d for the elderly, 30.95 d for adult males, 26.62 d for adult females, and 48.22 d for children. Therefore, the safety of the elderly and children exposed to PM 1 should be given more attention than the safety of adults. The results from this study demonstrate that the health risks posed by heavy metals in PM 1 in Changji, Xinjiang, China should be examined.

Heavy metals distribution and risk assessment in soil from an informal E-waste recycling site in Lagos State, Nigeria.

PubMed

Isimekhai, Khadijah A; Garelick, Hemda; Watt, John; Purchase, Diane

2017-07-01

Informal E-waste recycling can pose a risk to human health and the environment which this study endeavours to evaluate. The distribution of a number of heavy metals in soil from an informal recycling site in the largest market for used and new electronics and electrical equipment in West Africa was investigated. The potential bioavailability of heavy metals, extent of contamination, potential risk due to the recycling activities and impact of external factors such as rainfall were also assessed. The concentrations of all the heavy metals tested were higher in the area where burning of the waste occurred than at the control site, suggesting an impact of the recycling activities on the soil. The order of total metal concentrations was Cu > Pb > Zn > Mn > Ni > Sb > Cr > Cd for both the dry and wet seasons. The total concentrations of Cd, Cu, Mn, Ni and Zn were all significantly higher (p < 0.001) in the dry season than in the wet season. The concentrations of Cu (329-7106 mg kg -1 ), Pb (115-9623 mg kg -1 ) and Zn (508-8178 mg kg -1 ) were consistently higher than international soil guideline values. Using a sequential extraction method, the potential bioavailability of the heavy metals was indicated as Cd > Sb > Zn > Cu > Ni > Pb > Cr. When the risk was assessed using the Potential Ecological Risk Index (PERI), Cu was found to contribute the most to the potential ecological risk and Cd gave rise to the greatest concern due to its high toxic-response factor within the study site. Similarly, utilising the Risk Assessment Code (RAC) suggested that Cd posed the most risk in this site. This research establishes a high level of contamination in the study site and underscores the importance of applying the appropriate chemical speciation in risk assessment.

RAVEN User Manual

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

Mandelli, Diego; Rabiti, Cristian; Cogliati, Joshua Joseph

2015-10-01

RAVEN is a generic software framework to perform parametric and probabilistic analysis based on the response of complex system codes. The initial development was aimed to provide dynamic risk analysis capabilities to the Thermo-Hydraulic code RELAP-7, currently under development at the Idaho National Laboratory (INL). Although the initial goal has been fully accomplished, RAVEN is now a multi-purpose probabilistic and uncertainty quantification platform, capable to agnostically communicate with any system code. This agnosticism includes providing Application Programming Interfaces (APIs). These APIs are used to allow RAVEN to interact with any code as long as all the parameters that need tomore » be perturbed are accessible by inputs files or via python interfaces. RAVEN is capable of investigating the system response, and investigating the input space using Monte Carlo, Grid, or Latin Hyper Cube sampling schemes, but its strength is focused toward system feature discovery, such as limit surfaces, separating regions of the input space leading to system failure, using dynamic supervised learning techniques. The development of RAVEN has started in 2012, when, within the Nuclear Energy Advanced Modeling and Simulation (NEAMS) program, the need to provide a modern risk evaluation framework became stronger. RAVEN principal assignment is to provide the necessary software and algorithms in order to employ the concept developed by the Risk Informed Safety Margin Characterization (RISMC) program. RISMC is one of the pathways defined within the Light Water Reactor Sustainability (LWRS) program. In the RISMC approach, the goal is not just the individuation of the frequency of an event potentially leading to a system failure, but the closeness (or not) to key safety-related events. Hence, the approach is interested in identifying and increasing the safety margins related to those events. A safety margin is a numerical value quantifying the probability that a safety metric (e.g. for an important process such as peak pressure in a pipe) is exceeded under certain conditions. The initial development of RAVEN has been focused on providing dynamic risk assessment capability to RELAP-7, currently under development at the INL and, likely, future replacement of the RELAP5-3D code. Most the capabilities that have been implemented having RELAP-7 as principal focus are easily deployable for other system codes. For this reason, several side activaties are currently ongoing for coupling RAVEN with software such as RELAP5-3D, etc. The aim of this document is the explanation of the input requirements, focalizing on the input structure.« less

RAVEN User Manual

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

Mandelli, Diego; Rabiti, Cristian; Cogliati, Joshua Joseph

2016-02-01

RAVEN is a generic software framework to perform parametric and probabilistic analysis based on the response of complex system codes. The initial development was aimed to provide dynamic risk analysis capabilities to the Thermo-Hydraulic code RELAP-7, currently under development at the Idaho National Laboratory (INL). Although the initial goal has been fully accomplished, RAVEN is now a multi-purpose probabilistic and uncertainty quantification platform, capable to agnostically communicate with any system code. This agnosticism includes providing Application Programming Interfaces (APIs). These APIs are used to allow RAVEN to interact with any code as long as all the parameters that need tomore » be perturbed are accessible by input files or via python interfaces. RAVEN is capable of investigating the system response, and investigating the input space using Monte Carlo, Grid, or Latin Hyper Cube sampling schemes, but its strength is focused toward system feature discovery, such as limit surfaces, separating regions of the input space leading to system failure, using dynamic supervised learning techniques. The development of RAVEN started in 2012, when, within the Nuclear Energy Advanced Modeling and Simulation (NEAMS) program, the need to provide a modern risk evaluation framework became stronger. RAVEN principal assignment is to provide the necessary software and algorithms in order to employ the concept developed by the Risk Informed Safety Margin Characterization (RISMC) program. RISMC is one of the pathways defined within the Light Water Reactor Sustainability (LWRS) program. In the RISMC approach, the goal is not just the individuation of the frequency of an event potentially leading to a system failure, but the closeness (or not) to key safety-related events. Hence, the approach is interested in identifying and increasing the safety margins related to those events. A safety margin is a numerical value quantifying the probability that a safety metric (e.g. for an important process such as peak pressure in a pipe) is exceeded under certain conditions. The initial development of RAVEN has been focused on providing dynamic risk assessment capability to RELAP-7, currently under development at the INL and, likely, future replacement of the RELAP5-3D code. Most the capabilities that have been implemented having RELAP-7 as principal focus are easily deployable for other system codes. For this reason, several side activates are currently ongoing for coupling RAVEN with software such as RELAP5-3D, etc. The aim of this document is the explanation of the input requirements, focusing on the input structure.« less

RAVEN User Manual

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

Mandelli, Diego; Rabiti, Cristian; Cogliati, Joshua Joseph

2017-03-01

RAVEN is a generic software framework to perform parametric and probabilistic analy- sis based on the response of complex system codes. The initial development was aimed to provide dynamic risk analysis capabilities to the Thermo-Hydraulic code RELAP-7, currently under development at the Idaho National Laboratory (INL). Although the initial goal has been fully accomplished, RAVEN is now a multi-purpose probabilistic and uncer- tainty quantification platform, capable to agnostically communicate with any system code. This agnosticism includes providing Application Programming Interfaces (APIs). These APIs are used to allow RAVEN to interact with any code as long as all the parameters thatmore » need to be perturbed are accessible by inputs files or via python interfaces. RAVEN is capable of investigating the system response, and investigating the input space using Monte Carlo, Grid, or Latin Hyper Cube sampling schemes, but its strength is focused to- ward system feature discovery, such as limit surfaces, separating regions of the input space leading to system failure, using dynamic supervised learning techniques. The development of RAVEN has started in 2012, when, within the Nuclear Energy Advanced Modeling and Simulation (NEAMS) program, the need to provide a modern risk evaluation framework became stronger. RAVEN principal assignment is to provide the necessary software and algorithms in order to employ the concept developed by the Risk Informed Safety Margin Characterization (RISMC) program. RISMC is one of the pathways defined within the Light Water Reactor Sustainability (LWRS) program. In the RISMC approach, the goal is not just the individuation of the frequency of an event potentially leading to a system failure, but the closeness (or not) to key safety-related events. Hence, the approach is in- terested in identifying and increasing the safety margins related to those events. A safety margin is a numerical value quantifying the probability that a safety metric (e.g. for an important process such as peak pressure in a pipe) is exceeded under certain conditions. The initial development of RAVEN has been focused on providing dynamic risk assess- ment capability to RELAP-7, currently under develop-ment at the INL and, likely, future replacement of the RELAP5-3D code. Most the capabilities that have been implemented having RELAP-7 as principal focus are easily deployable for other system codes. For this reason, several side activates are currently ongoing for coupling RAVEN with soft- ware such as RELAP5-3D, etc. The aim of this document is the explaination of the input requirements, focalizing on the input structure.« less

Heavy Metal Pollution, Fractionation, and Potential Ecological Risks in Sediments from Lake Chaohu (Eastern China) and the Surrounding Rivers

PubMed Central

Zhang, Lei; Liao, Qianjiahua; Shao, Shiguang; Zhang, Nan; Shen, Qiushi; Liu, Cheng

2015-01-01

Heavy metal (Cr, Ni, Cu, Zn, Cd, and Pb) pollution, fractionation, and ecological risks in the sediments of Lake Chaohu (Eastern China), its eleven inflowing rivers and its only outflowing river were studied. An improved BCR (proposed by the European Community Bureau of Reference) sequential extraction procedure was applied to fractionate heavy metals within sediments, a geoaccumulation index was used to assess the extent of heavy metal pollution, and a risk assessment code was applied to evaluate potential ecological risks. Heavy metals in the Shuangqiao and Nanfei Rivers were generally higher than the other studied sites. Of the three Lake Chaohu sites, the highest concentrations were identified in western Chaohu. Heavy metal pollution and ecological risks in the lake’s only outflowing river were similar to those in the eastern region of the lake, to which the river is connected. Heavy metal concentrations occurred in the following order: Cd > Zn > Cu > Pb ≈ Ni ≈ Cr. Cr, Ni, and Cu made up the largest proportion of the residual fraction, while Cd was the most prominent metal in the exchangeable and carbonate-included fraction. Cd posed the greatest potential ecological risk; the heavy metals generally posed risks in the following order: Cd > Zn > Cu > Ni > Pb > Cr. PMID:26561822

Residential magnetic fields predicted from wiring configurations: II. Relationships To childhood leukemia.

PubMed

Thomas, D C; Bowman, J D; Jiang, L; Jiang, F; Peters, J M

1999-10-01

Case-control data on childhood leukemia in Los Angeles County were reanalyzed with residential magnetic fields predicted from the wiring configurations of nearby transmission and distribution lines. As described in a companion paper, the 24-h means of the magnetic field's magnitude in subjects' homes were predicted by a physically based regression model that had been fitted to 24-h measurements and wiring data. In addition, magnetic field exposures were adjusted for the most likely form of exposure assessment errors: classic errors for the 24-h measurements and Berkson errors for the predictions from wire configurations. Although the measured fields had no association with childhood leukemia (P for trend=.88), the risks were significant for predicted magnetic fields above 1.25 mG (odds ratio=2.00, 95% confidence interval=1.03-3.89), and a significant dose-response was seen (P for trend=.02). When exposures were determined by a combination of predictions and measurements that corrects for errors, the odds ratio (odd ratio=2.19, 95% confidence interval=1.12-4.31) and the trend (p =.007) showed somewhat greater significance. These findings support the hypothesis that magnetic fields from electrical lines are causally related to childhood leukemia but that this association has been inconsistent among epidemiologic studies due to different types of exposure assessment error. In these data, the leukemia risks from a child's residential magnetic field exposure appears to be better assessed by wire configurations than by 24-h area measurements. However, the predicted fields only partially account for the effect of the Wertheimer-Leeper wire code in a multivariate analysis and do not completely explain why these wire codes have been so often associated with childhood leukemia. The most plausible explanation for our findings is that the causal factor is another magnetic field exposure metric correlated to both wire code and the field's time-averaged magnitude. Copyright 1999 Wiley-Liss, Inc.

Assessment of occupational safety risks in Floridian solid waste systems using Bayesian analysis.

PubMed

Bastani, Mehrad; Celik, Nurcin

2015-10-01

Safety risks embedded within solid waste management systems continue to be a significant issue and are prevalent at every step in the solid waste management process. To recognise and address these occupational hazards, it is necessary to discover the potential safety concerns that cause them, as well as their direct and/or indirect impacts on the different types of solid waste workers. In this research, our goal is to statistically assess occupational safety risks to solid waste workers in the state of Florida. Here, we first review the related standard industrial codes to major solid waste management methods including recycling, incineration, landfilling, and composting. Then, a quantitative assessment of major risks is conducted based on the data collected using a Bayesian data analysis and predictive methods. The risks estimated in this study for the period of 2005-2012 are then compared with historical statistics (1993-1997) from previous assessment studies. The results have shown that the injury rates among refuse collectors in both musculoskeletal and dermal injuries have decreased from 88 and 15 to 16 and three injuries per 1000 workers, respectively. However, a contrasting trend is observed for the injury rates among recycling workers, for whom musculoskeletal and dermal injuries have increased from 13 and four injuries to 14 and six injuries per 1000 workers, respectively. Lastly, a linear regression model has been proposed to identify major elements of the high number of musculoskeletal and dermal injuries. © The Author(s) 2015.

Better big data.

PubMed

Al Kazzi, Elie S; Hutfless, Susan

2015-01-01

By 2018, Medicare payments will be tied to quality of care. The Centers for Medicare and Medicaid Services currently use quality-based metric for some reimbursements through their different programs. Existing and future quality metrics will rely on risk adjustment to avoid unfairly punishing those who see the sickest, highest-risk patients. Despite the limitations of the data used for risk adjustment, there are potential solutions to improve the accuracy of these codes by calibrating data by merging databases and compiling information collected for multiple reporting programs to improve accuracy. In addition, healthcare staff should be informed about the importance of risk adjustment for quality of care assessment and reimbursement. As the number of encounters tied to value-based reimbursements increases in inpatient and outpatient care, coupled with accurate data collection and utilization, the methods used for risk adjustment could be expanded to better account for differences in the care delivered in diverse settings.

Distribution, Fraction, and Ecological Assessment of Heavy Metals in Sediment-Plant System in Mangrove Forest, South China Sea.

PubMed

Li, Ruili; Chai, Minwei; Qiu, Guo Yu

2016-01-01

Overlying water, sediment, rhizosphere sediment and mangrove seedlings in the Futian mangrove forest were analyzed for heavy metals. The results showed that mangrove plant acidified sediment and increased organic matter contents. Except for chromium (Cr), nickel (Ni) and copper (Cu) in Aegiceras corniculatum sediment, heavy metals in all sediments were higher than in overlying water, rhizosphere sediment and mangrove root. Heavy metals in Avicennia marina sediments were higher than other sediments. The lower heavy metal biological concentration factors (BCFs) and translocation factors (TFs) indicated that mangrove plant adopted exclusion strategy. The geo-accumulation index, potential ecological risk index and risk assessment code (RAC) demonstrated that heavy metals have posed a considerable ecological risk, especially for cadmium (Cd). Heavy metals (Cr, Ni, Cu and Cd) mainly existed in the reducible fractions. These findings provide actual heavy metal accumulations in sediment-plant ecosystems in mangrove forest, being important in designing the long-term management and conservation policies for managers of mangrove forest.

Distribution, Fraction, and Ecological Assessment of Heavy Metals in Sediment-Plant System in Mangrove Forest, South China Sea

PubMed Central

Li, Ruili; Chai, Minwei; Qiu, Guo Yu

2016-01-01

Overlying water, sediment, rhizosphere sediment and mangrove seedlings in the Futian mangrove forest were analyzed for heavy metals. The results showed that mangrove plant acidified sediment and increased organic matter contents. Except for chromium (Cr), nickel (Ni) and copper (Cu) in Aegiceras corniculatum sediment, heavy metals in all sediments were higher than in overlying water, rhizosphere sediment and mangrove root. Heavy metals in Avicennia marina sediments were higher than other sediments. The lower heavy metal biological concentration factors (BCFs) and translocation factors (TFs) indicated that mangrove plant adopted exclusion strategy. The geo-accumulation index, potential ecological risk index and risk assessment code (RAC) demonstrated that heavy metals have posed a considerable ecological risk, especially for cadmium (Cd). Heavy metals (Cr, Ni, Cu and Cd) mainly existed in the reducible fractions. These findings provide actual heavy metal accumulations in sediment-plant ecosystems in mangrove forest, being important in designing the long-term management and conservation policies for managers of mangrove forest. PMID:26800267

Risk of preterm birth by subtype among Medi-Cal participants with mental illness.

PubMed

Baer, Rebecca J; Chambers, Christina D; Bandoli, Gretchen; Jelliffe-Pawlowski, Laura L

2016-10-01

Previous studies have demonstrated an association between mental illness and preterm birth (before 37 weeks). However, these investigations have not simultaneously considered gestation of preterm birth, the indication (eg, spontaneous or medically indicated), and specific mental illness classifications. The objective of the study was to examine the likelihood of preterm birth across gestational lengths and indications among Medi-Cal (California's Medicaid program) participants with a diagnostic code for mental illness. Mental illnesses were studied by specific illness classification. The study population was drawn from singleton live births in California from 2007 through 2011 in the birth cohort file maintained by the California Office of Statewide Health Planning and Development, which includes birth certificate and hospital discharge records. The sample was restricted to women with Medi-Cal coverage for prenatal care. Women with mental illness were identified using International Classification of Diseases, ninth revision, codes from their hospital discharge record. Women without a mental illness International Classification of Diseases, ninth revision, code were randomly selected at a 4:1 ratio. Adjusting for maternal characteristics and obstetric complications, relative risks and 95% confidence intervals were calculated for preterm birth comparing women with a mental illness diagnostic code with women without such a code. We identified 6198 women with a mental illness diagnostic code and selected 24,792 women with no such code. The risk of preterm birth in women with a mental illness were 1.2 times higher than women without a mental illness (adjusted relative risk, 1.2, 95% confidence interval, 1.1-1.3). Among the specific mental illnesses, schizophrenia, major depression, and personality disorders had the strongest associations with preterm birth (adjusted relative risks, 2.0, 2.0 and 3.3, respectively). Women receiving prenatal care through California's low-income health insurance who had at least 1 mental illness diagnostic code were 1.2-3.3-times more likely to have a preterm birth than women without a mental illness, and these risks persisted across most illness classifications. Although it cannot be determined from these data whether specific treatments for mental illness contribute to the observed associations, elevated risk across different diagnoses suggests that some aspects of mental illness itself may confer risk. Copyright © 2016 Elsevier Inc. All rights reserved.

Absolute fracture risk assessment using lumbar spine and femoral neck bone density measurements: derivation and validation of a hybrid system.

PubMed

Leslie, William D; Lix, Lisa M

2011-03-01

The World Health Organization (WHO) Fracture Risk Assessment Tool (FRAX) computes 10-year probability of major osteoporotic fracture from multiple risk factors, including femoral neck (FN) T-scores. Lumbar spine (LS) measurements are not currently part of the FRAX formulation but are used widely in clinical practice, and this creates confusion when there is spine-hip discordance. Our objective was to develop a hybrid 10-year absolute fracture risk assessment system in which nonvertebral (NV) fracture risk was assessed from the FN and clinical vertebral (V) fracture risk was assessed from the LS. We identified 37,032 women age 45 years and older undergoing baseline FN and LS dual-energy X-ray absorptiometry (DXA; 1990-2005) from a population database that contains all clinical DXA results for the Province of Manitoba, Canada. Results were linked to longitudinal health service records for physician billings and hospitalizations to identify nontrauma vertebral and nonvertebral fracture codes after bone mineral density (BMD) testing. The population was randomly divided into equal-sized derivation and validation cohorts. Using the derivation cohort, three fracture risk prediction systems were created from Cox proportional hazards models (adjusted for age and multiple FRAX risk factors): FN to predict combined all fractures, FN to predict nonvertebral fractures, and LS to predict vertebral (without nonvertebral) fractures. The hybrid system was the sum of nonvertebral risk from the FN model and vertebral risk from the LS model. The FN and hybrid systems were both strongly predictive of overall fracture risk (p < .001). In the validation cohort, ROC analysis showed marginally better performance of the hybrid system versus the FN system for overall fracture prediction (p = .24) and significantly better performance for vertebral fracture prediction (p < .001). In a discordance subgroup with FN and LS T-score differences greater than 1 SD, there was a significant improvement in overall fracture prediction with the hybrid method (p = .025). Risk reclassification under the hybrid system showed better alignment with observed fracture risk, with 6.4% of the women reclassified to a different risk category. In conclusion, a hybrid 10-year absolute fracture risk assessment system based on combining FN and LS information is feasible. The improvement in fracture risk prediction is small but supports clinical interest in a system that integrates LS in fracture risk assessment. Copyright © 2011 American Society for Bone and Mineral Research.

The effect of cost construction based on either DRG or ICD-9 codes or risk group stratification on the resulting cost-effectiveness ratios.

PubMed

Chumney, Elinor C G; Biddle, Andrea K; Simpson, Kit N; Weinberger, Morris; Magruder, Kathryn M; Zelman, William N

2004-01-01

As cost-effectiveness analyses (CEAs) are increasingly used to inform policy decisions, there is a need for more information on how different cost determination methods affect cost estimates and the degree to which the resulting cost-effectiveness ratios (CERs) may be affected. The lack of specificity of diagnosis-related groups (DRGs) could mean that they are ill-suited for costing applications in CEAs. Yet, the implications of using International Classification of Diseases-9th edition (ICD-9) codes or a form of disease-specific risk group stratification instead of DRGs has yet to be clearly documented. To demonstrate the implications of different disease coding mechanisms on costs and the magnitude of error that could be introduced in head-to-head comparisons of resulting CERs. We based our analyses on a previously published Markov model for HIV/AIDS therapies. We used the Healthcare Cost and Utilisation Project Nationwide Inpatient Sample (HCUP-NIS) data release 6, which contains all-payer data on hospital inpatient stays from selected states. We added costs for the mean number of hospitalisations, derived from analyses based on either DRG or ICD-9 codes or risk group stratification cost weights, to the standard outpatient and prescription drug costs to yield an estimate of total charges for each AIDS-defining illness (ADI). Finally, we estimated the Markov model three times with the appropriate ADI cost weights to obtain CERs specific to the use of either DRG or ICD-9 codes or risk group. Contrary to expectations, we found that the choice of coding/grouping assumptions that are disease-specific by either DRG codes, ICD-9 codes or risk group resulted in very similar CER estimates for highly active antiretroviral therapy. The large variations in the specific ADI cost weights across the three different coding approaches was especially interesting. However, because no one approach produced consistently higher estimates than the others, the Markov model's weighted cost per event and resulting CERs were remarkably close in value to one another. Although DRG codes are based on broader categories and contain less information than ICD-9 codes, in practice the choice of whether to use DRGs or ICD-9 codes may have little effect on the CEA results in heterogeneous conditions such as HIV/AIDS.

58th SOW Low-Dust Helicopter Landing Zone Final Environmental Assessment

DTIC Science & Technology

2012-11-01

Effects AQCR Air Quality Control Region BASH Bird/wildlife-Aircraft Strike Hazard CEQ Council on Environmental Quality CFR Code of Federal Regulations...force would continue to be applied to minimize risks to aircrews and the general population. No unacceptable hazards to military personnel, the public...and Final EA As a result of comments received on the Draft EA, Section 3.1.2, Global Climate Change, and Hazardous and Toxic Materials and Waste

Programmatic Environmental Assessment for Base General Plan Development, Schriever Air Force Base, Colorado

DTIC Science & Technology

2012-06-01

will not involve an element of high risk or uncertainty on the human environment, and its effects on the quality of the human environment are not...Information System HAPs Hazardous air pollutants HAZMAT Hazardous Material HVAC heating, ventilation , and air conditioning HUD U.S. Housing and...Engineers USAF Unites States Air Force USC United States Code USEPA United States Environmental Protection Agency USFWS United States Fish and Wildlife

Probabilistic structural analysis of aerospace components using NESSUS

NASA Technical Reports Server (NTRS)

Shiao, Michael C.; Nagpal, Vinod K.; Chamis, Christos C.

1988-01-01

Probabilistic structural analysis of a Space Shuttle main engine turbopump blade is conducted using the computer code NESSUS (numerical evaluation of stochastic structures under stress). The goal of the analysis is to derive probabilistic characteristics of blade response given probabilistic descriptions of uncertainties in blade geometry, material properties, and temperature and pressure distributions. Probability densities are derived for critical blade responses. Risk assessment and failure life analysis is conducted assuming different failure models.

Pleiotropic Effects of Variants in Dementia Genes in Parkinson Disease.

PubMed

Ibanez, Laura; Dube, Umber; Davis, Albert A; Fernandez, Maria V; Budde, John; Cooper, Breanna; Diez-Fairen, Monica; Ortega-Cubero, Sara; Pastor, Pau; Perlmutter, Joel S; Cruchaga, Carlos; Benitez, Bruno A

2018-01-01

Background: The prevalence of dementia in Parkinson disease (PD) increases dramatically with advancing age, approaching 80% in patients who survive 20 years with the disease. Increasing evidence suggests clinical, pathological and genetic overlap between Alzheimer disease, dementia with Lewy bodies and frontotemporal dementia with PD. However, the contribution of the dementia-causing genes to PD risk, cognitive impairment and dementia in PD is not fully established. Objective: To assess the contribution of coding variants in Mendelian dementia-causing genes on the risk of developing PD and the effect on cognitive performance of PD patients. Methods: We analyzed the coding regions of the amyloid-beta precursor protein ( APP ), Presenilin 1 and 2 ( PSEN1, PSEN2 ), and Granulin ( GRN ) genes from 1,374 PD cases and 973 controls using pooled-DNA targeted sequence, human exome-chip and whole-exome sequencing (WES) data by single variant and gene base (SKAT-O and burden tests) analyses. Global cognitive function was assessed using the Mini-Mental State Examination (MMSE) or the Montreal Cognitive Assessment (MoCA). The effect of coding variants in dementia-causing genes on cognitive performance was tested by multiple regression analysis adjusting for gender, disease duration, age at dementia assessment, study site and APOE carrier status. Results: Known AD pathogenic mutations in the PSEN1 (p.A79V) and PSEN2 (p.V148I) genes were found in 0.3% of all PD patients. There was a significant burden of rare, likely damaging variants in the GRN and PSEN1 genes in PD patients when compared with frequencies in the European population from the ExAC database. Multiple regression analysis revealed that PD patients carrying rare variants in the APP, PSEN1, PSEN2 , and GRN genes exhibit lower cognitive tests scores than non-carrier PD patients ( p = 2.0 × 10 -4 ), independent of age at PD diagnosis, age at evaluation, APOE status or recruitment site. Conclusions: Pathogenic mutations in the Alzheimer disease-causing genes ( PSEN1 and PSEN2) are found in sporadic PD patients. PD patients with cognitive decline carry rare variants in dementia-causing genes. Variants in genes causing Mendelian neurodegenerative diseases exhibit pleiotropic effects.

(U) Ristra Next Generation Code Report

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

Hungerford, Aimee L.; Daniel, David John

LANL’s Weapons Physics management (ADX) and ASC program office have defined a strategy for exascale-class application codes that follows two supportive, and mutually risk-mitigating paths: evolution for established codes (with a strong pedigree within the user community) based upon existing programming paradigms (MPI+X); and Ristra (formerly known as NGC), a high-risk/high-reward push for a next-generation multi-physics, multi-scale simulation toolkit based on emerging advanced programming systems (with an initial focus on data-flow task-based models exemplified by Legion [5]). Development along these paths is supported by the ATDM, IC, and CSSE elements of the ASC program, with the resulting codes forming amore » common ecosystem, and with algorithm and code exchange between them anticipated. Furthermore, solution of some of the more challenging problems of the future will require a federation of codes working together, using established-pedigree codes in partnership with new capabilities as they come on line. The role of Ristra as the high-risk/high-reward path for LANL’s codes is fully consistent with its role in the Advanced Technology Development and Mitigation (ATDM) sub-program of ASC (see Appendix C), in particular its emphasis on evolving ASC capabilities through novel programming models and data management technologies.« less

A technology to measure multiple driving behaviors without self-report or participant reactivity.

PubMed Central

Boyce, T E; Geller, E S

2001-01-01

An in-vehicle information system (IVIS) was used to videotape drivers (N = 61) without their knowledge while driving 22 miles in normal traffic. The drivers were told that they were participating in a study of direction following and map reading. Two data-coding procedures were used to analyze videotapes. Safety-related behaviors were counted during consecutive 15-s intervals of a driving trial, and the occurrence of certain safety-related behaviors was assessed under critical conditions. These two methods of data coding were assessed for practicality, reliability, and sensitivity. Interobserver agreement for the five different driving behaviors ranged from 85% to 95%. Within-subject variability in safe driving was more pronounced among younger drivers and decreased as a function of age. Contrary to previous research that has relied on self-reports, driver risk taking did not vary significantly as a function of gender. These results are used to illustrate the capabilities of the technology introduced here to design and evaluate behavior-analytic interventions to increase safe driving. PMID:11317986

Credibility Assessment of Deterministic Computational Models and Simulations for Space Biomedical Research and Operations

NASA Technical Reports Server (NTRS)

Mulugeta, Lealem; Walton, Marlei; Nelson, Emily; Myers, Jerry

2015-01-01

Human missions beyond low earth orbit to destinations, such as to Mars and asteroids will expose astronauts to novel operational conditions that may pose health risks that are currently not well understood and perhaps unanticipated. In addition, there are limited clinical and research data to inform development and implementation of health risk countermeasures for these missions. Consequently, NASA's Digital Astronaut Project (DAP) is working to develop and implement computational models and simulations (M&S) to help predict and assess spaceflight health and performance risks, and enhance countermeasure development. In order to effectively accomplish these goals, the DAP evaluates its models and simulations via a rigorous verification, validation and credibility assessment process to ensure that the computational tools are sufficiently reliable to both inform research intended to mitigate potential risk as well as guide countermeasure development. In doing so, DAP works closely with end-users, such as space life science researchers, to establish appropriate M&S credibility thresholds. We will present and demonstrate the process the DAP uses to vet computational M&S for space biomedical analysis using real M&S examples. We will also provide recommendations on how the larger space biomedical community can employ these concepts to enhance the credibility of their M&S codes.

Prematurity, maternal stress and mother-child interactions.

PubMed

Muller-Nix, Carole; Forcada-Guex, Margarita; Pierrehumbert, Blaise; Jaunin, Lyne; Borghini, Ayala; Ansermet, François

2004-09-01

Previous studies have shown that premature birth and the immaturity of the child can affect the quality of the parent-child relationship. The present study examines the relationship between maternal and infant interactional behavior over time and infant perinatal risk factors as well as maternal perinatal recollected traumatic experience. Few studies have explored the relationship between maternal stress and the quality of parent-infant interaction. Mother-child interaction was recorded at 6 and 18 months of infant's age, in a population of 47 preterm infants (GA<34 weeks) and 25 full-term infants, born in 1998, during a play interaction. According to the Care Index, sensitivity, control and unresponsiveness have been used to code maternal interactional characteristics, and cooperation, compliance-compulsiveness, difficulty and passivity have been used to code the infant's interactional characteristics. The level of maternal stress was evaluated with the Perinatal Posttraumatic Stress Disorder Questionnaire (PPQ), and the infant's perinatal risk factors were assessed with the Perinatal Risk Inventory (PERI). Mothers of high-risk infants, as well as mothers that had experienced traumatic stress in the perinatal period, were less sensitive and more controlling at 6 months. The interactional behavior of the preterm infant was different from that of the full-term infant at 18 months of age, and was correlated with maternal traumatic stress but not with perinatal risk factors. These results underline the importance of maternal traumatic experience related to premature birth and its potential long lasting influence on mother-child interactional behavior.

Development of an indoor air quality checklist for risk assessment of indoor air pollutants by semiquantitative score in nonindustrial workplaces

PubMed Central

Syazwan, AI; Rafee, B Mohd; Hafizan, Juahir; Azman, AZF; Nizar, AM; Izwyn, Z; Muhaimin, AA; Yunos, MA Syafiq; Anita, AR; Hanafiah, J Muhamad; Shaharuddin, MS; Ibthisham, A Mohd; Ismail, Mohd Hasmadi; Azhar, MN Mohamad; Azizan, HS; Zulfadhli, I; Othman, J

2012-01-01

Background To meet the current diversified health needs in workplaces, especially in nonindustrial workplaces in developing countries, an indoor air quality (IAQ) component of a participatory occupational safety and health survey should be included. Objectives The purpose of this study was to evaluate and suggest a multidisciplinary, integrated IAQ checklist for evaluating the health risk of building occupants. This IAQ checklist proposed to support employers, workers, and assessors in understanding a wide range of important elements in the indoor air environment to promote awareness in nonindustrial workplaces. Methods The general structure of and specific items in the IAQ checklist were discussed in a focus group meeting with IAQ assessors based upon the result of a literature review, previous industrial code of practice, and previous interviews with company employers and workers. Results For practicality and validity, several sessions were held to elicit the opinions of company members, and, as a result, modifications were made. The newly developed IAQ checklist was finally formulated, consisting of seven core areas, nine technical areas, and 71 essential items. Each item was linked to a suitable section in the Industry Code of Practice on Indoor Air Quality published by the Department of Occupational Safety and Health. Conclusion Combined usage of an IAQ checklist with the information from the Industry Code of Practice on Indoor Air Quality would provide easily comprehensible information and practical support. Intervention and evaluation studies using this newly developed IAQ checklist will clarify the effectiveness of a new approach in evaluating the risk of indoor air pollutants in the workplace. PMID:22570579

Development of an indoor air quality checklist for risk assessment of indoor air pollutants by semiquantitative score in nonindustrial workplaces.

PubMed

Syazwan, Ai; Rafee, B Mohd; Hafizan, Juahir; Azman, Azf; Nizar, Am; Izwyn, Z; Muhaimin, Aa; Yunos, Ma Syafiq; Anita, Ar; Hanafiah, J Muhamad; Shaharuddin, Ms; Ibthisham, A Mohd; Ismail, Mohd Hasmadi; Azhar, Mn Mohamad; Azizan, Hs; Zulfadhli, I; Othman, J

2012-01-01

To meet the current diversified health needs in workplaces, especially in nonindustrial workplaces in developing countries, an indoor air quality (IAQ) component of a participatory occupational safety and health survey should be included. The purpose of this study was to evaluate and suggest a multidisciplinary, integrated IAQ checklist for evaluating the health risk of building occupants. This IAQ checklist proposed to support employers, workers, and assessors in understanding a wide range of important elements in the indoor air environment to promote awareness in nonindustrial workplaces. The general structure of and specific items in the IAQ checklist were discussed in a focus group meeting with IAQ assessors based upon the result of a literature review, previous industrial code of practice, and previous interviews with company employers and workers. For practicality and validity, several sessions were held to elicit the opinions of company members, and, as a result, modifications were made. The newly developed IAQ checklist was finally formulated, consisting of seven core areas, nine technical areas, and 71 essential items. Each item was linked to a suitable section in the Industry Code of Practice on Indoor Air Quality published by the Department of Occupational Safety and Health. Combined usage of an IAQ checklist with the information from the Industry Code of Practice on Indoor Air Quality would provide easily comprehensible information and practical support. Intervention and evaluation studies using this newly developed IAQ checklist will clarify the effectiveness of a new approach in evaluating the risk of indoor air pollutants in the workplace.

Comparing respondent-driven sampling and targeted sampling methods of recruiting injection drug users in San Francisco.

PubMed

Kral, Alex H; Malekinejad, Mohsen; Vaudrey, Jason; Martinez, Alexis N; Lorvick, Jennifer; McFarland, Willi; Raymond, H Fisher

2010-09-01

The objective of this article is to compare demographic characteristics, risk behaviors, and service utilization among injection drug users (IDUs) recruited from two separate studies in San Francisco in 2005, one which used targeted sampling (TS) and the other which used respondent-driven sampling (RDS). IDUs were recruited using TS (n = 651) and RDS (n = 534) and participated in quantitative interviews that included demographic characteristics, risk behaviors, and service utilization. Prevalence estimates and 95% confidence intervals (CIs) were calculated to assess whether there were differences in these variables by sampling method. There was overlap in 95% CIs for all demographic variables except African American race (TS: 45%, 53%; RDS: 29%, 44%). Maps showed that the proportion of IDUs distributed across zip codes were similar for the TS and RDS sample, with the exception of a single zip code that was more represented in the TS sample. This zip code includes an isolated, predominantly African American neighborhood where only the TS study had a field site. Risk behavior estimates were similar for both TS and RDS samples, although self-reported hepatitis C infection was lower in the RDS sample. In terms of service utilization, more IDUs in the RDS sample reported no recent use of drug treatment and syringe exchange program services. Our study suggests that perhaps a hybrid sampling plan is best suited for recruiting IDUs in San Francisco, whereby the more intensive ethnographic and secondary analysis components of TS would aid in the planning of seed placement and field locations for RDS.

The Family Socialization Interview—Revised (FSI-R): a Comprehensive Assessment of Parental Disciplinary Behaviors

PubMed Central

O’Dor, Sarah L.; Grasso, Damion J.; Forbes, Danielle; Bates, John E.; McCarthy, Kimberly J.; Wakschlag, Lauren S.

2017-01-01

Elucidating the complex mechanisms by which harsh parenting increases risk of child psychopathology is key to targeted prevention. This requires nuanced methods that capture the varied perceptions and experiences of diverse families. The Family Socialization Interview—Revised (FSI-R), adapted from an interview developed by Dodge et al. (Child Development, 65,649–665,1994), is a comprehensive, semi-structured interview for characterizing methods of parental discipline used with young children. The FSI-R coding system systematically rates parenting style, usual discipline techniques, and most intense physical and psychological discipline based on rater judgment across two eras: (1) birth to the previous year, and (2) the previous year to present. The current study examined the psychometric properties of the FSI-R in a diverse, high-risk community sample of 386 mothers and their children, ages 3 to 6 years. Interrater reliability was good to excellent for codes capturing physically and psychologically harsh parenting, and restrictive/punitive parenting styles. Findings supported the FSI-R’s convergent and incremental validity. Importantly, the FSI-R demonstrated incremental utility, explaining unique variance in children’s externalizing and internalizing symptoms beyond that explained by traditional surveys and observed parenting. The FSI-R appeared particularly promising for capturing risk associated with young children’s depressive symptoms, as these were generally not significantly associated with other measures of harsh parenting. Overall, findings support the added value of the FSI-R within a multi-method assessment of disciplinary practices across early child development. Future implications for prevention are discussed. PMID:27718104

Carotid atherosclerosis predicts lower cognitive test results: a 7-year follow-up study of 4,371 stroke-free subjects - the Tromsø study.

PubMed

Arntzen, Kjell Arne; Schirmer, Henrik; Johnsen, Stein Harald; Wilsgaard, Tom; Mathiesen, Ellisiv B

2012-01-01

Carotid artery atherosclerosis is a major risk factor for stroke and subsequent cognitive impairment. Prospective population studies have shown associations between carotid intima-media thickness (IMT) and stenosis and cognitive decline and dementia in elderly stroke-free persons, whereas results in the middle-aged are conflicting. In this prospective population-based study, 4,371 stroke-free middle-aged participants underwent carotid ultrasound examination and assessment of vascular risk factors at baseline and were tested for cognitive function 7 years later. Associations between IMT, number of plaques and total plaque area and cognitive test scores on verbal memory test, digit symbol-coding test and tapping test were assessed in linear regression models. In the multivariable analyses adjusted for sex, age, education, depression and vascular risk factors, the presence of plaques was significantly associated with lower test scores on the verbal memory test (p = 0.01) and on the digit symbol-coding test (p = 0.03). The number of plaques (p = 0.01) and the total plaque area (p = 0.02) were associated with lower scores on the verbal memory test. No significant association was seen between common carotid artery IMT and cognitive test scores. The tapping test was not associated with the carotid ultrasound variables. In this middle-aged general population, subclinical carotid atherosclerosis measured as the presence of plaques, number of plaques and total plaque area were independent long-term predictors of lower cognitive test scores. Copyright © 2012 S. Karger AG, Basel.

Space Radiation Transport Codes: A Comparative Study for Galactic Cosmic Rays Environment

NASA Astrophysics Data System (ADS)

Tripathi, Ram; Wilson, John W.; Townsend, Lawrence W.; Gabriel, Tony; Pinsky, Lawrence S.; Slaba, Tony

For long duration and/or deep space human missions, protection from severe space radiation exposure is a challenging design constraint and may be a potential limiting factor. The space radiation environment consists of galactic cosmic rays (GCR), solar particle events (SPE), trapped radiation, and includes ions of all the known elements over a very broad energy range. These ions penetrate spacecraft materials producing nuclear fragments and secondary particles that damage biological tissues, microelectronic devices, and materials. In deep space missions, where the Earth's magnetic field does not provide protection from space radiation, the GCR environment is significantly enhanced due to the absence of geomagnetic cut-off and is a major component of radiation exposure. Accurate risk assessments critically depend on the accuracy of the input information as well as radiation transport codes used, and so systematic verification of codes is necessary. In this study, comparisons are made between the deterministic code HZETRN2006 and the Monte Carlo codes HETC-HEDS and FLUKA for an aluminum shield followed by a water target exposed to the 1977 solar minimum GCR spectrum. Interaction and transport of high charge ions present in GCR radiation environment provide a more stringent constraint in the comparison of the codes. Dose, dose equivalent and flux spectra are compared; details of the comparisons will be discussed, and conclusions will be drawn for future directions.

BRICK v0.2, a simple, accessible, and transparent model framework for climate and regional sea-level projections

NASA Astrophysics Data System (ADS)

Wong, Tony E.; Bakker, Alexander M. R.; Ruckert, Kelsey; Applegate, Patrick; Slangen, Aimée B. A.; Keller, Klaus

2017-07-01

Simple models can play pivotal roles in the quantification and framing of uncertainties surrounding climate change and sea-level rise. They are computationally efficient, transparent, and easy to reproduce. These qualities also make simple models useful for the characterization of risk. Simple model codes are increasingly distributed as open source, as well as actively shared and guided. Alas, computer codes used in the geosciences can often be hard to access, run, modify (e.g., with regards to assumptions and model components), and review. Here, we describe the simple model framework BRICK (Building blocks for Relevant Ice and Climate Knowledge) v0.2 and its underlying design principles. The paper adds detail to an earlier published model setup and discusses the inclusion of a land water storage component. The framework largely builds on existing models and allows for projections of global mean temperature as well as regional sea levels and coastal flood risk. BRICK is written in R and Fortran. BRICK gives special attention to the model values of transparency, accessibility, and flexibility in order to mitigate the above-mentioned issues while maintaining a high degree of computational efficiency. We demonstrate the flexibility of this framework through simple model intercomparison experiments. Furthermore, we demonstrate that BRICK is suitable for risk assessment applications by using a didactic example in local flood risk management.

Exposure to electromagnetic fields during pregnancy with emphasis on electrically heated beds: association with birthweight and intrauterine growth retardation.

PubMed

Bracken, M B; Belanger, K; Hellenbrand, K; Dlugosz, L; Holford, T R; McSharry, J E; Addesso, K; Leaderer, B

1995-05-01

Several animal and human studies indicate that fetal growth may be retarded following exposure to electromagnetic fields (EMF). We conducted a prospective study (N = 2,967) to evaluate the relation of birthweight and fetal growth retardation with use of electrically heated beds (electric blankets and heated water beds) during pregnancy. A "nested" study design allowed monitoring of exposure at different stages of pregnancy using both direct and indirect methods. We assessed EMF exposure using personal monitors, home measurement, video display terminal use, and wire code. Exposure to EMF during pregnancy, either at conception, at < or = 16 weeks, or in the third trimester, showed no important relation to risk of low birth-weight or fetal growth retardation. This result was the same whether we used subjective measures of exposure or direct measurement. Use of video display terminals at home or work, exposure to > or = 2.0-milligauss fields as measured by home or personal monitors, and home wire code were unrelated to the reproductive outcomes studied. A time-weighted analysis of electric bed use, which accounted for strength of EMF exposure and hours of use, also showed evidence of no meaningful increase in risk. None of the exposure measures showed a dose response relation to risk. We conclude that risk of low birth-weight and intrauterine growth retardation is not increased after electrically heated bed use during pregnancy.

Socioecological factors influencing women's HIV risk in the United States: qualitative findings from the women's HIV SeroIncidence study (HPTN 064).

PubMed

Frew, Paula M; Parker, Kimberly; Vo, Linda; Haley, Danielle; O'Leary, Ann; Diallo, Dazon Dixon; Golin, Carol E; Kuo, Irene; Soto-Torres, Lydia; Wang, Jing; Adimora, Adaora A; Randall, Laura A; Del Rio, Carlos; Hodder, Sally

2016-08-17

We sought to understand the multilevel syndemic factors that are concurrently contributing to the HIV epidemic among women living in the US. We specifically examined community, network, dyadic, and individual factors to explain HIV vulnerability within a socioecological framework. We gathered qualitative data (120 interviews and 31 focus groups) from a subset of women ages 18-44 years (N = 2,099) enrolled in the HPTN 064 HIV seroincidence estimation study across 10 US communities. We analyzed data from 4 diverse locations: Atlanta, New York City (the Bronx), Raleigh, and Washington, DC. Data were thematically coded using grounded theory methodology. Intercoder reliability was assessed to evaluate consistency of team-based coding practices. The following themes were identified at 4 levels including 1) exosystem (community): poverty prevalence, discrimination, gender imbalances, community violence, and housing challenges; 2) mesosystem (network): organizational social support and sexual concurrency; 3) microsystem (dyadic): sex exchange, interpersonal social support, intimate partner violence; and 4) individual: HIV/STI awareness, risk taking, and substance use. A strong theme emerged with over 80 % of responses linked to the fundamental role of financial insecurity underlying risk-taking behavioral pathways. Multilevel syndemic factors contribute to women's vulnerability to HIV in the US. Financial insecurity is a predominant theme, suggesting the need for tailored programming for women to reduce HIV risk. Clinicaltrials.gov, NCT00995176.

Cellular dosimetry calculations for Strontium-90 using Monte Carlo code PENELOPE.

PubMed

Hocine, Nora; Farlay, Delphine; Boivin, Georges; Franck, Didier; Agarande, Michelle

2014-11-01

To improve risk assessments associated with chronic exposure to Strontium-90 (Sr-90), for both the environment and human health, it is necessary to know the energy distribution in specific cells or tissue. Monte Carlo (MC) simulation codes are extremely useful tools for calculating deposition energy. The present work was focused on the validation of the MC code PENetration and Energy LOss of Positrons and Electrons (PENELOPE) and the assessment of dose distribution to bone marrow cells from punctual Sr-90 source localized within the cortical bone part. S-values (absorbed dose per unit cumulated activity) calculations using Monte Carlo simulations were performed by using PENELOPE and Monte Carlo N-Particle eXtended (MCNPX). Cytoplasm, nucleus, cell surface, mouse femur bone and Sr-90 radiation source were simulated. Cells are assumed to be spherical with the radii of the cell and cell nucleus ranging from 2-10 μm. The Sr-90 source is assumed to be uniformly distributed in cell nucleus, cytoplasm and cell surface. The comparison of S-values calculated with PENELOPE to MCNPX results and the Medical Internal Radiation Dose (MIRD) values agreed very well since the relative deviations were less than 4.5%. The dose distribution to mouse bone marrow cells showed that the cells localized near the cortical part received the maximum dose. The MC code PENELOPE may prove useful for cellular dosimetry involving radiation transport through materials other than water, or for complex distributions of radionuclides and geometries.

Development of an occupational airborne chemical exposure matrix

PubMed Central

Kurmi, O. P.; Chambers, H.; Lam, K. B. H.; Fishwick, D.

2016-01-01

Background Population-based studies of the occupational contribution to chronic obstructive pulmonary disease generally rely on self-reported exposures to vapours, gases, dusts and fumes (VGDF), which are susceptible to misclassification. Aims To develop an airborne chemical job exposure matrix (ACE JEM) for use with the UK Standard Occupational Classification (SOC 2000) system. Methods We developed the ACE JEM in stages: (i) agreement of definitions, (ii) a binary assignation of exposed/not exposed to VGDF, fibres or mists (VGDFFiM), for each of the individual 353 SOC codes and (iii) assignation of levels of exposure (L; low, medium and high) and (iv) the proportion of workers (P) likely to be exposed in each code. We then expanded the estimated exposures to include biological dusts, mineral dusts, metals, diesel fumes and asthmagens. Results We assigned 186 (53%) of all SOC codes as exposed to at least one category of VGDFFiM, with 23% assigned as having medium or high exposure. We assigned over 68% of all codes as not being exposed to fibres, gases or mists. The most common exposure was to dusts (22% of codes with >50% exposed); 12% of codes were assigned exposure to fibres. We assigned higher percentages of the codes as exposed to diesel fumes (14%) compared with metals (8%). Conclusions We developed an expert-derived JEM, using a strict set of a priori defined rules. The ACE JEM could also be applied to studies to assess risks of diseases where the main route of occupational exposure is via inhalation. PMID:27067914

Development of an occupational airborne chemical exposure matrix.

PubMed

Sadhra, S S; Kurmi, O P; Chambers, H; Lam, K B H; Fishwick, D

2016-07-01

Population-based studies of the occupational contribution to chronic obstructive pulmonary disease generally rely on self-reported exposures to vapours, gases, dusts and fumes (VGDF), which are susceptible to misclassification. To develop an airborne chemical job exposure matrix (ACE JEM) for use with the UK Standard Occupational Classification (SOC 2000) system. We developed the ACE JEM in stages: (i) agreement of definitions, (ii) a binary assignation of exposed/not exposed to VGDF, fibres or mists (VGDFFiM), for each of the individual 353 SOC codes and (iii) assignation of levels of exposure (L; low, medium and high) and (iv) the proportion of workers (P) likely to be exposed in each code. We then expanded the estimated exposures to include biological dusts, mineral dusts, metals, diesel fumes and asthmagens. We assigned 186 (53%) of all SOC codes as exposed to at least one category of VGDFFiM, with 23% assigned as having medium or high exposure. We assigned over 68% of all codes as not being exposed to fibres, gases or mists. The most common exposure was to dusts (22% of codes with >50% exposed); 12% of codes were assigned exposure to fibres. We assigned higher percentages of the codes as exposed to diesel fumes (14%) compared with metals (8%). We developed an expert-derived JEM, using a strict set of a priori defined rules. The ACE JEM could also be applied to studies to assess risks of diseases where the main route of occupational exposure is via inhalation. © Crown copyright 2016.

Nationwide Risk-Based PCB Remediation Waste Disposal Approvals under Title 40 of the Code of Federal Regulations (CFR) Section 761.61(c)

EPA Pesticide Factsheets

This page contains information about Nationwide Risk-Based Polychlorinated Biphenyls (PCBs) Remediation Waste Disposal Approvals under Title 40 of the Code of Federal Regulations (CFR) Section 761.61(c)

Communicating cardiovascular disease risk: an interview study of General Practitioners' use of absolute risk within tailored communication strategies.

PubMed

Bonner, Carissa; Jansen, Jesse; McKinn, Shannon; Irwig, Les; Doust, Jenny; Glasziou, Paul; McCaffery, Kirsten

2014-05-29

Cardiovascular disease (CVD) prevention guidelines encourage assessment of absolute CVD risk - the probability of a CVD event within a fixed time period, based on the most predictive risk factors. However, few General Practitioners (GPs) use absolute CVD risk consistently, and communication difficulties have been identified as a barrier to changing practice. This study aimed to explore GPs' descriptions of their CVD risk communication strategies, including the role of absolute risk. Semi-structured interviews were conducted with a purposive sample of 25 GPs in New South Wales, Australia. Transcribed audio-recordings were thematically coded, using the Framework Analysis method to ensure rigour. GPs used absolute CVD risk within three different communication strategies: 'positive', 'scare tactic', and 'indirect'. A 'positive' strategy, which aimed to reassure and motivate, was used for patients with low risk, determination to change lifestyle, and some concern about CVD risk. Absolute risk was used to show how they could reduce risk. A 'scare tactic' strategy was used for patients with high risk, lack of motivation, and a dismissive attitude. Absolute risk was used to 'scare' them into taking action. An 'indirect' strategy, where CVD risk was not the main focus, was used for patients with low risk but some lifestyle risk factors, high anxiety, high resistance to change, or difficulty understanding probabilities. Non-quantitative absolute risk formats were found to be helpful in these situations. This study demonstrated how GPs use three different communication strategies to address the issue of CVD risk, depending on their perception of patient risk, motivation and anxiety. Absolute risk played a different role within each strategy. Providing GPs with alternative ways of explaining absolute risk, in order to achieve different communication aims, may improve their use of absolute CVD risk assessment in practice.

ORAM-SENTINEL{trademark} demonstration at Fitzpatrick. Final report

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

Lee, L.K.; Anderson, V.M.; Mohammadi, K.

1998-06-01

New York Power Authority, in cooperation with EPRI, installed the ORAM-SENTINEL{trademark} software at James A. Fitzpatrick (JAF) Nuclear Power Plant. This software incorporates models of safety systems and support systems that are used for defense-in-depth in the plant during outage and on-line periods. A secondary goal was to include some pre-analyzed risk results to validate the methodology for quantitative assessment of the plant risks during proposed on-line maintenance. During the past year, New York Power Authority personnel have become familiar with the formal computerized Safety Assessment process associated with on-line and outage maintenance. The report describes techniques and lessons learnedmore » during development of the ORAM-SENTINEL model at JAF. It overviews the systems important to the Safety Function Assessment Process and provides details on development of the Plant Transient Assessment process using the station emergency operating procedures. The assessment results are displayed by color (green, yellow, orange, red) to show decreasing safety conditions. The report describes use of the JAF Probabilistic Safety Assessment within the ORAM-SENTINEL code to calculate an instantaneous core damage frequency and the criteria by which this frequency is translated to a color indicator.« less

Development of a Korean Fracture Risk Score (KFRS) for Predicting Osteoporotic Fracture Risk: Analysis of Data from the Korean National Health Insurance Service

PubMed Central

Jang, Eun Jin; Park, ByeongJu; Kim, Tae-Young; Shin, Soon-Ae

2016-01-01

Background Asian-specific prediction models for estimating individual risk of osteoporotic fractures are rare. We developed a Korean fracture risk prediction model using clinical risk factors and assessed validity of the final model. Methods A total of 718,306 Korean men and women aged 50–90 years were followed for 7 years in a national system-based cohort study. In total, 50% of the subjects were assigned randomly to the development dataset and 50% were assigned to the validation dataset. Clinical risk factors for osteoporotic fracture were assessed at the biennial health check. Data on osteoporotic fractures during the follow-up period were identified by ICD-10 codes and the nationwide database of the National Health Insurance Service (NHIS). Results During the follow-up period, 19,840 osteoporotic fractures were reported (4,889 in men and 14,951 in women) in the development dataset. The assessment tool called the Korean Fracture Risk Score (KFRS) is comprised of a set of nine variables, including age, body mass index, recent fragility fracture, current smoking, high alcohol intake, lack of regular exercise, recent use of oral glucocorticoid, rheumatoid arthritis, and other causes of secondary osteoporosis. The KFRS predicted osteoporotic fractures over the 7 years. This score was validated using an independent dataset. A close relationship with overall fracture rate was observed when we compared the mean predicted scores after applying the KFRS with the observed risks after 7 years within each 10th of predicted risk. Conclusion We developed a Korean specific prediction model for osteoporotic fractures. The KFRS was able to predict risk of fracture in the primary population without bone mineral density testing and is therefore suitable for use in both clinical setting and self-assessment. The website is available at http://www.nhis.or.kr. PMID:27399597

Development of a Korean Fracture Risk Score (KFRS) for Predicting Osteoporotic Fracture Risk: Analysis of Data from the Korean National Health Insurance Service.

PubMed

Kim, Ha Young; Jang, Eun Jin; Park, ByeongJu; Kim, Tae-Young; Shin, Soon-Ae; Ha, Yong-Chan; Jang, Sunmee

2016-01-01

Asian-specific prediction models for estimating individual risk of osteoporotic fractures are rare. We developed a Korean fracture risk prediction model using clinical risk factors and assessed validity of the final model. A total of 718,306 Korean men and women aged 50-90 years were followed for 7 years in a national system-based cohort study. In total, 50% of the subjects were assigned randomly to the development dataset and 50% were assigned to the validation dataset. Clinical risk factors for osteoporotic fracture were assessed at the biennial health check. Data on osteoporotic fractures during the follow-up period were identified by ICD-10 codes and the nationwide database of the National Health Insurance Service (NHIS). During the follow-up period, 19,840 osteoporotic fractures were reported (4,889 in men and 14,951 in women) in the development dataset. The assessment tool called the Korean Fracture Risk Score (KFRS) is comprised of a set of nine variables, including age, body mass index, recent fragility fracture, current smoking, high alcohol intake, lack of regular exercise, recent use of oral glucocorticoid, rheumatoid arthritis, and other causes of secondary osteoporosis. The KFRS predicted osteoporotic fractures over the 7 years. This score was validated using an independent dataset. A close relationship with overall fracture rate was observed when we compared the mean predicted scores after applying the KFRS with the observed risks after 7 years within each 10th of predicted risk. We developed a Korean specific prediction model for osteoporotic fractures. The KFRS was able to predict risk of fracture in the primary population without bone mineral density testing and is therefore suitable for use in both clinical setting and self-assessment. The website is available at http://www.nhis.or.kr.

General anesthesia exposure in early life reduces the risk of allergic diseases: A nationwide population-based cohort study.

PubMed

Kuo, Ho-Chang; Yang, Ya-Ling; Ho, Shu-Chen; Guo, Mindy Ming-Huey; Jiang, Jyun-Hong; Huang, Ying-Hsien

2016-07-01

General anesthesia (GA) has been used for second line treatment strategy for status asthmaticus in pediatric patients. The association between GA in children and risk of followed-up allergic diseases is unclear. This study aims to assess the risk of allergic diseases after GA in children.We did a nationwide retrospective cohort study by analyzing data from the National Health Insurance Research Database (NHIRD) in Taiwan. The subsequent risks for allergic diseases, including asthma (ICD-9: 493.X), allergic rhinitis (AR; ICD-9 CM code 477.X), and atopic dermatitis (AD; ICD-9-CM code 691.X), were compared between exposure to GA and none before 1 year of age throughout the follow-up period using the Cox proportional hazards model.Insurance claims data for 32,742 children younger than 1 year old from all insured children in the NHIRD. Of those, 2358 subjects were exposed to GA; 414 and 1944 children exposed to mask and intubation ventilation, respectively, served as the study cohort, whereas the remaining 30,384 children made up the comparison cohort. Children in the GA group were at a lower risk of developing asthma, AR and AD, with adjusted hazard ratios of 0.67 (0.62-0.72, 95%CI), 0.72 (0.68-0.77, 95%CI), 0.60 (0.56-0.64, 95%CI), respectively.Children who were exposed to GA in early life before 1 year of age had reduced risk of subsequently developing allergic diseases such as asthma, AD, and AR, when compared with general population.

Development of Graphical User Interface for ARRBOD (Acute Radiation Risk and BRYNTRN Organ Dose Projection)

NASA Technical Reports Server (NTRS)

Kim, Myung-Hee; Hu, Shaowen; Nounu, Hatem N.; Cucinotta, Francis A.

2010-01-01

The space radiation environment, particularly solar particle events (SPEs), poses the risk of acute radiation sickness (ARS) to humans; and organ doses from SPE exposure may reach critical levels during extra vehicular activities (EVAs) or within lightly shielded spacecraft. NASA has developed an organ dose projection model using the BRYNTRN with SUMDOSE computer codes, and a probabilistic model of Acute Radiation Risk (ARR). The codes BRYNTRN and SUMDOSE, written in FORTRAN, are a Baryon transport code and an output data processing code, respectively. The ARR code is written in C. The risk projection models of organ doses and ARR take the output from BRYNTRN as an input to their calculations. BRYNTRN code operation requires extensive input preparation. With a graphical user interface (GUI) to handle input and output for BRYNTRN, the response models can be connected easily and correctly to BRYNTRN in friendly way. A GUI for the Acute Radiation Risk and BRYNTRN Organ Dose (ARRBOD) projection code provides seamless integration of input and output manipulations, which are required for operations of the ARRBOD modules: BRYNTRN, SUMDOSE, and the ARR probabilistic response model. The ARRBOD GUI is intended for mission planners, radiation shield designers, space operations in the mission operations directorate (MOD), and space biophysics researchers. The ARRBOD GUI will serve as a proof-of-concept example for future integration of other human space applications risk projection models. The current version of the ARRBOD GUI is a new self-contained product and will have follow-on versions, as options are added: 1) human geometries of MAX/FAX in addition to CAM/CAF; 2) shielding distributions for spacecraft, Mars surface and atmosphere; 3) various space environmental and biophysical models; and 4) other response models to be connected to the BRYNTRN. The major components of the overall system, the subsystem interconnections, and external interfaces are described in this report; and the ARRBOD GUI product is explained step by step in order to serve as a tutorial.

Development of Advanced Life Cycle Costing Methods for Technology Benefit/Cost/Risk Assessment

NASA Technical Reports Server (NTRS)

Yackovetsky, Robert (Technical Monitor)

2002-01-01

The overall objective of this three-year grant is to provide NASA Langley's System Analysis Branch with improved affordability tools and methods based on probabilistic cost assessment techniques. In order to accomplish this objective, the Aerospace Systems Design Laboratory (ASDL) needs to pursue more detailed affordability, technology impact, and risk prediction methods and to demonstrate them on variety of advanced commercial transports. The affordability assessment, which is a cornerstone of ASDL methods, relies on the Aircraft Life Cycle Cost Analysis (ALCCA) program originally developed by NASA Ames Research Center and enhanced by ASDL. This grant proposed to improve ALCCA in support of the project objective by updating the research, design, test, and evaluation cost module, as well as the engine development cost module. Investigations into enhancements to ALCCA include improved engine development cost, process based costing, supportability cost, and system reliability with airline loss of revenue for system downtime. A probabilistic, stand-alone version of ALCCA/FLOPS will also be developed under this grant in order to capture the uncertainty involved in technology assessments. FLOPS (FLight Optimization System program) is an aircraft synthesis and sizing code developed by NASA Langley Research Center. This probabilistic version of the coupled program will be used within a Technology Impact Forecasting (TIF) method to determine what types of technologies would have to be infused in a system in order to meet customer requirements. A probabilistic analysis of the CER's (cost estimating relationships) within ALCCA will also be carried out under this contract in order to gain some insight as to the most influential costs and the impact that code fidelity could have on future RDS (Robust Design Simulation) studies.

Facility Targeting, Protection and Mission Decision Making Using the VISAC Code

NASA Technical Reports Server (NTRS)

Morris, Robert H.; Sulfredge, C. David

2011-01-01

The Visual Interactive Site Analysis Code (VISAC) has been used by DTRA and several other agencies to aid in targeting facilities and to predict the associated collateral effects for the go, no go mission decision making process. VISAC integrates the three concepts of target geometric modeling, damage assessment capabilities, and an event/fault tree methodology for evaluating accident/incident consequences. It can analyze a variety of accidents/incidents at nuclear or industrial facilities, ranging from simple component sabotage to an attack with military or terrorist weapons. For nuclear facilities, VISAC predicts the facility damage, estimated downtime, amount and timing of any radionuclides released. Used in conjunction with DTRA's HPAC code, VISAC also can analyze transport and dispersion of the radionuclides, levels of contamination of the surrounding area, and the population at risk. VISAC has also been used by the NRC to aid in the development of protective measures for nuclear facilities that may be subjected to attacks by car/truck bombs.

PRESTO-II: a low-level waste environmental transport and risk assessment code

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

Fields, D.E.; Emerson, C.J.; Chester, R.O.

PRESTO-II (Prediction of Radiation Effects from Shallow Trench Operations) is a computer code designed for the evaluation of possible health effects from shallow-land and, waste-disposal trenches. The model is intended to serve as a non-site-specific screening model for assessing radionuclide transport, ensuing exposure, and health impacts to a static local population for a 1000-year period following the end of disposal operations. Human exposure scenarios considered include normal releases (including leaching and operational spillage), human intrusion, and limited site farming or reclamation. Pathways and processes of transit from the trench to an individual or population include ground-water transport, overland flow, erosion,more » surface water dilution, suspension, atmospheric transport, deposition, inhalation, external exposure, and ingestion of contaminated beef, milk, crops, and water. Both population doses and individual doses, as well as doses to the intruder and farmer, may be calculated. Cumulative health effects in terms of cancer deaths are calculated for the population over the 1000-year period using a life-table approach. Data are included for three example sites: Barnwell, South Carolina; Beatty, Nevada; and West Valley, New York. A code listing and example input for each of the three sites are included in the appendices to this report.« less

An exploratory study of the relationship between socioeconomic status and motor vehicle safety features.

PubMed

Girasek, Deborah C; Taylor, Brett

2010-04-01

The purpose of this study was to assess the association between motor vehicle owners' socioeconomic status (SES) and the safety of their motor vehicles. Truncated vehicle identification numbers (VINs) were obtained from the Maryland Motor Vehicle Administration office. ZIP code-level income and educational data were assigned to each VIN. Software was used to identify safety-related vehicle characteristics including crash test rating, availability of electronic stability control and side impact air bags, age, and weight. Correlations and analyses of variance were performed to assess whether a ZIP code's median household income and educational level were associated with its proportion of registered vehicles with safety features. For 13 of the 16 correlations performed, SES was significantly associated with the availability of vehicle safety features in a direction that favored upper-income individuals. Vehicle weight was not associated with income or education. When ZIP codes were divided into median household income quintiles, their mean proportions of safety features also differed significantly, in the same direction, for availability of electronic stability control, side impact air bags, vehicle age, and crash test ratings. Safer motor vehicles appear to be distributed along socioeconomic lines, with lower income groups experiencing more risk. This previously unidentified mechanism of disparity merits further study and the attention of policy makers.

Path Toward a Unified Geometry for Radiation Transport

NASA Astrophysics Data System (ADS)

Lee, Kerry

The Direct Accelerated Geometry for Radiation Analysis and Design (DAGRAD) element of the RadWorks Project under Advanced Exploration Systems (AES) within the Space Technology Mission Directorate (STMD) of NASA will enable new designs and concepts of operation for radiation risk assessment, mitigation and protection. This element is designed to produce a solution that will allow NASA to calculate the transport of space radiation through complex CAD models using the state-of-the-art analytic and Monte Carlo radiation transport codes. Due to the inherent hazard of astronaut and spacecraft exposure to ionizing radiation in low-Earth orbit (LEO) or in deep space, risk analyses must be performed for all crew vehicles and habitats. Incorporating these analyses into the design process can minimize the mass needed solely for radiation protection. Transport of the radiation fields as they pass through shielding and body materials can be simulated using Monte Carlo techniques or described by the Boltzmann equation, which is obtained by balancing changes in particle fluxes as they traverse a small volume of material with the gains and losses caused by atomic and nuclear collisions. Deterministic codes that solve the Boltzmann transport equation, such as HZETRN (high charge and energy transport code developed by NASA LaRC), are generally computationally faster than Monte Carlo codes such as FLUKA, GEANT4, MCNP(X) or PHITS; however, they are currently limited to transport in one dimension, which poorly represents the secondary light ion and neutron radiation fields. NASA currently uses HZETRN space radiation transport software, both because it is computationally efficient and because proven methods have been developed for using this software to analyze complex geometries. Although Monte Carlo codes describe the relevant physics in a fully three-dimensional manner, their computational costs have thus far prevented their widespread use for analysis of complex CAD models, leading to the creation and maintenance of toolkit specific simplistic geometry models. The work presented here builds on the Direct Accelerated Geometry Monte Carlo (DAGMC) toolkit developed for use with the Monte Carlo N-Particle (MCNP) transport code. The work-flow for doing radiation transport on CAD models using MCNP and FLUKA has been demonstrated and the results of analyses on realistic spacecraft/habitats will be presented. Future work is planned that will further automate this process and enable the use of multiple radiation transport codes on identical geometry models imported from CAD. This effort will enhance the modeling tools used by NASA to accurately evaluate the astronaut space radiation risk and accurately determine the protection provided by as-designed exploration mission vehicles and habitats.

Cracking the Code: Assessing Institutional Compliance with the Australian Code for the Responsible Conduct of Research

ERIC Educational Resources Information Center

Morris, Suzanne E.

2010-01-01

This paper provides a review of institutional authorship policies as required by the "Australian Code for the Responsible Conduct of Research" (the "Code") (National Health and Medical Research Council (NHMRC), the Australian Research Council (ARC) & Universities Australia (UA) 2007), and assesses them for Code compliance.…

Case studies in Bayesian microbial risk assessments.

PubMed

Kennedy, Marc C; Clough, Helen E; Turner, Joanne

2009-12-21

The quantification of uncertainty and variability is a key component of quantitative risk analysis. Recent advances in Bayesian statistics make it ideal for integrating multiple sources of information, of different types and quality, and providing a realistic estimate of the combined uncertainty in the final risk estimates. We present two case studies related to foodborne microbial risks. In the first, we combine models to describe the sequence of events resulting in illness from consumption of milk contaminated with VTEC O157. We used Monte Carlo simulation to propagate uncertainty in some of the inputs to computer models describing the farm and pasteurisation process. Resulting simulated contamination levels were then assigned to consumption events from a dietary survey. Finally we accounted for uncertainty in the dose-response relationship and uncertainty due to limited incidence data to derive uncertainty about yearly incidences of illness in young children. Options for altering the risk were considered by running the model with different hypothetical policy-driven exposure scenarios. In the second case study we illustrate an efficient Bayesian sensitivity analysis for identifying the most important parameters of a complex computer code that simulated VTEC O157 prevalence within a managed dairy herd. This was carried out in 2 stages, first to screen out the unimportant inputs, then to perform a more detailed analysis on the remaining inputs. The method works by building a Bayesian statistical approximation to the computer code using a number of known code input/output pairs (training runs). We estimated that the expected total number of children aged 1.5-4.5 who become ill due to VTEC O157 in milk is 8.6 per year, with 95% uncertainty interval (0,11.5). The most extreme policy we considered was banning on-farm pasteurisation of milk, which reduced the estimate to 6.4 with 95% interval (0,11). In the second case study the effective number of inputs was reduced from 30 to 7 in the screening stage, and just 2 inputs were found to explain 82.8% of the output variance. A combined total of 500 runs of the computer code were used. These case studies illustrate the use of Bayesian statistics to perform detailed uncertainty and sensitivity analyses, integrating multiple information sources in a way that is both rigorous and efficient.

New ShakeMaps for Georgia Resulting from Collaboration with EMME

NASA Astrophysics Data System (ADS)

Kvavadze, N.; Tsereteli, N. S.; Varazanashvili, O.; Alania, V.

2015-12-01

Correct assessment of probabilistic seismic hazard and risks maps are first step for advance planning and action to reduce seismic risk. Seismic hazard maps for Georgia were calculated based on modern approach that was developed in the frame of EMME (Earthquake Modl for Middle east region) project. EMME was one of GEM's successful endeavors at regional level. With EMME and GEM assistance, regional models were analyzed to identify the information and additional work needed for the preparation national hazard models. Probabilistic seismic hazard map (PSH) provides the critical bases for improved building code and construction. The most serious deficiency in PSH assessment for the territory of Georgia is the lack of high-quality ground motion data. Due to this an initial hybrid empirical ground motion model is developed for PGA and SA at selected periods. An application of these coefficients for ground motion models have been used in probabilistic seismic hazard assessment. Obtained results of seismic hazard maps show evidence that there were gaps in seismic hazard assessment and the present normative seismic hazard map needed a careful recalculation.

[Observation of Attachment Disorder Symptoms in Middle Childhood].

PubMed

Iwanski, Alexandra; Zimmermann, Peter

2018-05-01

Observation of Attachment Disorder Symptoms in Middle Childhood Attachment in childhood is mainly assessed by observation. In contrast, assessment of attachment disorder symptoms (RAD) is mainly based on caregiver reports. The present study uses a newly developed observation tool (Coding of Attachment Disorder Behavior in Children; Iwanski u. Zimmermann, 2013) to assess attachment disorder symptoms in a group of school-aged children from a risk group for the development of attachment disorder symptoms and non-clinical controls. In addition, caregiver reports on RAD symptoms are also assessed (Relationship Problems Questionnaire; Minnis, Rabe-Hesketh, Wolkind, 2002; Disturbances of Attachment Interview; Smyke u. Zeanah, 1999). Moreover, associations with children's self-concept (Harter, 2012) were studied. Results reveal that children at risk showed more inhibited and disinhibited attachment disorder symptoms and a more negative self-concept compared to non-clinical controls. RAD symptoms are shown in interaction with both the caregiver and a stranger. The use of a reliable and valid observation tool for the diagnostic of attachment disorder symptoms besides ratings of caregivers is recommended for clinical practice and research.

A comparative study of space radiation organ doses and associated cancer risks using PHITS and HZETRN.

PubMed

Bahadori, Amir A; Sato, Tatsuhiko; Slaba, Tony C; Shavers, Mark R; Semones, Edward J; Van Baalen, Mary; Bolch, Wesley E

2013-10-21

NASA currently uses one-dimensional deterministic transport to generate values of the organ dose equivalent needed to calculate stochastic radiation risk following crew space exposures. In this study, organ absorbed doses and dose equivalents are calculated for 50th percentile male and female astronaut phantoms using both the NASA High Charge and Energy Transport Code to perform one-dimensional deterministic transport and the Particle and Heavy Ion Transport Code System to perform three-dimensional Monte Carlo transport. Two measures of radiation risk, effective dose and risk of exposure-induced death (REID) are calculated using the organ dose equivalents resulting from the two methods of radiation transport. For the space radiation environments and simplified shielding configurations considered, small differences (<8%) in the effective dose and REID are found. However, for the galactic cosmic ray (GCR) boundary condition, compensating errors are observed, indicating that comparisons between the integral measurements of complex radiation environments and code calculations can be misleading. Code-to-code benchmarks allow for the comparison of differential quantities, such as secondary particle differential fluence, to provide insight into differences observed in integral quantities for particular components of the GCR spectrum.

A comparative study of space radiation organ doses and associated cancer risks using PHITS and HZETRN

NASA Astrophysics Data System (ADS)

Bahadori, Amir A.; Sato, Tatsuhiko; Slaba, Tony C.; Shavers, Mark R.; Semones, Edward J.; Van Baalen, Mary; Bolch, Wesley E.

2013-10-01

NASA currently uses one-dimensional deterministic transport to generate values of the organ dose equivalent needed to calculate stochastic radiation risk following crew space exposures. In this study, organ absorbed doses and dose equivalents are calculated for 50th percentile male and female astronaut phantoms using both the NASA High Charge and Energy Transport Code to perform one-dimensional deterministic transport and the Particle and Heavy Ion Transport Code System to perform three-dimensional Monte Carlo transport. Two measures of radiation risk, effective dose and risk of exposure-induced death (REID) are calculated using the organ dose equivalents resulting from the two methods of radiation transport. For the space radiation environments and simplified shielding configurations considered, small differences (<8%) in the effective dose and REID are found. However, for the galactic cosmic ray (GCR) boundary condition, compensating errors are observed, indicating that comparisons between the integral measurements of complex radiation environments and code calculations can be misleading. Code-to-code benchmarks allow for the comparison of differential quantities, such as secondary particle differential fluence, to provide insight into differences observed in integral quantities for particular components of the GCR spectrum.

The Local Tissue Environment During the September 29, 1989 Solar Particle Event

NASA Technical Reports Server (NTRS)

Kim, M.-H. Y.; Wilson, J. W.; Cucinotta, F. A.; Simonsen, L. C.; Atwell, W.; Badavi, F. F.; Miller, J.

2004-01-01

The solar particle event (SPE) of September 29, 1989, produced an iron-rich spectrum with energies approaching 1 GeV/amu with an energy power index of 2.5. These high charge and energy (HZE) ions of the iron-rich SPEs challenge conventional methods of SPE shield design and assessment of astronaut risks. Shield and risk assessments are evaluated using the HZETRN code with computerized anatomical man (CAM) model for astronaut s body tissues. Since the HZE spectra decline rapidly with energy and HZE attenuation in materials is limited by their penetration power, details of the mass distributions about the sensitive tissues (shielding materials and the astronaut's body) are important determining factors of the exposure levels. Typical space suit and lightly shielded structures allow significant contributions from HZE components to some critical body tissues and have important implications on the models for risk assessment. Only a heavily shielded equipment room of a space vehicle or habitat provides sufficient shielding for the early response at sensitive organs from this event. The February 23, 1956 event of similar spectral characteristics and ten times this event may have important medical consequences without a well-shielded region.

Rural Nevada and climate change: vulnerability, beliefs, and risk perception.

PubMed

Safi, Ahmad Saleh; Smith, William James; Liu, Zhnongwei

2012-06-01

In this article, we present the results of a study investigating the influence of vulnerability to climate change as a function of physical vulnerability, sensitivity, and adaptive capacity on climate change risk perception. In 2008/2009, we surveyed Nevada ranchers and farmers to assess their climate change-related beliefs, and risk perceptions, political orientations, and socioeconomic characteristics. Ranchers' and farmers' sensitivity to climate change was measured through estimating the proportion of their household income originating from highly scarce water-dependent agriculture to the total income. Adaptive capacity was measured as a combination of the Social Status Index and the Poverty Index. Utilizing water availability and use, and population distribution GIS databases; we assessed water resource vulnerability in Nevada by zip code as an indicator of physical vulnerability to climate change. We performed correlation tests and multiple regression analyses to examine the impact of vulnerability and its three distinct components on risk perception. We find that vulnerability is not a significant determinant of risk perception. Physical vulnerability alone also does not impact risk perception. Both sensitivity and adaptive capacity increase risk perception. While age is not a significant determinant of it, gender plays an important role in shaping risk perception. Yet, general beliefs such as political orientations and climate change-specific beliefs such as believing in the anthropogenic causes of climate change and connecting the locally observed impacts (in this case drought) to climate change are the most prominent determinants of risk perception. © 2012 Society for Risk Analysis.

Exploration of association rule mining for coding consistency and completeness assessment in inpatient administrative health data.

PubMed

Peng, Mingkai; Sundararajan, Vijaya; Williamson, Tyler; Minty, Evan P; Smith, Tony C; Doktorchik, Chelsea T A; Quan, Hude

2018-03-01

Data quality assessment is a challenging facet for research using coded administrative health data. Current assessment approaches are time and resource intensive. We explored whether association rule mining (ARM) can be used to develop rules for assessing data quality. We extracted 2013 and 2014 records from the hospital discharge abstract database (DAD) for patients between the ages of 55 and 65 from five acute care hospitals in Alberta, Canada. The ARM was conducted using the 2013 DAD to extract rules with support ≥0.0019 and confidence ≥0.5 using the bootstrap technique, and tested in the 2014 DAD. The rules were compared against the method of coding frequency and assessed for their ability to detect error introduced by two kinds of data manipulation: random permutation and random deletion. The association rules generally had clear clinical meanings. Comparing 2014 data to 2013 data (both original), there were 3 rules with a confidence difference >0.1, while coding frequency difference of codes in the right hand of rules was less than 0.004. After random permutation of 50% of codes in the 2014 data, average rule confidence dropped from 0.72 to 0.27 while coding frequency remained unchanged. Rule confidence decreased with the increase of coding deletion, as expected. Rule confidence was more sensitive to code deletion compared to coding frequency, with slope of change ranging from 1.7 to 184.9 with a median of 9.1. The ARM is a promising technique to assess data quality. It offers a systematic way to derive coding association rules hidden in data, and potentially provides a sensitive and efficient method of assessing data quality compared to standard methods. Copyright © 2018 Elsevier Inc. All rights reserved.

Screening and association testing of common coding variation in steroid hormone receptor co-activator and co-repressor genes in relation to breast cancer risk: the Multiethnic Cohort.

PubMed

Haiman, Christopher A; Garcia, Rachel R; Hsu, Chris; Xia, Lucy; Ha, Helen; Sheng, Xin; Le Marchand, Loic; Kolonel, Laurence N; Henderson, Brian E; Stallcup, Michael R; Greene, Geoffrey L; Press, Michael F

2009-01-30

Only a limited number of studies have performed comprehensive investigations of coding variation in relation to breast cancer risk. Given the established role of estrogens in breast cancer, we hypothesized that coding variation in steroid receptor coactivator and corepressor genes may alter inter-individual response to estrogen and serve as markers of breast cancer risk. We sequenced the coding exons of 17 genes (EP300, CCND1, NME1, NCOA1, NCOA2, NCOA3, SMARCA4, SMARCA2, CARM1, FOXA1, MPG, NCOR1, NCOR2, CALCOCO1, PRMT1, PPARBP and CREBBP) suggested to influence transcriptional activation by steroid hormone receptors in a multiethnic panel of women with advanced breast cancer (n = 95): African Americans, Latinos, Japanese, Native Hawaiians and European Americans. Association testing of validated coding variants was conducted in a breast cancer case-control study (1,612 invasive cases and 1,961 controls) nested in the Multiethnic Cohort. We used logistic regression to estimate odds ratios for allelic effects in ethnic-pooled analyses as well as in subgroups defined by disease stage and steroid hormone receptor status. We also investigated effect modification by established breast cancer risk factors that are associated with steroid hormone exposure. We identified 45 coding variants with frequencies > or = 1% in any one ethnic group (43 non-synonymous variants). We observed nominally significant positive associations with two coding variants in ethnic-pooled analyses (NCOR2: His52Arg, OR = 1.79; 95% CI, 1.05-3.05; CALCOCO1: Arg12His, OR = 2.29; 95% CI, 1.00-5.26). A small number of variants were associated with risk in disease subgroup analyses and we observed no strong evidence of effect modification by breast cancer risk factors. Based on the large number of statistical tests conducted in this study, the nominally significant associations that we observed may be due to chance, and will need to be confirmed in other studies. Our findings suggest that common coding variation in these candidate genes do not make a substantial contribution to breast cancer risk in the general population. Cataloging and testing of coding variants in coactivator and corepressor genes should continue and may serve as a valuable resource for investigations of other hormone-related phenotypes, such as inter-individual response to hormonal therapies used for cancer treatment and prevention.

Ionizing Radiation Environments and Exposure Risks

NASA Astrophysics Data System (ADS)

Kim, M. H. Y.

2015-12-01

Space radiation environments for historically large solar particle events (SPE) and galactic cosmic rays (GCR) are simulated to characterize exposures to radio-sensitive organs for missions to low-Earth orbit (LEO), moon, near-Earth asteroid, and Mars. Primary and secondary particles for SPE and GCR are transported through the respective atmospheres of Earth or Mars, space vehicle, and astronaut's body tissues using NASA's HZETRN/QMSFRG computer code. Space radiation protection methods, which are derived largely from ground-based methods recommended by the National Council on Radiation Protection and Measurements (NCRP) or International Commission on Radiological Protections (ICRP), are built on the principles of risk justification, limitation, and ALARA (as low as reasonably achievable). However, because of the large uncertainties in high charge and energy (HZE) particle radiobiology and the small population of space crews, NASA develops distinct methods to implement a space radiation protection program. For the fatal cancer risks, which have been considered the dominant risk for GCR, the NASA Space Cancer Risk (NSCR) model has been developed from recommendations by NCRP; and undergone external review by the National Research Council (NRC), NCRP, and through peer-review publications. The NSCR model uses GCR environmental models, particle transport codes describing the GCR modification by atomic and nuclear interactions in atmospheric shielding coupled with spacecraft and tissue shielding, and NASA-defined quality factors for solid cancer and leukemia risk estimates for HZE particles. By implementing the NSCR model, the exposure risks from various heliospheric conditions are assessed for the radiation environments for various-class mission types to understand architectures and strategies of human exploration missions and ultimately to contribute to the optimization of radiation safety and well-being of space crewmembers participating in long-term space missions.

Seismic hazard, risk, and design for South America

USGS Publications Warehouse

Petersen, Mark D.; Harmsen, Stephen; Jaiswal, Kishor; Rukstales, Kenneth S.; Luco, Nicolas; Haller, Kathleen; Mueller, Charles; Shumway, Allison

2018-01-01

We calculate seismic hazard, risk, and design criteria across South America using the latest data, models, and methods to support public officials, scientists, and engineers in earthquake risk mitigation efforts. Updated continental scale seismic hazard models are based on a new seismicity catalog, seismicity rate models, evaluation of earthquake sizes, fault geometry and rate parameters, and ground‐motion models. Resulting probabilistic seismic hazard maps show peak ground acceleration, modified Mercalli intensity, and spectral accelerations at 0.2 and 1 s periods for 2%, 10%, and 50% probabilities of exceedance in 50 yrs. Ground shaking soil amplification at each site is calculated by considering uniform soil that is applied in modern building codes or by applying site‐specific factors based on VS30">VS30 shear‐wave velocities determined through a simple topographic proxy technique. We use these hazard models in conjunction with the Prompt Assessment of Global Earthquakes for Response (PAGER) model to calculate economic and casualty risk. Risk is computed by incorporating the new hazard values amplified by soil, PAGER fragility/vulnerability equations, and LandScan 2012 estimates of population exposure. We also calculate building design values using the guidelines established in the building code provisions. Resulting hazard and associated risk is high along the northern and western coasts of South America, reaching damaging levels of ground shaking in Chile, western Argentina, western Bolivia, Peru, Ecuador, Colombia, Venezuela, and in localized areas distributed across the rest of the continent where historical earthquakes have occurred. Constructing buildings and other structures to account for strong shaking in these regions of high hazard and risk should mitigate losses and reduce casualties from effects of future earthquake strong ground shaking. National models should be developed by scientists and engineers in each country using the best available science.

Hepatitis C Testing Practices and Prevalence in a High-risk Urban Ambulatory Care Setting

PubMed Central

Southern, William N.; Drainoni, Mari-Lynn; Smith, Bryce D.; Christiansen, Cindy L.; McKee, Diane; Gifford, Allen L.; Weinbaum, Cindy M.; Thompson, Devin; Koppelman, Elisa; Maher, Stacia; Litwin, Alain H.

2010-01-01

Approximately 3.2 million persons are chronically infected with the hepatitis C virus (HCV) in the U.S; most are not aware of their infection. Our objectives were to examine HCV testing practices to determine which patient characteristics are associated with HCV testing and positivity, and to estimate the prevalence of HCV infection in a high-risk urban population. The study subjects were all patients included in the baseline phase of the Hepatitis C Assessment and Testing Project (HepCAT), a serial cross-sectional study of HCV screening strategies. We examined all patients with a clinic visit to Montefiore Medical Center from 1/1/08 to 2/29/08. Demographic information, laboratory data and ICD-9 diagnostic codes from 3/1/97 – 2/29/08 were extracted from the electronic medical record. Risk factors for HCV were defined based on birth date, ICD-9 codes and laboratory data. The prevalence of HCV infection was estimated assuming that untested subjects would test positive at the same rate as tested subjects, based on risk-factors. Of 9579 subjects examined, 3803 (39.7%) had been tested for HCV and 438 (11.5%) were positive. The overall prevalence of HCV infection was estimated to be 7.7%. Risk factors associated with being tested and anti-HCV positivity included: born in the high-prevalence birth-cohort (1945-64), substance abuse, HIV infection, alcohol abuse, diagnosis of cirrhosis, end-stage renal disease, and ALT elevation. In a high-risk urban population, a significant proportion of patients were tested for HCV and the prevalence of HCV infection was high. Physicians appear to use a risk-based screening strategy to identify HCV infection. PMID:20497311

Assessment of Lymphedema Risk Following Lymph Node Dissection and Radiation Therapy for Primary Breast Cancer

DTIC Science & Technology

2007-09-01

RESPONSIBLE PERSON USAMRMC a. REPORT U b . ABSTRACT U c. THIS PAGE U UU 53 19b. TELEPHONE NUMBER (include area code) Standard...defensible. b . Data collection Complete 12-month data has been collected on 31 subjects. It is anticipated that data collection will be complete by...Cancer.(Appendix B ). 13 Conclusion Work to date has established that LNs draining the arm after surgical manipulation of the axilla in the

Stereotyped motor behaviors associated with autism in high-risk infants: a pilot videotape analysis of a sibling sample.

PubMed

Loh, Alvin; Soman, Teesta; Brian, Jessica; Bryson, Susan E; Roberts, Wendy; Szatmari, Peter; Smith, Isabel M; Zwaigenbaum, Lonnie

2007-01-01

This study examined motor behaviors in a longitudinal cohort of infant siblings of children with autism. Stereotypic movements and postures occurring during standardized observational assessments at 12 and 18 months were coded from videotapes. Participants included eight infant siblings later diagnosed with autism spectrum disorder (ASD), a random sample of nine non-diagnosed siblings, and 15 controls. Videos were coded blind to diagnostic group. At 12 and 18 months the ASD group "arm waved" more frequently and at 18 months, one posture ("hands to ears") was more frequently observed in the ASD and non-diagnosed group compared to the controls. Overall, the siblings subsequently diagnosed with ASD and the comparison groups had considerable overlap in their repertoires of stereotyped behaviors.

Static Stretching of the Hamstring Muscle for Injury Prevention in Football Codes: a Systematic Review

PubMed Central

Rogan, Slavko; Wüst, Dirk; Schwitter, Thomas; Schmidtbleicher, Dietmar

2012-01-01

Purpose Hamstring injuries are common among football players. There is still disagreement regarding prevention. The aim of this review is to determine whether static stretching reduces hamstring injuries in football codes. Methods A systematic literature search was conducted on the online databases PubMed, PEDro, Cochrane, Web of Science, Bisp and Clinical Trial register. Study results were presented descriptively and the quality of the studies assessed were based on Cochrane's ‘risk of bias’ tool. Results The review identified 35 studies, including four analysis studies. These studies show deficiencies in the quality of study designs. Conclusion The study protocols are varied in terms of the length of intervention and follow-up. No RCT studies are available, however, RCT studies should be conducted in the near future. PMID:23785569

Associations with resuscitation choice: Do not resuscitate, full code or undecided.

PubMed

Jordan, Kim; Elliott, John O; Wall, Sarah; Saul, Emily; Sheth, Rajiv; Coffman, Julie

2016-05-01

To examine associations of individual exposure and knowledge of resuscitation mechanics and prognosis with specific decision: Do Not Resuscitate (DNR), Full Code (FC) or Undecided (UD). Cross-sectional questionnaire at 3 sites: geriatric assessment center, internal medicine resident clinic, and inpatient palliative care service. 407 completed the questionnaire: 27% identified as DNR, 24% as FC and 49% as UD. Few (11.8%) respondents reported discussion of DNR status with their primary care doctor. DNR choice was associated with knowledge of DNR mechanics, OR=2.30 (95%CI: 1.23-4.30), physician discussion, OR=5.58 (95%CI: 2.39-13.04) and confidence in understanding own health problems, OR=2.89 (95%CI: 1.04-8.04). FC choice was associated with knowledge of FC mechanics, OR=2.01 (95%CI: 1.03-3.93) and media code exposure, OR=3.80 (95%CI: 1.46-9.92). Knowledge of resuscitation prognosis was negatively associated with FC, OR =0.48 (95%CI: 0.23-0.98). Many individuals lack knowledge or understanding of resuscitation procedure, its risks, and prognosis. Educational efforts, for both patients and healthcare professionals, are needed to improve individual knowledge needed for informed decision. Scheduled time for physician-patient discussion remains important for education about individual health conditions and risk/benefits related to resuscitation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Incidence and trends of central line associated pneumothorax using radiograph report text search versus administrative database codes.

PubMed

Reeson, Marc; Forster, Alan; van Walraven, Carl

2018-05-25

Central line associated pneumothorax (CLAP) could be a good quality of care indicator because they are objectively measured, clearly undesirable and possibly avoidable. We measured the incidence and trends of CLAP using radiograph report text search with manual review and compared them with measures using routinely collected health administrative data. For each hospitalisation to a tertiary care teaching hospital between 2002 and 2015, we searched all chest radiography reports for a central line with a sensitive computer algorithm. Screen positive reports were manually reviewed to confirm central lines. The index and subsequent chest radiography reports were screened for pneumothorax followed by manual confirmation. Diagnostic and procedural codes were used to identify CLAP in administrative data. In 685 044 hospitalisations, 10 819 underwent central line insertion (1.6%) with CLAP occurring 181 times (1.7%). CLAP risk did not change over time. Codes for CLAP were inaccurate (sensitivity 13.8%, positive predictive value 6.6%). However, overall code-based CLAP risk (1.8%) was almost identical to actual values possibly because patient strata with inflated CLAP risk were balanced by more common strata having underestimated CLAP risk. Code-based methods inflated central line incidence 2.2 times and erroneously concluded that CLAP risk decreased significantly over time. Using valid methods, CLAP incidence was similar to those in the literature but has not changed over time. Although administrative database codes for CLAP were very inaccurate, they generated CLAP risks very similar to actual values because of offsetting errors. In contrast to those from radiograph report text search with manual review, CLAP trends decreased significantly using administrative data. Hospital CLAP risk should not be measured using administrative data. © 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.

Earthquake Hazard Mitigation Using a Systems Analysis Approach to Risk Assessment

NASA Astrophysics Data System (ADS)

Legg, M.; Eguchi, R. T.

2015-12-01

The earthquake hazard mitigation goal is to reduce losses due to severe natural events. The first step is to conduct a Seismic Risk Assessment consisting of 1) hazard estimation, 2) vulnerability analysis, 3) exposure compilation. Seismic hazards include ground deformation, shaking, and inundation. The hazard estimation may be probabilistic or deterministic. Probabilistic Seismic Hazard Assessment (PSHA) is generally applied to site-specific Risk assessments, but may involve large areas as in a National Seismic Hazard Mapping program. Deterministic hazard assessments are needed for geographically distributed exposure such as lifelines (infrastructure), but may be important for large communities. Vulnerability evaluation includes quantification of fragility for construction or components including personnel. Exposure represents the existing or planned construction, facilities, infrastructure, and population in the affected area. Risk (expected loss) is the product of the quantified hazard, vulnerability (damage algorithm), and exposure which may be used to prepare emergency response plans, retrofit existing construction, or use community planning to avoid hazards. The risk estimate provides data needed to acquire earthquake insurance to assist with effective recovery following a severe event. Earthquake Scenarios used in Deterministic Risk Assessments provide detailed information on where hazards may be most severe, what system components are most susceptible to failure, and to evaluate the combined effects of a severe earthquake to the whole system or community. Casualties (injuries and death) have been the primary factor in defining building codes for seismic-resistant construction. Economic losses may be equally significant factors that can influence proactive hazard mitigation. Large urban earthquakes may produce catastrophic losses due to a cascading of effects often missed in PSHA. Economic collapse may ensue if damaged workplaces, disruption of utilities, and resultant loss of income produces widespread default on payments. With increased computational power and more complete inventories of exposure, Monte Carlo methods may provide more accurate estimation of severe losses and the opportunity to increase resilience of vulnerable systems and communities.

Mechanisms of contextual risk for adolescent self-injury: invalidation and conflict escalation in mother-child interactions.

PubMed

Crowell, Sheila E; Baucom, Brian R; McCauley, Elizabeth; Potapova, Natalia V; Fitelson, Martha; Barth, Heather; Smith, Cindy J; Beauchaine, Theodore P

2013-01-01

According to developmental theories of self-injury, both child characteristics and environmental contexts shape and maintain problematic behaviors. Although progress has been made toward identifying biological vulnerabilities to self-injury, mechanisms underlying psychosocial risk have received less attention. In the present study, we compared self-injuring adolescents (n = 17) with typical controls (n = 20) during a mother-child conflict discussion. Dyadic interactions were coded using both global and microanalytic systems, allowing for a highly detailed characterization of mother-child interactions. We also assessed resting state psychophysiological regulation, as indexed by respiratory sinus arrhythmia (RSA). Global coding revealed that maternal invalidation was associated with adolescent anger. Furthermore, maternal invalidation and coerciveness were both related to adolescent opposition/defiance. Results from the microanalytic system indicated that self-injuring dyads were more likely to escalate conflict, suggesting a potential mechanism through which emotion dysregulation is shaped and maintained over time. Finally, mother and teen aversiveness interacted to predict adolescent resting RSA. Low-aversive teens with highly aversive mothers had the highest RSA, whereas teens in high-high dyads showed the lowest RSA. These findings are consistent with theories that emotion invalidation and conflict escalation are possible contextual risk factors for self-injury.

Mechanisms of Contextual Risk for Adolescent Self-Injury: Invalidation and Conflict Escalation in Mother-Child Interactions

PubMed Central

Crowell, Sheila E.; Baucom, Brian R.; McCauley, Elizabeth; Potapova, Natalia V.; Fitelson, Martha; Barth, Heather; Smith, Cindy J.; Beauchaine, Theodore P.

2013-01-01

OBJECTIVE According to developmental theories of self-injury, both child characteristics and environmental contexts shape and maintain problematic behaviors. Although progress has been made toward identifying biological vulnerabilities to self-injury, mechanisms underlying psychosocial risk have received less attention. METHOD In the present study, we compared self-injuring adolescents (n=17) with typical controls (n=20) during a mother-child conflict discussion. Dyadic interactions were coded using both global and microanalytic systems, allowing for a highly detailed characterization of mother-child interactions. We also assessed resting state psychophysiological regulation, as indexed by respiratory sinus arrhythmia (RSA). RESULTS Global coding revealed that maternal invalidation was associated with adolescent anger. Furthermore, maternal invalidation and coerciveness were both related to adolescent opposition/defiance. Results from the microanalytic system indicated that self-injuring dyads were more likely to escalate conflict, suggesting a potential mechanism through which emotion dysregulation is shaped and maintained over time. Finally, mother and teen aversiveness interacted to predict adolescent resting RSA. Low-aversive teens with highly aversive mothers had the highest RSA, whereas teens in high-high dyads showed the lowest RSA. CONCLUSIONS These findings are consistent with theories that emotion invalidation and conflict escalation are possible contextual risk factors for self-injury. PMID:23581508

Gout and the Risk of Non-vertebral Fracture.

PubMed

Kim, Seoyoung C; Paik, Julie M; Liu, Jun; Curhan, Gary C; Solomon, Daniel H

2017-02-01

Prior studies suggest an association between osteoporosis, systemic inflammation, and pro-inflammatory cytokines such as interleukin (IL)-1 and IL-6. Conflicting findings exist on the association between hyperuricemia and osteoporosis. Furthermore, it remains unknown whether gout, a common inflammatory arthritis, affects fracture risk. Using data from a US commercial health plan (2004-2013), we evaluated the risk of non-vertebral fracture (ie, forearm, wrist, hip, and pelvis) in patients with gout versus those without. Gout patients were identified with ≥2 diagnosis codes and ≥1 dispensing for a gout-related drug. Non-gout patients, identified with ≥2 visits coded for any diagnosis and ≥1 dispensing for any prescription drugs, were free of gout diagnosis and received no gout-related drugs. Hip fracture was the secondary outcome. Fractures were identified with a combination of diagnosis and procedure codes. Cox proportional hazards models compared the risk of non-vertebral fracture in gout patients versus non-gout, adjusting for more than 40 risk factors for osteoporotic fracture. Among gout patients with baseline serum uric acid (sUA) measurements available, we assessed the risk of non-vertebral fracture associated with sUA. We identified 73,202 gout and 219,606 non-gout patients, matched on age, sex, and the date of study entry. The mean age was 60 years and 82% were men. Over the mean 2-year follow-up, the incidence rate of non-vertebral fracture per 1,000 person-years was 2.92 in gout and 2.66 in non-gout. The adjusted hazard ratio (HR) was 0.98 (95% confidence interval [CI] 0.85-1.12) for non-vertebral fracture and 0.83 (95% CI 0.65-1.07) for hip fracture in gout versus non-gout. Subgroup analysis (n = 15,079) showed no association between baseline sUA and non-vertebral fracture (HR = 1.03, 95% CI 0.93-1.15), adjusted for age, sex, comorbidity score, and number of any prescription drugs. Gout was not associated with a risk of non-vertebral fracture. Among patients with gout, sUA was not associated with the risk of non-vertebral fracture. © 2016 American Society for Bone and Mineral Research. © 2016 American Society for Bone and Mineral Research.

Upgrade of DRAMA-ESA's Space Debris Mitigation Analysis Tool Suite

NASA Astrophysics Data System (ADS)

Gelhaus, Johannes; Sanchez-Ortiz, Noelia; Braun, Vitali; Kebschull, Christopher; de Oliveira, Joaquim Correia; Dominguez-Gonzalez, Raul; Wiedemann, Carsten; Krag, Holger; Vorsmann, Peter

2013-08-01

One decade ago ESA started the dev elopment of the first version of the software tool called DRAMA (Debris Risk Assessment and Mitigation Analysis) to enable ESA space programs to assess their compliance with the recommendations in the European Code of Conduct for Space Debris Mitigation. This tool was maintained, upgraded and extended during the last year and is now a combination of five individual tools, each addressing a different aspect of debris mitigation. This paper gives an overview of the new DRAMA software in general. Both, the main tools ARES, OSCAR, MIDAS, CROC and SARA will be discussed and the environment used by DRAMA will be explained shortly.

Development and application of the dynamic system doctor to nuclear reactor probabilistic risk assessments.

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

Kunsman, David Marvin; Aldemir, Tunc; Rutt, Benjamin

2008-05-01

This LDRD project has produced a tool that makes probabilistic risk assessments (PRAs) of nuclear reactors - analyses which are very resource intensive - more efficient. PRAs of nuclear reactors are being increasingly relied on by the United States Nuclear Regulatory Commission (U.S.N.R.C.) for licensing decisions for current and advanced reactors. Yet, PRAs are produced much as they were 20 years ago. The work here applied a modern systems analysis technique to the accident progression analysis portion of the PRA; the technique was a system-independent multi-task computer driver routine. Initially, the objective of the work was to fuse the accidentmore » progression event tree (APET) portion of a PRA to the dynamic system doctor (DSD) created by Ohio State University. Instead, during the initial efforts, it was found that the DSD could be linked directly to a detailed accident progression phenomenological simulation code - the type on which APET construction and analysis relies, albeit indirectly - and thereby directly create and analyze the APET. The expanded DSD computational architecture and infrastructure that was created during this effort is called ADAPT (Analysis of Dynamic Accident Progression Trees). ADAPT is a system software infrastructure that supports execution and analysis of multiple dynamic event-tree simulations on distributed environments. A simulator abstraction layer was developed, and a generic driver was implemented for executing simulators on a distributed environment. As a demonstration of the use of the methodological tool, ADAPT was applied to quantify the likelihood of competing accident progression pathways occurring for a particular accident scenario in a particular reactor type using MELCOR, an integrated severe accident analysis code developed at Sandia. (ADAPT was intentionally created with flexibility, however, and is not limited to interacting with only one code. With minor coding changes to input files, ADAPT can be linked to other such codes.) The results of this demonstration indicate that the approach can significantly reduce the resources required for Level 2 PRAs. From the phenomenological viewpoint, ADAPT can also treat the associated epistemic and aleatory uncertainties. This methodology can also be used for analyses of other complex systems. Any complex system can be analyzed using ADAPT if the workings of that system can be displayed as an event tree, there is a computer code that simulates how those events could progress, and that simulator code has switches to turn on and off system events, phenomena, etc. Using and applying ADAPT to particular problems is not human independent. While the human resources for the creation and analysis of the accident progression are significantly decreased, knowledgeable analysts are still necessary for a given project to apply ADAPT successfully. This research and development effort has met its original goals and then exceeded them.« less

Potential Risks of Ecological Momentary Assessment Among Persons Who Inject Drugs.

PubMed

Roth, Alexis M; Rossi, John; Goldshear, Jesse L; Truong, Quan; Armenta, Richard F; Lankenau, Stephen E; Garfein, Richard S; Simmons, Janie

2017-06-07

Ecological momentary assessment (EMA)-which often involves brief surveys delivered via mobile technology-has transformed our understanding of the individual and contextual micro-processes associated with legal and illicit drug use. However, little empirical research has focused on participant's perspective on the probability and magnitude of potential risks in EMA studies. To garner participant perspectives on potential risks common to EMA studies of illicit drug use. We interviewed 38 persons who inject drugs living in San Diego (CA) and Philadelphia (PA), United States. They completed simulations of an EMA tool and then underwent a semi-structured interview that systematically explored domains of risk considered within the proposed revisions to the Federal Policy for the Protection of Human Subjects or the "Common Rule." Interviews were transcribed verbatim and coded systematically to explore psychological, physical, social, legal, and informational risks from participation. Participants perceived most risks to be minimal. Some indicated that repetitive questioning about mood or drug use could cause psychological (i.e., anxiety) or behavioral risks (i.e., drug use relapse). Ironically, the questions that were viewed as risky were considered motivational to engage in healthy behaviors. The most cited risks were legal and social risks stemming from participant concerns about data collection and security. Improving our understanding of these issues is an essential first step to protect human participants in future EMA research. We provide a brief set of recommendations that can aid in the design and ethics review of the future EMA protocol with substance using populations.

Exome-Wide Association Study Identifies New Low-Frequency and Rare UGT1A1 Coding Variants and UGT1A6 Coding Variants Influencing Serum Bilirubin in Elderly Subjects

PubMed Central

Oussalah, Abderrahim; Bosco, Paolo; Anello, Guido; Spada, Rosario; Guéant-Rodriguez, Rosa-Maria; Chery, Céline; Rouyer, Pierre; Josse, Thomas; Romano, Antonino; Elia, Maurizzio; Bronowicki, Jean-Pierre; Guéant, Jean-Louis

2015-01-01

Abstract Genome-wide association studies (GWASs) have identified loci contributing to total serum bilirubin level. However, no exome-wide approaches have been performed to address this question. Using exome-wide approach, we assessed the influence of protein-coding variants on unconjugated, conjugated, and total serum bilirubin levels in a well-characterized cohort of 773 ambulatory elderly subjects from Italy. Coding variants were replicated in 227 elderly subjects from the same area. We identified 4 missense rare (minor allele frequency, MAF < 0.5%) and low-frequency (MAF, 0.5%–5%) coding variants located in the first exon of the UGT1A1 gene, which encodes for the substrate-binding domain (rs4148323 [MAF = 0.06%; p.Gly71Arg], rs144398951 [MAF = 0.06%; p.Ile215Val], rs35003977 [MAF = 0.78%; p.Val225Gly], and rs57307513 [MAF = 0.06%; p.Ser250Pro]). These variants were in strong linkage disequilibrium with 3 intronic UGT1A1 variants (rs887829, rs4148325, rs6742078), which were significantly associated with total bilirubin level (P = 2.34 × 10−34, P = 7.02 × 10−34, and P = 8.27 × 10−34), as well as unconjugated, and conjugated bilirubin levels. We also identified UGT1A6 variants in association with total (rs6759892, p.Ser7Ala, P = 1.98 × 10−26; rs2070959, p.Thr181Ala, P = 2.87 × 10−27; and rs1105879, p.Arg184Ser, P = 3.27 × 10−29), unconjugated, and conjugated bilirubin levels. All UGT1A1 intronic variants (rs887829, rs6742078, and rs4148325) and UGT1A6 coding variants (rs6759892, rs2070959, and rs1105879) were significantly associated with gallstone-related cholecystectomy risk. The UGT1A6 variant rs2070959 (p.Thr181Ala) was associated with the highest risk of gallstone–related cholecystectomy (OR, 4.58; 95% CI, 1.58–13.28; P = 3.21 × 10−3). Using an exome-wide approach we identified coding variants on UGT1A1 and UGT1A6 genes in association with serum bilirubin level and hyperbilirubinemia risk in elderly subjects. UGT1A1 intronic single-nucleotide polymorphisms (SNPs) (rs6742078, rs887829, rs4148324) serve as proxy markers for the low-frequency and rare UGT1A1 variants, thereby providing mechanistic explanation to the relationship between UGT1A1 intronic SNPs and the UGT1A1 enzyme activity. UGT1A1 and UGT1A6 variants might be potentially associated with gallstone-related cholecystectomy risk. PMID:26039129

Methodology, status, and plans for development and assessment of the RELAP5 code

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

Johnson, G.W.; Riemke, R.A.

1997-07-01

RELAP/MOD3 is a computer code used for the simulation of transients and accidents in light-water nuclear power plants. The objective of the program to develop and maintain RELAP5 was and is to provide the U.S. Nuclear Regulatory Commission with an independent tool for assessing reactor safety. This paper describes code requirements, models, solution scheme, language and structure, user interface validation, and documentation. The paper also describes the current and near term development program and provides an assessment of the code`s strengths and limitations.

Joint Conference on Marine Safety and Environment/Ship Production (1st), held 1-5 June 1992

DTIC Science & Technology

1992-06-05

have to face fresh challenges in the future. But as long as we regard these challenges as opportunities, we will remain masters of our own destiny ...has recently published for discussion an “ Embryo Code of Practice” (1991) entitled “Engineers and Risk Issues”. Thii draft Code is intended to...Department of Energy5 Her Majesty’s Stationery Office. Cm.1310. The Engineering Counci1 (1991) Engineers and Risk Issues : An Embryo Code of Practice. London

[Mannheim Rating Scales for the analysis of mother-child interaction in toddlers].

PubMed

Dinter-Jörg, M; Polowczyk, M; Herrle, J; Esser, G; Laucht, M; Schmidt, M H

1997-12-01

As part of a prospective study on child development from birth to age 11 the Mannheim Rating Scales for the Analysis of Mother-Child Interaction in Toddlers was constructed. Ten-minute interactions of 352 mothers and their toddlers were videotaped in the laboratory and evaluated with micro- and macroanalytic techniques. The instrument consists of a combination of second-by-second codings and dimensional ratings of 5-second to 1 minute periods. Interrater reliability, assessed by having two raters analyze 16 mother-child dyads, proved satisfactory. Psychosocial risk showed different patterns from those at low risk. Interactions of mothers and daughters seemed to be more harmonious than interactions of mothers and sons.

Mortality Measures to Profile Hospital Performance for Patients With Septic Shock.

PubMed

Walkey, Allan J; Shieh, Meng-Shiou; Liu, Vincent X; Lindenauer, Peter K

2018-04-30

Sepsis care is becoming a more common target for hospital performance measurement, but few studies have evaluated the acceptability of sepsis or septic shock mortality as a potential performance measure. In the absence of a gold standard to identify septic shock in claims data, we assessed agreement and stability of hospital mortality performance under different case definitions. Retrospective cohort study. U.S. acute care hospitals. Hospitalized with septic shock at admission, identified by either implicit diagnosis criteria (charges for antibiotics, cultures, and vasopressors) or by explicit International Classification of Diseases, 9th revision, codes. None. We used hierarchical logistic regression models to determine hospital risk-standardized mortality rates and hospital performance outliers. We assessed agreement in hospital mortality rankings when septic shock cases were identified by either explicit International Classification of Diseases, 9th revision, codes or implicit diagnosis criteria. Kappa statistics and intraclass correlation coefficients were used to assess agreement in hospital risk-standardized mortality and hospital outlier status, respectively. Fifty-six thousand six-hundred seventy-three patients in 308 hospitals fulfilled at least one case definition for septic shock, whereas 19,136 (33.8%) met both the explicit International Classification of Diseases, 9th revision, and implicit septic shock definition. Hospitals varied widely in risk-standardized septic shock mortality (interquartile range of implicit diagnosis mortality: 25.4-33.5%; International Classification of Diseases, 9th revision, diagnosis: 30.2-38.0%). The median absolute difference in hospital ranking between septic shock cohorts defined by International Classification of Diseases, 9th revision, versus implicit criteria was 37 places (interquartile range, 16-70), with an intraclass correlation coefficient of 0.72, p value of less than 0.001; agreement between case definitions for identification of outlier hospitals was moderate (kappa, 0.44 [95% CI, 0.30-0.58]). Risk-standardized septic shock mortality rates varied considerably between hospitals, suggesting that septic shock is an important performance target. However, efforts to profile hospital performance were sensitive to septic shock case definitions, suggesting that septic shock mortality is not currently ready for widespread use as a hospital quality measure.

General practitioners’ justifications for therapeutic inertia in cardiovascular prevention: an empirically grounded typology

PubMed Central

Lebeau, Jean-Pierre; Cadwallader, Jean-Sébastien; Vaillant-Roussel, Hélène; Pouchain, Denis; Yaouanc, Virginie; Aubin-Auger, Isabelle; Mercier, Alain; Rusch, Emmanuel; Remmen, Roy; Vermeire, Etienne; Hendrickx, Kristin

2016-01-01

Objective To construct a typology of general practitioners’ (GPs) responses regarding their justification of therapeutic inertia in cardiovascular primary prevention for high-risk patients with hypertension. Design Empirically grounded construction of typology. Types were defined by attributes derived from the qualitative analysis of GPs’ reported reasons for inaction. Participants 256 GPs randomised in the intervention group of a cluster randomised controlled trial. Setting GPs members of 23 French Regional Colleges of Teachers in General Practice, included in the EffectS of a multifaceted intervention on CArdiovascular risk factors in high-risk hyPErtensive patients (ESCAPE) trial. Data collection and analysis The database consisted of 2638 written responses given by the GPs to an open-ended question asking for the reasons why drug treatment was not changed as suggested by the national guidelines. All answers were coded using constant comparison analysis. A matrix analysis of codes per GP allowed the construction of a response typology, where types were defined by codes as attributes. Initial coding and definition of types were performed independently by two teams. Results Initial coding resulted in a list of 69 codes in the final codebook, representing 4764 coded references in the question responses. A typology including seven types was constructed. 100 GPs were allocated to one and only one of these types, while 25 GPs did not provide enough data to allow classification. Types (numbers of GPs allocated) were: ‘optimists’ (28), ‘negotiators’ (20), ‘checkers’ (15), ‘contextualisers’ (13), ‘cautious’ (11), ‘rounders’ (8) and ‘scientists’ (5). For the 36 GPs that provided 50 or more coded references, analysis of the code evolution over time and across patients showed a consistent belonging to the initial type for any given GP. Conclusion This typology could provide GPs with some insight into their general ways of considering changes in the treatment/management of cardiovascular risk factors and guide design of specific physician-centred interventions to reduce inappropriate inaction. Trial registration number NCT00348855. PMID:27178974

The influence of commenting validity, placement, and style on perceptions of computer code trustworthiness: A heuristic-systematic processing approach.

PubMed

Alarcon, Gene M; Gamble, Rose F; Ryan, Tyler J; Walter, Charles; Jessup, Sarah A; Wood, David W; Capiola, August

2018-07-01

Computer programs are a ubiquitous part of modern society, yet little is known about the psychological processes that underlie reviewing code. We applied the heuristic-systematic model (HSM) to investigate the influence of computer code comments on perceptions of code trustworthiness. The study explored the influence of validity, placement, and style of comments in code on trustworthiness perceptions and time spent on code. Results indicated valid comments led to higher trust assessments and more time spent on the code. Properly placed comments led to lower trust assessments and had a marginal effect on time spent on code; however, the effect was no longer significant after controlling for effects of the source code. Low style comments led to marginally higher trustworthiness assessments, but high style comments led to longer time spent on the code. Several interactions were also found. Our findings suggest the relationship between code comments and perceptions of code trustworthiness is not as straightforward as previously thought. Additionally, the current paper extends the HSM to the programming literature. Copyright © 2018 Elsevier Ltd. All rights reserved.

Assessment and Requirements of Nuclear Reaction Databases for GCR Transport in the Atmosphere and Structures

NASA Technical Reports Server (NTRS)

Cucinotta, F. A.; Wilson, J. W.; Shinn, J. L.; Tripathi, R. K.

1998-01-01

The transport properties of galactic cosmic rays (GCR) in the atmosphere, material structures, and human body (self-shielding) am of interest in risk assessment for supersonic and subsonic aircraft and for space travel in low-Earth orbit and on interplanetary missions. Nuclear reactions, such as knockout and fragmentation, present large modifications of particle type and energies of the galactic cosmic rays in penetrating materials. We make an assessment of the current nuclear reaction models and improvements in these model for developing required transport code data bases. A new fragmentation data base (QMSFRG) based on microscopic models is compared to the NUCFRG2 model and implications for shield assessment made using the HZETRN radiation transport code. For deep penetration problems, the build-up of light particles, such as nucleons, light clusters and mesons from nuclear reactions in conjunction with the absorption of the heavy ions, leads to the dominance of the charge Z = 0, 1, and 2 hadrons in the exposures at large penetration depths. Light particles are produced through nuclear or cluster knockout and in evaporation events with characteristically distinct spectra which play unique roles in the build-up of secondary radiation's in shielding. We describe models of light particle production in nucleon and heavy ion induced reactions and make an assessment of the importance of light particle multiplicity and spectral parameters in these exposures.

A Model to Assess the Risk of Ice Accretion Due to Ice Crystal Ingestion in a Turbofan Engine and its Effects on Performance

NASA Technical Reports Server (NTRS)

Jorgenson, Philip C. E.; Veres, Joseph P.; Wright, William B.; Struk, Peter M.

2013-01-01

The occurrence of ice accretion within commercial high bypass aircraft turbine engines has been reported under certain atmospheric conditions. Engine anomalies have taken place at high altitudes that were attributed to ice crystal ingestion, partially melting, and ice accretion on the compression system components. The result was one or more of the following anomalies: degraded engine performance, engine roll back, compressor surge and stall, and flameout of the combustor. The main focus of this research is the development of a computational tool that can estimate whether there is a risk of ice accretion by tracking key parameters through the compression system blade rows at all engine operating points within the flight trajectory. The tool has an engine system thermodynamic cycle code, coupled with a compressor flow analysis code, and an ice particle melt code that has the capability of determining the rate of sublimation, melting, and evaporation through the compressor blade rows. Assumptions are made to predict the complex physics involved in engine icing. Specifically, the code does not directly estimate ice accretion and does not have models for particle breakup or erosion. Two key parameters have been suggested as conditions that must be met at the same location for ice accretion to occur: the local wet-bulb temperature to be near freezing or below and the local melt ratio must be above 10%. These parameters were deduced from analyzing laboratory icing test data and are the criteria used to predict the possibility of ice accretion within an engine including the specific blade row where it could occur. Once the possibility of accretion is determined from these parameters, the degree of blockage due to ice accretion on the local stator vane can be estimated from an empirical model of ice growth rate and time spent at that operating point in the flight trajectory. The computational tool can be used to assess specific turbine engines to their susceptibility to ice accretion in an ice crystal environment.

RELAP5-3D Developmental Assessment: Comparison of Versions 4.3.4i and 4.2.1i

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

Bayless, Paul David

2015-10-01

Figures have been generated comparing the parameters used in the developmental assessment of the RELAP5-3D code using versions 4.3.4i and 4.2.1i. The figures, which are the same as those used in Volume III of the RELAP5-3D code manual, compare calculations using the semi-implicit solution scheme with available experiment data. These figures provide a quick, visual indication of how the code predictions changed between these two code versions and can be used to identify cases in which the assessment judgment may need to be changed in Volume III of the code manual. Changes to the assessment judgments made after reviewing allmore » of the assessment cases are also provided.« less

RELAP5-3D Developmental Assessment: Comparison of Versions 4.2.1i and 4.1.3i

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

Bayless, Paul D.

2014-06-01

Figures have been generated comparing the parameters used in the developmental assessment of the RELAP5-3D code using versions 4.2.1i and 4.1.3i. The figures, which are the same as those used in Volume III of the RELAP5-3D code manual, compare calculations using the semi-implicit solution scheme with available experiment data. These figures provide a quick, visual indication of how the code predictions changed between these two code versions and can be used to identify cases in which the assessment judgment may need to be changed in Volume III of the code manual. Changes to the assessment judgments made after reviewing allmore » of the assessment cases are also provided.« less

PARS risk charts: A 10-year study of risk assessment for cardiovascular diseases in Eastern Mediterranean Region

PubMed Central

Talaei, Mohammad; Sadeghi, Masoumeh; Roohafza, Hamid Reza; Masoudkabir, Farzad; OveisGharan, Shahram; Mohebian, Mohammad Reza; Mañanas, Miquel Angel

2017-01-01

This study was designed to develop a risk assessment chart for the clinical management and prevention of the risk of cardiovascular disease (CVD) in Iranian population, which is vital for developing national prevention programs. The Isfahan Cohort Study (ICS) is a population-based prospective study of 6504 Iranian adults ≥35 years old, followed-up for ten years, from 2001 to 2010. Behavioral and cardiometabolic risk factors were examined every five years, while biennial follow-ups for the occurrence of the events was performed by phone calls or by verbal autopsy. Among these participants, 5432 (2784 women, 51.3%) were CVD free at baseline examination and had at least one follow-up. Cox proportional hazard regression was used to predict the risk of ischemic CVD events, including sudden cardiac death due to unstable angina, myocardial infarction, and stroke. The model fit statistics such as area under the receiver-operating characteristic (AUROC), calibration chi-square and the overall bias were used to assess the model performance. We also tested the Framingham model for comparison. Seven hundred and five CVD events occurred during 49452.8 person-years of follow-up. The event probabilities were calculated and presented color-coded on each gender-specific PARS chart. The AUROC and Harrell’s C indices were 0.74 (95% CI, 0.72–0.76) and 0.73, respectively. In the calibration, the Nam-D’Agostino χ2 was 10.82 (p = 0.29). The overall bias of the proposed model was 95.60%. PARS model was also internally validated using cross-validation. The Android app and the Web-based risk assessment tool were also developed as to have an impact on public health. In comparison, the refitted and recalibrated Framingham models, estimated the CVD incidence with the overall bias of 149.60% and 128.23% for men, and 222.70% and 176.07% for women, respectively. In conclusion, the PARS risk assessment chart is a simple, accurate, and well-calibrated tool for predicting a 10-year risk of CVD occurrence in Iranian population and can be used in an attempt to develop national guidelines for the CVD management. PMID:29261727

Children in health research: a matter of trust.

PubMed

Woodgate, Roberta L; Edwards, Marie

2010-04-01

Central to the involvement of children in health research is the notion of risk. In this paper we present one of the factors, a matter of trust, that shaped Canadian parents' and children's perceptions and assessments of risk in child health research. Part of a larger qualitative research study, 82 parents took part an in-depth qualitative interview, with 51 parents having children who had participated in health research and 31 having children with no research history. 51 children ranging from 6 to 19 years of age were also interviewed, with 28 having a history of participation in child health research and 23 having no history. Children also took part in 3 focus groups interviews. Themes emerged through a grounded theory analysis of coded interview transcripts. The presence or absence of trust was not only perceived by parents and children as a contributing factor to involving children in health research, but also shaped their perceptions and assessments of risk. Three interrelated subthemes identified were: (1) relationships of trust; (2) placing trust in symbols of authority; and (3) the continuum of trust. Our study reinforces that trust is an important factor when parents assess risk in child health research and shows that children use the language of trust in relation to risk. More discussion regarding trust in training researchers is warranted given the trust in researchers and institutions evident in this study. We also recommend further study of the continuum of trust in child health research.

The Paraoxonase 1 Gene c.-108C>T SNP in the Promoter Is Associated with Risk for Glioma in Mexican Patients, but Not the p.L55M or p.Q192R Polymorphisms in the Coding Region.

PubMed

González-Herrera, Lizbeth; Gamas-Trujillo, Pablo Alejandro; Medina-Escobedo, Gilberto; Oaxaca-Castillo, David; Pérez-Mendoza, Gerardo; Williams-Jacquez, Dayana; Canto-Cetina, Thelma; Vargas-García, Rubén Darío

2015-09-01

To evaluate the association of the paraoxonase 1 (PON1) gene polymorphisms c.-108C>T, p.L55M, and p.Q192R with the risk of glioma in Southeast Mexico. Decreased PON1 activity caused by polymorphisms has been observed in gliomas, thus supporting the theory that PON1 is involved in tumorigenesis in the brain. Sixty-seven glioma patients and 58 control individuals were included. Three PON1 polymorphisms were genotyped by real-time PCR allelic discrimination using TaqMan probes: c.-108C>T in the promoter region, p.Q192R and p.L55M, both of which were in the coding region. Allele, genotype, and haplotype frequencies were assessed in cases and controls to test for statistical associations (STATA 10.2 package). Significant differences were found for the PON1 c.-108C>T polymorphism between the cases and controls. Compared to the controls the cases were more likely to be CT heterozygous (p =  0.002) or TT homozygous (p = 0.036); similarly cases were more likely to possess a T allele (p = 0.032). In contrast, the p.L55M and p.Q192R polymorphisms did not show significant differences between the glioma cases and controls (p > 0.05). The PON1 c.-108C>T polymorphism in the promoter region is associated with genetic risk for glioma. Conversely, p.L55M and p.Q192R polymorphisms in the coding region do not seem to have an influence in this population.

Professional Ethics for Climate Scientists

NASA Astrophysics Data System (ADS)

Peacock, K.; Mann, M. E.

2014-12-01

Several authors have warned that climate scientists sometimes exhibit a tendency to "err on the side of least drama" in reporting the risks associated with fossil fuel emissions. Scientists are often reluctant to comment on the implications of their work for public policy, despite the fact that because of their expertise they may be among those best placed to make recommendations about such matters as mitigation and preparedness. Scientists often have little or no training in ethics or philosophy, and consequently they may feel that they lack clear guidelines for balancing the imperative to avoid error against the need to speak out when it may be ethically required to do so. This dilemma becomes acute in cases such as abrupt ice sheet collapse where it is easier to identify a risk than to assess its probability. We will argue that long-established codes of ethics in the learned professions such as medicine and engineering offer a model that can guide research scientists in cases like this, and we suggest that ethical training could be regularly incorporated into graduate curricula in fields such as climate science and geology. We recognize that there are disanalogies between professional and scientific ethics, the most important of which is that codes of ethics are typically written into the laws that govern licensed professions such as engineering. Presently, no one can legally compel a research scientist to be ethical, although legal precedent may evolve such that scientists are increasingly expected to communicate their knowledge of risks. We will show that the principles of professional ethics can be readily adapted to define an ethical code that could be voluntarily adopted by scientists who seek clearer guidelines in an era of rapid climate change.

Modeling Acute Health Effects of Astronauts from Exposure to Large Solar Particle Events

NASA Technical Reports Server (NTRS)

Hu, Shaowen; Kim, Myung-Hee Y.; Cucinotta, Francis A.

2011-01-01

In space exploration outside the Earth s geomagnetic field, radiation exposure from solar particle events (SPE) presents a health concern for astronauts, that could impair their performance and result in possible failure of the mission. Acute risks are of special concern during extra-vehicular activities because of the rapid onset of SPE. However, most SPEs will not lead to acute risks but can lead to mission disruption if accurate projection methods are not available. Acute Radiation Sickness (ARS) is a group of clinical syndromes developing acutely (within several seconds to 3 days) after high dose whole-body or significant partial-body ionizing radiation exposures. The manifestation of these syndromes reflects the disturbance of physiological processes of various cellular groups damaged by radiation. Hematopoietic cells, skin, epithelium, intestine, and vascular endothelium are among the most sensitive tissues of human body to ionizing radiation. Most ARS symptoms are directly related to these tissues and other systems (nervous, endocrine, and cardiovascular, etc.) with coupled regulations. Here we report the progress in bio-mathematical models to describe the dose and time-dependent early human responses to ionizing radiation. The responses include lymphocyte depression, granulocyte modulation, fatigue and weakness syndrome, and upper gastrointestinal distress. The modest dose and dose-rates of SPEs are predicted to lead to large sparing of ARS, however detailed experimental data on a range of proton dose-rates for organ doses from 0.5 to 2 Gy is needed to validate the models. We also report on the ARRBOD code that integrates the BRYNTRN and SUMDOSE codes, which are used to estimate the SPE organ doses for astronauts under various space travel scenarios, with our models of ARS. The more recent effort is to provide easy web access to space radiation risk assessment using the ARRBOD code.

Analyses in Support of Risk-Informed Natural Gas Vehicle Maintenance Facility Codes and Standards: Phase II.

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

Blaylock, Myra L.; LaFleur, Chris Bensdotter; Muna, Alice Baca

Safety standards development for maintenance facilities of liquid and compressed natural gas fueled vehicles is required to ensure proper facility design and operating procedures. Standard development organizations are utilizing risk-informed concepts to develop natural gas vehicle (NGV) codes and standards so that maintenance facilities meet acceptable risk levels. The present report summarizes Phase II work for existing NGV repair facility code requirements and highlights inconsistencies that need quantitative analysis into their effectiveness. A Hazardous and Operability study was performed to identify key scenarios of interest using risk ranking. Detailed simulations and modeling were performed to estimate the location and behaviormore » of natural gas releases based on these scenarios. Specific code conflicts were identified, and ineffective code requirements were highlighted and resolutions proposed. These include ventilation rate basis on area or volume, as well as a ceiling offset which seems ineffective at protecting against flammable gas concentrations. ACKNOWLEDGEMENTS The authors gratefully acknowledge Bill Houf (SNL -- Retired) for his assistance with the set-up and post-processing of the numerical simulations. The authors also acknowledge Doug Horne (retired) for his helpful discussions. We would also like to acknowledge the support from the Clean Cities program of DOE's Vehicle Technology Office.« less

Adapting the coping in deliberation (CODE) framework: a multi-method approach in the context of familial ovarian cancer risk management.

PubMed

Witt, Jana; Elwyn, Glyn; Wood, Fiona; Rogers, Mark T; Menon, Usha; Brain, Kate

2014-11-01

To test whether the coping in deliberation (CODE) framework can be adapted to a specific preference-sensitive medical decision: risk-reducing bilateral salpingo-oophorectomy (RRSO) in women at increased risk of ovarian cancer. We performed a systematic literature search to identify issues important to women during deliberations about RRSO. Three focus groups with patients (most were pre-menopausal and untested for genetic mutations) and 11 interviews with health professionals were conducted to determine which issues mattered in the UK context. Data were used to adapt the generic CODE framework. The literature search yielded 49 relevant studies, which highlighted various issues and coping options important during deliberations, including mutation status, risks of surgery, family obligations, physician recommendation, peer support and reliable information sources. Consultations with UK stakeholders confirmed most of these factors as pertinent influences on deliberations. Questions in the generic framework were adapted to reflect the issues and coping options identified. The generic CODE framework was readily adapted to a specific preference-sensitive medical decision, showing that deliberations and coping are linked during deliberations about RRSO. Adapted versions of the CODE framework may be used to develop tailored decision support methods and materials in order to improve patient-centred care. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

High burden of kidney disease in youth-onset type 2 diabetes.

PubMed

Dart, Allison B; Sellers, Elizabeth A; Martens, Patricia J; Rigatto, Claudio; Brownell, Marni D; Dean, Heather J

2012-06-01

To evaluate renal outcomes and survival in youth with type 2 diabetes (T2DM) versus type 1 diabetes (T1DM) versus nondiabetic control subjects. In total, 342 prevalent youth (aged 1-18 years) with T2DM, 1,011 youth with T1DM, and 1,710 control subjects identified from 1986 to 2007 were anonymously linked to health care records housed at the Manitoba Centre for Health Policy to assess long-term outcomes using ICD codes. Youth with T2DM were found to have a fourfold increased risk of renal failure versus youth with T1DM. Risk factors associated with renal failure were renin angiotensin aldosterone system inhibitor use and albuminuria in adolescence. Compared with control subjects (age, sex, and postal code matched), youth with T2DM had a 23-fold increased risk of renal failure and a 39-fold increased risk of dialysis. Kaplan-Meier survival at 10 years was 91.4% in the type 2 diabetic group versus 99.5% in the type 1 diabetic group (P < 0.0001). Renal survival was 100% at 10 years in both groups. It decreased to 92.0% at 15 years and 55.0% at 20 years in the type 2 diabetic group but remained stable in the type 1 diabetic group (P < 0.0001). Youth with T2DM are at high risk of adverse renal outcomes and death. Albuminuria and angiotensin aldosterone system inhibitor use, which may be a marker of severity of disease, are associated with poor outcomes in early adulthood.

Multiple myeloma among Danish women: employment history and workplace exposures.

PubMed

Pottern, L M; Heineman, E F; Olsen, J H; Raffn, E; Blair, A

1992-09-01

To investigate the role of employment history and workplace exposures as risk factors for multiple myeloma among women, a population-based case-control study using the Danish Cancer Registry data linkage system was conducted. All cases of myeloma diagnosed in Danish women between 1970 and 1984 (1,010 cases) and 4,040 age-matched women alive at the time of case-diagnosis were identified. Industrial histories from 1964 forward were obtained from the nationwide Pension Fund for 363 cases and 1,517 controls, and the most recent occupation on the tax record was available for 607 cases and 2,596 controls. Using industry/occupational-code combinations for the cases and controls who had industry employment, Danish industrial hygienists assessed the likelihood of exposure to 47 workplace substances. An increased myeloma risk (odds ratio [OR] = 1.2, 95 percent confidence interval [CI] = 1.0-1.5) was seen for women not in the Pension Fund, but who had an occupational title coded as 'Mrs/homemaker.' Nonsignificantly elevated risks of 1.3 or greater were observed for employment in: production of agricultural products; orchards/nurseries; spinning/weaving; other textile and plastics manufacturing; hotel, entertainment, and social services industries. Elevated, but nonsignificant risks were observed for possible and probable exposure to exhaust fumes, formaldehyde, wood dust, animals or animal products, and pesticides. The strongest association with myeloma was employment in the agricultural industry (OR = 1.5, CI = 0.8-2.8), however, the number of women who worked on family farms was unknown and could not be included in this risk estimate.

High Burden of Kidney Disease in Youth-Onset Type 2 Diabetes

PubMed Central

Dart, Allison B.; Sellers, Elizabeth A.; Martens, Patricia J.; Rigatto, Claudio; Brownell, Marni D.; Dean, Heather J.

2012-01-01

OBJECTIVE To evaluate renal outcomes and survival in youth with type 2 diabetes (T2DM) versus type 1 diabetes (T1DM) versus nondiabetic control subjects. RESEARCH DESIGN AND METHODS In total, 342 prevalent youth (aged 1–18 years) with T2DM, 1,011 youth with T1DM, and 1,710 control subjects identified from 1986 to 2007 were anonymously linked to health care records housed at the Manitoba Centre for Health Policy to assess long-term outcomes using ICD codes. RESULTS Youth with T2DM were found to have a fourfold increased risk of renal failure versus youth with T1DM. Risk factors associated with renal failure were renin angiotensin aldosterone system inhibitor use and albuminuria in adolescence. Compared with control subjects (age, sex, and postal code matched), youth with T2DM had a 23-fold increased risk of renal failure and a 39-fold increased risk of dialysis. Kaplan-Meier survival at 10 years was 91.4% in the type 2 diabetic group versus 99.5% in the type 1 diabetic group (P < 0.0001). Renal survival was 100% at 10 years in both groups. It decreased to 92.0% at 15 years and 55.0% at 20 years in the type 2 diabetic group but remained stable in the type 1 diabetic group (P < 0.0001). CONCLUSIONS Youth with T2DM are at high risk of adverse renal outcomes and death. Albuminuria and angiotensin aldosterone system inhibitor use, which may be a marker of severity of disease, are associated with poor outcomes in early adulthood. PMID:22432116

The Impact of Lumbar Spine Disease and Deformity on Total Hip Arthroplasty Outcomes.

PubMed

Blizzard, Daniel J; Sheets, Charles Z; Seyler, Thorsten M; Penrose, Colin T; Klement, Mitchell R; Gallizzi, Michael A; Brown, Christopher R

2017-05-01

Concomitant spine and hip disease in patients undergoing total hip arthroplasty (THA) presents a management challenge. Degenerative lumbar spine conditions are known to decrease lumbar lordosis and limit lumbar flexion and extension, leading to altered pelvic mechanics and increased demand for hip motion. In this study, the effect of lumbar spine disease on complications after primary THA was assessed. The Medicare database was searched from 2005 to 2012 using International Classification of Diseases, Ninth Revision, procedure codes for primary THA and diagnosis codes for preoperative diagnoses of lumbosacral spondylosis, lumbar disk herniation, acquired spondylolisthesis, and degenerative disk disease. The control group consisted of all patients without a lumbar spine diagnosis who underwent THA. The risk ratios for prosthetic hip dislocation, revision THA, periprosthetic fracture, and infection were significantly higher for all 4 lumbar diseases at all time points relative to controls. The average complication risk ratios at 90 days were 1.59 for lumbosacral spondylosis, 1.62 for disk herniation, 1.65 for spondylolisthesis, and 1.53 for degenerative disk disease. The average complication risk ratios at 2 years were 1.66 for lumbosacral spondylosis, 1.73 for disk herniation, 1.65 for spondylolisthesis, and 1.59 for degenerative disk disease. Prosthetic hip dislocation was the most common complication at 2 years in all 4 spinal disease cohorts, with risk ratios ranging from 1.76 to 2.00. This study shows a significant increase in the risk of complications following THA in patients with lumbar spine disease. [Orthopedics. 2017; 40(3):e520-e525.]. Copyright 2017, SLACK Incorporated.

Preliminary Assessment of Turbomachinery Codes

NASA Technical Reports Server (NTRS)

Mazumder, Quamrul H.

2007-01-01

This report assesses different CFD codes developed and currently being used at Glenn Research Center to predict turbomachinery fluid flow and heat transfer behavior. This report will consider the following codes: APNASA, TURBO, GlennHT, H3D, and SWIFT. Each code will be described separately in the following section with their current modeling capabilities, level of validation, pre/post processing, and future development and validation requirements. This report addresses only previously published and validations of the codes. However, the codes have been further developed to extend the capabilities of the codes.

Population-based evaluation of a suggested anatomic and clinical classification of congenital heart defects based on the International Paediatric and Congenital Cardiac Code.

PubMed

Houyel, Lucile; Khoshnood, Babak; Anderson, Robert H; Lelong, Nathalie; Thieulin, Anne-Claire; Goffinet, François; Bonnet, Damien

2011-10-03

Classification of the overall spectrum of congenital heart defects (CHD) has always been challenging, in part because of the diversity of the cardiac phenotypes, but also because of the oft-complex associations. The purpose of our study was to establish a comprehensive and easy-to-use classification of CHD for clinical and epidemiological studies based on the long list of the International Paediatric and Congenital Cardiac Code (IPCCC). We coded each individual malformation using six-digit codes from the long list of IPCCC. We then regrouped all lesions into 10 categories and 23 subcategories according to a multi-dimensional approach encompassing anatomic, diagnostic and therapeutic criteria. This anatomic and clinical classification of congenital heart disease (ACC-CHD) was then applied to data acquired from a population-based cohort of patients with CHD in France, made up of 2867 cases (82% live births, 1.8% stillbirths and 16.2% pregnancy terminations). The majority of cases (79.5%) could be identified with a single IPCCC code. The category "Heterotaxy, including isomerism and mirror-imagery" was the only one that typically required more than one code for identification of cases. The two largest categories were "ventricular septal defects" (52%) and "anomalies of the outflow tracts and arterial valves" (20% of cases). Our proposed classification is not new, but rather a regrouping of the known spectrum of CHD into a manageable number of categories based on anatomic and clinical criteria. The classification is designed to use the code numbers of the long list of IPCCC but can accommodate ICD-10 codes. Its exhaustiveness, simplicity, and anatomic basis make it useful for clinical and epidemiologic studies, including those aimed at assessment of risk factors and outcomes.

Increased length of inpatient stay and poor clinical coding: audit of patients with diabetes.

PubMed

Daultrey, Harriet; Gooday, Catherine; Dhatariya, Ketan

2011-11-01

People with diabetes stay in hospital for longer than those without diabetes for similar conditions. Clinical coding is poor across all specialties. Inpatients with diabetes often have unrecognized foot problems. We wanted to look at the relationships between these factors. A single day audit, looking at the prevalence of diabetes in all adult inpatients. Also looking at their feet to find out how many were high-risk or had existing problems. A 998-bed university teaching hospital. All adult inpatients. (a) To see if patients with diabetes and foot problems were in hospital for longer than the national average length of stay compared with national data; (b) to see if there were people in hospital with acute foot problems who were not known to the specialist diabetic foot team; and (c) to assess the accuracy of clinical coding. We identified 110 people with diabetes. However, discharge coding data for inpatients on that day showed 119 people with diabetes. Length of stay (LOS) was substantially higher for those with diabetes compared to those without (± SD) at 22.39 (22.26) days, vs. 11.68 (6.46) (P < 0.001). Finally, clinical coding was poor with some people who had been identified as having diabetes on the audit, who were not coded as such on discharge. Clinical coding - which is dependent on discharge summaries - poorly reflects diagnoses. Additionally, length of stay is significantly longer than previous estimates. The discrepancy between coding and diagnosis needs addressing by increasing the levels of awareness and education of coders and physicians. We suggest that our data be used by healthcare planners when deciding on future tariffs.

Increased length of inpatient stay and poor clinical coding: audit of patients with diabetes

PubMed Central

Daultrey, Harriet; Gooday, Catherine; Dhatariya, Ketan

2011-01-01

Objectives People with diabetes stay in hospital for longer than those without diabetes for similar conditions. Clinical coding is poor across all specialties. Inpatients with diabetes often have unrecognized foot problems. We wanted to look at the relationships between these factors. Design A single day audit, looking at the prevalence of diabetes in all adult inpatients. Also looking at their feet to find out how many were high-risk or had existing problems. Setting A 998-bed university teaching hospital. Participants All adult inpatients. Main outcome measures (a) To see if patients with diabetes and foot problems were in hospital for longer than the national average length of stay compared with national data; (b) to see if there were people in hospital with acute foot problems who were not known to the specialist diabetic foot team; and (c) to assess the accuracy of clinical coding. Results We identified 110 people with diabetes. However, discharge coding data for inpatients on that day showed 119 people with diabetes. Length of stay (LOS) was substantially higher for those with diabetes compared to those without (± SD) at 22.39 (22.26) days, vs. 11.68 (6.46) (P < 0.001). Finally, clinical coding was poor with some people who had been identified as having diabetes on the audit, who were not coded as such on discharge. Conclusion Clinical coding – which is dependent on discharge summaries – poorly reflects diagnoses. Additionally, length of stay is significantly longer than previous estimates. The discrepancy between coding and diagnosis needs addressing by increasing the levels of awareness and education of coders and physicians. We suggest that our data be used by healthcare planners when deciding on future tariffs. PMID:22140609

Interaction effects and mechanism of Pb pollution and soil microorganism in the presence of earthworm.

PubMed

Liu, Gao; Ling, Siyuan; Zhan, Xiuping; Lin, Zhifen; Zhang, Wei; Lin, Kuangfei

2017-04-01

Heavy metals usually cause great damage to soil ecosystem. Lead (Pb) was chosen as a research object in the present study. Here repeated exposure of Pb was designed for the soil artificially contaminated. A laboratory study was conducted to determine the changes in the Pb availability and biological activity in the presence of earthworm, and the risk assessment code (RAC) was applied to evaluate the remediated soil. Results demonstrated that Pb gradually transformed to more stable fractions (OMB- and FeMnOX-Pb) under microbial action, indicating the risk level of Pb was declined. On the other hand, Pb also caused the inhibition of soil respiration and microbial biomass, and the higher the concentration of Pb, the stronger the inhibition; While in the presence of earthworm, it could absorb Pb and facilitate microbial activity, reflected the decrease of Pb content and the increase of respiration intensity in soil, as well as microbial biomass. Additionally, a good dose-response relationship between EXCH-Pb content and respiration intensity might provide a basis for ecological risk assessment. Copyright © 2017 Elsevier Ltd. All rights reserved.

Listening to Our Patients: Learning About Suicide Risk and Protective Factors From Veterans With HIV/AIDS.

PubMed

Signoracci, Gina M; Stearns-Yoder, Kelly A; Holliman, Brooke Dorsey; Huggins, Joseph A; Janoff, Edward N; Brenner, Lisa A

2016-12-01

We sought to gather perspectives of veterans with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) regarding suicide risk factors, warning signs, and protective factors. We also aimed to modify an existing Veterans Health Administration tool, the Suicide Risk Assessment Guide Pocket Card, for HIV/AIDS provider use. Twenty male veterans participated in audio-recorded semistructured interviews that were transcribed and coded for themes. Veterans highlighted personally relevant psychosocial stressors (i.e., poverty, social isolation and loneliness, and physical health). Although the concept of warning signs did not seem salient to participants, they named indicators of elevated imminent risk for self-directed violence (i.e., "relapse," "not take'n medications," and "miss'n appointments") and few protective factors. No themes emerged regarding recommended pocket card changes. This sample of veterans identified self-directed violence risks noted in the general population and others with HIV/AIDS, as well as proximal events associated with increased risk. Care providers are encouraged to explore the relevance of noted imminent and persistent indicators of increased risk with veterans seeking care. © The Author(s) 2015.

The Cumulative Burden of Mental, Substance Use, and General Medical Disorders and Rehospitalization and Mortality After an Injury.

PubMed

Zatzick, Douglas F; Rowhani-Rahbar, Ali; Wang, Jin; Russo, Joan; Darnell, Doyanne; Ingraham, Leah; Whiteside, Lauren K; Guiney, Roxanne; Hedrick, Margot Kelly; Rivara, Frederick P

2017-06-01

Each year in the United States, 1.5-2.5 million individuals require hospitalization for an injury. Multiple mental, substance use, and chronic general medical disorders are endemic among injury survivors with and without traumatic brain injury (TBI), yet few studies have assessed the association between the cumulative burden of these conditions and health care outcomes. This study of patients hospitalized for an injury assessed associations between comorbid mental, substance use, and general medical disorders, TBI, and violent events or suicide attempts and the postinjury outcomes of recurrent hospitalization and death. Recurrent hospitalization and all-cause mortality were examined in this population-based retrospective cohort study. A total of 76,942 patients hospitalized for an injury in Washington State during 2006-2007 were followed for five years. ICD-9-CM codes identified conditions prior to or at the index injury admission. Index admissions related to injuries from firearms, assaultive violence, suicide attempts, and overdoses were identified through E-codes. Adjusted regression analyses demonstrated a significant, dose-response relationship between an increasing cumulative burden of disorders and an increasing risk of recurrent hospitalization (four or more conditions, relative risk=3.89, 95% confidence interval [CI]=3.66-4.14). Adjusted Cox proportional hazard regression demonstrated a similar relationship between increasing cumulative burden of disorders and all-cause mortality (four or more conditions, hazard ratio=5.33, CI=4.71-6.04). Increasing cumulative burden of disorders was associated with greater postinjury risk of recurrent hospitalization and death. Orchestrated investigative and policy efforts could introduce screening and intervention procedures that target this spectrum of comorbidity.

Environmental monitoring and assessment of heavy metals in surface sediments at Coleroon River Estuary in Tamil Nadu, India.

PubMed

Venkatramanan, S; Chung, S Y; Ramkumar, T; Selvam, S

2015-08-01

The combined studies on grain size distribution, organic matter contents of sediments, sequential extraction and bulk concentration of heavy metals, statistical analysis, and ecological risk assessments were carried out to investigate the contamination sources and ecological risks of surface sediments at Coleroon River Estuary in Tamil Nadu, India. The sequential extraction of metals showed that a larger portion of the metals was associated with the residual phase and also in other fractions. The low concentrations of heavy metals were found in exchangeable and carbonate bounds (bioavailable phases). It revealed that sediments of Coleroon River Estuary were relatively unpolluted and were influenced mainly by natural sources. The observed order of bulk concentrations of heavy metals in the sediments was as follows: Fe > Mn > Zn > Cu > Pb > Cr > Ni > Co. Factor analyses represented that the enrichment of heavy metals was mostly resulted from lithogenic origins associated with anthropogenic sources. These sources were reconfirmed by cluster analysis. Risk assessment code (RAC) suggested that all metals were not harmful in monsoon season. However, Fe was in medium risk, and Mn and Cu were in low risk in summer. According to pollution load index (PLI) of sediments, all heavy metals were toxic. Cu might be related with adverse biological effects on the basis of sediment quality guidelines (SQG) in both seasons. These integrated approaches were very useful to identify the contamination sources and ecological risks of sediments in estuarine environment. It is expected that this research can give a useful information for the remediation of heavy metals in sediments.

Occurrence and fractionation of Cr along the Loushan River affected by a chromium slag heap in East China.

PubMed

Chen, Youyuan; Dong, Bingbing; Xin, Jia

2017-06-01

This study investigated the chromium (Cr) occurrence and distribution along the Loushan River adjacent to a chromium slag heap. The speciation and chemical fractionation of Cr in different environmental media were determined. The potential ecological risks for the surrounding environment were assessed on the basis of both potential ecological risk index (RI) and risk assessment code (RAC). The results show that the surface soil experienced severe Cr contamination with Cr(T) and Cr(VI) values of 3220 ± 6266 and 64 ± 94 mg/kg, respectively, even though the chromium slag heap had already been removed. The chromium slag enhanced the Cr concentration level in the surface soil, water, and sediment samples more than the background level to different extents, which indicates that Cr released from the chromium slag actually affects the surrounding environment. The spatial distribution variety of Cr implies that their transport might have been affected by soil leaking, atmospheric transport, and fluvial hydraulics. The chemical fractionation results demonstrate that the residual fraction was the dominant form, accounting for 54.6 and 66.1% Cr(T) in surface soil and sediment samples, respectively. The content of bioavailable exchangeable Cr fraction correlated with the organic matter (OM), cation exchange capacity (CEC), and pH value. The ecological risk assessment suggests no considerable ecological risk toward the biota despite a relatively high Cr(T) level. Nevertheless, attention should be paid to the potential long-term risks owing to the slow release of oxidizable and residual fractions.

Risk of tinnitus in patients with sleep apnea: A nationwide, population-based, case-control study.

PubMed

Koo, Malcolm; Hwang, Juen-Haur

2017-09-01

To investigate the risk of tinnitus in patients with sleep disturbance or sleep apnea. Case control study. We identified 21,798 middle-aged and elderly patients with otolaryngologist-diagnosed tinnitus between January 1, 2000, and December 31, 2012, from the Longitudinal Health Insurance Database 2000 of the Taiwan National Health Insurance Research Database. A total of 108,990 controls were also identified from the same database based on frequency-matching on 10-year age interval, sex, and year of index date of the cases. Diagnoses of sleep disturbance (International Classification of Diseases, 9th Revision, Clinical Modification [ICD-9-CM] codes 780.50, 780.52, 307.4) and sleep apnea (ICD-9-CM codes 780.51, 780.53, 780.57) in the cases and controls prior to the index date were assessed. The risks of tinnitus in patients with sleep disturbance and sleep apnea were separately evaluated with multivariate logistic regression analyses. The mean age of the total 130,788 patients was 59.8 years, and 47% of them were males. The risk of tinnitus was higher in patients with sleep disturbance compared to those without the condition (adjusted odds ratio [OR] = 1.13, 95% confidence interval [CI] [95% CI] = 1.11-1.17), and the risk of tinnitus was higher in patients with sleep apnea compared to those without the condition (adjusted OR = 1.36, 95% CI = 1.16-1.60). In this population-based, case-control study, the risk of tinnitus was found to be significantly higher among middle-aged and elderly Taiwanese patients with sleep disturbances, especially with sleep apnea. 3b. Laryngoscope, 127:2171-2175, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Patient information leaflets: informing or frightening? A focus group study exploring patients' emotional reactions and subsequent behavior towards package leaflets of commonly prescribed medications in family practices.

PubMed

Herber, Oliver Rudolf; Gies, Verena; Schwappach, David; Thürmann, Petra; Wilm, Stefan

2014-10-02

The purpose of patient information leaflets (PILs) is to inform patients about the administration, precautions and potential side effects of their prescribed medication. Despite European Commission guidelines aiming at increasing readability and comprehension of PILs little is known about the potential risk information has on patients. This article explores patients' reactions and subsequent behavior towards risk information conveyed in PILs of commonly prescribed drugs by general practitioners (GPs) for the treatment of Type 2 diabetes, hypertension or hypercholesterolemia; the most frequent cause for consultations in family practices in Germany. We conducted six focus groups comprising 35 patients which were recruited in GP practices. Transcripts were read and coded for themes; categories were created by abstracting data and further refined into a coding framework. Three interrelated categories are presented: (i) The vast amount of side effects and drug interactions commonly described in PILs provoke various emotional reactions in patients which (ii) lead to specific patient behavior of which (iii) consulting the GP for assistance is among the most common. Findings show that current description of potential risk information caused feelings of fear and anxiety in the reader resulting in undesirable behavioral reactions. Future PILs need to convey potential risk information in a language that is less frightening while retaining the information content required to make informed decisions about the prescribed medication. Thus, during the production process greater emphasis needs to be placed on testing the degree of emotional arousal provoked in patients when reading risk information to allow them to undertake a benefit-risk-assessment of their medication that is based on rational rather than emotional (fearful) reactions.

The adaption and use of research codes for performance assessment

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

Liebetrau, A.M.

1987-05-01

Models of real-world phenomena are developed for many reasons. The models are usually, if not always, implemented in the form of a computer code. The characteristics of a code are determined largely by its intended use. Realizations or implementations of detailed mathematical models of complex physical and/or chemical processes are often referred to as research or scientific (RS) codes. Research codes typically require large amounts of computing time. One example of an RS code is a finite-element code for solving complex systems of differential equations that describe mass transfer through some geologic medium. Considerable computing time is required because computationsmore » are done at many points in time and/or space. Codes used to evaluate the overall performance of real-world physical systems are called performance assessment (PA) codes. Performance assessment codes are used to conduct simulated experiments involving systems that cannot be directly observed. Thus, PA codes usually involve repeated simulations of system performance in situations that preclude the use of conventional experimental and statistical methods. 3 figs.« less

Risk and protective factors for recidivism among juveniles who have offended sexually.

PubMed

Spice, Andrew; Viljoen, Jodi L; Latzman, Natasha E; Scalora, Mario J; Ullman, Daniel

2013-08-01

Literature on risk factors for recidivism among juveniles who have sexually offended (JSOs) is limited. In addition, there have been no studies published concerning protective factors among this population. The purpose of this study was to examine the relationship of risk and protective factors to sexual and nonsexual recidivism among a sample of 193 male JSOs (mean age = 15.26). Youths were followed for an average of 7.24 years following discharge from a residential sex offender treatment program. The risk factor opportunities to reoffend, as coded based on the Estimate of Risk of Adolescent Sexual Offense Recidivism, was associated with sexual recidivism. Several risk factors (e.g., prior offending; peer delinquency) were associated with nonsexual recidivism. No protective factors examined were associated with sexual recidivism, although strong attachments and bonds as measured by the Structured Assessment of Violence Risk in Youth was negatively related to nonsexual recidivism. These findings indicate that risk factors for nonsexual recidivism may be consistent across both general adolescent offender populations and JSOs, but that there may be distinct protective factors that apply to sexual recidivism among JSOs. Results also indicate important needs for further research on risk factors, protective factors, and risk management strategies for JSOs.

Early cancer diagnoses through BRCA1/2 screening of unselected adult biobank participants

PubMed Central

Buchanan, Adam H; Manickam, Kandamurugu; Meyer, Michelle N; Wagner, Jennifer K; Hallquist, Miranda L G; Williams, Janet L; Rahm, Alanna Kulchak; Williams, Marc S; Chen, Zong-Ming E; Shah, Chaitali K; Garg, Tullika K; Lazzeri, Amanda L; Schwartz, Marci L B; Lindbuchler, D'Andra M; Fan, Audrey L; Leeming, Rosemary; Servano, Pedro O; Smith, Ashlee L; Vogel, Victor G; Abul-Husn, Noura S; Dewey, Frederick E; Lebo, Matthew S; Mason-Suares, Heather M; Ritchie, Marylyn D; Davis, F Daniel; Carey, David J; Feinberg, David T; Faucett, W Andrew; Ledbetter, David H; Murray, Michael F

2018-01-01

Purpose The clinical utility of screening unselected individuals for pathogenic BRCA1/2 variants has not been established. Data on cancer risk management behaviors and diagnoses of BRCA1/2-associated cancers can help inform assessments of clinical utility. Methods Whole-exome sequences of participants in the MyCode Community Health Initiative were reviewed for pathogenic/likely pathogenic BRCA1/2 variants. Clinically confirmed variants were disclosed to patient–participants and their clinicians. We queried patient–participants’ electronic health records for BRCA1/2-associated cancer diagnoses and risk management that occurred within 12 months after results disclosure, and calculated the percentage of patient–participants of eligible age who had begun risk management. Results Thirty-seven MyCode patient–participants were unaware of their pathogenic/likely pathogenic BRCA1/2 variant, had not had a BRCA1/2-associated cancer, and had 12 months of follow-up. Of the 33 who were of an age to begin BRCA1/2-associated risk management, 26 (79%) had performed at least one such procedure. Three were diagnosed with an early-stage, BRCA1/2-associated cancer—including a stage 1C fallopian tube cancer—via these procedures. Conclusion Screening for pathogenic BRCA1/2 variants among unselected individuals can lead to occult cancer detection shortly after disclosure. Comprehensive outcomes data generated within our learning healthcare system will aid in determining whether population-wide BRCA1/2 genomic screening programs offer clinical utility. PMID:29261187

Radioactive waste isolation in salt: special advisory report on the status of the Office of Nuclear Waste Isolation's plans for repository performance assessment

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

Ditmars, J.D.; Walbridge, E.W.; Rote, D.M.

1983-10-01

Repository performance assessment is analysis that identifies events and processes that might affect a repository system for isolation of radioactive waste, examines their effects on barriers to waste migration, and estimates the probabilities of their occurrence and their consequences. In 1983 Battelle Memorial Institute's Office of Nuclear Waste Isolation (ONWI) prepared two plans - one for performance assessment for a waste repository in salt and one for verification and validation of performance assessment technology. At the request of the US Department of Energy's Salt Repository Project Office (SRPO), Argonne National Laboratory reviewed those plans and prepared this report to advisemore » SRPO of specific areas where ONWI's plans for performance assessment might be improved. This report presents a framework for repository performance assessment that clearly identifies the relationships among the disposal problems, the processes underlying the problems, the tools for assessment (computer codes), and the data. In particular, the relationships among important processes and 26 model codes available to ONWI are indicated. A common suggestion for computer code verification and validation is the need for specific and unambiguous documentation of the results of performance assessment activities. A major portion of this report consists of status summaries of 27 model codes indicated as potentially useful by ONWI. The code summaries focus on three main areas: (1) the code's purpose, capabilities, and limitations; (2) status of the elements of documentation and review essential for code verification and validation; and (3) proposed application of the code for performance assessment of salt repository systems. 15 references, 6 figures, 4 tables.« less

Spatial-temporal distribution and risk assessment of mercury in different fractions in surface sediments from the Yangtze River estuary.

PubMed

Wang, Qingrui; Liu, Ruimin; Men, Cong; Xu, Fei; Guo, Lijia; Shen, Zhenyao

2017-11-15

The temporal and spatial distributions of mercury in different fractions and its potential ecological risk were investigated in sediments from the Yangtze River estuary (YRE) by analyzing data collected from the study area. The results showed that mercury in the organic and residual fractions had dominant proportions, from 15.2% to 48.52% and from 45.96% to 81.59%, respectively. The fractions were more susceptible to seasonal changes than other fractions. Higher proportions of mercury in organic fraction were found in wet seasons; the opposite was true for mercury in residual fraction. With respect to the spatial distribution, the concentration mercury in exchangeable, carbonate and Fe-Mn oxide fractions showed a decreasing trend from the inner estuary to the outer estuary, but no obvious trends were found in the distributions of mercury in the organic and residual fractions. The risk assessment code (RAC) was used to evaluate the potential ecological risk in the study area based on the proportions of exchangeable and carbonate fractions. The average RAC values during the four periods were 6.00%, 2.20%, 2.83%, and 0.61%. Although these values show that the risk in the study area is generally low, the distribution of RAC values indicates that the inner estuary has a medium risk, with a value up to 10%. Copyright © 2017 Elsevier Ltd. All rights reserved.

Community context, acculturation and low-birth-weight risk among Arab Americans: evidence from the Arab-American birth-outcomes study.

PubMed

El-Sayed, Abdulrahman M; Galea, Sandro

2010-02-01

An assessment was made as to whether maternal residence in areas with high Arab-American concentrations, hence with expected low acculturation for this ethnic group, was associated with low-birth-weight (<2500 g) (LBW) risk among Arab-ethnicity mothers (AEM). Data on all births in Michigan from 2000 to 2005 were collected. Bivariate chi(2) tests and multivariable logistic regression models were used to assess the relation between residence in areas with a high Arab-American concentration and risk for LBW among AEM. As a control, analyses were replicated among non-Arab white mothers. Both residence in Dearborn (OR=0.85, 95% CI 0.75 to 0.97), the city with the highest Arab-American concentration in the USA, and residence in 48126 (OR=0.81, 95% CI 0.71 to 0.93), the zip code with the highest concentration of AEM in Dearborn, were associated with a lower risk for LBW compared with residence in the rest of Michigan in multivariable models adjusted for potential confounders. Neither residence in Dearborn nor residence in 48126 was associated with LBW risk among non-Arab white mothers. Residence in areas with high Arab-American concentrations was associated with a lower LBW risk among AEM. Future work should directly measure acculturation, a plausible mediator of this observed relation.

[Quality management and strategic consequences of assessing documentation and coding under the German Diagnostic Related Groups system].

PubMed

Schnabel, M; Mann, D; Efe, T; Schrappe, M; V Garrel, T; Gotzen, L; Schaeg, M

2004-10-01

The introduction of the German Diagnostic Related Groups (D-DRG) system requires redesigning administrative patient management strategies. Wrong coding leads to inaccurate grouping and endangers the reimbursement of treatment costs. This situation emphasizes the roles of documentation and coding as factors of economical success. The aims of this study were to assess the quantity and quality of initial documentation and coding (ICD-10 and OPS-301) and find operative strategies to improve efficiency and strategic means to ensure optimal documentation and coding quality. In a prospective study, documentation and coding quality were evaluated in a standardized way by weekly assessment. Clinical data from 1385 inpatients were processed for initial correctness and quality of documentation and coding. Principal diagnoses were found to be accurate in 82.7% of cases, inexact in 7.1%, and wrong in 10.1%. Effects on financial returns occurred in 16%. Based on these findings, an optimized, interdisciplinary, and multiprofessional workflow on medical documentation, coding, and data control was developed. Workflow incorporating regular assessment of documentation and coding quality is required by the DRG system to ensure efficient accounting of hospital services. Interdisciplinary and multiprofessional cooperation is recognized to be an important factor in establishing an efficient workflow in medical documentation and coding.

Preliminary results of consequence assessment of a hypothetical severe accident using Thai meteorological data

NASA Astrophysics Data System (ADS)

Silva, K.; Lawawirojwong, S.; Promping, J.

2017-06-01

Consequence assessment of a hypothetical severe accident is one of the important elements of the risk assessment of a nuclear power plant. It is widely known that the meteorological conditions can significantly influence the outcomes of such assessment, since it determines the results of the calculation of the radionuclide environmental transport. This study aims to assess the impacts of the meteorological conditions to the results of the consequence assessment. The consequence assessment code, OSCAAR, of Japan Atomic Energy Agency (JAEA) is used for the assessment. The results of the consequence assessment using Thai meteorological data are compared with those using Japanese meteorological data. The Thai case has following characteristics. Low wind speed made the radionuclides concentrate at the center comparing to the Japanese case. The squalls induced the peaks in the ground concentration distribution. The evacuated land is larger than the Japanese case though the relocated land is smaller, which is attributed to the concentration of the radionuclides near the release point.

Multilocus genetic risk scores for venous thromboembolism risk assessment.

PubMed

Soria, José Manuel; Morange, Pierre-Emmanuel; Vila, Joan; Souto, Juan Carlos; Moyano, Manel; Trégouët, David-Alexandre; Mateo, José; Saut, Noémi; Salas, Eduardo; Elosua, Roberto

2014-10-23

Genetics plays an important role in venous thromboembolism (VTE). Factor V Leiden (FVL or rs6025) and prothrombin gene G20210A (PT or rs1799963) are the genetic variants currently tested for VTE risk assessment. We hypothesized that primary VTE risk assessment can be improved by using genetic risk scores with more genetic markers than just FVL-rs6025 and prothrombin gene PT-rs1799963. To this end, we have designed a new genetic risk score called Thrombo inCode (TiC). TiC was evaluated in terms of discrimination (Δ of the area under the receiver operating characteristic curve) and reclassification (integrated discrimination improvement and net reclassification improvement). This evaluation was performed using 2 age- and sex-matched case-control populations: SANTPAU (248 cases, 249 controls) and the Marseille Thrombosis Association study (MARTHA; 477 cases, 477 controls). TiC was compared with other literature-based genetic risk scores. TiC including F5 rs6025/rs118203906/rs118203905, F2 rs1799963, F12 rs1801020, F13 rs5985, SERPINC1 rs121909548, and SERPINA10 rs2232698 plus the A1 blood group (rs8176719, rs7853989, rs8176743, rs8176750) improved the area under the curve compared with a model based only on F5-rs6025 and F2-rs1799963 in SANTPAU (0.677 versus 0.575, P<0.001) and MARTHA (0.605 versus 0.576, P=0.008). TiC showed good integrated discrimination improvement of 5.49 (P<0.001) for SANTPAU and 0.96 (P=0.045) for MARTHA. Among the genetic risk scores evaluated, the proportion of VTE risk variance explained by TiC was the highest. We conclude that TiC greatly improves prediction of VTE risk compared with other genetic risk scores. TiC should improve prevention, diagnosis, and treatment of VTE. © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Multilocus Genetic Risk Scores for Venous Thromboembolism Risk Assessment

PubMed Central

Soria, José Manuel; Morange, Pierre‐Emmanuel; Vila, Joan; Souto, Juan Carlos; Moyano, Manel; Trégouët, David‐Alexandre; Mateo, José; Saut, Noémi; Salas, Eduardo; Elosua, Roberto

2014-01-01

Background Genetics plays an important role in venous thromboembolism (VTE). Factor V Leiden (FVL or rs6025) and prothrombin gene G20210A (PT or rs1799963) are the genetic variants currently tested for VTE risk assessment. We hypothesized that primary VTE risk assessment can be improved by using genetic risk scores with more genetic markers than just FVL‐rs6025 and prothrombin gene PT‐rs1799963. To this end, we have designed a new genetic risk score called Thrombo inCode (TiC). Methods and Results TiC was evaluated in terms of discrimination (Δ of the area under the receiver operating characteristic curve) and reclassification (integrated discrimination improvement and net reclassification improvement). This evaluation was performed using 2 age‐ and sex‐matched case–control populations: SANTPAU (248 cases, 249 controls) and the Marseille Thrombosis Association study (MARTHA; 477 cases, 477 controls). TiC was compared with other literature‐based genetic risk scores. TiC including F5 rs6025/rs118203906/rs118203905, F2 rs1799963, F12 rs1801020, F13 rs5985, SERPINC1 rs121909548, and SERPINA10 rs2232698 plus the A1 blood group (rs8176719, rs7853989, rs8176743, rs8176750) improved the area under the curve compared with a model based only on F5‐rs6025 and F2‐rs1799963 in SANTPAU (0.677 versus 0.575, P<0.001) and MARTHA (0.605 versus 0.576, P=0.008). TiC showed good integrated discrimination improvement of 5.49 (P<0.001) for SANTPAU and 0.96 (P=0.045) for MARTHA. Among the genetic risk scores evaluated, the proportion of VTE risk variance explained by TiC was the highest. Conclusions We conclude that TiC greatly improves prediction of VTE risk compared with other genetic risk scores. TiC should improve prevention, diagnosis, and treatment of VTE. PMID:25341889

Landscape structure and management alter the outcome of a pesticide ERA: Evaluating impacts of endocrine disruption using the ALMaSS European Brown Hare model.

PubMed

Topping, Chris J; Dalby, Lars; Skov, Flemming

2016-01-15

There is a gradual change towards explicitly considering landscapes in regulatory risk assessment. To realise the objective of developing representative scenarios for risk assessment it is necessary to know how detailed a landscape representation is needed to generate a realistic risk assessment, and indeed how to generate such landscapes. This paper evaluates the contribution of landscape and farming components to a model based risk assessment of a fictitious endocrine disruptor on hares. In addition, we present methods and code examples for generation of landscape structures and farming simulation from data collected primarily for EU agricultural subsidy support and GIS map data. Ten different Danish landscapes were generated and the ERA carried out for each landscape using two different assumed toxicities. The results showed negative impacts in all cases, but the extent and form in terms of impacts on abundance or occupancy differed greatly between landscapes. A meta-model was created, predicting impact from landscape and farming characteristics. Scenarios based on all combinations of farming and landscape for five landscapes representing extreme and middle impacts were created. The meta-models developed from the 10 real landscapes failed to predict impacts for these 25 scenarios. Landscape, farming, and the emergent density of hares all influenced the results of the risk assessment considerably. The study indicates that prediction of a reasonable worst case scenario is difficult from structural, farming or population metrics; rather the emergent properties generated from interactions between landscape, management and ecology are needed. Meta-modelling may also fail to predict impacts, even when restricting inputs to combinations of those used to create the model. Future ERA may therefore need to make use of multiple scenarios representing a wide range of conditions to avoid locally unacceptable risks. This approach could now be feasible Europe wide given the landscape generation methods presented.

Quantifying Risk for Anxiety Disorders in Preschool Children: A Machine Learning Approach.

PubMed

Carpenter, Kimberly L H; Sprechmann, Pablo; Calderbank, Robert; Sapiro, Guillermo; Egger, Helen L

2016-01-01

Early childhood anxiety disorders are common, impairing, and predictive of anxiety and mood disorders later in childhood. Epidemiological studies over the last decade find that the prevalence of impairing anxiety disorders in preschool children ranges from 0.3% to 6.5%. Yet, less than 15% of young children with an impairing anxiety disorder receive a mental health evaluation or treatment. One possible reason for the low rate of care for anxious preschoolers is the lack of affordable, timely, reliable and valid tools for identifying young children with clinically significant anxiety. Diagnostic interviews assessing psychopathology in young children require intensive training, take hours to administer and code, and are not available for use outside of research settings. The Preschool Age Psychiatric Assessment (PAPA) is a reliable and valid structured diagnostic parent-report interview for assessing psychopathology, including anxiety disorders, in 2 to 5 year old children. In this paper, we apply machine-learning tools to already collected PAPA data from two large community studies to identify sub-sets of PAPA items that could be developed into an efficient, reliable, and valid screening tool to assess a young child's risk for an anxiety disorder. Using machine learning, we were able to decrease by an order of magnitude the number of items needed to identify a child who is at risk for an anxiety disorder with an accuracy of over 96% for both generalized anxiety disorder (GAD) and separation anxiety disorder (SAD). Additionally, rather than considering GAD or SAD as discrete/binary entities, we present a continuous risk score representing the child's risk of meeting criteria for GAD or SAD. Identification of a short question-set that assesses risk for an anxiety disorder could be a first step toward development and validation of a relatively short screening tool feasible for use in pediatric clinics and daycare/preschool settings.

Quantifying Risk for Anxiety Disorders in Preschool Children: A Machine Learning Approach

PubMed Central

Calderbank, Robert; Sapiro, Guillermo; Egger, Helen L.

2016-01-01

Early childhood anxiety disorders are common, impairing, and predictive of anxiety and mood disorders later in childhood. Epidemiological studies over the last decade find that the prevalence of impairing anxiety disorders in preschool children ranges from 0.3% to 6.5%. Yet, less than 15% of young children with an impairing anxiety disorder receive a mental health evaluation or treatment. One possible reason for the low rate of care for anxious preschoolers is the lack of affordable, timely, reliable and valid tools for identifying young children with clinically significant anxiety. Diagnostic interviews assessing psychopathology in young children require intensive training, take hours to administer and code, and are not available for use outside of research settings. The Preschool Age Psychiatric Assessment (PAPA) is a reliable and valid structured diagnostic parent-report interview for assessing psychopathology, including anxiety disorders, in 2 to 5 year old children. In this paper, we apply machine-learning tools to already collected PAPA data from two large community studies to identify sub-sets of PAPA items that could be developed into an efficient, reliable, and valid screening tool to assess a young child’s risk for an anxiety disorder. Using machine learning, we were able to decrease by an order of magnitude the number of items needed to identify a child who is at risk for an anxiety disorder with an accuracy of over 96% for both generalized anxiety disorder (GAD) and separation anxiety disorder (SAD). Additionally, rather than considering GAD or SAD as discrete/binary entities, we present a continuous risk score representing the child’s risk of meeting criteria for GAD or SAD. Identification of a short question-set that assesses risk for an anxiety disorder could be a first step toward development and validation of a relatively short screening tool feasible for use in pediatric clinics and daycare/preschool settings. PMID:27880812

Female Sex Offenders' Relationship Experiences

PubMed Central

Lawson, Louanne

2010-01-01

Interventions for child sexual abusers should take into account their perspectives on the context of their offenses, but no descriptions of everyday life from the offender's point of view have been published. This study therefore explored female offenders' views of their strengths and challenges. Documented risk assessments of 20 female offenders were analyzed using inductive content analysis (Cavanagh, 1997; Priest, Roberts & Woods, 2002; Woods, Priest & Roberts, 2002). The Good Lives Model provided the initial coding framework and Atlas/ti software (Muhr, 1997) was used for simultaneous data collection and analysis. The content analysis yielded 999 coding decisions organized in three themes. The global theme was relationship experiences. Offenders described the quality of their relationship experiences, including their personal perspectives, intimate relationships and social lives. These descriptions have implications for treatment planning and future research with women who have molested children. PMID:18624098

PRESTO low-level waste transport and risk assessment code

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

Little, C.A.; Fields, D.E.; McDowell-Boyer, L.M.

1981-01-01

PRESTO (Prediction of Radiation Effects from Shallow Trench Operations) is a computer code developed under US Environmental Protection Agency (EPA) funding to evaluate possible health effects from shallow land burial trenches. The model is intended to be generic and to assess radionuclide transport, ensuing exposure, and health impact to a static local population for a 1000-y period following the end of burial operations. Human exposure scenarios considered by the model include normal releases (including leaching and operational spillage), human intrusion, and site farming or reclamation. Pathways and processes of transit from the trench to an individual or population inlude: groundwatermore » transport, overland flow, erosion, surface water dilution, resuspension, atmospheric transport, deposition, inhalation, and ingestion of contaminated beef, milk, crops, and water. Both population doses and individual doses are calculated as well as doses to the intruder and farmer. Cumulative health effects in terms of deaths from cancer are calculated for the population over the thousand-year period using a life-table approach. Data bases are being developed for three extant shallow land burial sites: Barnwell, South Carolina; Beatty, Nevada; and West Valley, New York.« less

Model competencies in regulatory therapeutic product assessment: Health Canada's good review guiding principles as a reviewing community's code of intellectual conduct.

PubMed

Lim, Robyn R

2007-08-01

This article describes some work from the Therapeutic Products Directorate of Health Canada regarding Good Review Practices (GRP). Background information is provided on the Therapeutic Products Directorate (TPD) and its regulatory activities regarding drug and medical device assessment in both the pre- and post-market setting. The TPD Good Review Guiding Principles (GRGP) are described which include a Definition of a Good Therapeutic Product Regulatory Review, Ten Hallmarks of a Good Therapeutic Product Regulatory Review and Ten Precepts. Analysis of the guiding principles discusses possible linkages between the guiding principles and intellectual virtues. Through this analysis an hypothesis is developed that the guiding principles outline a code of intellectual conduct for Health Canada's reviewers of evidence for efficacy, safety, manufacturing quality and benefit-risk regarding therapeutic products. Opportunities to advance therapeutic product regulatory review as a scientific discipline in its own right and to acknowledge that these reviewers constitute a specific community of practice are discussed. Integration of intellectual and ethical approaches across therapeutic product review sectors is also suggested.

Heap leach cyanide irrigation and risk to wildlife: Ramifications for the international cyanide management code.

PubMed

Donato, D B; Madden-Hallett, D M; Smith, G B; Gursansky, W

2017-06-01

Exposed cyanide-bearing solutions associated with gold and silver recovery processes in the mining industry pose a risk to wildlife that interact with these solutions. This has been documented with cyanide-bearing tailings storage facilities, however risks associated with heap leach facilities are poorly documented, monitored and audited. Gold and silver leaching heap leach facilities use cyanide, pH-stabilised, at concentrations deemed toxic to wildlife. Their design and management are known to result in exposed cyanide-bearing solutions that are accessible to and present a risk to wildlife. Monitoring of the presence of exposed solutions, wildlife interaction, interpretation of risks and associated wildlife deaths are poorly documented. This paper provides a list of critical monitoring criteria and attempts to predict wildlife guilds most at risk. Understanding the significance of risks to wildlife from exposed cyanide solutions is complex, involving seasonality, relative position of ponding, temporal nature of ponding, solution palatability, environmental conditions, in situ wildlife species inventory and provision of alternative drinking sources for wildlife. Although a number of heap leach operations are certified as complaint with the International Cyanide Management Code (Cyanide Code), these criteria are not considered by auditors nor has systematic monitoring regime data been published. Without systematic monitoring and further knowledge, wildlife deaths on heap leach facilities are likely to remain largely unrecorded. This has ramifications for those operations certified as compliance with the Cyanide Code. Copyright © 2017 Elsevier Inc. All rights reserved.

Second annual review update preliminary risk assessment of federally protected species at the Los Alamos National Laboratory

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

Gonzales, G.J.; Gallegos, A.F.; Foxx, T.S.

1998-02-01

In FY96 and FY97, preliminary assessments were conducted of the potential risk from legacy waste to the American peregrine falcon (Falco peregrimus), the bald eagle (Haliaeetus leucocephalus), and the Mexican spotted owl (Strix occidentalis lucida). Estimated doses were compared against toxicity reference values (TRVs) to generate hazard indices that included a measure of cumulative effects from multiple contaminants (radionuclides, metals, and organic chemicals). The tools used included a custom FORTRAN code ECORSK, and a geographic information system. The assessments originally included only the soil ingestion contaminant pathway. Since the initial assessments, a food consumption contaminant pathway has been added, bioaccumulationmore » and biomagnification of some contaminants have been factored into the food consumption pathway, and some of the TRVs against which estimated doses are compared have been changed to values which relate more closely to the Aves taxonomical class. With these and other more subtle improvements in model input parameters, ECORSK has been revised and the model has been re-executed for the owl and peregrine exposure units that originally generated the highest risk indices. This report contains the updated results. On average, results indicate a small potential for impact to the peregrine falcon, but no appreciable impact to the spotted owl nor the bald eagle. The original reports cited in this document should be consulted for details on methods.« less

Comparison of landslide hazard and risk assessment practices in Europe

NASA Astrophysics Data System (ADS)

Corominas, J.; Mavrouli, O.

2012-04-01

An overview is made of the landslide hazard and risk assessment practices that are officially promoted or applied in Europe by administration offices, geological surveys, and decision makers (recommendations, regulations and codes). The reported countries are: Andorra, Austria, France, Italy (selected river basins), Romania, Spain (Catalonia), Switzerland and United Kingdom. The objective here was to compare the different practices for hazard and risk evaluation with respect to the official policies, the methodologies used (qualitative and quantitative), the provided outputs and their contents, and the terminology and map symbols used. The main observations made are illustrated with examples and the possibility of harmonization of the policies and the application of common practices to bridge the existing gaps is discussed. Some of the conclusions reached include the following: zoning maps are legally binding for public administrators and land owners only in some cases and generally when referring to site-specific or local scales rather than regional or national ones; so far, information is mainly provided on landslide susceptibility and hazard and risk assessment is performed only in a few countries; there is a variation in the use of scales between countries; the classification criteria for landslide types and mechanisms present large diversity even within the same country (in some cases no landslide mechanisms are specified while in others there is an exhaustive list); the techniques to obtain input data for the landslide inventory and susceptibility maps vary from basic to sophisticated, resulting in various levels of data quality and quantity; the procedures followed for hazard and risk assessment include analytical procedures supported by computer simulation, weighted-indicators, expert judgment and field survey-based, or a combination of all; there is an important variation between hazard and risk matrices with respect to the used parameters, the thresholds defining the different hazard or risk levels and the number and physical interpretation of the latter. In this context suggestions are made to bridge the gaps between the practices and to enhance homogenization of the hazard and risk assessment procedures and of their outputs. This work is presented within the framework of the SafeLand project funded by the European Commission's FP7 programme.

Application of the Life Safety Code to a Historic Test Stand

NASA Technical Reports Server (NTRS)

Askins, Bruce; Lemke, Paul R.; Lewis, William L.; Covell, Carol C.

2011-01-01

NASA has conducted a study to assess alternatives to refurbishing existing launch vehicle modal test facilities as opposed to developing new test facilities to meet the demands of a very fiscally constrained test and evaluation environment. The results of this study showed that Marshall Space Flight Center (MSFC) Test Stand (TS) 4550 could be made compliant, within reasonable cost and schedule impacts, if safety processes and operational limitations were put in place to meet the safety codes and concerns of the Fire Marshall. Trades were performed with key selection criteria to ensure that appropriate levels of occupant safety are incorporated into test facility design modifications. In preparation for the ground vibration tests that were to be performed on the Ares I launch vehicle, the Ares Flight and Integrated Test Office (FITO) organization evaluated the available test facility options, which included the existing mothballed structural dynamic TS4550 used by Apollo and Shuttle, alternative ground vibration test facilities at other locations, and construction of a new dynamic test stand. After an exhaustive assessment of the alternatives, the results favored modifying the TS4550 because it was the lowest cost option and presented the least schedule risk to the NASA Constellation Program for Ares Integrated Vehicle Ground Vibration Test (IVGVT). As the renovation design plans and drawings were being developed for TS4550, a safety concern was discovered the original design for the construction of the test stand, originally built for the Apollo Program and renovated for the Shuttle Program, was completed before NASA s adoption of the currently imposed safety and building codes per National Fire Protection Association Life Safety Code [NFPA 101] and International Building Codes. The initial FITO assessment of the design changes, required to make TS4550 compliant with current safety and building standards, identified a significant cost increase and schedule impact. An effort was launched to thoroughly evaluate the applicable life safety requirements, examine the context in which they were derived, and determine a means by which the TS4550 modifications could be made within budget and on schedule, while still providing the occupants with appropriate levels of safety.

Code Verification Capabilities and Assessments in Support of ASC V&V Level 2 Milestone #6035

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

Doebling, Scott William; Budzien, Joanne Louise; Ferguson, Jim Michael

This document provides a summary of the code verification activities supporting the FY17 Level 2 V&V milestone entitled “Deliver a Capability for V&V Assessments of Code Implementations of Physics Models and Numerical Algorithms in Support of Future Predictive Capability Framework Pegposts.” The physics validation activities supporting this milestone are documented separately. The objectives of this portion of the milestone are: 1) Develop software tools to support code verification analysis; 2) Document standard definitions of code verification test problems; and 3) Perform code verification assessments (focusing on error behavior of algorithms). This report and a set of additional standalone documents servemore » as the compilation of results demonstrating accomplishment of these objectives.« less

Recent MELCOR and VICTORIA Fission Product Research at the NRC

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

Bixler, N.E.; Cole, R.K.; Gauntt, R.O.

1999-01-21

The MELCOR and VICTORIA severe accident analysis codes, which were developed at Sandia National Laboratories for the U. S. Nuclear Regulatory Commission, are designed to estimate fission product releases during nuclear reactor accidents in light water reactors. MELCOR is an integrated plant-assessment code that models the key phenomena in adequate detail for risk-assessment purposes. VICTORIA is a more specialized fission- product code that provides detailed modeling of chemical reactions and aerosol processes under the high-temperature conditions encountered in the reactor coolant system during a severe reactor accident. This paper focuses on recent enhancements and assessments of the two codes inmore » the area of fission product chemistry modeling. Recently, a model for iodine chemistry in aqueous pools in the containment building was incorporated into the MELCOR code. The model calculates dissolution of iodine into the pool and releases of organic and inorganic iodine vapors from the pool into the containment atmosphere. The main purpose of this model is to evaluate the effect of long-term revolatilization of dissolved iodine. Inputs to the model include dose rate in the pool, the amount of chloride-containing polymer, such as Hypalon, and the amount of buffering agents in the containment. Model predictions are compared against the Radioiodine Test Facility (RTF) experiments conduced by Atomic Energy of Canada Limited (AECL), specifically International Standard Problem 41. Improvements to VICTORIA's chemical reactions models were implemented as a result of recommendations from a peer review of VICTORIA that was completed last year. Specifically, an option is now included to model aerosols and deposited fission products as three condensed phases in addition to the original option of a single condensed phase. The three-condensed-phase model results in somewhat higher predicted fission product volatilities than does the single-condensed-phase model. Modeling of U02 thermochemistry was also improved, and results in better prediction of vaporization of uranium from fuel, which can react with released fission products to affect their volatility. This model also improves the prediction of fission product release rates from fuel. Finally, recent comparisons of MELCOR and VICTORIA with International Standard Problem 40 (STORM) data are presented. These comparisons focus on predicted therrnophoretic deposition, which is the dominant deposition mechanism. Sensitivity studies were performed with the codes to examine experimental and modeling uncertainties.« less

Path Toward a Unifid Geometry for Radiation Transport

NASA Technical Reports Server (NTRS)

Lee, Kerry; Barzilla, Janet; Davis, Andrew; Zachmann

2014-01-01

The Direct Accelerated Geometry for Radiation Analysis and Design (DAGRAD) element of the RadWorks Project under Advanced Exploration Systems (AES) within the Space Technology Mission Directorate (STMD) of NASA will enable new designs and concepts of operation for radiation risk assessment, mitigation and protection. This element is designed to produce a solution that will allow NASA to calculate the transport of space radiation through complex computer-aided design (CAD) models using the state-of-the-art analytic and Monte Carlo radiation transport codes. Due to the inherent hazard of astronaut and spacecraft exposure to ionizing radiation in low-Earth orbit (LEO) or in deep space, risk analyses must be performed for all crew vehicles and habitats. Incorporating these analyses into the design process can minimize the mass needed solely for radiation protection. Transport of the radiation fields as they pass through shielding and body materials can be simulated using Monte Carlo techniques or described by the Boltzmann equation, which is obtained by balancing changes in particle fluxes as they traverse a small volume of material with the gains and losses caused by atomic and nuclear collisions. Deterministic codes that solve the Boltzmann transport equation, such as HZETRN [high charge and energy transport code developed by NASA Langley Research Center (LaRC)], are generally computationally faster than Monte Carlo codes such as FLUKA, GEANT4, MCNP(X) or PHITS; however, they are currently limited to transport in one dimension, which poorly represents the secondary light ion and neutron radiation fields. NASA currently uses HZETRN space radiation transport software, both because it is computationally efficient and because proven methods have been developed for using this software to analyze complex geometries. Although Monte Carlo codes describe the relevant physics in a fully three-dimensional manner, their computational costs have thus far prevented their widespread use for analysis of complex CAD models, leading to the creation and maintenance of toolkit-specific simplistic geometry models. The work presented here builds on the Direct Accelerated Geometry Monte Carlo (DAGMC) toolkit developed for use with the Monte Carlo N-Particle (MCNP) transport code. The workflow for achieving radiation transport on CAD models using MCNP and FLUKA has been demonstrated and the results of analyses on realistic spacecraft/habitats will be presented. Future work is planned that will further automate this process and enable the use of multiple radiation transport codes on identical geometry models imported from CAD. This effort will enhance the modeling tools used by NASA to accurately evaluate the astronaut space radiation risk and accurately determine the protection provided by as-designed exploration mission vehicles and habitats

Risk of leukaemia or cancer in the central nervous system among children living in an area with high indoor radon concentrations: results from a cohort study in Norway.

PubMed

Del Risco Kollerud, R; Blaasaas, K G; Claussen, B

2014-09-23

Over the past few years, there has been growing interest in assessing the relationship between exposure to radon at home and the risk of childhood cancer. Previous studies have produced conflicting results, probably because of limitations assessing radon exposure, too few cancer cases and poorly documented health statistics. We used a cohort approach of 0-15-year-old children to examine whether residential radon exposure was associated with childhood leukaemia and cancer in the central nervous system in the Oslo region. The study was based on Norwegian population registers and identified cancer cases from The Cancer Registry of Norway. The residence of every child was geo-coded and assigned a radon exposure. In all, 712 674 children were followed from 1967 to 2009 from birth to date of cancer diagnosis, death, emigration or 15 years of age. A total of 864 cancer cases were identified, 437 children got leukaemia and 427 got cancer in the central nervous system.Conclusions or interpretation:No association was found for childhood leukaemia. An elevated nonsignificant risk for cancer in the central nervous system was observed. This association should be interpreted with caution owing to the crude exposure assessment and possibilities of confounding.

Contribution of High Charge and Energy (HZE) Ions During Solar-Particle Event of September 29, 1989

NASA Technical Reports Server (NTRS)

Kim, Myung-Hee Y.; Wilson, John W.; Cucinotta, Francis A.; Simonsen, Lisa C.; Atwell, William; Badavi, Francis F.; Miller, Jack

1999-01-01

The solar-particle event (SPE) of September 29, 1989, produced an iron-rich spectrum with energies approaching 1 A GeV with an approximate spectral slope parameter of 2.5. These high charge and energy (HZE) ions challenge conventional methods of shield design and assessment of astronaut risks. In the past, shield design and risk assessment have relied on proton shielding codes and biological response models derived from X-ray and neutron exposure data. Because the HZE spectra decline rapidly with energy and HZE attenuation in materials is limited by their penetration power, details of the mass distributions about the sensitive tissues (shielding materials and the astronaut's body) are important determining factors of the exposure levels and distributions of linear energy transfer. Local tissue environments during the SPE of September 29, 1989, with its f= components are examined to analyze the importance of these ions to human SPE exposure. Typical space suit and lightly shielded structures leave significant contributions from HZE components to certain critical body tissues and have important implications on the models for risk assessment. A heavily shielded equipment room of a space vehicle or habitat requires knowledge of the breakup of these ions into lighter components, including neutrons, for shield design specifications.

Seismic risk assessment of architectural heritages in Gyeongju considering local site effects

NASA Astrophysics Data System (ADS)

Park, H.-J.; Kim, D.-S.; Kim, D.-M.

2013-02-01

A seismic risk assessment is conducted for cultural heritage sites in Gyeongju, the capital of Korea's ancient Silla Kingdom. Gyeongju, home to UNESCO World Heritage sites, contains remarkable artifacts of Korean Buddhist art. An extensive geotechnical survey including a series of in situ tests is presented, providing pertinent soil profiles for site response analyses on thirty cultural heritage sites. After the shear wave velocity profiles and dynamic material properties were obtained, site response analyses were carried out at each historical site and the amplification characteristics, site period, and response spectrum of the site were determined for the earthquake levels of 2400 yr and 1000 yr return periods based on the Korean seismic hazard map. Response spectrum and corresponding site coefficients obtained from site response analyses considering geologic conditions differ significantly from the current Korean seismic code. This study confirms the importance of site-specific ground response analyses considering local geological conditions. Results are given in the form of the spatial distribution of bedrock depth, site period, and site amplification coefficients, which are particularly valuable in the context of a seismic vulnerability study. This study presents the potential amplification of hazard maps and provides primary data on the seismic risk assessment of each cultural heritage.

Accounting for overdispersion when determining primary care outliers for the identification of chronic kidney disease: learning from the National Chronic Kidney Disease Audit.

PubMed

Kim, Lois G; Caplin, Ben; Cleary, Faye; Hull, Sally A; Griffith, Kathryn; Wheeler, David C; Nitsch, Dorothea

2017-04-01

Early diagnosis of chronic kidney disease (CKD) facilitates best management in primary care. Testing coverage of those at risk and translation into subsequent diagnostic coding will impact on observed CKD prevalence. Using initial data from 915 general practitioner (GP) practices taking part in a UK national audit, we seek to apply appropriate methods to identify outlying practices in terms of CKD stages 3-5 prevalence and diagnostic coding. We estimate expected numbers of CKD stages 3-5 cases in each practice, adjusted for key practice characteristics, and further inflate the control limits to account for overdispersion related to unobserved factors (including unobserved risk factors for CKD, and between-practice differences in coding and testing). GP practice prevalence of coded CKD stages 3-5 ranges from 0.04 to 7.8%. Practices differ considerably in coding of CKD in individuals where CKD is indicated following testing (ranging from 0 to 97% of those with and glomerular filtration rate  <60 mL/min/1.73 m 2 ). After adjusting for risk factors and overdispersion, the number of  'extreme' practices is reduced from 29 to 2.6% for the low-coded CKD prevalence outcome, from 21 to 1% for high-uncoded CKD stage and from 22 to 2.4% for low total (coded and uncoded) CKD prevalence. Thirty-one practices are identified as outliers for at least one of these outcomes. These can then be categorized into practices needing to address testing, coding or data storage/transfer issues. GP practice prevalence of coded CKD shows wide variation. Accounting for overdispersion is crucial in providing useful information about outlying practices for CKD prevalence. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Characterization and environmental risk assessment of heavy metals in construction and demolition wastes from five sources (chemical, metallurgical and light industries, and residential and recycled aggregates).

PubMed

Gao, Xiaofeng; Gu, Yilu; Xie, Tian; Zhen, Guangyin; Huang, Sheng; Zhao, Youcai

2015-06-01

Total concentrations of heavy metals (Cu, Zn, Pb, Cr, Cd, and Ni) were measured among 63 samples of construction and demolition (C&D) wastes collected from chemical, metallurgical and light industries, and residential and recycled aggregates within China for risk assessment. The heavy metal contamination was primarily concentrated in the chemical and metallurgical industries, especially in the electroplating factory and zinc smelting plant. High concentrations of Cd were found in light industry samples, while the residential and recycled aggregate samples were severely polluted by Zn. Six most polluted samples were selected for deep research. Mineralogical analysis by X-ray fluorescence (XRF) spectrometry and X-ray diffraction (XRD), combined with element speciation through European Community Bureau of Reference (BCR) sequential extraction, revealed that a relatively slight corrosion happened in the four samples from electroplating plants but high transfer ability for large quantities of Zn and Cu. Lead arsenate existed in the acid extractable fraction in CI7-8 and potassium chromium oxide existed in the mobility fraction. High concentration of Cr could be in amorphous forms existing in CI9. The high content of sodium in the two samples from zinc smelter plants suggested severe deposition and erosion on the workshop floor. Large quantities of Cu existed as copper halide and most of the Zn appeared to be zinc, zinc oxide, barium zinc oxide, and zincite. From the results of the risk assessment code (RAC), the samples from the electroplating factory posed a very high risk of Zn, Cu, and Cr, a high risk of Ni, a middle risk of Pb, and a low risk of Cd. The samples from the zinc smelting plant presented a high risk of Zn, a middle risk of Cu, and a low risk of Pb, Cr, Cd, and Ni.

Personality characteristics and motor skills attributed to occupations in Parkinson disease.

PubMed

Gatto, Nicole M; Bordelon, Yvette; Gatz, Margaret; Ritz, Beate

2011-03-01

It has previously been speculated that a distinct premorbid personality characterized by introversion, rigidity, and over cautiousness might be associated with Parkinson disease (PD). Only 1 previous study has assessed personality before PD onset, and other data collected retrospectively do not exclude reverse causation. We relied on the longest held job reported in an interview to infer personality traits and motor skills for 355 incident PD patients and 335 population controls enrolled in a PD study in California. Jobs were coded according to the 1980 US Census Occupational Code and assigned scores for various demands, skills, and aptitudes required by the job. None of the occupational temperament or interest factors required, expected, or exhibited by workers were related to statistically significantly higher odds of having PD per unit increase in scores, whereas there was some suggestion of differences when the extremes were examined. Analyses of physical aptitude factors showed that PD cases were less likely to have worked in jobs that involved certain motor skills. This study uses a novel approach to assess personality traits using occupational characteristics. Most job attributes thought to reflect conservativeness; risk taking, stress resistance, and flexibility were not associated with PD in a linear manner. Thus, these occupation-derived traits do not seem to support the existence of a distinct parkinsonian personality. However, the negative associations with jobs requiring certain motor skills are intriguing, and may suggest very early premotor features or a lack of continuous motor training as a risk factor for PD.

Evaluation of nonlinear structural dynamic responses using a fast-running spring-mass formulation

NASA Astrophysics Data System (ADS)

Benjamin, A. S.; Altman, B. S.; Gruda, J. D.

In today's world, accurate finite-element simulations of large nonlinear systems may require meshes composed of hundreds of thousands of degrees of freedom. Even with today's fast computers and the promise of ever-faster ones in the future, central processing unit (CPU) expenditures for such problems could be measured in days. Many contemporary engineering problems, such as those found in risk assessment, probabilistic structural analysis, and structural design optimization, cannot tolerate the cost or turnaround time for such CPU-intensive analyses, because these applications require a large number of cases to be run with different inputs. For many risk assessment applications, analysts would prefer running times to be measurable in minutes. There is therefore a need for approximation methods which can solve such problems far more efficiently than the very detailed methods and yet maintain an acceptable degree of accuracy. For this purpose, we have been working on two methods of approximation: neural networks and spring-mass models. This paper presents our work and results to date for spring-mass modeling and analysis, since we are further along in this area than in the neural network formulation. It describes the physical and numerical models contained in a code we developed called STRESS, which stands for 'Spring-mass Transient Response Evaluation for structural Systems'. The paper also presents results for a demonstration problem, and compares these with results obtained for the same problem using PRONTO3D, a state-of-the-art finite element code which was also developed at Sandia.

Communicating cardiovascular disease risk: an interview study of General Practitioners’ use of absolute risk within tailored communication strategies

PubMed Central

2014-01-01

Background Cardiovascular disease (CVD) prevention guidelines encourage assessment of absolute CVD risk - the probability of a CVD event within a fixed time period, based on the most predictive risk factors. However, few General Practitioners (GPs) use absolute CVD risk consistently, and communication difficulties have been identified as a barrier to changing practice. This study aimed to explore GPs’ descriptions of their CVD risk communication strategies, including the role of absolute risk. Methods Semi-structured interviews were conducted with a purposive sample of 25 GPs in New South Wales, Australia. Transcribed audio-recordings were thematically coded, using the Framework Analysis method to ensure rigour. Results GPs used absolute CVD risk within three different communication strategies: ‘positive’, ‘scare tactic’, and ‘indirect’. A ‘positive’ strategy, which aimed to reassure and motivate, was used for patients with low risk, determination to change lifestyle, and some concern about CVD risk. Absolute risk was used to show how they could reduce risk. A ‘scare tactic’ strategy was used for patients with high risk, lack of motivation, and a dismissive attitude. Absolute risk was used to ‘scare’ them into taking action. An ‘indirect’ strategy, where CVD risk was not the main focus, was used for patients with low risk but some lifestyle risk factors, high anxiety, high resistance to change, or difficulty understanding probabilities. Non-quantitative absolute risk formats were found to be helpful in these situations. Conclusions This study demonstrated how GPs use three different communication strategies to address the issue of CVD risk, depending on their perception of patient risk, motivation and anxiety. Absolute risk played a different role within each strategy. Providing GPs with alternative ways of explaining absolute risk, in order to achieve different communication aims, may improve their use of absolute CVD risk assessment in practice. PMID:24885409

Spatial distributions, fractionation characteristics, and ecological risk assessment of trace elements in sediments of Chaohu Lake, a large eutrophic freshwater lake in eastern China.

PubMed

Wu, Lei; Liu, Guijian; Zhou, Chuncai; Liu, Rongqiong; Xi, Shanshan; Da, Chunnian; Liu, Fei

2018-01-01

The concentrations, spatial distribution, fractionation characteristics, and potential ecological risks of trace elements (Cu, Pb, Zn, Cr, Ni, and Co) in the surface sediment samples collected from 32 sites in Chaohu Lake were investigated. The improved BCR sequential extraction procedure was applied to analyze the chemical forms of trace elements in sediments. The enrichment factor (EF), sediment quality guidelines (SQGs), potential ecological risk index (PERI), and risk assessment code (RAC) were employed to evaluate the pollution levels and the potential ecological risks. The results found that the concentrations of Cu, Pb, Zn, Cr, Ni, and Co in the surface sediments were 78.59, 36.91, 161.84, 98.87, 38.92, and 10.09 mg kg -1 , respectively. The lower concentrations of Cu, Pb, Zn, Cr, and Ni were almost found in the middle part of the lake, while Co increased from the western toward the eastern parts of the lake. Cr, Ni, Co, and Zn predominantly existed in the residual fractions, with the average values of 76.35, 59.22, 45.60, and 44.30%, respectively. Cu and Pb were mainly combined with Fe/Mn oxides in reducible fraction, with the average values of 66.4 and 69.1%, respectively. The pollution levels were different among the selected elements. Cu had the highest potential ecological risk, while Cr had the lowest potential ecological risk.

Impacts of Model Building Energy Codes

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

Athalye, Rahul A.; Sivaraman, Deepak; Elliott, Douglas B.

The U.S. Department of Energy (DOE) Building Energy Codes Program (BECP) periodically evaluates national and state-level impacts associated with energy codes in residential and commercial buildings. Pacific Northwest National Laboratory (PNNL), funded by DOE, conducted an assessment of the prospective impacts of national model building energy codes from 2010 through 2040. A previous PNNL study evaluated the impact of the Building Energy Codes Program; this study looked more broadly at overall code impacts. This report describes the methodology used for the assessment and presents the impacts in terms of energy savings, consumer cost savings, and reduced CO 2 emissions atmore » the state level and at aggregated levels. This analysis does not represent all potential savings from energy codes in the U.S. because it excludes several states which have codes which are fundamentally different from the national model energy codes or which do not have state-wide codes. Energy codes follow a three-phase cycle that starts with the development of a new model code, proceeds with the adoption of the new code by states and local jurisdictions, and finishes when buildings comply with the code. The development of new model code editions creates the potential for increased energy savings. After a new model code is adopted, potential savings are realized in the field when new buildings (or additions and alterations) are constructed to comply with the new code. Delayed adoption of a model code and incomplete compliance with the code’s requirements erode potential savings. The contributions of all three phases are crucial to the overall impact of codes, and are considered in this assessment.« less

Alternate Assessment Manual for the Arizona Student Achievement Program

ERIC Educational Resources Information Center

Arizona Department of Education, 2005

2005-01-01

The Alternate Assessment Code of Ethics informs school personnel involved in alternate assessments of ethical, nondiscriminatory assessment practices and underscores the diligence necessary to provide accurate assessment data for instructional decision-making. The importance of commitment and adherence to the Alternate Assessment Code of Ethics by…

[Infants' attachment security in a vulnerable French sample].

PubMed

Tereno, S; Guedeney, N; Dugravier, R; Greacen, T; Saïas, T; Tubach, F; Ulgen, S; Matos, I; Guédeney, A

2017-04-01

Attachment is a long lasting emotional link established between infants and their caregivers. The quality of early relationships allows infants to safely explore their environment and contribute to the establishment of a broad range of social skills. Several intervention programs targeting infant attachment have been implemented in different contexts, showing diverse degrees of efficacy. The present paper describes, for the first time, children's attachment quality distributions in a French multi-risk population, with a preventive intervention, usual or reinforced. In the CAPEDP study (Parenting and Attachment in Early Childhood: reducing mental health disorder risks and promoting resilience), a sub-sample of 117 women was recruited to assess the effects of this home-visiting program on children's attachment security. With that intent, the Strange Situation Paradigm was used when infants were between 12 and 16 months of age. In the intervention group, 63% (n=41) of the infants were coded as secure, while 15% (n=10) of them were coded as insecure-avoidant and 22% (n=14) as insecure-ambivalent/resistant. 56% (n=29) of control group infants (usual care) were coded as secure, while 27% (n=14) were coded as insecure-avoidant and 17% (n=9) as insecure-ambivalent/resistant. Even if the percentage of children with a secure attachment in the reinforced intervention group was higher than that of the control group, this difference did not reach the threshold of significance [Chi 2 (2)=2.40, P=0.30]. Intervention group distributions were closer to normative samples, and these distributions show the clinical impact of our program. In general, preventive interventions focused on attachment quality have moderate effects but, in our case, several factors might have contributed to lower the statistical impact of the program. Firstly, the control group cannot be considered has having received zero intervention for two reasons: (a) the French usual perinatal health system (Maternal and Infant Protection System) is particularly generous and (b) the effect of this usual system might have been increased by the project intensive assessment protocol (6 visits during 28 months). Secondly, it is possible that the full effect of the intervention had not yet been detected because, when a child's attachment was assessed, only two thirds of the intervention visits had been performed (29 of 44 visits). A "sleeper effect" is still possible: we hope that a more clear result will be seen when children are assessed again, at 48 months, in our follow-up study (CAPEDP-A II). By clarifying the mechanisms involved in the development of a secure attachment, our study aims to contribute and refine the development of early preventive intervention strategies in high perinatal and psychosocial vulnerability contexts. Copyright © 2016 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Analysis of potential protein-modifying variants in 9000 endometriosis patients and 150000 controls of European ancestry.

PubMed

Sapkota, Yadav; Vivo, Immaculata De; Steinthorsdottir, Valgerdur; Fassbender, Amelie; Bowdler, Lisa; Buring, Julie E; Edwards, Todd L; Jones, Sarah; O, Dorien; Peterse, Daniëlle; Rexrode, Kathryn M; Ridker, Paul M; Schork, Andrew J; Thorleifsson, Gudmar; Wallace, Leanne M; Kraft, Peter; Morris, Andrew P; Nyholt, Dale R; Edwards, Digna R Velez; Nyegaard, Mette; D'Hooghe, Thomas; Chasman, Daniel I; Stefansson, Kari; Missmer, Stacey A; Montgomery, Grant W

2017-09-12

Genome-wide association (GWA) studies have identified 19 independent common risk loci for endometriosis. Most of the GWA variants are non-coding and the genes responsible for the association signals have not been identified. Herein, we aimed to assess the potential role of protein-modifying variants in endometriosis using exome-array genotyping in 7164 cases and 21005 controls, and a replication set of 1840 cases and 129016 controls of European ancestry. Results in the discovery sample identified significant evidence for association with coding variants in single-variant (rs1801232-CUBN) and gene-level (CIITA and PARP4) meta-analyses, but these did not survive replication. In the combined analysis, there was genome-wide significant evidence for rs13394619 (P = 2.3 × 10 -9 ) in GREB1 at 2p25.1 - a locus previously identified in a GWA meta-analysis of European and Japanese samples. Despite sufficient power, our results did not identify any protein-modifying variants (MAF > 0.01) with moderate or large effect sizes in endometriosis, although these variants may exist in non-European populations or in high-risk families. The results suggest continued discovery efforts should focus on genotyping large numbers of surgically-confirmed endometriosis cases and controls, and/or sequencing high-risk families to identify novel rare variants to provide greater insights into the molecular pathogenesis of the disease.

Whole-Genome Sequencing Suggests Schizophrenia Risk Mechanisms in Humans with 22q11.2 Deletion Syndrome.

PubMed

Merico, Daniele; Zarrei, Mehdi; Costain, Gregory; Ogura, Lucas; Alipanahi, Babak; Gazzellone, Matthew J; Butcher, Nancy J; Thiruvahindrapuram, Bhooma; Nalpathamkalam, Thomas; Chow, Eva W C; Andrade, Danielle M; Frey, Brendan J; Marshall, Christian R; Scherer, Stephen W; Bassett, Anne S

2015-09-16

Chromosome 22q11.2 microdeletions impart a high but incomplete risk for schizophrenia. Possible mechanisms include genome-wide effects of DGCR8 haploinsufficiency. In a proof-of-principle study to assess the power of this model, we used high-quality, whole-genome sequencing of nine individuals with 22q11.2 deletions and extreme phenotypes (schizophrenia, or no psychotic disorder at age >50 years). The schizophrenia group had a greater burden of rare, damaging variants impacting protein-coding neurofunctional genes, including genes involved in neuron projection (nominal P = 0.02, joint burden of three variant types). Variants in the intact 22q11.2 region were not major contributors. Restricting to genes affected by a DGCR8 mechanism tended to amplify between-group differences. Damaging variants in highly conserved long intergenic noncoding RNA genes also were enriched in the schizophrenia group (nominal P = 0.04). The findings support the 22q11.2 deletion model as a threshold-lowering first hit for schizophrenia risk. If applied to a larger and thus better-powered cohort, this appears to be a promising approach to identify genome-wide rare variants in coding and noncoding sequence that perturb gene networks relevant to idiopathic schizophrenia. Similarly designed studies exploiting genetic models may prove useful to help delineate the genetic architecture of other complex phenotypes. Copyright © 2015 Merico et al.

Whole-Genome Sequencing Suggests Schizophrenia Risk Mechanisms in Humans with 22q11.2 Deletion Syndrome

PubMed Central

Merico, Daniele; Zarrei, Mehdi; Costain, Gregory; Ogura, Lucas; Alipanahi, Babak; Gazzellone, Matthew J.; Butcher, Nancy J.; Thiruvahindrapuram, Bhooma; Nalpathamkalam, Thomas; Chow, Eva W. C.; Andrade, Danielle M.; Frey, Brendan J.; Marshall, Christian R.; Scherer, Stephen W.; Bassett, Anne S.

2015-01-01

Chromosome 22q11.2 microdeletions impart a high but incomplete risk for schizophrenia. Possible mechanisms include genome-wide effects of DGCR8 haploinsufficiency. In a proof-of-principle study to assess the power of this model, we used high-quality, whole-genome sequencing of nine individuals with 22q11.2 deletions and extreme phenotypes (schizophrenia, or no psychotic disorder at age >50 years). The schizophrenia group had a greater burden of rare, damaging variants impacting protein-coding neurofunctional genes, including genes involved in neuron projection (nominal P = 0.02, joint burden of three variant types). Variants in the intact 22q11.2 region were not major contributors. Restricting to genes affected by a DGCR8 mechanism tended to amplify between-group differences. Damaging variants in highly conserved long intergenic noncoding RNA genes also were enriched in the schizophrenia group (nominal P = 0.04). The findings support the 22q11.2 deletion model as a threshold-lowering first hit for schizophrenia risk. If applied to a larger and thus better-powered cohort, this appears to be a promising approach to identify genome-wide rare variants in coding and noncoding sequence that perturb gene networks relevant to idiopathic schizophrenia. Similarly designed studies exploiting genetic models may prove useful to help delineate the genetic architecture of other complex phenotypes. PMID:26384369

Shared genetic predisposition in rheumatoid arthritis-interstitial lung disease and familial pulmonary fibrosis.

PubMed

Juge, Pierre-Antoine; Borie, Raphaël; Kannengiesser, Caroline; Gazal, Steven; Revy, Patrick; Wemeau-Stervinou, Lidwine; Debray, Marie-Pierre; Ottaviani, Sébastien; Marchand-Adam, Sylvain; Nathan, Nadia; Thabut, Gabriel; Richez, Christophe; Nunes, Hilario; Callebaut, Isabelle; Justet, Aurélien; Leulliot, Nicolas; Bonnefond, Amélie; Salgado, David; Richette, Pascal; Desvignes, Jean-Pierre; Lioté, Huguette; Froguel, Philippe; Allanore, Yannick; Sand, Olivier; Dromer, Claire; Flipo, René-Marc; Clément, Annick; Béroud, Christophe; Sibilia, Jean; Coustet, Baptiste; Cottin, Vincent; Boissier, Marie-Christophe; Wallaert, Benoit; Schaeverbeke, Thierry; Dastot le Moal, Florence; Frazier, Aline; Ménard, Christelle; Soubrier, Martin; Saidenberg, Nathalie; Valeyre, Dominique; Amselem, Serge; Boileau, Catherine; Crestani, Bruno; Dieudé, Philippe

2017-05-01

Despite its high prevalence and mortality, little is known about the pathogenesis of rheumatoid arthritis-associated interstitial lung disease (RA-ILD). Given that familial pulmonary fibrosis (FPF) and RA-ILD frequently share the usual pattern of interstitial pneumonia and common environmental risk factors, we hypothesised that the two diseases might share additional risk factors, including FPF-linked genes. Our aim was to identify coding mutations of FPF-risk genes associated with RA-ILD.We used whole exome sequencing (WES), followed by restricted analysis of a discrete number of FPF-linked genes and performed a burden test to assess the excess number of mutations in RA-ILD patients compared to controls.Among the 101 RA-ILD patients included, 12 (11.9%) had 13 WES-identified heterozygous mutations in the TERT , RTEL1 , PARN or SFTPC coding regions . The burden test, based on 81 RA-ILD patients and 1010 controls of European ancestry, revealed an excess of TERT , RTEL1 , PARN or SFTPC mutations in RA-ILD patients (OR 3.17, 95% CI 1.53-6.12; p=9.45×10 -4 ). Telomeres were shorter in RA-ILD patients with a TERT , RTEL1 or PARN mutation than in controls (p=2.87×10 -2 ).Our results support the contribution of FPF-linked genes to RA-ILD susceptibility. Copyright ©ERS 2017.

Performance assessment methodology and preliminary results for low-level radioactive waste disposal in Taiwan.

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

Arnold, Bill Walter; Chang, Fu-lin; Mattie, Patrick D.

2006-02-01

Sandia National Laboratories (SNL) and Taiwan's Institute for Nuclear Energy Research (INER) have teamed together to evaluate several candidate sites for Low-Level Radioactive Waste (LLW) disposal in Taiwan. Taiwan currently has three nuclear power plants, with another under construction. Taiwan also has a research reactor, as well as medical and industrial wastes to contend with. Eventually the reactors will be decomissioned. Operational and decommissioning wastes will need to be disposed in a licensed disposal facility starting in 2014. Taiwan has adopted regulations similar to the US Nuclear Regulatory Commission's (NRC's) low-level radioactive waste rules (10 CFR 61) to govern themore » disposal of LLW. Taiwan has proposed several potential sites for the final disposal of LLW that is now in temporary storage on Lanyu Island and on-site at operating nuclear power plants, and for waste generated in the future through 2045. The planned final disposal facility will have a capacity of approximately 966,000 55-gallon drums. Taiwan is in the process of evaluating the best candidate site to pursue for licensing. Among these proposed sites there are basically two disposal concepts: shallow land burial and cavern disposal. A representative potential site for shallow land burial is located on a small island in the Taiwan Strait with basalt bedrock and interbedded sedimentary rocks. An engineered cover system would be constructed to limit infiltration for shallow land burial. A representative potential site for cavern disposal is located along the southeastern coast of Taiwan in a tunnel system that would be about 500 to 800 m below the surface. Bedrock at this site consists of argillite and meta-sedimentary rocks. Performance assessment analyses will be performed to evaluate future performance of the facility and the potential dose/risk to exposed populations. Preliminary performance assessment analyses will be used in the site-selection process and to aid in design of the disposal system. Final performance assessment analyses will be used in the regulatory process of licensing a site. The SNL/INER team has developed a performance assessment methodology that is used to simulate processes associated with the potential release of radionuclides to evaluate these sites. The following software codes are utilized in the performance assessment methodology: GoldSim (to implement a probabilistic analysis that will explicitly address uncertainties); the NRC's Breach, Leach, and Transport - Multiple Species (BLT-MS) code (to simulate waste-container degradation, waste-form leaching, and transport through the host rock); the Finite Element Heat and Mass Transfer code (FEHM) (to simulate groundwater flow and estimate flow velocities); the Hydrologic Evaluation of Landfill performance Model (HELP) code (to evaluate infiltration through the disposal cover); the AMBER code (to evaluate human health exposures); and the NRC's Disposal Unit Source Term -- Multiple Species (DUST-MS) code (to screen applicable radionuclides). Preliminary results of the evaluations of the two disposal concept sites are presented.« less

Integrated Assessment of Heavy Metal Pollution in the Surface Sediments of the Laizhou Bay and the Coastal Waters of the Zhangzi Island, China: Comparison among Typical Marine Sediment Quality Indices

PubMed Central

Zhuang, Wen; Gao, Xuelu

2014-01-01

The total concentrations and chemical forms of heavy metals (Cd, Cr, Cu, Ni, Pb and Zn) in the surface sediments of the Laizhou Bay and the surrounding marine area of the Zhangzi Island (hereafter referred to as Zhangzi Island for short) were obtained and multiple indices and guidelines were applied to assess their contamination and ecological risks. The sedimentary conditions were fine in both of the two studied areas according to the marine sediment quality of China. Whereas the probable effects level guideline suggested that Ni might cause adverse biological effects to occur frequently in some sites. All indices used suggested that Cd posed the highest environmental risk in both the Laizhou Bay and the Zhangzi Island, though Cd may unlikely be harmful to human and ecological health due to the very low total concentrations. The enrichment factor (EF) showed that a substantial portion of Cr was delivered from anthropogenic sources, whereas the risk assessment code (RAC) indicated that most Cr was in an inactive state that it may not have any adverse effect either. Moreover, the results of EF and geoaccumulation index were consistent with the trend of the total metal concentrations except for Cd, while the results of RAC and potential ecological risk factor did not follow the same trend of their corresponding total metal concentrations. We also evaluated the effects of using different indices to assess the environmental impact of these heavy metals. PMID:24709993

Verification and Validation in a Rapid Software Development Process

NASA Technical Reports Server (NTRS)

Callahan, John R.; Easterbrook, Steve M.

1997-01-01

The high cost of software production is driving development organizations to adopt more automated design and analysis methods such as rapid prototyping, computer-aided software engineering (CASE) tools, and high-level code generators. Even developers of safety-critical software system have adopted many of these new methods while striving to achieve high levels Of quality and reliability. While these new methods may enhance productivity and quality in many cases, we examine some of the risks involved in the use of new methods in safety-critical contexts. We examine a case study involving the use of a CASE tool that automatically generates code from high-level system designs. We show that while high-level testing on the system structure is highly desirable, significant risks exist in the automatically generated code and in re-validating releases of the generated code after subsequent design changes. We identify these risks and suggest process improvements that retain the advantages of rapid, automated development methods within the quality and reliability contexts of safety-critical projects.

Comment on "How can seismic hazard around the New Madrid seismic zone be similar to that in California?" by Arthur Frankel

USGS Publications Warehouse

Wang, Z.; Shi, B.; Kiefer, J.D.

2005-01-01

PSHA is the method used most to assess seismic hazards for input into various aspects of public and financial policy. For example, PSHA was used by the U.S. Geological Survey to develop the National Seismic Hazard Maps (Frankel et al., 1996, 2002). These maps are the basis for many national, state, and local seismic safety regulations and design standards, such as the NEHRP Recommended Provisions for Seismic Regulations for New Buildings and Other Structures, the International Building Code, and the International Residential Code. Adoption and implementation of these regulations and design standards would have significant impacts on many communities in the New Madrid area, including Memphis, Tennessee and Paducah, Kentucky. Although "mitigating risks to society from earthquakes involves economic and policy issues" (Stein, 2004), seismic hazard assessment is the basis. Seismologists should provide the best information on seismic hazards and communicate them to users and policy makers. There is a lack of effort in communicating the uncertainties in seismic hazard assessment in the central U.S., however. Use of 10%, 5%, and 2% PE in 50 years causes confusion in communicating seismic hazard assessment. It would be easy to discuss and understand the design ground motions if the true meaning of the ground motion derived from PSHA were presented, i.e., the ground motion with the estimated uncertainty or the associated confidence level.

Development of a Coding Instrument to Assess the Quality and Content of Anti-Tobacco Video Games.

PubMed

Alber, Julia M; Watson, Anna M; Barnett, Tracey E; Mercado, Rebeccah; Bernhardt, Jay M

2015-07-01

Previous research has shown the use of electronic video games as an effective method for increasing content knowledge about the risks of drugs and alcohol use for adolescents. Although best practice suggests that theory, health communication strategies, and game appeal are important characteristics for developing games, no instruments are currently available to examine the quality and content of tobacco prevention and cessation electronic games. This study presents the systematic development of a coding instrument to measure the quality, use of theory, and health communication strategies of tobacco cessation and prevention electronic games. Using previous research and expert review, a content analysis coding instrument measuring 67 characteristics was developed with three overarching categories: type and quality of games, theory and approach, and type and format of messages. Two trained coders applied the instrument to 88 games on four platforms (personal computer, Nintendo DS, iPhone, and Android phone) to field test the instrument. Cohen's kappa for each item ranged from 0.66 to 1.00, with an average kappa value of 0.97. Future research can adapt this coding instrument to games addressing other health issues. In addition, the instrument questions can serve as a useful guide for evidence-based game development.

Assessment of genetic mutations in the XRCC2 coding region by high resolution melting curve analysis and the risk of differentiated thyroid carcinoma in Iran

PubMed Central

Fayaz, Shima; Fard-Esfahani, Pezhman; Fard-Esfahani, Armaghan; Mostafavi, Ehsan; Meshkani, Reza; Mirmiranpour, Hossein; Khaghani, Shahnaz

2012-01-01

Homologous recombination (HR) is the major pathway for repairing double strand breaks (DSBs) in eukaryotes and XRCC2 is an essential component of the HR repair machinery. To evaluate the potential role of mutations in gene repair by HR in individuals susceptible to differentiated thyroid carcinoma (DTC) we used high resolution melting (HRM) analysis, a recently introduced method for detecting mutations, to examine the entire XRCC2 coding region in an Iranian population. HRM analysis was used to screen for mutations in three XRCC2 coding regions in 50 patients and 50 controls. There was no variation in the HRM curves obtained from the analysis of exons 1 and 2 in the case and control groups. In exon 3, an Arg188His polymorphism (rs3218536) was detected as a new melting curve group (OR: 1.46; 95%CI: 0.432–4.969; p = 0.38) compared with the normal melting curve. We also found a new Ser150Arg polymorphism in exon 3 of the control group. These findings suggest that genetic variations in the XRCC2 coding region have no potential effects on susceptibility to DTC. However, further studies with larger populations are required to confirm this conclusion. PMID:22481871

MELCOR computer code manuals

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

Summers, R.M.; Cole, R.K. Jr.; Smith, R.C.

1995-03-01

MELCOR is a fully integrated, engineering-level computer code that models the progression of severe accidents in light water reactor nuclear power plants. MELCOR is being developed at Sandia National Laboratories for the U.S. Nuclear Regulatory Commission as a second-generation plant risk assessment tool and the successor to the Source Term Code Package. A broad spectrum of severe accident phenomena in both boiling and pressurized water reactors is treated in MELCOR in a unified framework. These include: thermal-hydraulic response in the reactor coolant system, reactor cavity, containment, and confinement buildings; core heatup, degradation, and relocation; core-concrete attack; hydrogen production, transport, andmore » combustion; fission product release and transport; and the impact of engineered safety features on thermal-hydraulic and radionuclide behavior. Current uses of MELCOR include estimation of severe accident source terms and their sensitivities and uncertainties in a variety of applications. This publication of the MELCOR computer code manuals corresponds to MELCOR 1.8.3, released to users in August, 1994. Volume 1 contains a primer that describes MELCOR`s phenomenological scope, organization (by package), and documentation. The remainder of Volume 1 contains the MELCOR Users Guides, which provide the input instructions and guidelines for each package. Volume 2 contains the MELCOR Reference Manuals, which describe the phenomenological models that have been implemented in each package.« less

Development of a Coding Instrument to Assess the Quality and Content of Anti-Tobacco Video Games

PubMed Central

Alber, Julia M.; Watson, Anna M.; Barnett, Tracey E.; Mercado, Rebeccah

2015-01-01

Abstract Previous research has shown the use of electronic video games as an effective method for increasing content knowledge about the risks of drugs and alcohol use for adolescents. Although best practice suggests that theory, health communication strategies, and game appeal are important characteristics for developing games, no instruments are currently available to examine the quality and content of tobacco prevention and cessation electronic games. This study presents the systematic development of a coding instrument to measure the quality, use of theory, and health communication strategies of tobacco cessation and prevention electronic games. Using previous research and expert review, a content analysis coding instrument measuring 67 characteristics was developed with three overarching categories: type and quality of games, theory and approach, and type and format of messages. Two trained coders applied the instrument to 88 games on four platforms (personal computer, Nintendo DS, iPhone, and Android phone) to field test the instrument. Cohen's kappa for each item ranged from 0.66 to 1.00, with an average kappa value of 0.97. Future research can adapt this coding instrument to games addressing other health issues. In addition, the instrument questions can serve as a useful guide for evidence-based game development. PMID:26167842

Methodology, status and plans for development and assessment of TUF and CATHENA codes

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

Luxat, J.C.; Liu, W.S.; Leung, R.K.

1997-07-01

An overview is presented of the Canadian two-fluid computer codes TUF and CATHENA with specific focus on the constraints imposed during development of these codes and the areas of application for which they are intended. Additionally a process for systematic assessment of these codes is described which is part of a broader, industry based initiative for validation of computer codes used in all major disciplines of safety analysis. This is intended to provide both the licensee and the regulator in Canada with an objective basis for assessing the adequacy of codes for use in specific applications. Although focused specifically onmore » CANDU reactors, Canadian experience in developing advanced two-fluid codes to meet wide-ranging application needs while maintaining past investment in plant modelling provides a useful contribution to international efforts in this area.« less

Advancing methods for reliably assessing motivational interviewing fidelity using the Motivational Interviewing Skills Code

PubMed Central

Lord, Sarah Peregrine; Can, Doğan; Yi, Michael; Marin, Rebeca; Dunn, Christopher W.; Imel, Zac E.; Georgiou, Panayiotis; Narayanan, Shrikanth; Steyvers, Mark; Atkins, David C.

2014-01-01

The current paper presents novel methods for collecting MISC data and accurately assessing reliability of behavior codes at the level of the utterance. The MISC 2.1 was used to rate MI interviews from five randomized trials targeting alcohol and drug use. Sessions were coded at the utterance-level. Utterance-based coding reliability was estimated using three methods and compared to traditional reliability estimates of session tallies. Session-level reliability was generally higher compared to reliability using utterance-based codes, suggesting that typical methods for MISC reliability may be biased. These novel methods in MI fidelity data collection and reliability assessment provided rich data for therapist feedback and further analyses. Beyond implications for fidelity coding, utterance-level coding schemes may elucidate important elements in the counselor-client interaction that could inform theories of change and the practice of MI. PMID:25242192

Advancing methods for reliably assessing motivational interviewing fidelity using the motivational interviewing skills code.

PubMed

Lord, Sarah Peregrine; Can, Doğan; Yi, Michael; Marin, Rebeca; Dunn, Christopher W; Imel, Zac E; Georgiou, Panayiotis; Narayanan, Shrikanth; Steyvers, Mark; Atkins, David C

2015-02-01

The current paper presents novel methods for collecting MISC data and accurately assessing reliability of behavior codes at the level of the utterance. The MISC 2.1 was used to rate MI interviews from five randomized trials targeting alcohol and drug use. Sessions were coded at the utterance-level. Utterance-based coding reliability was estimated using three methods and compared to traditional reliability estimates of session tallies. Session-level reliability was generally higher compared to reliability using utterance-based codes, suggesting that typical methods for MISC reliability may be biased. These novel methods in MI fidelity data collection and reliability assessment provided rich data for therapist feedback and further analyses. Beyond implications for fidelity coding, utterance-level coding schemes may elucidate important elements in the counselor-client interaction that could inform theories of change and the practice of MI. Copyright © 2015 Elsevier Inc. All rights reserved.

General practitioners' justifications for therapeutic inertia in cardiovascular prevention: an empirically grounded typology.

PubMed

Lebeau, Jean-Pierre; Cadwallader, Jean-Sébastien; Vaillant-Roussel, Hélène; Pouchain, Denis; Yaouanc, Virginie; Aubin-Auger, Isabelle; Mercier, Alain; Rusch, Emmanuel; Remmen, Roy; Vermeire, Etienne; Hendrickx, Kristin

2016-05-13

To construct a typology of general practitioners' (GPs) responses regarding their justification of therapeutic inertia in cardiovascular primary prevention for high-risk patients with hypertension. Empirically grounded construction of typology. Types were defined by attributes derived from the qualitative analysis of GPs' reported reasons for inaction. 256 GPs randomised in the intervention group of a cluster randomised controlled trial. GPs members of 23 French Regional Colleges of Teachers in General Practice, included in the EffectS of a multifaceted intervention on CArdiovascular risk factors in high-risk hyPErtensive patients (ESCAPE) trial. The database consisted of 2638 written responses given by the GPs to an open-ended question asking for the reasons why drug treatment was not changed as suggested by the national guidelines. All answers were coded using constant comparison analysis. A matrix analysis of codes per GP allowed the construction of a response typology, where types were defined by codes as attributes. Initial coding and definition of types were performed independently by two teams. Initial coding resulted in a list of 69 codes in the final codebook, representing 4764 coded references in the question responses. A typology including seven types was constructed. 100 GPs were allocated to one and only one of these types, while 25 GPs did not provide enough data to allow classification. Types (numbers of GPs allocated) were: 'optimists' (28), 'negotiators' (20), 'checkers' (15), 'contextualisers' (13), 'cautious' (11), 'rounders' (8) and 'scientists' (5). For the 36 GPs that provided 50 or more coded references, analysis of the code evolution over time and across patients showed a consistent belonging to the initial type for any given GP. This typology could provide GPs with some insight into their general ways of considering changes in the treatment/management of cardiovascular risk factors and guide design of specific physician-centred interventions to reduce inappropriate inaction. NCT00348855. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Space Radiation Cancer Risk Projections and Uncertainties - 2010

NASA Technical Reports Server (NTRS)

Cucinotta, Francis A.; Kim, Myung-Hee Y.; Chappell, Lori J.

2011-01-01

Uncertainties in estimating health risks from galactic cosmic rays greatly limit space mission lengths and potential risk mitigation evaluations. NASA limits astronaut exposures to a 3% risk of exposure-induced death and protects against uncertainties using an assessment of 95% confidence intervals in the projection model. Revisions to this model for lifetime cancer risks from space radiation and new estimates of model uncertainties are described here. We review models of space environments and transport code predictions of organ exposures, and characterize uncertainties in these descriptions. We summarize recent analysis of low linear energy transfer radio-epidemiology data, including revision to Japanese A-bomb survivor dosimetry, longer follow-up of exposed cohorts, and reassessments of dose and dose-rate reduction effectiveness factors. We compare these projections and uncertainties with earlier estimates. Current understanding of radiation quality effects and recent data on factors of relative biological effectiveness and particle track structure are reviewed. Recent radiobiology experiment results provide new information on solid cancer and leukemia risks from heavy ions. We also consider deviations from the paradigm of linearity at low doses of heavy ions motivated by non-targeted effects models. New findings and knowledge are used to revise the NASA risk projection model for space radiation cancer risks.

Probabilistic accident consequence uncertainty analysis: Dispersion and deposition uncertainty assessment, appendices A and B

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

Harper, F.T.; Young, M.L.; Miller, L.A.

The development of two new probabilistic accident consequence codes, MACCS and COSYMA, completed in 1990, estimate the risks presented by nuclear installations based on postulated frequencies and magnitudes of potential accidents. In 1991, the US Nuclear Regulatory Commission (NRC) and the Commission of the European Communities (CEC) began a joint uncertainty analysis of the two codes. The objective was to develop credible and traceable uncertainty distributions for the input variables of the codes. Expert elicitation, developed independently, was identified as the best technology available for developing a library of uncertainty distributions for the selected consequence parameters. The study was formulatedmore » jointly and was limited to the current code models and to physical quantities that could be measured in experiments. To validate the distributions generated for the wet deposition input variables, samples were taken from these distributions and propagated through the wet deposition code model along with the Gaussian plume model (GPM) implemented in the MACCS and COSYMA codes. Resulting distributions closely replicated the aggregated elicited wet deposition distributions. Project teams from the NRC and CEC cooperated successfully to develop and implement a unified process for the elaboration of uncertainty distributions on consequence code input parameters. Formal expert judgment elicitation proved valuable for synthesizing the best available information. Distributions on measurable atmospheric dispersion and deposition parameters were successfully elicited from experts involved in the many phenomenological areas of consequence analysis. This volume is the second of a three-volume document describing the project and contains two appendices describing the rationales for the dispersion and deposition data along with short biographies of the 16 experts who participated in the project.« less

Validation of a coding algorithm for intra-abdominal surgeries and adhesion-related complications in an electronic medical records database

PubMed Central

Scott, Frank I; Mamtani, Ronac; Haynes, Kevin; Goldberg, David S; Mahmoud, Najjia N.; Lewis, James D

2016-01-01

PURPOSE Epidemiological data on adhesion-related complications following intra-abdominal surgery are limited. We tested the accuracy of recording of these surgeries and complications within The Health Improvement Network (THIN), a primary care database within the United Kingdom. METHODS Individuals within THIN from 1995–2011 with an incident intra-abdominal surgery and subsequent bowel obstruction (SBO) or adhesiolysis were identified using diagnostic codes. To compute positive predictive values (PPVs), requests were sent to treating physicians of patients with these diagnostic codes to confirm the surgery, SBO, or adhesiolysis code. Completeness of recording was estimated by comparing observed surgical rates within THIN to expected rates derived from the Hospital Episode Statistics (HES) dataset within England. Cumulative incidence rates of adhesion-related complications at 5 years were compared to a previously published cohort within Scotland. RESULTS 217 of 245 (89%) questionnaires were returned (180 SBO and 37 adhesiolysis). The PPV of codes for surgery was 94.5% (95%CI: 91–97%). 88.8% of procedure types were correctly coded. The PPV for SBO and adhesiolysis was 86.1% (95% CI: 80–91%) and 89.2% (95% CI: 75–97%), respectively. Colectomy, appendectomy, and cholecystectomy rates within THIN were 99%, 95%, and 84% of rates observed in national HES data, respectively. Cumulative incidence rates of adhesion related complications following colectomy, appendectomy, and small bowel surgery were similar to those published previously. CONCLUSIONS Surgical procedures, SBO, and adhesiolysis can be accurately identified within THIN using diagnostic codes. THIN represents a new tool for assessing patient-specific risk factors for adhesion-related complications and long term outcomes. PMID:26860870

[Using attachment measures in the context of providing expert witness through psychiatric assessment in family court proceedings].

PubMed

Besier, Tanja; Ziegenhain, Ute; Fegert, Jörg M; Künster, Anne Katrin

2012-01-01

Prognostic evaluation of child development in the context of his/her actual family situation plays an important role in family law disputes. However, there is a lack of empirically validated instruments to assess socio-emotional development in very young children. Attachment research provides instruments which could be utilized in clinical practice. At this, the focus should be on assessing the quality of parent-child-relationship and the occurrence of risky parenting behaviour. The article illustrates the use of attachment measures in the context of a family court proceeding according to subsection 1666 German Civil Code. Risk assessment is carried out through direct observation of the quality of interaction between mother and ten months old infant as well as through evaluation of the attachment representations of both parent caregivers. Instruments used are the Strange Situation Test (to assess infant attachment), the CARE-Index (to assess parental sensitivity), the Adult Attachment Interview, and the Adult Attachment Projective (to assess parental attachment representations).

Heavy metal pollution and ecological risk assessment of the paddy soils near a zinc-lead mining area in Hunan.

PubMed

Lu, Sijin; Wang, Yeyao; Teng, Yanguo; Yu, Xuan

2015-10-01

Soil pollution by Cd, Hg, As, Pb, Cr, Cu, and Zn was characterized in the area of the mining and smelting of metal ores at Guiyang, northeast of Hunan Province. A total of 150 topsoil (0-20 cm) samples were collected in May 2012 with a nominal density of one sample per 4 km(2). High concentrations of heavy metals especially, Cd, Zn, and Pb were found in many of the samples taken from surrounding paddy soil, indicating a certain extent of spreading of heavy metal pollution. Sequential extraction technique and risk assessment code (RAC) were used to study the mobility of chemical forms of heavy metals in the soils and their ecological risk. The results reveal that Cd represents a high ecological risk due to its highest percentage of the exchangeable and carbonate fractions. The metals of Zn and Cu pose a medium risk, and the rest of the metals represent a low environmental risk. The range of the potential ecological risk of soil calculated by risk index (RI) was 123.5~2791.2 and revealed a considerable-high ecological risk in study area especially in the neighboring and surrounding the mining activities area. Additionally, cluster analyses suggested that metals such as Pb, As, Hg, Zn, and Cd could be from the same sources probably related to the acidic drainage and wind transport of dust. Cluster analysis also clearly distinguishes the samples with similar characteristics according to their spatial distribution. The results could be used during the ecological risk screening stage, in conjunction with total concentrations and metal fractionation values to better estimate ecological risk.

Gist and verbatim communication concerning medication risks/benefits.

PubMed

Blalock, Susan J; DeVellis, Robert F; Chewning, Betty; Sleath, Betsy L; Reyna, Valerie F

2016-06-01

To describe the information about medication risks/benefits that rheumatologists provide during patient office visits, the gist that patients with rheumatoid arthritis (RA) extract from the information provided, and the relationship between communication and medication satisfaction. Data from 169 RA patients were analyzed. Each participant had up to three visits audiotaped. Four RA patients coded the audiotapes using a Gist Coding Scheme and research assistants coded the audiotapes using a Verbatim Coding Scheme. When extracting gist from the information discussed during visits, patient coders distinguished between discussion concerning the possibility of medication side effects versus expression of significant safety concerns. Among patients in the best health, nearly 80% reported being totally satisfied with their medications when the physician communicated the gist that the medication was effective, compared to approximately 50% when this gist was not communicated. Study findings underscore the multidimensional nature of medication risk communication and the importance of communication concerning medication effectiveness/need. Health care providers should ensure that patients understand that medication self-management practices can minimize potential risks. Communicating simple gist messages may increase patient satisfaction, especially messages about benefits for well-managed patients. Optimal communication also requires shared understanding of desired therapeutic outcomes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Automation of PCXMC and ImPACT for NASA Astronaut Medical Imaging Dose and Risk Tracking

NASA Technical Reports Server (NTRS)

Bahadori, Amir; Picco, Charles; Flores-McLaughlin, John; Shavers, Mark; Semones, Edward

2011-01-01

To automate astronaut organ and effective dose calculations from occupational X-ray and computed tomography (CT) examinations incorporating PCXMC and ImPACT tools and to estimate the associated lifetime cancer risk per the National Council on Radiation Protection & Measurements (NCRP) using MATLAB(R). Methods: NASA follows guidance from the NCRP on its operational radiation safety program for astronauts. NCRP Report 142 recommends that astronauts be informed of the cancer risks from reported exposures to ionizing radiation from medical imaging. MATLAB(R) code was written to retrieve exam parameters for medical imaging procedures from a NASA database, calculate associated dose and risk, and return results to the database, using the Microsoft .NET Framework. This code interfaces with the PCXMC executable and emulates the ImPACT Excel spreadsheet to calculate organ doses from X-rays and CTs, respectively, eliminating the need to utilize the PCXMC graphical user interface (except for a few special cases) and the ImPACT spreadsheet. Results: Using MATLAB(R) code to interface with PCXMC and replicate ImPACT dose calculation allowed for rapid evaluation of multiple medical imaging exams. The user inputs the exam parameter data into the database and runs the code. Based on the imaging modality and input parameters, the organ doses are calculated. Output files are created for record, and organ doses, effective dose, and cancer risks associated with each exam are written to the database. Annual and post-flight exposure reports, which are used by the flight surgeon to brief the astronaut, are generated from the database. Conclusions: Automating PCXMC and ImPACT for evaluation of NASA astronaut medical imaging radiation procedures allowed for a traceable and rapid method for tracking projected cancer risks associated with over 12,000 exposures. This code will be used to evaluate future medical radiation exposures, and can easily be modified to accommodate changes to the risk calculation procedure.

Spatial panel analyses of alcohol outlets and motor vehicle crashes in California: 1999–2008

PubMed Central

Ponicki, William R.; Gruenewald, Paul J.; Remer, Lillian G.

2014-01-01

Although past research has linked alcohol outlet density to higher rates of drinking and many related social problems, there is conflicting evidence of density’s association with traffic crashes. An abundance of local alcohol outlets simultaneously encourages drinking and reduces driving distances required to obtain alcohol, leading to an indeterminate expected impact on alcohol-involved crash risk. This study separately investigates the effects of outlet density on (1) the risk of injury crashes relative to population and (2) the likelihood that any given crash is alcohol-involved, as indicated by police reports and single-vehicle nighttime status of crashes. Alcohol outlet density effects are estimated using Bayesian misalignment Poisson analyses of all California ZIP codes over the years 1999–2008. These misalignment models allow panel analysis of ZIP-code data despite frequent redefinition of postal-code boundaries, while also controlling for overdispersion and the effects of spatial autocorrelation. Because models control for overall retail density, estimated alcohol-outlet associations represent the extra effect of retail establishments selling alcohol. The results indicate a number of statistically well-supported associations between retail density and crash behavior, but the implied effects on crash risks are relatively small. Alcohol-serving restaurants have a greater impact on overall crash risks than on the likelihood that those crashes involve alcohol, whereas bars primarily affect the odds that crashes are alcohol-involved. Off-premise outlet density is negatively associated with risks of both crashes and alcohol involvement, while the presence of a tribal casino in a ZIP code is linked to higher odds of police-reported drinking involvement. Alcohol outlets in a given area are found to influence crash risks both locally and in adjacent ZIP codes, and significant spatial autocorrelation also suggests important relationships across geographical units. These results suggest that each type of alcohol outlet can have differing impacts on risks of crashing as well as the alcohol involvement of those crashes. PMID:23537623

Identification of Trends into Dose Calculations for Astronauts through Performing Sensitivity Analysis on Calculational Models Used by the Radiation Health Office

NASA Technical Reports Server (NTRS)

Adams, Thomas; VanBaalen, Mary

2009-01-01

The Radiation Health Office (RHO) determines each astronaut s cancer risk by using models to associate the amount of radiation dose that astronauts receive from spaceflight missions. The baryon transport codes (BRYNTRN), high charge (Z) and energy transport codes (HZETRN), and computer risk models are used to determine the effective dose received by astronauts in Low Earth orbit (LEO). This code uses an approximation of the Boltzman transport formula. The purpose of the project is to run this code for various International Space Station (ISS) flight parameters in order to gain a better understanding of how this code responds to different scenarios. The project will determine how variations in one set of parameters such as, the point of the solar cycle and altitude can affect the radiation exposure of astronauts during ISS missions. This project will benefit NASA by improving mission dosimetry.

Contract and Tort Based Ethics in Student Affairs.

ERIC Educational Resources Information Center

Barratt, Will

1996-01-01

Argues that contract law and tort law are appropriate means for providing enforceable professional ethics in student affairs and that incorporating student affairs ethical codes into contracts with students creates enforceable ethical codes. Believes that providing such codes strengthens risk management programs, as well as encouraging…

Developing small-area predictions for smoking and obesity prevalence in the United States for use in Environmental Public Health Tracking.

PubMed

Ortega Hinojosa, Alberto M; Davies, Molly M; Jarjour, Sarah; Burnett, Richard T; Mann, Jennifer K; Hughes, Edward; Balmes, John R; Turner, Michelle C; Jerrett, Michael

2014-10-01

Globally and in the United States, smoking and obesity are leading causes of death and disability. Reliable estimates of prevalence for these risk factors are often missing variables in public health surveillance programs. This may limit the capacity of public health surveillance to target interventions or to assess associations between other environmental risk factors (e.g., air pollution) and health because smoking and obesity are often important confounders. To generate prevalence estimates of smoking and obesity rates over small areas for the United States (i.e., at the ZIP code and census tract levels). We predicted smoking and obesity prevalence using a combined approach first using a lasso-based variable selection procedure followed by a two-level random effects regression with a Poisson link clustered on state and county. We used data from the Behavioral Risk Factor Surveillance System (BRFSS) from 1991 to 2010 to estimate the model. We used 10-fold cross-validated mean squared errors and the variance of the residuals to test our model. To downscale the estimates we combined the prediction equations with 1990 and 2000 U.S. Census data for each of the four five-year time periods in this time range at the ZIP code and census tract levels. Several sensitivity analyses were conducted using models that included only basic terms, that accounted for spatial autocorrelation, and used Generalized Linear Models that did not include random effects. The two-level random effects model produced improved estimates compared to the fixed effects-only models. Estimates were particularly improved for the two-thirds of the conterminous U.S. where BRFSS data were available to estimate the county level random effects. We downscaled the smoking and obesity rate predictions to derive ZIP code and census tract estimates. To our knowledge these smoking and obesity predictions are the first to be developed for the entire conterminous U.S. for census tracts and ZIP codes. Our estimates could have significant utility for public health surveillance. Copyright © 2014. Published by Elsevier Inc.

Maternal reflective functioning among mothers with childhood maltreatment histories: links to sensitive parenting and infant attachment security.

PubMed

Stacks, Ann M; Muzik, Maria; Wong, Kristyn; Beeghly, Marjorie; Huth-Bocks, Alissa; Irwin, Jessica L; Rosenblum, Katherine L

2014-01-01

This study examined relationships among maternal reflective functioning, parenting, infant attachment, and demographic risk in a relatively large (N = 83) socioeconomically diverse sample of women with and without a history of childhood maltreatment and their infants. Most prior research on parental reflective functioning has utilized small homogenous samples. Reflective functioning was assessed with the Parent Development Interview, parenting was coded from videotaped mother-child interactions, and infant attachment was evaluated in Ainsworth's Strange Situation by independent teams of reliable coders masked to maternal history. Reflective functioning was associated with parenting sensitivity and secure attachment, and inversely associated with demographic risk and parenting negativity; however, it was not associated with maternal maltreatment history or PTSD. Parenting sensitivity mediated the relationship between reflective functioning and infant attachment, controlling for demographic risk. Findings are discussed in the context of prior research on reflective functioning and the importance of targeting reflective functioning in interventions.

Maternal occupation and risk for low birth weight delivery: assessment using state birth registry data.

PubMed

Meyer, John D; Nichols, Ginger H; Warren, Nicholas; Reisine, Susan

2008-03-01

To determine the effects of employment on low birth weight (LBW) in a service-based economy, we evaluated the association of LBW delivery with occupational data collected in a state birth registry. Occupational data in the 2000 Connecticut birth registry were coded for 41,009 singleton births. Associations between employment and LBW delivery were analyzed using logistic regression controlling for covariates in the registry data set. Evidence for improved LBW outcomes in working mothers did not persist when adjusted for maternal covariates. Among working mothers, elevated risk of LBW was seen in textile, food service, personal appearance, material dispatching or distributing, and retail sales workers. Improved overall birth outcomes seen in working mothers may arise from favorable demographic and health attributes. Higher LBW risk was seen in several types of service sector jobs and in textile work.

Developing points-based risk-scoring systems in the presence of competing risks.

PubMed

Austin, Peter C; Lee, Douglas S; D'Agostino, Ralph B; Fine, Jason P

2016-09-30

Predicting the occurrence of an adverse event over time is an important issue in clinical medicine. Clinical prediction models and associated points-based risk-scoring systems are popular statistical methods for summarizing the relationship between a multivariable set of patient risk factors and the risk of the occurrence of an adverse event. Points-based risk-scoring systems are popular amongst physicians as they permit a rapid assessment of patient risk without the use of computers or other electronic devices. The use of such points-based risk-scoring systems facilitates evidence-based clinical decision making. There is a growing interest in cause-specific mortality and in non-fatal outcomes. However, when considering these types of outcomes, one must account for competing risks whose occurrence precludes the occurrence of the event of interest. We describe how points-based risk-scoring systems can be developed in the presence of competing events. We illustrate the application of these methods by developing risk-scoring systems for predicting cardiovascular mortality in patients hospitalized with acute myocardial infarction. Code in the R statistical programming language is provided for the implementation of the described methods. © 2016 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd. © 2016 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd.

Performance Measures in Neurosurgical Patient Care: Differing Applications of Patient Safety Indicators.

PubMed

Moghavem, Nuriel; McDonald, Kathryn; Ratliff, John K; Hernandez-Boussard, Tina

2016-04-01

Patient Safety Indicators (PSIs) are administratively coded identifiers of potentially preventable adverse events. These indicators are used for multiple purposes, including benchmarking and quality improvement efforts. Baseline PSI evaluation in high-risk surgeries is fundamental to both purposes. Determine PSI rates and their impact on other outcomes in patients undergoing cranial neurosurgery compared with other surgeries. The Agency for Healthcare Research and Quality (AHRQ) PSI software was used to flag adverse events and determine risk-adjusted rates (RAR). Regression models were built to assess the association between PSIs and important patient outcomes. We identified cranial neurosurgeries based on International Classification of Diseases, Ninth Revision, Clinical Modification codes in California, Florida, New York, Arkansas, and Mississippi State Inpatient Databases, AHRQ, 2010-2011. PSI development, 30-day all-cause readmission, length of stay, hospital costs, and inpatient mortality. A total of 48,424 neurosurgical patients were identified. Procedure indication was strongly associated with PSI development. The neurosurgical population had significantly higher RAR of most PSIs evaluated compared with other surgical patients. Development of a PSI was strongly associated with increased length of stay and hospital cost and, in certain PSIs, increased inpatient mortality and 30-day readmission. In this population-based study, certain accountability measures proposed for use as value-based payment modifiers show higher RAR in neurosurgery patients compared with other surgical patients and were subsequently associated with poor outcomes. Our results indicate that for quality improvement efforts, the current AHRQ risk-adjustment models should be viewed in clinically meaningful stratified subgroups: for profiling and pay-for-performance applications, additional factors should be included in the risk-adjustment models. Further evaluation of PSIs in additional high-risk surgeries is needed to better inform the use of these metrics.

The Dutch Hospital Standardised Mortality Ratio (HSMR) method and cardiac surgery: benchmarking in a national cohort using hospital administration data versus a clinical database

PubMed Central

Siregar, S; Pouw, M E; Moons, K G M; Versteegh, M I M; Bots, M L; van der Graaf, Y; Kalkman, C J; van Herwerden, L A; Groenwold, R H H

2014-01-01

Objective To compare the accuracy of data from hospital administration databases and a national clinical cardiac surgery database and to compare the performance of the Dutch hospital standardised mortality ratio (HSMR) method and the logistic European System for Cardiac Operative Risk Evaluation, for the purpose of benchmarking of mortality across hospitals. Methods Information on all patients undergoing cardiac surgery between 1 January 2007 and 31 December 2010 in 10 centres was extracted from The Netherlands Association for Cardio-Thoracic Surgery database and the Hospital Discharge Registry. The number of cardiac surgery interventions was compared between both databases. The European System for Cardiac Operative Risk Evaluation and hospital standardised mortality ratio models were updated in the study population and compared using the C-statistic, calibration plots and the Brier-score. Results The number of cardiac surgery interventions performed could not be assessed using the administrative database as the intervention code was incorrect in 1.4–26.3%, depending on the type of intervention. In 7.3% no intervention code was registered. The updated administrative model was inferior to the updated clinical model with respect to discrimination (c-statistic of 0.77 vs 0.85, p<0.001) and calibration (Brier Score of 2.8% vs 2.6%, p<0.001, maximum score 3.0%). Two average performing hospitals according to the clinical model became outliers when benchmarking was performed using the administrative model. Conclusions In cardiac surgery, administrative data are less suitable than clinical data for the purpose of benchmarking. The use of either administrative or clinical risk-adjustment models can affect the outlier status of hospitals. Risk-adjustment models including procedure-specific clinical risk factors are recommended. PMID:24334377

Beyond crosswalks: reliability of exposure assessment following automated coding of free-text job descriptions for occupational epidemiology.

PubMed

Burstyn, Igor; Slutsky, Anton; Lee, Derrick G; Singer, Alison B; An, Yuan; Michael, Yvonne L

2014-05-01

Epidemiologists typically collect narrative descriptions of occupational histories because these are less prone than self-reported exposures to recall bias of exposure to a specific hazard. However, the task of coding these narratives can be daunting and prohibitively time-consuming in some settings. The aim of this manuscript is to evaluate the performance of a computer algorithm to translate the narrative description of occupational codes into standard classification of jobs (2010 Standard Occupational Classification) in an epidemiological context. The fundamental question we address is whether exposure assignment resulting from manual (presumed gold standard) coding of the narratives is materially different from that arising from the application of automated coding. We pursued our work through three motivating examples: assessment of physical demands in Women's Health Initiative observational study, evaluation of predictors of exposure to coal tar pitch volatiles in the US Occupational Safety and Health Administration's (OSHA) Integrated Management Information System, and assessment of exposure to agents known to cause occupational asthma in a pregnancy cohort. In these diverse settings, we demonstrate that automated coding of occupations results in assignment of exposures that are in reasonable agreement with results that can be obtained through manual coding. The correlation between physical demand scores based on manual and automated job classification schemes was reasonable (r = 0.5). The agreement between predictive probability of exceeding the OSHA's permissible exposure level for polycyclic aromatic hydrocarbons, using coal tar pitch volatiles as a surrogate, based on manual and automated coding of jobs was modest (Kendall rank correlation = 0.29). In the case of binary assignment of exposure to asthmagens, we observed that fair to excellent agreement in classifications can be reached, depending on presence of ambiguity in assigned job classification (κ = 0.5-0.8). Thus, the success of automated coding appears to depend on the setting and type of exposure that is being assessed. Our overall recommendation is that automated translation of short narrative descriptions of jobs for exposure assessment is feasible in some settings and essential for large cohorts, especially if combined with manual coding to both assess reliability of coding and to further refine the coding algorithm.

Validity of Principal Diagnoses in Discharge Summaries and ICD-10 Coding Assessments Based on National Health Data of Thailand.

PubMed

Sukanya, Chongthawonsatid

2017-10-01

This study examined the validity of the principal diagnoses on discharge summaries and coding assessments. Data were collected from the National Health Security Office (NHSO) of Thailand in 2015. In total, 118,971 medical records were audited. The sample was drawn from government hospitals and private hospitals covered by the Universal Coverage Scheme in Thailand. Hospitals and cases were selected using NHSO criteria. The validity of the principal diagnoses listed in the "Summary and Coding Assessment" forms was established by comparing data from the discharge summaries with data obtained from medical record reviews, and additionally, by comparing data from the coding assessments with data in the computerized ICD (the data base used for reimbursement-purposes). The summary assessments had low sensitivities (7.3%-37.9%), high specificities (97.2%-99.8%), low positive predictive values (9.2%-60.7%), and high negative predictive values (95.9%-99.3%). The coding assessments had low sensitivities (31.1%-69.4%), high specificities (99.0%-99.9%), moderate positive predictive values (43.8%-89.0%), and high negative predictive values (97.3%-99.5%). The discharge summaries and codings often contained mistakes, particularly the categories "Endocrine, nutritional, and metabolic diseases", "Symptoms, signs, and abnormal clinical and laboratory findings not elsewhere classified", "Factors influencing health status and contact with health services", and "Injury, poisoning, and certain other consequences of external causes". The validity of the principal diagnoses on the summary and coding assessment forms was found to be low. The training of physicians and coders must be strengthened to improve the validity of discharge summaries and codings.

Spatial Distribution, Chemical Fraction and Fuzzy Comprehensive Risk Assessment of Heavy Metals in Surface Sediments from the Honghu Lake, China

PubMed Central

Xiao, Minsi; Zhang, Jingdong; Liu, Chaoyang; Qiu, Zhenzhen; Cai, Ying

2018-01-01

Spatial concentrations and chemical fractions of heavy metals (Cr, Cu, Pb, Zn and Cd) in 16 sampling sites from the Honghu Lake were investigated using an atomic absorption spectrophotometer and optimized BCR (the European Community Bureau of Reference) three-stage extraction procedure. Compared with the corresponding probable effect levels (PELs), adverse biological effects of the studied five sediment metals decreased in the sequence of Cr > Cu > Zn > Pb > Cd. Geo-accumulation index (Igeo) values for Cr, Cu, Pb and Zn in each sampling site were at un-contamination level, while the values for Cd varied from un-contamination level to moderate contamination level. Spatially, the enrichment degree of Cd in lower part of the South Lake, the west part of the North Lake and the outlet were higher than the other parts of Honghu Lake. For metal chemical fractions, the proportions of the acid-extractable fraction of five metal contents were in the descending order: Cd, Cu, Zn, Pb and Cr. Cd had the highest bioaccessibility. Being the above indexes focused always on heavy metals’ total content or chemical fraction in deterministic assessment system, which may confuse decision makers, the fuzzy comprehensive risk assessment method was established based on PEI (Potential ecological risk index), RAC (Risk assessment code) and fuzzy theory. Average comprehensive risks of heavy metals in sediments revealed the following orders: Cd (considerable risk) > Cu (moderate risk) > Zn (low risk) > Pb > Cr. Thus, Cd and Cu were determined as the pollutants of most concern. The central part of South Honghu Lake (S4, S5, S6, S9, S12 and S14), east part of the North Honghu Lake (S1) and outlet of outlet of the Honghu Lake (S10) were recommended as the priority control areas. Specifically, it is necessary to pay more attention to S1, S4, S5, S6, S9 and S16 when decision making for their calculated membership values (probabilities) of adjacent risk levels quite close. PMID:29373483

Chemical fractionation of arsenic and heavy metals in fine particle matter and its implications for risk assessment: A case study in Nanjing, China

NASA Astrophysics Data System (ADS)

Li, Huiming; Wang, Jinhua; Wang, Qin'geng; Qian, Xin; Qian, Yu; Yang, Meng; Li, Fengying; Lu, Hao; Wang, Cheng

2015-02-01

A four-step sequential extraction procedure was used to study the chemical fractionation of As and heavy metals (Cd, Cr, Cu, Fe, Mn, Ni, Pb and Zn) in fine particulate matter (PM2.5) collected from Nanjing, China. The mass concentrations of most PM2.5 samples exceeded the 24 h standard (75 μg/m3) recommended by the new national ambient air quality standard of China. The most abundant elements were Fe, Zn and Pb, while As and Cd were present at the lowest concentrations. As, Cd, Cu, Mn, Pb and Zn were mostly present in the two mobile fractions, including the soluble and exchangeable fraction (F1), and carbonates, oxides and reducible fraction (F2). Fe had the highest proportion present in the residual fraction (F4). Relatively high proportions of the metals Ni and Cr were present in the oxidizable and sulfidic fraction (F3). High proportions of Zn, As and Cu and lower proportions of Cd, Cr and Fe were present in the potentially mobile phases. The enrichment factor, contamination factor and risk assessment code were calculated to analyze the main sources and assess the environmental risks of the metals in PM2.5. The carcinogenic risks of As, Cd, Ni and Pb were all lower than the accepted criterion of 10-6, whereas the carcinogenic risks of Cr for children and As and Cr for adults were higher than 10-6. The non-carcinogenic health risk of As and heavy metals because of PM2.5 exposure for children and adults were lower than but close to the safe level of 1.

Injuries from the wichita falls tornado: implications for prevention.

PubMed

Glass, R I; Craven, R B; Bregman, D J; Stoll, B J; Horowitz, N; Kerndt, P; Winkle, J

1980-02-15

We examined the circumstances of death and injury among victims of the tornado that struck Wichita Falls, Texas, on 10 April 1979. We also assessed the protective measures taken by a representative sample of community residents who suffered no major injury in order to estimate the relative risk of injury to people directly in the tornado's path. Twenty-six (60 percent) of the 43 traumatic deaths and 30 (51 percent) of the 59 serious injuries occurred in people who, despite ample warning, went to their cars to drive out of the storm's path. These people had a risk of serious or fatal injury of 23 per 1000. People who remained indoors and in stationary homes were at relatively low risk (3 per 1000) if they took simple precautions; people in mobile homes were at greatest risk (85 per 1000). Current safety recommendations and housing codes for single family homes and mobile homes need to be amended to decrease the impact of future tornadoes on human health.

A new approach to assessing affect and the emotional implications of personal genomic testing for common disease risk

PubMed Central

O'Neill, Suzanne C.; Tercyak, Kenneth P.; Baytop, Chanza; Alford, Sharon Hensley; McBride, Colleen M.

2015-01-01

Aims Personal genomic testing (PGT) for common disease risk is becoming increasingly frequent, but little is known about people's array of emotional reactions to learning their genomic risk profiles and the psychological harms/benefits of PGT. We conducted a study of post-PGT affect, including positive, neutral, and negative states that may arise after testing. Methods Two hundred twenty-eight healthy adults received PGT for common disease variants and completed a semi-structured research interview within two weeks of disclosure. Study participants reported how PGT results made them feel in their own words. Using an iterative coding process, responses were organized into three broad affective categories (Negative, Neutral, and Positive affect). Results Neutral affect was the most prevalent response (53.9%), followed by Positive affect (26.9%) and Negative affect (19.2%). We found no differences by gender, race or education. Conclusions While <20% of participants reported negative affect in response to learning their genomic risk profile for common disease, a majority experience either neutral or positive emotions. These findings contribute to the growing evidence that PGT does not impose significant psychological harms. Moreover, they point to a need to better link theories and assessments in both emotional and cognitive processing to capitalize on PGT information for healthy behavior change. PMID:25612474

Compliance Verification Paths for Residential and Commercial Energy Codes

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

Conover, David R.; Makela, Eric J.; Fannin, Jerica D.

2011-10-10

This report looks at different ways to verify energy code compliance and to ensure that the energy efficiency goals of an adopted document are achieved. Conformity assessment is the body of work that ensures compliance, including activities that can ensure residential and commercial buildings satisfy energy codes and standards. This report identifies and discusses conformity-assessment activities and provides guidance for conducting assessments.

The Relative Importance of the Vadose Zone in Multimedia Risk Assessment Modeling Applied at a National Scale: An Analysis of Benzene Using 3MRA

NASA Astrophysics Data System (ADS)

Babendreier, J. E.

2002-05-01

Evaluating uncertainty and parameter sensitivity in environmental models can be a difficult task, even for low-order, single-media constructs driven by a unique set of site-specific data. The challenge of examining ever more complex, integrated, higher-order models is a formidable one, particularly in regulatory settings applied on a national scale. Quantitative assessment of uncertainty and sensitivity within integrated, multimedia models that simulate hundreds of sites, spanning multiple geographical and ecological regions, will ultimately require a systematic, comparative approach coupled with sufficient computational power. The Multimedia, Multipathway, and Multireceptor Risk Assessment Model (3MRA) is an important code being developed by the United States Environmental Protection Agency for use in site-scale risk assessment (e.g. hazardous waste management facilities). The model currently entails over 700 variables, 185 of which are explicitly stochastic. The 3MRA can start with a chemical concentration in a waste management unit (WMU). It estimates the release and transport of the chemical throughout the environment, and predicts associated exposure and risk. The 3MRA simulates multimedia (air, water, soil, sediments), pollutant fate and transport, multipathway exposure routes (food ingestion, water ingestion, soil ingestion, air inhalation, etc.), multireceptor exposures (resident, gardener, farmer, fisher, ecological habitats and populations), and resulting risk (human cancer and non-cancer effects, ecological population and community effects). The 3MRA collates the output for an overall national risk assessment, offering a probabilistic strategy as a basis for regulatory decisions. To facilitate model execution of 3MRA for purposes of conducting uncertainty and sensitivity analysis, a PC-based supercomputer cluster was constructed. Design of SuperMUSE, a 125 GHz Windows-based Supercomputer for Model Uncertainty and Sensitivity Evaluation is described, along with the conceptual layout of an accompanying java-based paralleling software toolset. Preliminary work is also reported for a scenario involving Benzene disposal that describes the relative importance of the vadose zone in driving risk levels for ecological receptors and human health. Incorporating landfills, waste piles, aerated tanks, surface impoundments, and land application units, the site-based data used in the analysis included 201 national facilities representing 419 site-WMU combinations.

Heavy metal concentrations and speciation in riverine sediments and the risks posed in three urban belts in the Haihe Basin.

PubMed

Zhang, Chao; Shan, Baoqing; Tang, Wenzhong; Dong, Lixin; Zhang, Wenqiang; Pei, Yuansheng

2017-05-01

Heavy metal (Cr, Cu, Ni, Pb, and Zn) pollution and the risks posed by the heavy metals in riverine sediments in a mountainous urban-belt area (MB), a mountain-plain urban-belt area (MPB), and a plain urban-belt area (PB) in the Haihe Basin, China, were assessed. The enrichment factors indicated that the sediments were more polluted with Cu and Zn than with the other metals, especially in the MPB. The sediments in the MPB were strongly affected by Cu and Zn inputs from anthropogenic sources. The risk assessment codes and individual contamination factors showed that Zn was mobile and posed ecological risks, the exchangeable fractions being 21.1%, 21.2%, and 19.2% of the total Zn concentrations in the samples from the MB, MPB, and PB, respectively. Cr, Cu, and Zn in the sediments from the MPB were potentially highly bioavailable because the non-residual fractions were 56.2%, 54.9%, and 56.5%, respectively, of the total concentrations. The potential risks posed by the heavy metals (determined from the chemical fractions of the heavy metals) in the different areas generally decreased in the order MPB > MB > PB. Pictorial representation of cluster analysis results showed that urbanization development level could cause Cr and Zn pollution in the urban riverine sediments to become more severe. Copyright © 2017 Elsevier Inc. All rights reserved.

Increased risk of hospital admission for dehydration or heat-related illness after initiation of medicines: a sequence symmetry analysis.

PubMed

Kalisch Ellett, L M; Pratt, N L; Le Blanc, V T; Westaway, K; Roughead, E E

2016-10-01

Although several studies have identified factors which increase the risk of heat-related illness, few have assessed the contribution of medicines. To address this knowledge gap, our study aimed to assess the risk of hospital admission for dehydration or other heat-related illness following initiation of medicines. We conducted a retrospective analysis using prescription event symmetry analysis (PESA) of 6700 veterans with incident hospital admission for dehydration or heat-related illness (ICD-10-AM codes E86, X30, T67), between 1 January 2001 and 30 June 2013. The main outcome measure was first ever hospital admission for dehydration or heat-related illness following initiation of commonly used medicines. A significantly higher risk of incident hospital admission for dehydration or heat-related illness was observed following initiation of anticoagulants, cardiovascular medicines, NSAIDs, antipsychotics, antidepressants and anticholinergic agents. The risk of hospital admission for dehydration or heat-related illness ranged from 1·17 (SSRIs) to 2·79 (ACEI plus diuretic combination product). No significant association was observed between initiation of anticonvulsants, anti-Parkinson's agents, hypnotics, anxiolytics or antihistamines and hospital admission for dehydration or heat-related illness. Many commonly used medicines were found to be associated with increased risk of hospitalization for dehydration or heat-related illness. Initiation of ACE inhibitors in combination with diuretics had the highest risk. Prescribers and patients should be aware of the potential for medicines to be associated with increased risk of dehydration and heat-related illness. © 2016 John Wiley & Sons Ltd.

An imprinted non-coding genomic cluster at 14q32 defines clinically relevant molecular subtypes in osteosarcoma across multiple independent datasets.

PubMed

Hill, Katherine E; Kelly, Andrew D; Kuijjer, Marieke L; Barry, William; Rattani, Ahmed; Garbutt, Cassandra C; Kissick, Haydn; Janeway, Katherine; Perez-Atayde, Antonio; Goldsmith, Jeffrey; Gebhardt, Mark C; Arredouani, Mohamed S; Cote, Greg; Hornicek, Francis; Choy, Edwin; Duan, Zhenfeng; Quackenbush, John; Haibe-Kains, Benjamin; Spentzos, Dimitrios

2017-05-15

A microRNA (miRNA) collection on the imprinted 14q32 MEG3 region has been associated with outcome in osteosarcoma. We assessed the clinical utility of this miRNA set and their association with methylation status. We integrated coding and non-coding RNA data from three independent annotated clinical osteosarcoma cohorts (n = 65, n = 27, and n = 25) and miRNA and methylation data from one in vitro (19 cell lines) and one clinical (NCI Therapeutically Applicable Research to Generate Effective Treatments (TARGET) osteosarcoma dataset, n = 80) dataset. We used time-dependent receiver operating characteristic (tdROC) analysis to evaluate the clinical value of candidate miRNA profiles and machine learning approaches to compare the coding and non-coding transcriptional programs of high- and low-risk osteosarcoma tumors and high- versus low-aggressiveness cell lines. In the cell line and TARGET datasets, we also studied the methylation patterns of the MEG3 imprinting control region on 14q32 and their association with miRNA expression and tumor aggressiveness. In the tdROC analysis, miRNA sets on 14q32 showed strong discriminatory power for recurrence and survival in the three clinical datasets. High- or low-risk tumor classification was robust to using different microRNA sets or classification methods. Machine learning approaches showed that genome-wide miRNA profiles and miRNA regulatory networks were quite different between the two outcome groups and mRNA profiles categorized the samples in a manner concordant with the miRNAs, suggesting potential molecular subtypes. Further, miRNA expression patterns were reproducible in comparing high-aggressiveness versus low-aggressiveness cell lines. Methylation patterns in the MEG3 differentially methylated region (DMR) also distinguished high-aggressiveness from low-aggressiveness cell lines and were associated with expression of several 14q32 miRNAs in both the cell lines and the large TARGET clinical dataset. Within the limits of available CpG array coverage, we observed a potential methylation-sensitive regulation of the non-coding RNA cluster by CTCF, a known enhancer-blocking factor. Loss of imprinting/methylation changes in the 14q32 non-coding region defines reproducible previously unrecognized osteosarcoma subtypes with distinct transcriptional programs and biologic and clinical behavior. Future studies will define the precise relationship between 14q32 imprinting, non-coding RNA expression, genomic enhancer binding, and tumor aggressiveness, with possible therapeutic implications for both early- and advanced-stage patients.

Reoperative surgery: a critical risk factor for complications inadequately captured by operative reporting and coding of lysis of adhesions.

PubMed

Aloia, Thomas A; Cooper, Amanda; Shi, Weiming; Vauthey, Jean-Nicolas; Lee, Jeffrey E

2014-07-01

Reoperative surgery is suspected, but not proven, to increase postoperative complication rates. In the absence of a specific definition for reoperative surgery, the American College of Surgeons NSQIP has proposed using procedural coding for lysis of adhesions (LOA) as a surrogate for reoperative surgery to risk adjust hospitals. We hypothesized that coding of reoperative surgery will be associated with worse 30-day outcomes and, for abdominal procedures, will be more accurate than operative dictation and coding of "lysis of adhesions." Reoperative surgery was categorized at the time of data abstraction from February 2012 to December 2012 for all NSQIP cases collected at a single institution by independent surgical clinical reviewers. Reoperative surgery classification and coding of LOA were compared with each other and with 30-day outcomes. The setting was a tertiary cancer center, multispecialty NSQIP model. During the study period, 1,289 operations were classified as nonreoperative (n = 793), regionally reoperative (n = 39; prior surgery in an adjacent area of current operation), or locally reoperative (n = 457; prior surgery at same site or organ). In the multispecialty cohort, the non-risk-adjusted rates of overall 30-day morbidity, serious morbidity, and mortality were 21.5%, 17.7%, and 0.5%. Compared with nonreoperative surgery (overall 30-day morbidity 16.8%, serious morbidity 13.9%, and mortality .38%), both regionally reoperative surgery (overall 30-day morbidity 30.8%, serious morbidity 28.2%, and mortality 2.5%) and locally reoperative surgery (overall 30-day morbidity 28.9%, serious morbidity 23.4%, and mortality .66%) were associated with worse outcomes (p < 0.001). One hundred ninety-nine of the 327 gastrointestinal/laparotomy cases were recorded as reoperative, but only of 20 of these were CPT coded as LOA (sensitivity = 10%). Reoperative surgery is frequent, increases the risk of complications, and can be captured. Operative LOA coding vastly under reports reoperative surgery and, therefore, is not an adequate surrogate for this important risk factor. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Rare and Coding Region Genetic Variants Associated With Risk of Ischemic Stroke: The NHLBI Exome Sequence Project.

PubMed

Auer, Paul L; Nalls, Mike; Meschia, James F; Worrall, Bradford B; Longstreth, W T; Seshadri, Sudha; Kooperberg, Charles; Burger, Kathleen M; Carlson, Christopher S; Carty, Cara L; Chen, Wei-Min; Cupples, L Adrienne; DeStefano, Anita L; Fornage, Myriam; Hardy, John; Hsu, Li; Jackson, Rebecca D; Jarvik, Gail P; Kim, Daniel S; Lakshminarayan, Kamakshi; Lange, Leslie A; Manichaikul, Ani; Quinlan, Aaron R; Singleton, Andrew B; Thornton, Timothy A; Nickerson, Deborah A; Peters, Ulrike; Rich, Stephen S

2015-07-01

Stroke is the second leading cause of death and the third leading cause of years of life lost. Genetic factors contribute to stroke prevalence, and candidate gene and genome-wide association studies (GWAS) have identified variants associated with ischemic stroke risk. These variants often have small effects without obvious biological significance. Exome sequencing may discover predicted protein-altering variants with a potentially large effect on ischemic stroke risk. To investigate the contribution of rare and common genetic variants to ischemic stroke risk by targeting the protein-coding regions of the human genome. The National Heart, Lung, and Blood Institute (NHLBI) Exome Sequencing Project (ESP) analyzed approximately 6000 participants from numerous cohorts of European and African ancestry. For discovery, 365 cases of ischemic stroke (small-vessel and large-vessel subtypes) and 809 European ancestry controls were sequenced; for replication, 47 affected sibpairs concordant for stroke subtype and an African American case-control series were sequenced, with 1672 cases and 4509 European ancestry controls genotyped. The ESP's exome sequencing and genotyping started on January 1, 2010, and continued through June 30, 2012. Analyses were conducted on the full data set between July 12, 2012, and July 13, 2013. Discovery of new variants or genes contributing to ischemic stroke risk and subtype (primary analysis) and determination of support for protein-coding variants contributing to risk in previously published candidate genes (secondary analysis). We identified 2 novel genes associated with an increased risk of ischemic stroke: a protein-coding variant in PDE4DIP (rs1778155; odds ratio, 2.15; P = 2.63 × 10(-8)) with an intracellular signal transduction mechanism and in ACOT4 (rs35724886; odds ratio, 2.04; P = 1.24 × 10(-7)) with a fatty acid metabolism; confirmation of PDE4DIP was observed in affected sibpair families with large-vessel stroke subtype and in African Americans. Replication of protein-coding variants in candidate genes was observed for 2 previously reported GWAS associations: ZFHX3 (cardioembolic stroke) and ABCA1 (large-vessel stroke). Exome sequencing discovered 2 novel genes and mechanisms, PDE4DIP and ACOT4, associated with increased risk for ischemic stroke. In addition, ZFHX3 and ABCA1 were discovered to have protein-coding variants associated with ischemic stroke. These results suggest that genetic variation in novel pathways contributes to ischemic stroke risk and serves as a target for prediction, prevention, and therapy.

Environmental risk assessment of cobalt and manganese from industrial sources in an estuarine system.

PubMed

Barrio-Parra, F; Elío, J; De Miguel, E; García-González, J E; Izquierdo, M; Álvarez, R

2018-04-01

A total of 74 samples of soil, sediment, industrial sludge, and surface water were collected in a Mediterranean estuarine system in order to assess the potential ecological impact of elevated concentrations of Co and Mn associated with a Terephthalic (PTA) and Isophthalic (PIPA) acids production plant. Samples were analyzed for elemental composition (37 elements), pH, redox potential, organic carbon, and CaCO 3 content, and a group of 16 selected samples were additionally subjected to a Tessier sequential extraction. Co and Mn soil concentrations were significantly higher inside the industrial facility and around its perimeter than in background samples, and maximum dissolved Co and Mn concentrations were found in a creek near the plant's discharge point, reaching values 17,700 and 156 times higher than their respective background concentrations. The ecological risk was evaluated as a function of Co and Mn fractionation and bioavailability which were controlled by the environmental conditions generated by the advance of seawater into the estuarine system during high tide. Co appeared to precipitate near the river mouth due to the pH increase produced by the influence of seawater intrusion, reaching hazardous concentrations in sediments. In terms of their bioavailability and the corresponding risk assessment code, both Co and Mn present sediment concentrations that result in medium to high ecological risk whereas water concentrations of both elements reach values that more than double their corresponding Secondary Acute Values.

Modeling Commercial Turbofan Engine Icing Risk With Ice Crystal Ingestion

NASA Technical Reports Server (NTRS)

Jorgenson, Philip C. E.; Veres, Joseph P.

2013-01-01

The occurrence of ice accretion within commercial high bypass aircraft turbine engines has been reported under certain atmospheric conditions. Engine anomalies have taken place at high altitudes that have been attributed to ice crystal ingestion, partially melting, and ice accretion on the compression system components. The result was degraded engine performance, and one or more of the following: loss of thrust control (roll back), compressor surge or stall, and flameout of the combustor. As ice crystals are ingested into the fan and low pressure compression system, the increase in air temperature causes a portion of the ice crystals to melt. It is hypothesized that this allows the ice-water mixture to cover the metal surfaces of the compressor stationary components which leads to ice accretion through evaporative cooling. Ice accretion causes a blockage which subsequently results in the deterioration in performance of the compressor and engine. The focus of this research is to apply an engine icing computational tool to simulate the flow through a turbofan engine and assess the risk of ice accretion. The tool is comprised of an engine system thermodynamic cycle code, a compressor flow analysis code, and an ice particle melt code that has the capability of determining the rate of sublimation, melting, and evaporation through the compressor flow path, without modeling the actual ice accretion. A commercial turbofan engine which has previously experienced icing events during operation in a high altitude ice crystal environment has been tested in the Propulsion Systems Laboratory (PSL) altitude test facility at NASA Glenn Research Center. The PSL has the capability to produce a continuous ice cloud which are ingested by the engine during operation over a range of altitude conditions. The PSL test results confirmed that there was ice accretion in the engine due to ice crystal ingestion, at the same simulated altitude operating conditions as experienced previously in flight. The computational tool was utilized to help guide a portion of the PSL testing, and was used to predict ice accretion could also occur at significantly lower altitudes. The predictions were qualitatively verified by subsequent testing of the engine in the PSL. The PSL test has helped to calibrate the engine icing computational tool to assess the risk of ice accretion. The results from the computer simulation identified prevalent trends in wet bulb temperature, ice particle melt ratio, and engine inlet temperature as a function of altitude for predicting engine icing risk due to ice crystal ingestion.

Quantitative analysis and reduction of the eco-toxicity risk of heavy metals for the fine fraction of automobile shredder residue (ASR) using H2O2.

PubMed

Singh, Jiwan; Yang, Jae-Kyu; Chang, Yoon-Young

2016-02-01

Automobile shredder residue (ASR) fraction (size <0.25mm) can be considered as hazardous due to presence of high concentrations of heavy metals. Hydrogen peroxide combined with nitric acid has been used for the recovery of heavy metals (Zn, Cu, Mn, Fe, Ni, Pb, Cd and Cr) from the fine fraction of ASR. A sequential extraction procedure has also been used to determine the heavy metal speciation in the fine fraction of ASR before and after treatment. A risk analysis of the fine fraction of ASR before and after treatment was conducted to assess the bioavailability and eco-toxicity of heavy metals. These results showed that the recovery of heavy metals from ASR increased with an increase in the hydrogen peroxide concentration. A high concentration of heavy metals was found to be present in Cbio fractions (the sum of the exchangeable and carbonate fractions) in the fine fraction of ASR, indicating high toxicity risk. The Cbio rate of all selected heavy metals was found to range from 8.6% to 33.4% of the total metal content in the fine fraction of ASR. After treatment, Cbio was reduced to 0.3-3.3% of total metal upon a treatment with 2.0% hydrogen peroxide. On the basis of the risk assessment code (RAC), the environmental risk values for heavy metals in the fine fraction of ASR reflect high risk/medium risk. However, after treatment, the heavy metals would be categorized as low risk/no risk. The present study concludes that hydrogen peroxide combined with nitric acid is a promising treatment for the recovery and reduction of the eco-toxicity risk of heavy metals in ASR. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Global Earthquake Model and Disaster Risk Reduction

NASA Astrophysics Data System (ADS)

Smolka, A. J.

2015-12-01

Advanced, reliable and transparent tools and data to assess earthquake risk are inaccessible to most, especially in less developed regions of the world while few, if any, globally accepted standards currently allow a meaningful comparison of risk between places. The Global Earthquake Model (GEM) is a collaborative effort that aims to provide models, datasets and state-of-the-art tools for transparent assessment of earthquake hazard and risk. As part of this goal, GEM and its global network of collaborators have developed the OpenQuake engine (an open-source software for hazard and risk calculations), the OpenQuake platform (a web-based portal making GEM's resources and datasets freely available to all potential users), and a suite of tools to support modelers and other experts in the development of hazard, exposure and vulnerability models. These resources are being used extensively across the world in hazard and risk assessment, from individual practitioners to local and national institutions, and in regional projects to inform disaster risk reduction. Practical examples for how GEM is bridging the gap between science and disaster risk reduction are: - Several countries including Switzerland, Turkey, Italy, Ecuador, Papua-New Guinea and Taiwan (with more to follow) are computing national seismic hazard using the OpenQuake-engine. In some cases these results are used for the definition of actions in building codes. - Technical support, tools and data for the development of hazard, exposure, vulnerability and risk models for regional projects in South America and Sub-Saharan Africa. - Going beyond physical risk, GEM's scorecard approach evaluates local resilience by bringing together neighborhood/community leaders and the risk reduction community as a basis for designing risk reduction programs at various levels of geography. Actual case studies are Lalitpur in the Kathmandu Valley in Nepal and Quito/Ecuador. In agreement with GEM's collaborative approach, all projects are undertaken with strong involvement of local scientific and risk reduction communities. Open-source software and careful documentation of the methodologies create full transparency of the modelling process, so that results can be reproduced any time by third parties.

Using health-system-wide data to understand hepatitis B virus prophylaxis and reactivation outcomes in patients receiving rituximab.

PubMed

Schmajuk, Gabriela; Tonner, Chris; Trupin, Laura; Li, Jing; Sarkar, Urmimala; Ludwig, Dana; Shiboski, Stephen; Sirota, Marina; Dudley, R Adams; Murray, Sara; Yazdany, Jinoos

2017-03-01

Hepatitis B virus (HBV) reactivation in the setting of rituximab use is a potentially fatal but preventable safety event. The rate of HBV screening and proportion of patients at risk who receive antiviral prophylaxis in patients initiating rituximab is unknown.We analyzed electronic health record (EHR) data from 2 health systems, a university center and a safety net health system, including diagnosis grouper codes, problem lists, medications, laboratory results, procedures codes, clinical encounter notes, and scanned documents. We identified all patients who received rituximab between 6/1/2012 and 1/1/2016. We calculated the proportion of rituximab users with inadequate screening for HBV according to the Centers for Disease Control guidelines for detecting latent HBV infection before their first rituximab infusion during the study period. We also assessed the proportion of patients with positive hepatitis B screening tests who were prescribed antiviral prophylaxis. Finally, we characterized safety failures and adverse events.We included 926 patients from the university and 132 patients from the safety net health system. Sixty-one percent of patients from the university had adequate screening for HBV compared with 90% from the safety net. Among patients at risk for reactivation based on results of HBV testing, 66% and 92% received antiviral prophylaxis at the university and safety net, respectively.We found wide variations in hepatitis B screening practices among patients receiving rituximab, resulting in unnecessary risks to patients. Interventions should be developed to improve patient safety procedures in this high-risk patient population.

New "Risk-Targeted" Seismic Maps Introduced into Building Codes

USGS Publications Warehouse

Luco, Nicholas; Garrett, B.; Hayes, J.

2012-01-01

Throughout most municipalities of the United States, structural engineers design new buildings using the U.S.-focused International Building Code (IBC). Updated editions of the IBC are published every 3 years. The latest edition (2012) contains new "risk-targeted maximum considered earthquake" (MCER) ground motion maps, which are enabling engineers to incorporate a more consistent and better defined level of seismic safety into their building designs.

Disposal Notifications and Quarterly Membership Updates for the Utility Solid Waste Group Members’ Risk-Based Approvals to Dispose of PCB Remediation Waste Under Title 40 of the Code of Federal Regulations Section 761.61(c)

EPA Pesticide Factsheets

Disposal Notifications and Quarterly Membership Updates for the Utility Solid Waste Group Members’ Risk-Based Approvals to Dispose of Polychlorinated Biphenyl (PCB) Remediation Waste Under Title 40 of the Code of Federal Regulations Section 761.61(c)

Beverage consumption patterns of children born at different risk of obesity.

PubMed

Kral, Tanja V E; Stunkard, Albert J; Berkowitz, Robert I; Stallings, Virginia A; Moore, Reneé H; Faith, Myles S

2008-08-01

Increased intake of sugar-sweetened beverages and fruit juice has been associated with overweight in children. This study prospectively assessed beverage consumption patterns and their relationship with weight status in a cohort of children born at different risk for obesity. Participants were children born at low risk (n = 27) or high risk (n = 22) for obesity based on maternal prepregnancy BMI (kg/m(2)). Daily beverage consumption was generated from 3-day food records from children aged 3-6 years and coded into seven beverage categories (milk, fruit juice, fruit drinks, caloric and non-caloric soda, soft drinks including and excluding fruit juice). Child anthropometric measures were assessed yearly. High-risk children consumed a greater percentage of daily calories from beverages at age 3, more fruit juice at ages 3 and 4, more soft drinks (including fruit juice) at ages 3-5, and more soda at age 6 compared to low-risk children. Longitudinal analyses showed that a greater 3-year increase in soda intake was associated with an increased change in waist circumference, whereas a greater increase in milk intake was associated with a reduced change in waist circumference. There was no significant association between change in intake from any of the beverage categories and change in BMI z-score across analyses. Children's familial predisposition to obesity may differentially affect their beverage consumption patterns. Future research should examine the extent to which dietary factors may play a role in pediatric body fat deposition over time.

Fractionation, Bioaccessibility, and Risk Assessment of Heavy Metals in the Soil of an Urban Recreational Area Amended with Composted Sewage Sludge

PubMed Central

Zhang, Tao; Shao, Yanqiu; Tian, Chao; Cattle, Stephen R.; Zhu, Ying; Song, Jinjuan

2018-01-01

A composted sewage sludge (CSS) was added to the soil of an urban garden at 5%, 10%, and 25% (w/w soil) and stabilised for 180 days. Samples were then collected and analysed for total heavy metal concentrations, chemical fractions, and bioaccessibility, together with some physicochemical properties. The results showed that the total chromium (Cr), copper (Cu), lead (Pb), and zinc (Zn) concentrations were increased with CSS addition rate. The CSS addition decreased the residual fractions of these four elements. The exchangeable Cr, Cu, and Pb fractions were very small or not detected, while Zn exhibited an increasing trend in its exchangeable fraction with CSS addition rate. The bioaccessibility of these four elements was increased with the CSS addition rate. Moreover, the Cr, Cu, and Zn bioaccessibility correlated positively with the total concentration, while the bioaccessibility of these four elements exhibited a negative correlation with the residual fraction. The fractionation and bioaccessibility of heavy metals may have also been influenced by pH, cation exchange capacity, and organic matter. The risk assessment code reflected the amended soil showed no or low environmental risks for Cr, Cu, and Pb and a medium risk for Zn. The hazardous index values and cancer risk levels indicated that the heavy metals in the soil amended with 25% CSS posed negligible potential noncarcinogenic and carcinogenic risks to children and adults via incidental ingestion. PMID:29597244

Child Maltreatment and Sexual Risk Behavior: Maltreatment Types and Gender Differences.

PubMed

Negriff, Sonya; Schneiderman, Janet U; Trickett, Penelope K

2015-01-01

To compare sexual risk behaviors in maltreated male and female sexually active adolescents with a comparison population and examine whether specific maltreatment experiences were associated with sexual risk behaviors and teen pregnancy. Data came from the fourth assessment (M = 7.2 years after baseline) of an ongoing longitudinal study with case-control design. The sample was restricted to only the sexually active adolescents, leaving a sample of 251 (n = 82 comparison, n = 169 maltreated, mean age = 18.49 years, SD = 1.46). Maltreatment type was coded from case records, and sexual behaviors were assessed via computerized questionnaire. Maltreated youth were significantly younger at first consensual intercourse than comparison youth, and males were younger than females. Maltreated males reported significantly higher number of lifetime sexual partners than maltreated females. Neglected, sexually abused, and physically abused youth were more likely to have had a one-night stand than comparison youth. Sexually abused females were at higher risk of having sex under the influence than other maltreated females. Neglected females were more likely to have ever been pregnant than females with other maltreatment types or comparison females. A higher number of maltreatment victimizations predicted a younger age at first pregnancy involvement for both sexes. Many maltreated youth continue to be at high risk for engaging in behaviors that may initiate a trajectory of problematic sexual behaviors. The findings highlight maltreated males and neglected females as vulnerable groups that should be targeted in prevention efforts to curtail sexual risk behaviors and prevent teenage pregnancy.

Exome sequencing identifies rare LDLR and APOA5 alleles conferring risk for myocardial infarction.

PubMed

Do, Ron; Stitziel, Nathan O; Won, Hong-Hee; Jørgensen, Anders Berg; Duga, Stefano; Angelica Merlini, Pier; Kiezun, Adam; Farrall, Martin; Goel, Anuj; Zuk, Or; Guella, Illaria; Asselta, Rosanna; Lange, Leslie A; Peloso, Gina M; Auer, Paul L; Girelli, Domenico; Martinelli, Nicola; Farlow, Deborah N; DePristo, Mark A; Roberts, Robert; Stewart, Alexander F R; Saleheen, Danish; Danesh, John; Epstein, Stephen E; Sivapalaratnam, Suthesh; Hovingh, G Kees; Kastelein, John J; Samani, Nilesh J; Schunkert, Heribert; Erdmann, Jeanette; Shah, Svati H; Kraus, William E; Davies, Robert; Nikpay, Majid; Johansen, Christopher T; Wang, Jian; Hegele, Robert A; Hechter, Eliana; Marz, Winfried; Kleber, Marcus E; Huang, Jie; Johnson, Andrew D; Li, Mingyao; Burke, Greg L; Gross, Myron; Liu, Yongmei; Assimes, Themistocles L; Heiss, Gerardo; Lange, Ethan M; Folsom, Aaron R; Taylor, Herman A; Olivieri, Oliviero; Hamsten, Anders; Clarke, Robert; Reilly, Dermot F; Yin, Wu; Rivas, Manuel A; Donnelly, Peter; Rossouw, Jacques E; Psaty, Bruce M; Herrington, David M; Wilson, James G; Rich, Stephen S; Bamshad, Michael J; Tracy, Russell P; Cupples, L Adrienne; Rader, Daniel J; Reilly, Muredach P; Spertus, John A; Cresci, Sharon; Hartiala, Jaana; Tang, W H Wilson; Hazen, Stanley L; Allayee, Hooman; Reiner, Alex P; Carlson, Christopher S; Kooperberg, Charles; Jackson, Rebecca D; Boerwinkle, Eric; Lander, Eric S; Schwartz, Stephen M; Siscovick, David S; McPherson, Ruth; Tybjaerg-Hansen, Anne; Abecasis, Goncalo R; Watkins, Hugh; Nickerson, Deborah A; Ardissino, Diego; Sunyaev, Shamil R; O'Donnell, Christopher J; Altshuler, David; Gabriel, Stacey; Kathiresan, Sekar

2015-02-05

Myocardial infarction (MI), a leading cause of death around the world, displays a complex pattern of inheritance. When MI occurs early in life, genetic inheritance is a major component to risk. Previously, rare mutations in low-density lipoprotein (LDL) genes have been shown to contribute to MI risk in individual families, whereas common variants at more than 45 loci have been associated with MI risk in the population. Here we evaluate how rare mutations contribute to early-onset MI risk in the population. We sequenced the protein-coding regions of 9,793 genomes from patients with MI at an early age (≤50 years in males and ≤60 years in females) along with MI-free controls. We identified two genes in which rare coding-sequence mutations were more frequent in MI cases versus controls at exome-wide significance. At low-density lipoprotein receptor (LDLR), carriers of rare non-synonymous mutations were at 4.2-fold increased risk for MI; carriers of null alleles at LDLR were at even higher risk (13-fold difference). Approximately 2% of early MI cases harbour a rare, damaging mutation in LDLR; this estimate is similar to one made more than 40 years ago using an analysis of total cholesterol. Among controls, about 1 in 217 carried an LDLR coding-sequence mutation and had plasma LDL cholesterol > 190 mg dl(-1). At apolipoprotein A-V (APOA5), carriers of rare non-synonymous mutations were at 2.2-fold increased risk for MI. When compared with non-carriers, LDLR mutation carriers had higher plasma LDL cholesterol, whereas APOA5 mutation carriers had higher plasma triglycerides. Recent evidence has connected MI risk with coding-sequence mutations at two genes functionally related to APOA5, namely lipoprotein lipase and apolipoprotein C-III (refs 18, 19). Combined, these observations suggest that, as well as LDL cholesterol, disordered metabolism of triglyceride-rich lipoproteins contributes to MI risk.

Next-generation sequencing analysis of the ARMS2 gene in Turkish exudative age-related macular degeneration patients.

PubMed

Bardak, H; Gunay, M; Ercalik, Y; Bardak, Y; Ozbas, H; Bagci, O

2017-01-23

Age-related macular degeneration (AMD) is the leading cause of blindness in developed countries. It is a complex disease with both genetic and environmental risk factors. To improve clinical management of this condition, it is important to develop risk assessment and prevention strategies for environmental influences, and establish a more effective treatment approach. The aim of the present study was to investigate age-related maculopathy susceptibility protein 2 (ARMS2) gene sequences among Turkish patients with exudative AMD. In addition to 39 advanced exudative AMD patients, 250 healthy individuals for whom exome sequencing data were available were included as a control group. Patients with a history of known environmental and systemic AMD risk factors were excluded. Genomic DNA was isolated from peripheral blood and analyzed using next-generation sequencing. All coding exons of the ARMS2 gene were assessed. Three different ARMS2 sequence variations (rs10490923, rs2736911, and rs10490924) were identified in both the patient and control group. Within the control group, two further ARMS2 gene variants (rs7088128 and rs36213074) were also detected. Logistic regression analysis revealed a relationship between the rs10490924 polymorphism and AMD in the Turkish population.

Monitoring Cosmic Radiation Risk: Comparisons between Observations and Predictive Codes for Naval Aviation

DTIC Science & Technology

2009-01-01

proton PARMA PHITS -based Analytical Radiation Model in the Atmosphere PCAIRE Predictive Code for Aircrew Radiation Exposure PHITS Particle and...radiation transport code utilized is called PARMA ( PHITS based Analytical Radiation Model in the Atmosphere) [36]. The particle fluxes calculated from the...same dose equivalent coefficient regulations from the ICRP-60 regulations. As a result, the transport codes utilized by EXPACS ( PHITS ) and CARI-6

Monitoring Cosmic Radiation Risk: Comparisons Between Observations and Predictive Codes for Naval Aviation

DTIC Science & Technology

2009-07-05

proton PARMA PHITS -based Analytical Radiation Model in the Atmosphere PCAIRE Predictive Code for Aircrew Radiation Exposure PHITS Particle and Heavy...transport code utilized is called PARMA ( PHITS based Analytical Radiation Model in the Atmosphere) [36]. The particle fluxes calculated from the input...dose equivalent coefficient regulations from the ICRP-60 regulations. As a result, the transport codes utilized by EXPACS ( PHITS ) and CARI-6 (PARMA

The Use of Coding Methods to Estimate the Social Behavior Directed toward Peers and Adults of Preschoolers with ASD in TEACCH, LEAP, and Eclectic ''BAU'' Classrooms

ERIC Educational Resources Information Center

Sam, Ann; Reszka, Stephanie; Odom, Samuel; Hume, Kara; Boyd, Brian

2015-01-01

Momentary time sampling, partial-interval recording, and event coding are observational coding methods commonly used to examine the social and challenging behaviors of children at risk for or with developmental delays or disabilities. Yet there is limited research comparing the accuracy of and relationship between these three coding methods. By…

A multidisciplinary approach to vascular surgery procedure coding improves coding accuracy, work relative value unit assignment, and reimbursement.

PubMed

Aiello, Francesco A; Judelson, Dejah R; Messina, Louis M; Indes, Jeffrey; FitzGerald, Gordon; Doucet, Danielle R; Simons, Jessica P; Schanzer, Andres

2016-08-01

Vascular surgery procedural reimbursement depends on accurate procedural coding and documentation. Despite the critical importance of correct coding, there has been a paucity of research focused on the effect of direct physician involvement. We hypothesize that direct physician involvement in procedural coding will lead to improved coding accuracy, increased work relative value unit (wRVU) assignment, and increased physician reimbursement. This prospective observational cohort study evaluated procedural coding accuracy of fistulograms at an academic medical institution (January-June 2014). All fistulograms were coded by institutional coders (traditional coding) and by a single vascular surgeon whose codes were verified by two institution coders (multidisciplinary coding). The coding methods were compared, and differences were translated into revenue and wRVUs using the Medicare Physician Fee Schedule. Comparison between traditional and multidisciplinary coding was performed for three discrete study periods: baseline (period 1), after a coding education session for physicians and coders (period 2), and after a coding education session with implementation of an operative dictation template (period 3). The accuracy of surgeon operative dictations during each study period was also assessed. An external validation at a second academic institution was performed during period 1 to assess and compare coding accuracy. During period 1, traditional coding resulted in a 4.4% (P = .004) loss in reimbursement and a 5.4% (P = .01) loss in wRVUs compared with multidisciplinary coding. During period 2, no significant difference was found between traditional and multidisciplinary coding in reimbursement (1.3% loss; P = .24) or wRVUs (1.8% loss; P = .20). During period 3, traditional coding yielded a higher overall reimbursement (1.3% gain; P = .26) than multidisciplinary coding. This increase, however, was due to errors by institution coders, with six inappropriately used codes resulting in a higher overall reimbursement that was subsequently corrected. Assessment of physician documentation showed improvement, with decreased documentation errors at each period (11% vs 3.1% vs 0.6%; P = .02). Overall, between period 1 and period 3, multidisciplinary coding resulted in a significant increase in additional reimbursement ($17.63 per procedure; P = .004) and wRVUs (0.50 per procedure; P = .01). External validation at a second academic institution was performed to assess coding accuracy during period 1. Similar to institution 1, traditional coding revealed an 11% loss in reimbursement ($13,178 vs $14,630; P = .007) and a 12% loss in wRVU (293 vs 329; P = .01) compared with multidisciplinary coding. Physician involvement in the coding of endovascular procedures leads to improved procedural coding accuracy, increased wRVU assignments, and increased physician reimbursement. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Local stakeholders' perception of landslide and flood risks in Iasi County, Romania

NASA Astrophysics Data System (ADS)

Ciprian Margarint, Mihai; Niculita, Mihai; Rosu, Lucian

2015-04-01

Risk perception is an important issue for an efficient management and mitigation measures of natural hazards and theirs negative consequences on social and economic activity. At administrative unit scale (LAU2), local stakeholders play an effective role in case of an emergency situation, regarding the warning and alerting the population, collaboration with specialized institution and managing material assistance during and after the crisis. In addition they are among the best connoisseurs of local community and places, and consequently they could substantial help the national level forces during emergency situations. These issues argues the high degree of responsibilities assigned to Romanian mayors, and is reflected in the legislation in terms of evaluation of damages produced and the management of natural hazards, like landslide and floods. Also their degree of awareness can assess more accurately the collective perception against the individual one. In this work we have assessed the local stakeholders' perception for natural risks in general, and particularly for landslides and floods. We have tested the discrepancies of the specific risks perception and an assessment of correspondence between scientific outputs versus the subjective judgement the administrative decision makers. This approach was based on a questionnaire which was applied in the summer of 2014, to all 98 mayors from Iasi County, north-east Romania. It contained 12 questions structured in a specific mode, from general to particular. The assessment of the answers provided from the commune halls, was realized with integration in a GIS environment of codes assigned to each question, and the overlay with the scientific outputs regarding landslide occurrence and susceptibility and floods risk maps. The differences between the outputs of the questionnaires and the scientific outputs of landslide and flood risk was further analyzed and interpreted. There were registered large variations of answers and important discrepancies between scientific results and the stakeholders' estimations, both for landslides and flood components. Farther multicriterial analysis (clustering method) was applied for highlighting a correspondance between the distance to certain risk areas and stakeholders perception. As a main conclusion we can state that the decision makers perception is strongly influenced by their personal and recent experiences but also by the distance to the source of risk.

Selection of a computer code for Hanford low-level waste engineered-system performance assessment

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

McGrail, B.P.; Mahoney, L.A.

Planned performance assessments for the proposed disposal of low-level waste (LLW) glass produced from remediation of wastes stored in underground tanks at Hanford, Washington will require calculations of radionuclide release rates from the subsurface disposal facility. These calculations will be done with the aid of computer codes. Currently available computer codes were ranked in terms of the feature sets implemented in the code that match a set of physical, chemical, numerical, and functional capabilities needed to assess release rates from the engineered system. The needed capabilities were identified from an analysis of the important physical and chemical process expected tomore » affect LLW glass corrosion and the mobility of radionuclides. The highest ranked computer code was found to be the ARES-CT code developed at PNL for the US Department of Energy for evaluation of and land disposal sites.« less

New CPT codes: hospital, consultation, emergency and nursing facility services.

PubMed

Zuber, T J; Henley, D E

1992-03-01

New evaluation and management codes were created by the Current Procedural Terminology (CPT) Editorial Panel to ensure more accurate and consistent reporting of physician services. The new hospital inpatient codes describe three levels of service for both initial and subsequent care. Critical care services are reported according to the total time spent by a physician providing constant attention to a critically ill patient. Consultation codes are divided into four categories: office/outpatient, initial inpatient, follow-up inpatient and confirmatory. Emergency department services for both new and established patients are limited to five codes. In 1992, nursing facility services are described with either comprehensive-assessment codes or subsequent-care codes. Hospital discharge services may be reported in addition to the comprehensive nursing facility assessment. Since the 1992 CPT book will list only the new codes, and since all insurance carriers will not be using these codes in 1992, physicians are encouraged to keep their 1991 code books and contact their local insurance carriers to determine which codes will be used.

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

Bracken, M.B.

This joint EPRI/National Institutes of Health study is the largest epidemiological study ever undertaken to examine the relationship between exposure to electric and magnetic fields (EMF) during pregnancy and reproductive outcomes. Overall, the study concludes that EMF exposure during pregnancy is unrelated to pregnancy outcome. In specific, the study reveals no association between electromagnetic field exposure from electrically heated beds and intrauterine growth retardation or spontaneous abortion. Among the many strengths of this study are clearly specified hypotheses; prospective design; randomized assignment to exposure monitoring; very large sample size; detailed assessment of potential confounding by known risk factors for adversemore » pregnancy outcomes; and comprehensive statistical analyses. The study also featured extensive exposure assessment, including measurements of EMF from a variety of sources, personal monitoring, and wire coding information.« less

Case-finding for common mental disorders of anxiety and depression in primary care: an external validation of routinely collected data.

PubMed

John, Ann; McGregor, Joanne; Fone, David; Dunstan, Frank; Cornish, Rosie; Lyons, Ronan A; Lloyd, Keith R

2016-03-15

The robustness of epidemiological research using routinely collected primary care electronic data to support policy and practice for common mental disorders (CMD) anxiety and depression would be greatly enhanced by appropriate validation of diagnostic codes and algorithms for data extraction. We aimed to create a robust research platform for CMD using population-based, routinely collected primary care electronic data. We developed a set of Read code lists (diagnosis, symptoms, treatments) for the identification of anxiety and depression in the General Practice Database (GPD) within the Secure Anonymised Information Linkage Databank at Swansea University, and assessed 12 algorithms for Read codes to define cases according to various criteria. Annual incidence rates were calculated per 1000 person years at risk (PYAR) to assess recording practice for these CMD between January 1(st) 2000 and December 31(st) 2009. We anonymously linked the 2799 MHI-5 Caerphilly Health and Social Needs Survey (CHSNS) respondents aged 18 to 74 years to their routinely collected GP data in SAIL. We estimated the sensitivity, specificity and positive predictive value of the various algorithms using the MHI-5 as the gold standard. The incidence of combined depression/anxiety diagnoses remained stable over the ten-year period in a population of over 500,000 but symptoms increased from 6.5 to 20.7 per 1000 PYAR. A 'historical' GP diagnosis for depression/anxiety currently treated plus a current diagnosis (treated or untreated) resulted in a specificity of 0.96, sensitivity 0.29 and PPV 0.76. Adding current symptom codes improved sensitivity (0.32) with a marginal effect on specificity (0.95) and PPV (0.74). We have developed an algorithm with a high specificity and PPV of detecting cases of anxiety and depression from routine GP data that incorporates symptom codes to reflect GP coding behaviour. We have demonstrated that using diagnosis and current treatment alone to identify cases for depression and anxiety using routinely collected primary care data will miss a number of true cases given changes in GP recording behaviour. The Read code lists plus the developed algorithms will be applicable to other routinely collected primary care datasets, creating a platform for future e-cohort research into these conditions.

Action Research of a Color-Coded, Onset-Rime Decoding Intervention: Examining the Effects with First Grade Students Identified as at Risk

ERIC Educational Resources Information Center

Wall, Candace A.; Rafferty, Lisa A.; Camizzi, Mariya A.; Max, Caroline A.; Van Blargan, David M.

2016-01-01

Many students who struggle to obtain the alphabetic principle are at risk for being identified as having a reading disability and would benefit from additional explicit phonics instruction as a remedial measure. In this action research case study, the research team conducted two experiments to investigate the effects of a color-coded, onset-rime,…

Using topic coding to understand the nature of change language in a motivational intervention to reduce alcohol and sex risk behaviors in emergency department patients.

PubMed

Kahler, Christopher W; Caswell, Amy J; Laws, M Barton; Walthers, Justin; Magill, Molly; Mastroleo, Nadine R; Howe, Chanelle J; Souza, Timothy; Wilson, Ira; Bryant, Kendall; Monti, Peter M

2016-10-01

To elucidate patient language that supports changing a health behavior (change talk) or sustaining the behavior (sustain talk). We developed a novel coding system to characterize topics of patient speech in a motivational intervention targeting alcohol and HIV/sexual risk in 90 Emergency Department patients. We further coded patient language as change or sustain talk. For both alcohol and sex, discussions focusing on benefits of behavior change or change planning were most likely to involve change talk, and these topics comprised a large portion of all change talk. Greater discussion of barriers and facilitators of change also was associated with more change talk. For alcohol use, benefits of drinking behavior was the most common topic of sustain talk. For sex risk, benefits of sexual behavior were rarely discussed, and sustain talk centered more on patterns and contexts, negations of drawbacks, and drawbacks of sexual risk behavior change. Topic coding provided unique insights into the content of patient change and sustain talk. Patients are most likely to voice change talk when conversation focuses on behavior change rather than ongoing behavior. Interventions addressing multiple health behaviors should address the unique motivations for maintaining specific risky behaviors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Automatic Coding of Short Text Responses via Clustering in Educational Assessment

ERIC Educational Resources Information Center

Zehner, Fabian; Sälzer, Christine; Goldhammer, Frank

2016-01-01

Automatic coding of short text responses opens new doors in assessment. We implemented and integrated baseline methods of natural language processing and statistical modelling by means of software components that are available under open licenses. The accuracy of automatic text coding is demonstrated by using data collected in the "Programme…

Effectiveness of teaching International Caries Detection and Assessment System II and its e-learning program to freshman dental students on occlusal caries detection

PubMed Central

El-Damanhoury, Hatem M.; Fakhruddin, Kausar Sadia; Awad, Manal A.

2014-01-01

Objective: To assess the feasibility of teaching International Caries Detection and Assessment System (ICDAS) II and its e-learning program as tools for occlusal caries detection to freshmen dental students in comparison to dental graduates with 2 years of experience. Materials and Methods: Eighty-four freshmen and 32 dental graduates examined occlusal surfaces of molars/premolars (n = 72) after a lecture and a hands-on workshop. The same procedure was repeated after 1 month following the training with ICDAS II e-learning program. Validation of ICDAS II codes was done histologically. Intra- and inter-examiner reproducibility of ICDAS II severity scores were assessed before and after e-learning using (Fleiss's kappa). Results: The kappa values showed inter-examiner reproducibility ranged from 0.53 (ICDAS II code cut off ≥ 1) to 0.70 (ICDAS II code cut off ≥ 3) by undergraduates and 0.69 (ICDAS II code cut off ≥ 1) to 0.95 (ICDAS II code cut off ≥ 3) by graduates. The inter-examiner reproducibility ranged from 0.64 (ICDAS II code cut off ≥ 1) to 0.89 (ICDAS II code cut off ≥ 3). No statistically significant difference was found between both groups in intra-examiner agreements for assessing ICDAS II codes. A high statistically significant difference (P ≤ 0.01) in correct identification of codes 1, 2, and 4 from before to after e-learning were observed in both groups. The bias indices for the undergraduate group were higher than those of the graduate group. Conclusions: Early exposure of students to ICDAS II is a valuable method of teaching caries detection and its e-learning program significantly improves their caries diagnostic skills. PMID:25512730

Spoken Narrative Assessment: A Supplementary Measure of Children's Creativity

ERIC Educational Resources Information Center

Wong, Miranda Kit-Yi; So, Wing Chee

2016-01-01

This study developed a spoken narrative (i.e., storytelling) assessment as a supplementary measure of children's creativity. Both spoken and gestural contents of children's spoken narratives were coded to assess their verbal and nonverbal creativity. The psychometric properties of the coding system for the spoken narrative assessment were…

Rare coding variants in the phospholipase D3 gene confer risk for Alzheimer's disease

NASA Astrophysics Data System (ADS)

2014-01-01

Genome-wide association studies (GWAS) have identified several risk variants for late-onset Alzheimer's disease (LOAD). These common variants have replicable but small effects on LOAD risk and generally do not have obvious functional effects. Low-frequency coding variants, not detected by GWAS, are predicted to include functional variants with larger effects on risk. To identify low-frequency coding variants with large effects on LOAD risk, we carried out whole-exome sequencing (WES) in 14 large LOAD families and follow-up analyses of the candidate variants in several large LOAD case-control data sets. A rare variant in PLD3 (phospholipase D3; Val232Met) segregated with disease status in two independent families and doubled risk for Alzheimer's disease in seven independent case-control series with a total of more than 11,000 cases and controls of European descent. Gene-based burden analyses in 4,387 cases and controls of European descent and 302 African American cases and controls, with complete sequence data for PLD3, reveal that several variants in this gene increase risk for Alzheimer's disease in both populations. PLD3 is highly expressed in brain regions that are vulnerable to Alzheimer's disease pathology, including hippocampus and cortex, and is expressed at significantly lower levels in neurons from Alzheimer's disease brains compared to control brains. Overexpression of PLD3 leads to a significant decrease in intracellular amyloid-β precursor protein (APP) and extracellular Aβ42 and Aβ40 (the 42- and 40-residue isoforms of the amyloid-β peptide), and knockdown of PLD3 leads to a significant increase in extracellular Aβ42 and Aβ40. Together, our genetic and functional data indicate that carriers of PLD3 coding variants have a twofold increased risk for LOAD and that PLD3 influences APP processing. This study provides an example of how densely affected families may help to identify rare variants with large effects on risk for disease or other complex traits.

Rare coding variants in the phospholipase D3 gene confer risk for Alzheimer's disease.

PubMed

Cruchaga, Carlos; Karch, Celeste M; Jin, Sheng Chih; Benitez, Bruno A; Cai, Yefei; Guerreiro, Rita; Harari, Oscar; Norton, Joanne; Budde, John; Bertelsen, Sarah; Jeng, Amanda T; Cooper, Breanna; Skorupa, Tara; Carrell, David; Levitch, Denise; Hsu, Simon; Choi, Jiyoon; Ryten, Mina; Sassi, Celeste; Bras, Jose; Gibbs, Raphael J; Hernandez, Dena G; Lupton, Michelle K; Powell, John; Forabosco, Paola; Ridge, Perry G; Corcoran, Christopher D; Tschanz, JoAnn T; Norton, Maria C; Munger, Ronald G; Schmutz, Cameron; Leary, Maegan; Demirci, F Yesim; Bamne, Mikhil N; Wang, Xingbin; Lopez, Oscar L; Ganguli, Mary; Medway, Christopher; Turton, James; Lord, Jenny; Braae, Anne; Barber, Imelda; Brown, Kristelle; Pastor, Pau; Lorenzo-Betancor, Oswaldo; Brkanac, Zoran; Scott, Erick; Topol, Eric; Morgan, Kevin; Rogaeva, Ekaterina; Singleton, Andy; Hardy, John; Kamboh, M Ilyas; George-Hyslop, Peter St; Cairns, Nigel; Morris, John C; Kauwe, John S K; Goate, Alison M

2014-01-23

Genome-wide association studies (GWAS) have identified several risk variants for late-onset Alzheimer's disease (LOAD). These common variants have replicable but small effects on LOAD risk and generally do not have obvious functional effects. Low-frequency coding variants, not detected by GWAS, are predicted to include functional variants with larger effects on risk. To identify low-frequency coding variants with large effects on LOAD risk, we carried out whole-exome sequencing (WES) in 14 large LOAD families and follow-up analyses of the candidate variants in several large LOAD case-control data sets. A rare variant in PLD3 (phospholipase D3; Val232Met) segregated with disease status in two independent families and doubled risk for Alzheimer's disease in seven independent case-control series with a total of more than 11,000 cases and controls of European descent. Gene-based burden analyses in 4,387 cases and controls of European descent and 302 African American cases and controls, with complete sequence data for PLD3, reveal that several variants in this gene increase risk for Alzheimer's disease in both populations. PLD3 is highly expressed in brain regions that are vulnerable to Alzheimer's disease pathology, including hippocampus and cortex, and is expressed at significantly lower levels in neurons from Alzheimer's disease brains compared to control brains. Overexpression of PLD3 leads to a significant decrease in intracellular amyloid-β precursor protein (APP) and extracellular Aβ42 and Aβ40 (the 42- and 40-residue isoforms of the amyloid-β peptide), and knockdown of PLD3 leads to a significant increase in extracellular Aβ42 and Aβ40. Together, our genetic and functional data indicate that carriers of PLD3 coding variants have a twofold increased risk for LOAD and that PLD3 influences APP processing. This study provides an example of how densely affected families may help to identify rare variants with large effects on risk for disease or other complex traits.

Rare, low frequency, and common coding variants in CHRNA5 and their contribution to nicotine dependence in European and African Americans

PubMed Central

Olfson, Emily; Saccone, Nancy L.; Johnson, Eric O.; Chen, Li-Shiun; Culverhouse, Robert; Doheny, Kimberly; Foltz, Steven M.; Fox, Louis; Gogarten, Stephanie M.; Hartz, Sarah; Hetrick, Kurt; Laurie, Cathy C.; Marosy, Beth; Amin, Najaf; Arnett, Donna; Barr, R. Graham; Bartz, Traci M.; Bertelsen, Sarah; Borecki, Ingrid B.; Brown, Michael R.; Chasman, Daniel I.; van Duijn, Cornelia M.; Feitosa, Mary F.; Fox, Ervin R.; Franceschini, Nora; Franco, Oscar H.; Grove, Megan L.; Guo, Xiuqing; Hofman, Albert; Kardia, Sharon L.R.; Morrison, Alanna C.; Musani, Solomon K.; Psaty, Bruce M.; Rao, D.C.; Reiner, Alex P.; Rice, Kenneth; Ridker, Paul M.; Rose, Lynda M.; Schick, Ursula M.; Schwander, Karen; Uitterlinden, Andre G.; Vojinovic, Dina; Wang, Jen-Chyong; Ware, Erin B.; Wilson, Gregory; Yao, Jie; Zhao, Wei; Breslau, Naomi; Hatsukami, Dorothy; Stitzel, Jerry A.; Rice, John; Goate, Alison; Bierut, Laura J.

2015-01-01

The common nonsynonymous variant rs16969968 in the α5 nicotinic receptor subunit gene (CHRNA5) is the strongest genetic risk factor for nicotine dependence in European Americans and contributes to risk in African Americans. To comprehensively examine whether other CHRNA5 coding variation influences nicotine dependence risk, we performed targeted sequencing on 1582 nicotine dependent cases (Fagerström Test for Nicotine Dependence score≥4) and 1238 non-dependent controls, with independent replication of common and low frequency variants using 12 studies with exome chip data. Nicotine dependence was examined using logistic regression with individual common variants (MAF≥0.05), aggregate low frequency variants (0.05>MAF≥0.005), and aggregate rare variants (MAF<0.005). Meta-analysis of primary results was performed with replication studies containing 12 174 heavy and 11 290 light smokers. Next-generation sequencing with 180X coverage identified 24 nonsynonymous variants and 2 frameshift deletions in CHRNA5, including 9 novel variants in the 2820 subjects. Meta-analysis confirmed the risk effect of the only common variant (rs16969968, European ancestry: OR=1.3, p=3.5×10−11; African ancestry: OR=1.3, p=0.01) and demonstrated that 3 low frequency variants contributed an independent risk (aggregate term, European ancestry: OR=1.3, p=0.005; African ancestry: OR=1.4, p=0.0006). The remaining 22 rare coding variants were associated with increased risk of nicotine dependence in the European American primary sample (OR=12.9, p=0.01) and in the same risk direction in African Americans (OR=1.5, p=0.37). Our results indicate that common, low frequency and rare CHRNA5 coding variants are independently associated with nicotine dependence risk. These newly identified variants likely influence risk for smoking-related diseases such as lung cancer. PMID:26239294

Rare, low frequency and common coding variants in CHRNA5 and their contribution to nicotine dependence in European and African Americans.

PubMed

Olfson, E; Saccone, N L; Johnson, E O; Chen, L-S; Culverhouse, R; Doheny, K; Foltz, S M; Fox, L; Gogarten, S M; Hartz, S; Hetrick, K; Laurie, C C; Marosy, B; Amin, N; Arnett, D; Barr, R G; Bartz, T M; Bertelsen, S; Borecki, I B; Brown, M R; Chasman, D I; van Duijn, C M; Feitosa, M F; Fox, E R; Franceschini, N; Franco, O H; Grove, M L; Guo, X; Hofman, A; Kardia, S L R; Morrison, A C; Musani, S K; Psaty, B M; Rao, D C; Reiner, A P; Rice, K; Ridker, P M; Rose, L M; Schick, U M; Schwander, K; Uitterlinden, A G; Vojinovic, D; Wang, J-C; Ware, E B; Wilson, G; Yao, J; Zhao, W; Breslau, N; Hatsukami, D; Stitzel, J A; Rice, J; Goate, A; Bierut, L J

2016-05-01

The common nonsynonymous variant rs16969968 in the α5 nicotinic receptor subunit gene (CHRNA5) is the strongest genetic risk factor for nicotine dependence in European Americans and contributes to risk in African Americans. To comprehensively examine whether other CHRNA5 coding variation influences nicotine dependence risk, we performed targeted sequencing on 1582 nicotine-dependent cases (Fagerström Test for Nicotine Dependence score⩾4) and 1238 non-dependent controls, with independent replication of common and low frequency variants using 12 studies with exome chip data. Nicotine dependence was examined using logistic regression with individual common variants (minor allele frequency (MAF)⩾0.05), aggregate low frequency variants (0.05>MAF⩾0.005) and aggregate rare variants (MAF<0.005). Meta-analysis of primary results was performed with replication studies containing 12 174 heavy and 11 290 light smokers. Next-generation sequencing with 180 × coverage identified 24 nonsynonymous variants and 2 frameshift deletions in CHRNA5, including 9 novel variants in the 2820 subjects. Meta-analysis confirmed the risk effect of the only common variant (rs16969968, European ancestry: odds ratio (OR)=1.3, P=3.5 × 10(-11); African ancestry: OR=1.3, P=0.01) and demonstrated that three low frequency variants contributed an independent risk (aggregate term, European ancestry: OR=1.3, P=0.005; African ancestry: OR=1.4, P=0.0006). The remaining 22 rare coding variants were associated with increased risk of nicotine dependence in the European American primary sample (OR=12.9, P=0.01) and in the same risk direction in African Americans (OR=1.5, P=0.37). Our results indicate that common, low frequency and rare CHRNA5 coding variants are independently associated with nicotine dependence risk. These newly identified variants likely influence the risk for smoking-related diseases such as lung cancer.

Acute pesticide poisoning and pesticide registration in Central America

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

Wesseling, Catharina; Corriols, Marianela; Bravo, Viria

The International Code of Conduct on the Distribution and Use of Pesticides of the Food and Agriculture Organization (FAO) of the United Nations has been for 20 years the most acknowledged international initiative for reducing negative impact from pesticide use in developing countries. We analyzed pesticide use and poisoning in Central America, particularly in Costa Rica and Nicaragua, and evaluated whether registration decisions are based on such data, in accordance with the FAO Code. Extensive use of very hazardous pesticides continues in Central America and so do poisonings with organophosphates, carbamates, endosulfan and paraquat as the main causative agents. Centralmore » American governments do not carry out or commission scientific risk assessments. Instead, guidelines from international agencies are followed for risk management through the registration process. Documentation of pesticide poisonings during several decades never induced any decision to ban or restrict a pesticide. However, based on the official surveillance systems, in 2000, the ministers of health of the seven Central American countries agreed to ban or restrict twelve of these pesticides. Now, almost 4 years later, restrictions have been implemented in El Salvador and in Nicaragua public debate is ongoing. Chemical and agricultural industries do not withdraw problematic pesticides voluntarily. In conclusion, the registration processes in Central America do not comply satisfactorily with the FAO Code. However, international regulatory guidelines are important in developing countries, and international agencies should strongly extend its scope and influence, limiting industry involvement. Profound changes in international and national agricultural policies, steering towards sustainable agriculture based on non-chemical pest management, are the only way to reduce poisonings.« less

Risk of leukaemia or cancer in the central nervous system among children living in an area with high indoor radon concentrations: results from a cohort study in Norway

PubMed Central

Del Risco Kollerud, R; Blaasaas, K G; Claussen, B

2014-01-01

Background: Over the past few years, there has been growing interest in assessing the relationship between exposure to radon at home and the risk of childhood cancer. Previous studies have produced conflicting results, probably because of limitations assessing radon exposure, too few cancer cases and poorly documented health statistics. Methods: We used a cohort approach of 0–15-year-old children to examine whether residential radon exposure was associated with childhood leukaemia and cancer in the central nervous system in the Oslo region. The study was based on Norwegian population registers and identified cancer cases from The Cancer Registry of Norway. The residence of every child was geo-coded and assigned a radon exposure. Results: In all, 712 674 children were followed from 1967 to 2009 from birth to date of cancer diagnosis, death, emigration or 15 years of age. A total of 864 cancer cases were identified, 437 children got leukaemia and 427 got cancer in the central nervous system. Conclusions or interpretation: No association was found for childhood leukaemia. An elevated nonsignificant risk for cancer in the central nervous system was observed. This association should be interpreted with caution owing to the crude exposure assessment and possibilities of confounding. PMID:25117818

Validation of newly developed and redesigned key indicator methods for assessment of different working conditions with physical workloads based on mixed-methods design: a study protocol

PubMed Central

Liebers, Falk; Brandstädt, Felix; Schust, Marianne; Serafin, Patrick; Schäfer, Andreas; Gebhardt, Hansjürgen; Hartmann, Bernd; Steinberg, Ulf

2017-01-01

Introduction The impact of work-related musculoskeletal disorders is considerable. The assessment of work tasks with physical workloads is crucial to estimate the work-related health risks of exposed employees. Three key indicator methods are available for risk assessment regarding manual lifting, holding and carrying of loads; manual pulling and pushing of loads; and manual handling operations. Three further KIMs for risk assessment regarding whole-body forces, awkward body postures and body movement have been developed de novo. In addition, the development of a newly drafted combined method for mixed exposures is planned. All methods will be validated regarding face validity, reliability, convergent validity, criterion validity and further aspects of utility under practical conditions. Methods and analysis As part of the joint project MEGAPHYS (multilevel risk assessment of physical workloads), a mixed-methods study is being designed for the validation of KIMs and conducted in companies of different sizes and branches in Germany. Workplaces are documented and analysed by observations, applying KIMs, interviews and assessment of environmental conditions. Furthermore, a survey among the employees at the respective workplaces takes place with standardised questionnaires, interviews and physical examinations. It is intended to include 1200 employees at 120 different workplaces. For analysis of the quality criteria, recommendations of the COSMIN checklist (COnsensus-based Standards for the selection of health Measurement INstruments) will be taken into account. Ethics and dissemination The study was planned and conducted in accordance with the German Medical Professional Code and the Declaration of Helsinki as well as the German Federal Data Protection Act. The design of the study was approved by ethics committees. We intend to publish the validated KIMs in 2018. Results will be published in peer-reviewed journals, presented at international meetings and disseminated to actual users for practical application. PMID:28827239

Validation of newly developed and redesigned key indicator methods for assessment of different working conditions with physical workloads based on mixed-methods design: a study protocol.

PubMed

Klussmann, Andre; Liebers, Falk; Brandstädt, Felix; Schust, Marianne; Serafin, Patrick; Schäfer, Andreas; Gebhardt, Hansjürgen; Hartmann, Bernd; Steinberg, Ulf

2017-08-21

The impact of work-related musculoskeletal disorders is considerable. The assessment of work tasks with physical workloads is crucial to estimate the work-related health risks of exposed employees. Three key indicator methods are available for risk assessment regarding manual lifting, holding and carrying of loads; manual pulling and pushing of loads; and manual handling operations. Three further KIMs for risk assessment regarding whole-body forces, awkward body postures and body movement have been developed de novo. In addition, the development of a newly drafted combined method for mixed exposures is planned. All methods will be validated regarding face validity, reliability, convergent validity, criterion validity and further aspects of utility under practical conditions. As part of the joint project MEGAPHYS (multilevel risk assessment of physical workloads), a mixed-methods study is being designed for the validation of KIMs and conducted in companies of different sizes and branches in Germany. Workplaces are documented and analysed by observations, applying KIMs, interviews and assessment of environmental conditions. Furthermore, a survey among the employees at the respective workplaces takes place with standardised questionnaires, interviews and physical examinations. It is intended to include 1200 employees at 120 different workplaces. For analysis of the quality criteria, recommendations of the COSMIN checklist (COnsensus-based Standards for the selection of health Measurement INstruments) will be taken into account. The study was planned and conducted in accordance with the German Medical Professional Code and the Declaration of Helsinki as well as the German Federal Data Protection Act. The design of the study was approved by ethics committees. We intend to publish the validated KIMs in 2018. Results will be published in peer-reviewed journals, presented at international meetings and disseminated to actual users for practical application. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Numerical Investigation of the Consequences of Land Impacts, Water Impacts, or Air Bursts of Asteroids

NASA Astrophysics Data System (ADS)

Ezzedine, S. M.; Dearborn, D. S.; Miller, P. L.

2015-12-01

The annual probability of an asteroid impact is low, but over time, such catastrophic events are inevitable. Interest in assessing the impact consequences has led us to develop a physics-based framework to seamlessly simulate the event from entry to impact, including air and water shock propagation and wave generation. The non-linear effects are simulated using the hydrodynamics code GEODYN. As effects propagate outward, they become a wave source for the linear-elastic-wave propagation code, WPP/WWP. The GEODYN-WPP/WWP coupling is based on the structured adaptive-mesh-refinement infrastructure, SAMRAI, and has been used in FEMA table-top exercises conducted in 2013 and 2014, and more recently, the 2015 Planetary Defense Conference exercise. Results from these simulations provide an estimate of onshore effects and can inform more sophisticated inundation models. The capabilities of this methodology are illustrated by providing results for different impact locations, and an exploration of asteroid size on the waves arriving at the shoreline of area cities. We constructed the maximum and minimum envelops of water-wave heights given the size of the asteroid and the location of the impact along the risk corridor. Such profiles can inform emergency response and disaster-mitigation efforts, and may be used for design of maritime protection or assessment of risk to shoreline structures of interest. This work was performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344. LLNL-ABS-675390-DRAFT.

Personality Characteristics and Motor Skills Attributed to Occupations in Parkinson Disease

PubMed Central

Gatto, Nicole M.; Bordelon, Yvette; Gatz, Margaret; Ritz, Beate

2013-01-01

Background It has previously been speculated that a distinct premorbid personality characterized by introversion, rigidity, and over cautiousness might be associated with Parkinson disease (PD). Only 1 previous study has assessed personality before PD onset, and other data collected retrospectively do not exclude reverse causation. Objective We relied on the longest held job reported in an interview to infer personality traits and motor skills for 355 incident PD patients and 335 population controls enrolled in a PD study in California. Methods Jobs were coded according to the 1980 US Census Occupational Code and assigned scores for various demands, skills, and aptitudes required by the job. Results None of the occupational temperament or interest factors required, expected, or exhibited by workers were related to statistically significantly higher odds of having PD per unit increase in scores, whereas there was some suggestion of differences when the extremes were examined. Analyses of physical aptitude factors showed that PD cases were less likely to have worked in jobs that involved certain motor skills. Conclusions This study uses a novel approach to assess personality traits using occupational characteristics. Most job attributes thought to reflect conservativeness; risk taking, stress resistance, and flexibility were not associated with PD in a linear manner. Thus, these occupation-derived traits do not seem to support the existence of a distinct parkinsonian personality. However, the negative associations with jobs requiring certain motor skills are intriguing, and may suggest very early premotor features or a lack of continuous motor training as a risk factor for PD. PMID:21487260

Suicide, hospital-presenting suicide attempts, and criminality in bipolar disorder: examination of risk for multiple adverse outcomes.

PubMed

Webb, Roger T; Lichtenstein, Paul; Larsson, Henrik; Geddes, John R; Fazel, Seena

2014-08-01

To compare risks for suicidality and criminality in a national cohort of people diagnosed with bipolar disorder, and to assess how risk factor profiles differ between these outcomes. We conducted 2 case-cohort studies using interlinked Swedish national registers. Primarily, using International Classification of Diseases (ICD) coding, we identified 15,337 people diagnosed with bipolar disorder, 1973-2009, matched by age and gender to 20 individuals per case sampled randomly from the general population. We estimated risks of suicide and hospital-presenting attempted suicide, and violent and nonviolent criminal offending. We separately assessed these risks among 14,677 unaffected siblings matched to a second general population sample. 22.2% of bipolar disorder cohort members engaged in suicidal or criminal acts after diagnosis. They were at greatly elevated risk for completed suicide (risk ratio = 18.8; 95% CI, 16.0-22.2), attempted suicide (risk ratio = 14.3; 95% CI, 13.5-15.2), violent crime (risk ratio = 5.0; 95% CI, 4.6-5.4), and nonviolent crime (risk ratio = 2.9; 95% CI, 2.8-3.1) compared with the general population. Elevations in risk were far less marked among the unaffected siblings than in the bipolar disorder cohort. Three factors independently predicted raised risk of all 4 adverse outcomes: if the first 2 patient episodes for bipolar disorder required admission, a history of attempted suicide, and a history of diagnosed alcohol/drug disorder. Criminal offending before bipolar diagnosis was an especially strong independent predictor of criminality after diagnosis. The combined risk of suicidality or criminality is substantially elevated in both relative and absolute terms. Clinical prediction rules focusing on multiple vulnerabilities following onset of bipolar disorder, especially when there is history of attempted suicide, substance misuse disorders, or criminal offending, may improve risk management. © Copyright 2014 Physicians Postgraduate Press, Inc.

Suicide, Hospital-Presenting Suicide Attempts, and Criminality in Bipolar Disorder: Examination of Risk for Multiple Adverse Outcomes

PubMed Central

Webb, Roger T.; Lichtenstein, Paul; Larsson, Henrik; Geddes, John R.; Fazel, Seena

2014-01-01

Objective To compare risks for suicidality and criminality in a national cohort of people diagnosed with bipolar disorder, and to assess how risk factor profiles differ between these outcomes. Method We conducted 2 case-cohort studies using interlinked Swedish national registers. Primarily, using International Classification of Diseases (ICD) coding, we identified 15,337 people diagnosed with bipolar disorder, 1973–2009, matched by age and gender to 20 individuals per case sampled randomly from the general population. We estimated risks of suicide and hospital-presenting attempted suicide, and violent and nonviolent criminal offending. We separately assessed these risks among 14,677 unaffected siblings matched to a second general population sample. Results 22.2% of bipolar disorder cohort members engaged in suicidal or criminal acts after diagnosis. They were at greatly elevated risk for completed suicide (risk ratio = 18.8; 95% CI, 16.0–22.2), attempted suicide (risk ratio = 14.3; 95% CI, 13.5–15.2), violent crime (risk ratio = 5.0; 95% CI, 4.6–5.4), and nonviolent crime (risk ratio = 2.9; 95% CI, 2.8–3.1) compared with the general population. Elevations in risk were far less marked among the unaffected siblings than in the bipolar disorder cohort. Three factors independently predicted raised risk of all 4 adverse outcomes: if the first 2 patient episodes for bipolar disorder required admission, a history of attempted suicide, and a history of diagnosed alcohol/drug disorder. Criminal offending before bipolar diagnosis was an especially strong independent predictor of criminality after diagnosis. Conclusions The combined risk of suicidality or criminality is substantially elevated in both relative and absolute terms. Clinical prediction rules focusing on multiple vulnerabilities following onset of bipolar disorder, especially when there is history of attempted suicide, substance misuse disorders, or criminal offending, may improve risk management. PMID:25191918

ASTARTE: Assessment Strategy and Risk Reduction for Tsunamis in Europe

NASA Astrophysics Data System (ADS)

Baptista, M. A.; Yalciner, A. C.; Canals, M.

2014-12-01

Tsunamis are low frequency but high impact natural disasters. In 2004, the Boxing Day tsunami killed hundreds of thousands of people from many nations along the coastlines of the Indian Ocean. Tsunami run-up exceeded 35 m. Seven years later, and in spite of some of the best warning technologies and levels of preparedness in the world, the Tohoku-Oki tsunami in Japan dramatically showed the limitations of scientific knowledge on tsunami sources, coastal impacts and mitigation measures. The experience from Japan raised serious questions on how to improve the resilience of coastal communities, to upgrade the performance of coastal defenses, to adopt a better risk management, and also on the strategies and priorities for the reconstruction of damaged coastal areas. Societal resilience requires the reinforcement of capabilities to manage and reduce risk at national and local scales.ASTARTE (Assessment STrategy And Risk for Tsunami in Europe), a 36-month FP7 project, aims to develop a comprehensive strategy to mitigate tsunami impact in this region. To achieve this goal, an interdisciplinary consortium has been assembled. It includes all CTWPs of NEAM and expert institutions across Europe and worldwide. ASTARTE will improve i) basic knowledge of tsunami generation and recurrence going beyond simple catalogues, with novel empirical data and new statistical analyses for assessing long-term recurrence and hazards of large events in sensitive areas of NEAM, ii) numerical techniques for tsunami simulation, with focus on real-time codes and novel statistical emulation approaches, and iii) methods for assessment of hazard, vulnerability, and risk. ASTARTE will also provide i) guidelines for tsunami Eurocodes, ii) better tools for forecast and warning for CTWPs and NTWCs, and iii) guidelines for decision makers to increase sustainability and resilience of coastal communities. In summary, ASTARTE will develop basic scientific and technical elements allowing for a significant enhancement of the Tsunami Warning System in the NEAM region in terms of monitoring, early warning and forecast, governance and resilience. This work is funded by project ASTARTE - Assessment, STrategy And Risk Reduction for Tsunamis in Europe. Grant 603839, 7th FP (ENV.2013.6.4-3 ENV.2013.6.4-3)

A Qualitative Analysis of Narrative Preclerkship Assessment Data to Evaluate Teamwork Skills.

PubMed

Dolan, Brigid M; O'Brien, Celia Laird; Cameron, Kenzie A; Green, Marianne M

2018-04-16

Construct: Students entering the health professions require competency in teamwork. Although many teamwork curricula and assessments exist, studies have not demonstrated robust longitudinal assessment of preclerkship students' teamwork skills and attitudes. Assessment portfolios may serve to fill this gap, but it is unknown how narrative comments within portfolios describe student teamwork behaviors. We performed a qualitative analysis of narrative data in 15 assessment portfolios. Student portfolios were randomly selected from 3 groups stratified by quantitative ratings of teamwork performance gathered from small-group and clinical preceptor assessment forms. Narrative data included peer and faculty feedback from these same forms. Data were coded for teamwork-related behaviors using a constant comparative approach combined with an identification of the valence of the coded statements as either "positive observation" or "suggestion for improvement." Eight codes related to teamwork emerged: attitude and demeanor, information facilitation, leadership, preparation and dependability, professionalism, team orientation, values team member contributions, and nonspecific teamwork comments. The frequency of codes and valence varied across the 3 performance groups, with students in the low-performing group receiving more suggestions for improvement across all teamwork codes. Narrative data from assessment portfolios included specific descriptions of teamwork behavior, with important contributions provided by both faculty and peers. A variety of teamwork domains were represented. Such feedback as collected in an assessment portfolio can be used for longitudinal assessment of preclerkship student teamwork skills and attitudes.

Assessment of the safety of aquatic animal commodities for international trade: the OIE Aquatic Animal Health code.

PubMed

Oidtmann, B; Johnston, C; Klotins, K; Mylrea, G; Van, P T; Cabot, S; Martin, P Rosado; Ababouch, L; Berthe, F

2013-02-01

Trading of aquatic animals and aquatic animal products has become increasingly globalized during the last couple of decades. This commodity trade has increased the risk for the spread of aquatic animal pathogens. The World Organisation for Animal Health (OIE) is recognized as the international standard-setting organization for measures relating to international trade in animals and animal products. In this role, OIE has developed the Aquatic Animal Health Code, which provides health measures to be used by competent authorities of importing and exporting countries to avoid the transfer of agents pathogenic for animals or humans, whilst avoiding unjustified sanitary barriers. An OIE ad hoc group developed criteria for assessing the safety of aquatic animals or aquatic animal products for any purpose from a country, zone or compartment not declared free from a given disease 'X'. The criteria were based on the absence of the pathogenic agent in the traded commodity or inactivation of the pathogenic agent by the commercial processing used to produce the commodity. The group also developed criteria to assess the safety of aquatic animals or aquatic animal products for retail trade for human consumption from potentially infected areas. Such commodities were assessed considering the form and presentation of the product, the expected volume of waste tissues generated by the consumer and the likely presence of viable pathogenic agent in the waste. The ad hoc group applied the criteria to commodities listed in the individual disease chapters of the Aquatic Animal Health Code (2008 edition). Revised lists of commodities for which no additional measures should be required by the importing countries regardless of the status for disease X of the exporting country were developed and adopted by the OIE World Assembly of Delegates in May 2011. The rationale of the criteria and their application will be explained and demonstrated using examples. © 2012 Crown Copyright. Reproduced with the permission of the Controller of Her Majesty’s Stationery Office and Cefas, Aquatic Animal Disease Group.

Rolling-refresher simulation improves performance and retention of paediatric intensive care unit nurse code cart management.

PubMed

Singleton, Marcy N; Allen, Kimberly F; Li, Zhongze; McNerney, Kevin; Naber, Urs H; Braga, Matthew S

2018-04-01

Paediatric Intensive Care Unit Nurses (PICU RNs) manage the code cart during paediatric emergencies at the Children's Hospital at Dartmouth-Hitchcock. These are low -frequency, high-stakes events. An uncontrolled intervention study with 6-month follow-up. A collaboration of physician and nursing experts developed a rolling-refresher training programme consisting of five simulated scenarios, including 22 code cart skills, to establish nursing code cart competency. The cohort of PICU RNs underwent a competency assessment in training 1. To achieve competence, the participating RN received immediate feedback and instruction and repeated each task until mastery during training 1. The competencies were repeated 6 months later, designated training 2. Thirty-two RNs participated in training 1. Sixteen RNs (50%) completed the second training. Our rolling-refresher training programme resulted in a 43% reduction in the odds of first attempt failures between training 1 and training 2 (p=0.01). Multivariate linear regression evaluating the difference in first attempt failure between training 1 and training 2 revealed that the following covariates were not significantly associated with this improvement: interval Paediatric Advanced Life Support training, interval use of the code cart or defibrillator (either real or simulated) and time between training sessions. Univariate analysis between the two trainings revealed a statistically significant reduction in first attempt failures for: preparing an epinephrine infusion (72% vs 41%, p=0.04) and providing bag-mask ventilation (28% vs 0%, p=0.02). Our rolling-refresher training programme demonstrated significant improvement in performance for low-frequency, high-risk skills required to manage a paediatric code cart with retention after initial training.

Is diabetes mellitus correctly registered and classified in primary care? A population-based study in Catalonia, Spain.

PubMed

Mata-Cases, Manel; Mauricio, Dídac; Real, Jordi; Bolíbar, Bonaventura; Franch-Nadal, Josep

2016-11-01

To assess the prevalence of miscoding, misclassification, misdiagnosis and under-registration of diabetes mellitus (DM) in primary health care in Catalonia (Spain), and to explore use of automated algorithms to identify them. In this cross-sectional, retrospective study using an anonymized electronic general practice database, data were collected from patients or users with a diabetes-related code or from patients with no DM or prediabetes code but treated with antidiabetic drugs (unregistered DM). Decision algorithms were designed to classify the true diagnosis of type 1 DM (T1DM), type 2 DM (T2DM), and undetermined DM (UDM), and to classify unregistered DM patients treated with antidiabetic drugs. Data were collected from a total of 376,278 subjects with a DM ICD-10 code, and from 8707 patients with no DM or prediabetes code but treated with antidiabetic drugs. After application of the algorithms, 13.9% of patients with T1DM were identified as misclassified, and were probably T2DM; 80.9% of patients with UDM were reclassified as T2DM, and 19.1% of them were misdiagnosed as DM when they probably had prediabetes. The overall prevalence of miscoding (multiple codes or UDM) was 2.2%. Finally, 55.2% of subjects with unregistered DM were classified as prediabetes, 35.7% as T2DM, 8.5% as UDM treated with insulin, and 0.6% as T1DM. The prevalence of inappropriate codification or classification and under-registration of DM is relevant in primary care. Implementation of algorithms could automatically flag cases that need review and would substantially decrease the risk of inappropriate registration or coding. Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

Occupational exposure to ionizing radiation and electromagnetic fields in relation to the risk of thyroid cancer in Sweden.

PubMed

Lope, Virginia; Pérez-Gómez, Beatriz; Aragonés, Nuria; López-Abente, Gonzalo; Gustavsson, Per; Floderus, Birgitta; Dosemeci, Mustafa; Silva, Agustín; Pollán, Marina

2006-08-01

This study sought to ascertain the risk of thyroid cancer in relation to occupational exposure to ionizing radiation and extremely low-frequency magnetic fields (ELFMF) in a cohort representative of Sweden's gainfully employed population. A historical cohort of 2 992 166 gainfully employed Swedish male and female workers was followed up from 1971 through 1989. Exposure to ELFMF and ionizing radiation was assessed using three job exposure matrices based on industrial branch or occupational codes. Relative risks (RR) for male and female workers, adjusted for age and geographic area, were computed using log-linear Poisson models. Occupational ELFMF exposure showed no effect on the risk of thyroid cancer in the study. However, female workers exposed to high intensities of ionizing radiation registered a marked excess risk (RR 1.85, 95% confidence interval (95% CI) 1.02-3.35]. This trend was not in evidence among the men. While the study confirms the etiologic role of ionizing radiation, with a higher incidence of thyroid cancer being recorded for the most-exposed female workers, our results do not support the possibility of occupational exposure to ELFMF being a risk factor for the development of thyroid cancer.

A Machine Learning Framework for Plan Payment Risk Adjustment.

PubMed

Rose, Sherri

2016-12-01

To introduce cross-validation and a nonparametric machine learning framework for plan payment risk adjustment and then assess whether they have the potential to improve risk adjustment. 2011-2012 Truven MarketScan database. We compare the performance of multiple statistical approaches within a broad machine learning framework for estimation of risk adjustment formulas. Total annual expenditure was predicted using age, sex, geography, inpatient diagnoses, and hierarchical condition category variables. The methods included regression, penalized regression, decision trees, neural networks, and an ensemble super learner, all in concert with screening algorithms that reduce the set of variables considered. The performance of these methods was compared based on cross-validated R 2 . Our results indicate that a simplified risk adjustment formula selected via this nonparametric framework maintains much of the efficiency of a traditional larger formula. The ensemble approach also outperformed classical regression and all other algorithms studied. The implementation of cross-validated machine learning techniques provides novel insight into risk adjustment estimation, possibly allowing for a simplified formula, thereby reducing incentives for increased coding intensity as well as the ability of insurers to "game" the system with aggressive diagnostic upcoding. © Health Research and Educational Trust.

Familial risk and sibling mentalization: Links with preschoolers' internalizing problems.

PubMed

Rodrigues, Michelle; Binnoon-Erez, Noam; Prime, Heather; Perlman, Michal; Jenkins, Jennifer M

2017-09-01

The current study explored whether older sibling mentalization moderated the relationship between familial risk for internalizing symptoms and the development of future internalizing problems in the younger siblings, referred to as target children. Data were collected on 397 older siblings at Time 1 (T1) when target children were newborn and their older siblings were on average 2.61 years old (SD = .75). Target children were on average 1.60 years old at Time 2 (T2). Internalizing problems were assessed via mother and partner reports. Familial risk was operationalized as the average of all older siblings' level of internalizing problems. Older sibling mentalization, indexed by internal state talk and reasoning, was observed and coded during a sibling pretend-play interaction at T2. Results revealed a significant interaction between familial risk of internalizing problems and older siblings' mentalizing abilities, showing that familial risk was related to target children's internalizing problems in the absence of sibling mentalization. Familial risk was not associated with target children's internalizing problems when siblings demonstrated mentalizing abilities. Findings support the need to consider sibling mentalization as a protective factor for children's internalizing problems. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Hospital financing of ischaemic stroke: determinants of funding and usefulness of DRG subcategories based on severity of illness.

PubMed

Dewilde, Sarah; Annemans, Lieven; Pincé, Hilde; Thijs, Vincent

2018-05-11

Several Western and Arab countries, as well as over 30 States in the US are using the "All-Patient Refined Diagnosis-Related Groups" (APR-DRGs) with four severity-of-illness (SOI) subcategories as a model for hospital funding. The aim of this study is to verify whether this is an adequate model for funding stroke hospital admissions, and to explore which risk factors and complications may influence the amount of funding. A bottom-up analysis of 2496 ischaemic stroke admissions in Belgium compares detailed in-hospital resource use (including length of stay, imaging, lab tests, visits and drugs) per SOI category and calculates total hospitalisation costs. A second analysis examines the relationship between the type and location of the index stroke, medical risk factors, patient characteristics, comorbidities and in-hospital complications on the one hand, and the funding level received by the hospital on the other hand. This dataset included 2513 hospitalisations reporting on 35,195 secondary diagnosis codes, all medically coded with the International Classification of Disease (ICD-9). Total costs per admission increased by SOI (€3710-€16,735), with severe patients costing proportionally more in bed days (86%), and milder patients costing more in medical imaging (24%). In all resource categories (bed days, medications, visits and imaging and laboratory tests), the absolute utilisation rate was higher among severe patients, but also showed more variability. SOI 1-2 was associated with vague, non-specific stroke-related ICD-9 codes as primary diagnosis (71-81% of hospitalisations). 24% hospitalisations had, in addition to the primary diagnosis, other stroke-related codes as secondary diagnoses. Presence of lung infections, intracranial bleeding, severe kidney disease, and do-not-resuscitate status were each associated with extreme SOI (p < 0.0001). APR-DRG with SOI subclassification is a useful funding model as it clusters stroke patients in homogenous groups in terms of resource use. The data on medical care utilisation can be used with unit costs from other countries with similar healthcare set-ups to 1) assess stroke-related hospital funding versus actual costs; 2) inform economic models on stroke prevention and treatment. The data on diagnosis codes can be used to 3) understand which factors influence hospital funding; 4) raise awareness about medical coding practices.

Utility of linking primary care electronic medical records with Canadian census data to study the determinants of chronic disease: an example based on socioeconomic status and obesity.

PubMed

Biro, Suzanne; Williamson, Tyler; Leggett, Jannet Ann; Barber, David; Morkem, Rachael; Moore, Kieran; Belanger, Paul; Mosley, Brian; Janssen, Ian

2016-03-11

Electronic medical records (EMRs) used in primary care contain a breadth of data that can be used in public health research. Patient data from EMRs could be linked with other data sources, such as a postal code linkage with Census data, to obtain additional information on environmental determinants of health. While promising, successful linkages between primary care EMRs with geographic measures is limited due to ethics review board concerns. This study tested the feasibility of extracting full postal code from primary care EMRs and linking this with area-level measures of the environment to demonstrate how such a linkage could be used to examine the determinants of disease. The association between obesity and area-level deprivation was used as an example to illustrate inequalities of obesity in adults. The analysis included EMRs of 7153 patients aged 20 years and older who visited a single, primary care site in 2011. Extracted patient information included demographics (date of birth, sex, postal code) and weight status (height, weight). Information extraction and management procedures were designed to mitigate the risk of individual re-identification when extracting full postal code from source EMRs. Based on patients' postal codes, area-based deprivation indexes were created using the smallest area unit used in Canadian censuses. Descriptive statistics and socioeconomic disparity summary measures of linked census and adult patients were calculated. The data extraction of full postal code met technological requirements for rendering health information extracted from local EMRs into anonymized data. The prevalence of obesity was 31.6 %. There was variation of obesity between deprivation quintiles; adults in the most deprived areas were 35 % more likely to be obese compared with adults in the least deprived areas (Chi-Square = 20.24(1), p < 0.0001). Maps depicting spatial representation of regional deprivation and obesity were created to highlight high risk areas. An area based socio-economic measure was linked with EMR-derived objective measures of height and weight to show a positive association between area-level deprivation and obesity. The linked dataset demonstrates a promising model for assessing health disparities and ecological factors associated with the development of chronic diseases with far reaching implications for informing public health and primary health care interventions and services.

Reduced discretization error in HZETRN

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

Slaba, Tony C., E-mail: Tony.C.Slaba@nasa.gov; Blattnig, Steve R., E-mail: Steve.R.Blattnig@nasa.gov; Tweed, John, E-mail: jtweed@odu.edu

2013-02-01

The deterministic particle transport code HZETRN is an efficient analysis tool for studying the effects of space radiation on humans, electronics, and shielding materials. In a previous work, numerical methods in the code were reviewed, and new methods were developed that further improved efficiency and reduced overall discretization error. It was also shown that the remaining discretization error could be attributed to low energy light ions (A < 4) with residual ranges smaller than the physical step-size taken by the code. Accurately resolving the spectrum of low energy light particles is important in assessing risk associated with astronaut radiation exposure.more » In this work, modifications to the light particle transport formalism are presented that accurately resolve the spectrum of low energy light ion target fragments. The modified formalism is shown to significantly reduce overall discretization error and allows a physical approximation to be removed. For typical step-sizes and energy grids used in HZETRN, discretization errors for the revised light particle transport algorithms are shown to be less than 4% for aluminum and water shielding thicknesses as large as 100 g/cm{sup 2} exposed to both solar particle event and galactic cosmic ray environments.« less

MELCOR computer code manuals: Primer and user`s guides, Version 1.8.3 September 1994. Volume 1

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

Summers, R.M.; Cole, R.K. Jr.; Smith, R.C.

1995-03-01

MELCOR is a fully integrated, engineering-level computer code that models the progression of severe accidents in light water reactor nuclear power plants. MELCOR is being developed at Sandia National Laboratories for the US Nuclear Regulatory Commission as a second-generation plant risk assessment tool and the successor to the Source Term Code Package. A broad spectrum of severe accident phenomena in both boiling and pressurized water reactors is treated in MELCOR in a unified framework. These include: thermal-hydraulic response in the reactor coolant system, reactor cavity, containment, and confinement buildings; core heatup, degradation, and relocation; core-concrete attack; hydrogen production, transport, andmore » combustion; fission product release and transport; and the impact of engineered safety features on thermal-hydraulic and radionuclide behavior. Current uses of MELCOR include estimation of severe accident source terms and their sensitivities and uncertainties in a variety of applications. This publication of the MELCOR computer code manuals corresponds to MELCOR 1.8.3, released to users in August, 1994. Volume 1 contains a primer that describes MELCOR`s phenomenological scope, organization (by package), and documentation. The remainder of Volume 1 contains the MELCOR Users` Guides, which provide the input instructions and guidelines for each package. Volume 2 contains the MELCOR Reference Manuals, which describe the phenomenological models that have been implemented in each package.« less

Risk-Based Probabilistic Approach to Aeropropulsion System Assessment

NASA Technical Reports Server (NTRS)

Tong, Michael T.

2002-01-01

In an era of shrinking development budgets and resources, where there is also an emphasis on reducing the product development cycle, the role of system assessment, performed in the early stages of an engine development program, becomes very critical to the successful development of new aeropropulsion systems. A reliable system assessment not only helps to identify the best propulsion system concept among several candidates, it can also identify which technologies are worth pursuing. This is particularly important for advanced aeropropulsion technology development programs, which require an enormous amount of resources. In the current practice of deterministic, or point-design, approaches, the uncertainties of design variables are either unaccounted for or accounted for by safety factors. This could often result in an assessment with unknown and unquantifiable reliability. Consequently, it would fail to provide additional insight into the risks associated with the new technologies, which are often needed by decision makers to determine the feasibility and return-on-investment of a new aircraft engine. In this work, an alternative approach based on the probabilistic method was described for a comprehensive assessment of an aeropropulsion system. The statistical approach quantifies the design uncertainties inherent in a new aeropropulsion system and their influences on engine performance. Because of this, it enhances the reliability of a system assessment. A technical assessment of a wave-rotor-enhanced gas turbine engine was performed to demonstrate the methodology. The assessment used probability distributions to account for the uncertainties that occur in component efficiencies and flows and in mechanical design variables. The approach taken in this effort was to integrate the thermodynamic cycle analysis embedded in the computer code NEPP (NASA Engine Performance Program) and the engine weight analysis embedded in the computer code WATE (Weight Analysis of Turbine Engines) with the fast probability integration technique (FPI). FPI was developed by Southwest Research Institute under contract with the NASA Glenn Research Center. The results were plotted in the form of cumulative distribution functions and sensitivity analyses and were compared with results from the traditional deterministic approach. The comparison showed that the probabilistic approach provides a more realistic and systematic way to assess an aeropropulsion system. The current work addressed the application of the probabilistic approach to assess specific fuel consumption, engine thrust, and weight. Similarly, the approach can be used to assess other aspects of aeropropulsion system performance, such as cost, acoustic noise, and emissions. Additional information is included in the original extended abstract.

Exploration of ICD-9-CM Coding of Chronic Disease within the Elixhauser Comorbidity Measure in Patients with Chronic Heart Failure

PubMed Central

Garvin, Jennifer Hornung; Redd, Andrew; Bolton, Dan; Graham, Pauline; Roche, Dominic; Groeneveld, Peter; Leecaster, Molly; Shen, Shuying; Weiner, Mark G.

2013-01-01

Introduction International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes capture comorbidities that can be used to risk adjust nonrandom patient groups. We explored the accuracy of capturing comorbidities associated with one risk adjustment method, the Elixhauser Comorbidity Measure (ECM), in patients with chronic heart failure (CHF) at one Veterans Affairs (VA) medical center. We explored potential reasons for the differences found between the original codes assigned and conditions found through retrospective review. Methods This descriptive, retrospective study used a cohort of patients discharged with a principal diagnosis coded as CHF from one VA medical center in 2003. One admission per patient was used in the study; with multiple admissions, only the first admission was analyzed. We compared the assignment of original codes assigned to conditions found in a retrospective, manual review of the medical record conducted by an investigator with coding expertise as well as by physicians. Members of the team experienced with assigning ICD-9-CM codes and VA coding processes developed themes related to systemic reasons why chronic conditions were not coded in VA records using applied thematic techniques. Results In the 181-patient cohort, 388 comorbid conditions were identified; 305 of these were chronic conditions, originally coded at the time of discharge with an average of 1.7 comorbidities related to the ECM per patient. The review by an investigator with coding expertise revealed a total of 937 comorbidities resulting in 618 chronic comorbid conditions with an average of 3.4 per patient; physician review found 872 total comorbidities with 562 chronic conditions (average 3.1 per patient). The agreement between the original and the retrospective coding review was 88 percent. The kappa statistic for the original and the retrospective coding review was 0.375 with a 95 percent confidence interval (CI) of 0.352 to 0.398. The kappa statistic for the retrospective coding review and physician review was 0.849 (CI, 0.823–0.875). The kappa statistic for the original coding and the physician review was 0.340 (CI, 0.316–0.364). Several systemic factors were identified, including familiarity with inpatient VA and non-VA guidelines, the quality of documentation, and operational requirements to complete the coding process within short time frames and to identify the reasons for movement within a given facility. Conclusion Comorbidities within the ECM representing chronic conditions were significantly underrepresented in the original code assignment. Contributing factors potentially include prioritization of codes related to acute conditions over chronic conditions; coders’ professional training, educational level, and experience; and the limited number of codes allowed in initial coding software. This study highlights the need to evaluate systemic causes of underrepresentation of chronic conditions to improve the accuracy of risk adjustment used for health services research, resource allocation, and performance measurement. PMID:24159270

Assessment of radiation-induced secondary cancer risk in the Brazilian population from left-sided breast-3D-CRT using MCNPX.

PubMed

Mendes, Bruno Melo; Trindade, Bruno Machado; Fonseca, Telma Cristina Ferreira; de Campos, Tarcisio Passos Ribeiro

2017-12-01

The aim of this work was to simulate a 6MV conventional breast 3D conformational radiation therapy (3D-CRT) with physical wedges (50 Gy/25#) in the left breast, calculate the mean absorbed dose in the body organs using robust models and computational tools and estimate the secondary cancer-incidence risk to the Brazilian population. The VW female phantom was used in the simulations. Planning target volume (PTV) was defined in the left breast. The 6MV parallel-opposed fields breast-radiotherapy (RT) protocol was simulated with MCNPx code. The absorbed doses were evaluated in all the organs. The secondary cancer-incidence risk induced by radiotherapy was calculated for different age groups according to the BEIR VII methodology. RT quality indexes indicated that the protocol was properly simulated. Significant absorbed dose values in red bone marrow, RBM (0.8 Gy) and stomach (0.6 Gy) were observed. The contralateral breast presented the highest risk of incidence of a secondary cancer followed by leukaemia, lung and stomach. The risk of a secondary cancer-incidence by breast-RT, for the Brazilian population, ranged between 2.2-1.7% and 0.6-0.4%. RBM and stomach, usually not considered as OAR, presented high second cancer incidence risks of 0.5-0.3% and 0.4-0.1%, respectively. This study may be helpful for breast-RT risk/benefit assessment. Advances in knowledge: MCNPX-dosimetry was able to provide the scatter radiation and dose for all body organs in conventional breast-RT. It was found a relevant risk up to 2.2% of induced-cancer from breast-RT, considering the whole thorax organs and Brazilian cancer-incidence.

Benchmarking computational fluid dynamics models of lava flow simulation for hazard assessment, forecasting, and risk management

USGS Publications Warehouse

Dietterich, Hannah; Lev, Einat; Chen, Jiangzhi; Richardson, Jacob A.; Cashman, Katharine V.

2017-01-01

Numerical simulations of lava flow emplacement are valuable for assessing lava flow hazards, forecasting active flows, designing flow mitigation measures, interpreting past eruptions, and understanding the controls on lava flow behavior. Existing lava flow models vary in simplifying assumptions, physics, dimensionality, and the degree to which they have been validated against analytical solutions, experiments, and natural observations. In order to assess existing models and guide the development of new codes, we conduct a benchmarking study of computational fluid dynamics (CFD) models for lava flow emplacement, including VolcFlow, OpenFOAM, FLOW-3D, COMSOL, and MOLASSES. We model viscous, cooling, and solidifying flows over horizontal planes, sloping surfaces, and into topographic obstacles. We compare model results to physical observations made during well-controlled analogue and molten basalt experiments, and to analytical theory when available. Overall, the models accurately simulate viscous flow with some variability in flow thickness where flows intersect obstacles. OpenFOAM, COMSOL, and FLOW-3D can each reproduce experimental measurements of cooling viscous flows, and OpenFOAM and FLOW-3D simulations with temperature-dependent rheology match results from molten basalt experiments. We assess the goodness-of-fit of the simulation results and the computational cost. Our results guide the selection of numerical simulation codes for different applications, including inferring emplacement conditions of past lava flows, modeling the temporal evolution of ongoing flows during eruption, and probabilistic assessment of lava flow hazard prior to eruption. Finally, we outline potential experiments and desired key observational data from future flows that would extend existing benchmarking data sets.

Dopaminergic Variants in Siblings at High Risk for Autism: Associations With Initiating Joint Attention

PubMed Central

Gangi, Devon N.; Messinger, Daniel S.; Martin, Eden R.; Cuccaro, Michael L.

2016-01-01

Younger siblings of children with autism spectrum disorder (ASD; high-risk siblings) exhibit lower levels of initiating joint attention (IJA; sharing an object or experience with a social partner through gaze and/or gesture) than low-risk siblings of children without ASD. However, high-risk siblings also exhibit substantial variability in this domain. The neurotransmitter dopamine is linked to brain areas associated with reward, motivation, and attention, and common dopaminergic variants have been associated with attention difficulties. We examined whether these common dopaminergic variants, DRD4 and DRD2, explain variability in IJA in high-risk (n = 55) and low-risk (n = 38) siblings. IJA was assessed in the first year during a semi-structured interaction with an examiner. DRD4 and DRD2 genotypes were coded according to associated dopaminergic functioning to create a gene score, with higher scores indicating more genotypes associated with less efficient dopaminergic functioning. Higher dopamine gene scores (indicative of less efficient dopaminergic functioning) were associated with lower levels of IJA in the first year for high-risk siblings, while the opposite pattern emerged in low-risk siblings. Findings suggest differential susceptibility—IJA was differentially associated with dopaminergic functioning depending on familial ASD risk. Understanding genes linked to ASD-relevant behaviors in high-risk siblings will aid in early identification of children at greatest risk for difficulties in these behavioral domains, facilitating targeted prevention and intervention. PMID:26990357

Falling Down on the Job: Evaluation and Treatment of Fall Risk Among Older Adults With Upper Extremity Fragility Fractures.

PubMed

McDonough, Christine M; Colla, Carrie H; Carmichael, Donald; Tosteson, Anna N A; Tosteson, Tor D; Bell, John-Erik; Cantu, Robert V; Lurie, Jonathan D; Bynum, Julie P W

2017-03-01

Clinical practice guidelines recommend fall risk assessment and intervention for older adults who sustain a fall-related injury to prevent future injury and mobility decline. The aim of this study was to describe how often Medicare beneficiaries with upper extremity fracture receive evaluation and treatment for fall risk. Observational cohort. Participants were fee-for-service beneficiaries age 66 to 99 treated as outpatients for proximal humerus or distal radius/ulna ("wrist") fragility fractures. -Participants were studied using Carrier and Outpatient Hospital files. The proportion of patients evaluated or treated for fall risk up to 6 months after proximal humerus or wrist fracture from 2007-2009 was examined based on evaluation, treatment, and diagnosis codes. Time to evaluation and number of treatment sessions were calculated. Logistic regression was used to analyze patient characteristics that predicted receiving evaluation or treatment. Narrow (gait training) and broad (gait training or therapeutic exercise) definitions of service were used. There were 309,947 beneficiaries who sustained proximal humerus (32%) or wrist fracture (68%); 10.7% received evaluation or treatment for fall risk or gait issues (humerus: 14.2%; wrist: 9.0%). Using the broader definition, the percentage increased to 18.5% (humerus: 23.4%; wrist: 16.3%). Factors associated with higher likelihood of services after fracture were: evaluation or treatment for falls or gait prior to fracture, more comorbidities, prior nursing home stay, older age, humerus fracture (vs wrist), female sex, and white race. Claims analysis may underestimate physician and physical therapist fall assessments, but it is not likely to qualitatively change the results. A small proportion of older adults with upper extremity fracture received fall risk assessment and treatment. Providers and health systems must advance efforts to provide timely evidence-based management of fall risk in this population. © 2017 American Physical Therapy Association

Does abortion increase women's risk for post-traumatic stress? Findings from a prospective longitudinal cohort study

PubMed Central

Biggs, M Antonia; Rowland, Brenly; McCulloch, Charles E; Foster, Diana G

2016-01-01

Objective To prospectively assess women's risk for post-traumatic stress disorder (PTSD) and of experiencing post-traumatic stress symptoms (PTSS) over 4 years after seeking an abortion, and to assess whether symptoms are attributed to the pregnancy, abortion or birth, or other events in women's lives. Design Prospective longitudinal cohort study which followed women from approximately 1 week after receiving or being denied an abortion (baseline), then every 6 months for 4 years (9 interview waves). Setting 30 abortion facilities located throughout the USA. Participants Among 956 women presenting for abortion care, some of whom received an abortion and some of whom were denied due to advanced gestational age; 863 women are included in the longitudinal analyses. Main outcome measures PTSS and PTSD risk were measured using the Primary Care PTSD Screen (PC-PTSD). Index pregnancy-related PTSS was measured by coding the event(s) described by women as the cause of their symptoms. Analyses We used unadjusted and adjusted logistic mixed-effects regression analyses to assess whether PTSS, PTSD risk and pregnancy-related PTSS trajectories of women obtaining abortions differed from those who were denied one. Results At baseline, 39% of participants reported any PTSS and 16% reported three or more symptoms. Among women with symptoms 1-week post-abortion seeking (n=338), 30% said their symptoms were due to experiences of sexual, physical or emotional abuse or violence; 20% attributed their symptoms to non-violent relationship issues; and 19% said they were due to the index pregnancy. Baseline levels of PTSS, PTSD risk and pregnancy-related PTSS outcomes did not differ significantly between women who received and women who were denied an abortion. PTSS, PTSD risk and pregnancy-related PTSS declined over time for all study groups. Conclusions Women who received an abortion were at no higher risk of PTSD than women denied an abortion. PMID:26832431

Falling Down on the Job: Evaluation and Treatment of Fall Risk Among Older Adults With Upper Extremity Fragility Fractures

PubMed Central

Colla, Carrie H.; Carmichael, Donald; Tosteson, Anna N. A.; Tosteson, Tor D.; Bell, John-Erik; Cantu, Robert V.; Lurie, Jonathan D.; Bynum, Julie P. W.

2017-01-01

Abstract Background: Clinical practice guidelines recommend fall risk assessment and intervention for older adults who sustain a fall-related injury to prevent future injury and mobility decline. Objective: The aim of this study was to describe how often Medicare beneficiaries with upper extremity fracture receive evaluation and treatment for fall risk. Design: Observational cohort. Methods: Participants were fee-for-service beneficiaries age 66 to 99 treated as outpatients for proximal humerus or distal radius/ulna (“wrist”) fragility fractures. -Participants were studied using Carrier and Outpatient Hospital files. The proportion of patients evaluated or treated for fall risk up to 6 months after proximal humerus or wrist fracture from 2007–2009 was examined based on evaluation, treatment, and diagnosis codes. Time to evaluation and number of treatment sessions were calculated. Logistic regression was used to analyze patient characteristics that predicted receiving evaluation or treatment. Narrow (gait training) and broad (gait training or therapeutic exercise) definitions of service were used. Results: There were 309,947 beneficiaries who sustained proximal humerus (32%) or wrist fracture (68%); 10.7% received evaluation or treatment for fall risk or gait issues (humerus: 14.2%; wrist: 9.0%). Using the broader definition, the percentage increased to 18.5% (humerus: 23.4%; wrist: 16.3%). Factors associated with higher likelihood of services after fracture were: evaluation or treatment for falls or gait prior to fracture, more comorbidities, prior nursing home stay, older age, humerus fracture (vs wrist), female sex, and white race. Limitations: Claims analysis may underestimate physician and physical therapist fall assessments, but it is not likely to qualitatively change the results. Conclusions: A small proportion of older adults with upper extremity fracture received fall risk assessment and treatment. Providers and health systems must advance efforts to provide timely evidence-based management of fall risk in this population. PMID:28340130

Stochastic Plume Simulations for the Fukushima Accident and the Deep Water Horizon Oil Spill

NASA Astrophysics Data System (ADS)

Coelho, E.; Peggion, G.; Rowley, C.; Hogan, P.

2012-04-01

The Fukushima Dai-ichi power plant suffered damage leading to radioactive contamination of coastal waters. Major issues in characterizing the extent of the affected waters were a poor knowledge of the radiation released to the coastal waters and the rather complex coastal dynamics of the region, not deterministically captured by the available prediction systems. Equivalently, during the Gulf of Mexico Deep Water Horizon oil platform accident in April 2010, significant amounts of oil and gas were released from the ocean floor. For this case, issues in mapping and predicting the extent of the affected waters in real-time were a poor knowledge of the actual amounts of oil reaching the surface and the fact that coastal dynamics over the region were not deterministically captured by the available prediction systems. To assess the ocean regions and times that were most likely affected by these accidents while capturing the above sources of uncertainty, ensembles of the Navy Coastal Ocean Model (NCOM) were configured over the two regions (NE Japan and Northern Gulf of Mexico). For the Fukushima case tracers were released on each ensemble member; their locations at each instant provided reference positions of water volumes where the signature of water released from the plant could be found. For the Deep Water Horizon oil spill case each ensemble member was coupled with a diffusion-advection solution to estimate possible scenarios of oil concentrations using perturbed estimates of the released amounts as the source terms at the surface. Stochastic plumes were then defined using a Risk Assessment Code (RAC) analysis that associates a number from 1 to 5 to each grid point, determined by the likelihood of having tracer particle within short ranges (for the Fukushima case), hence defining the high risk areas and those recommended for monitoring. For the Oil Spill case the RAC codes were determined by the likelihood of reaching oil concentrations as defined in the Bonn Agreement Oil Appearance Code. The likelihoods were taken in both cases from probability distribution functions derived from the ensemble runs. Results were compared with a control-deterministic solution and checked against available reports to assess their skill in capturing the actual observed plumes and other in-situ data, as well as their relevance for planning surveys and reconnaissance flights for both cases.

Parents' Assessments of Disability in Their Children Using World Health Organization International Classification of Functioning, Disability and Health, Child and Youth Version Joined Body Functions and Activity Codes Related to Everyday Life.

PubMed

Illum, Niels Ove; Gradel, Kim Oren

2017-01-01

To help parents assess disability in their own children using World Health Organization (WHO) International Classification of Functioning, Disability and Health, Child and Youth Version (ICF-CY) code qualifier scoring and to assess the validity and reliability of the data sets obtained. Parents of 162 children with spina bifida, spinal muscular atrophy, muscular disorders, cerebral palsy, visual impairment, hearing impairment, mental disability, or disability following brain tumours performed scoring for 26 body functions qualifiers (b codes) and activities and participation qualifiers (d codes). Scoring was repeated after 6 months. Psychometric and Rasch data analysis was undertaken. The initial and repeated data had Cronbach α of 0.96 and 0.97, respectively. Inter-code correlation was 0.54 (range: 0.23-0.91) and 0.76 (range: 0.20-0.92). The corrected code-total correlations were 0.72 (range: 0.49-0.83) and 0.75 (range: 0.50-0.87). When repeated, the ICF-CY code qualifier scoring showed a correlation R of 0.90. Rasch analysis of the selected ICF-CY code data demonstrated a mean measure of 0.00 and 0.00, respectively. Code qualifier infit mean square (MNSQ) had a mean of 1.01 and 1.00. The mean corresponding outfit MNSQ was 1.05 and 1.01. The ICF-CY code τ thresholds and category measures were continuous when assessed and reassessed by parents. Participating children had a mean of 56 codes scores (range: 26-130) before and a mean of 55.9 scores (range: 25-125) after repeat. Corresponding measures were -1.10 (range: -5.31 to 5.25) and -1.11 (range: -5.42 to 5.36), respectively. Based on measures obtained at the 2 occasions, the correlation coefficient R was 0.84. The child code map showed coherence of ICF-CY codes at each level. There was continuity in covering the range across disabilities. And, first and foremost, the distribution of codes reflexed a true continuity in disability with codes for motor functions activated first, then codes for cognitive functions, and, finally, codes for more complex functions. Parents can assess their own children in a valid and reliable way, and if the WHO ICF-CY second-level code data set is functioning in a clinically sound way, it can be employed as a tool for identifying the severity of disabilities and for monitoring changes in those disabilities over time. The ICF-CY codes selected in this study might be one cornerstone in forming a national or even international generic set of ICF-CY codes for the benefit of children with disabilities, their parents, and caregivers and for the whole community supporting with children with disabilities on a daily and perpetual basis.

Parents’ Assessments of Disability in Their Children Using World Health Organization International Classification of Functioning, Disability and Health, Child and Youth Version Joined Body Functions and Activity Codes Related to Everyday Life

PubMed Central

Illum, Niels Ove; Gradel, Kim Oren

2017-01-01

AIM To help parents assess disability in their own children using World Health Organization (WHO) International Classification of Functioning, Disability and Health, Child and Youth Version (ICF-CY) code qualifier scoring and to assess the validity and reliability of the data sets obtained. METHOD Parents of 162 children with spina bifida, spinal muscular atrophy, muscular disorders, cerebral palsy, visual impairment, hearing impairment, mental disability, or disability following brain tumours performed scoring for 26 body functions qualifiers (b codes) and activities and participation qualifiers (d codes). Scoring was repeated after 6 months. Psychometric and Rasch data analysis was undertaken. RESULTS The initial and repeated data had Cronbach α of 0.96 and 0.97, respectively. Inter-code correlation was 0.54 (range: 0.23-0.91) and 0.76 (range: 0.20-0.92). The corrected code-total correlations were 0.72 (range: 0.49-0.83) and 0.75 (range: 0.50-0.87). When repeated, the ICF-CY code qualifier scoring showed a correlation R of 0.90. Rasch analysis of the selected ICF-CY code data demonstrated a mean measure of 0.00 and 0.00, respectively. Code qualifier infit mean square (MNSQ) had a mean of 1.01 and 1.00. The mean corresponding outfit MNSQ was 1.05 and 1.01. The ICF-CY code τ thresholds and category measures were continuous when assessed and reassessed by parents. Participating children had a mean of 56 codes scores (range: 26-130) before and a mean of 55.9 scores (range: 25-125) after repeat. Corresponding measures were −1.10 (range: −5.31 to 5.25) and −1.11 (range: −5.42 to 5.36), respectively. Based on measures obtained at the 2 occasions, the correlation coefficient R was 0.84. The child code map showed coherence of ICF-CY codes at each level. There was continuity in covering the range across disabilities. And, first and foremost, the distribution of codes reflexed a true continuity in disability with codes for motor functions activated first, then codes for cognitive functions, and, finally, codes for more complex functions. CONCLUSIONS Parents can assess their own children in a valid and reliable way, and if the WHO ICF-CY second-level code data set is functioning in a clinically sound way, it can be employed as a tool for identifying the severity of disabilities and for monitoring changes in those disabilities over time. The ICF-CY codes selected in this study might be one cornerstone in forming a national or even international generic set of ICF-CY codes for the benefit of children with disabilities, their parents, and caregivers and for the whole community supporting with children with disabilities on a daily and perpetual basis. PMID:28680270

Results of comparative RBMK neutron computation using VNIIEF codes (cell computation, 3D statics, 3D kinetics). Final report

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

Grebennikov, A.N.; Zhitnik, A.K.; Zvenigorodskaya, O.A.

1995-12-31

In conformity with the protocol of the Workshop under Contract {open_quotes}Assessment of RBMK reactor safety using modern Western Codes{close_quotes} VNIIEF performed a neutronics computation series to compare western and VNIIEF codes and assess whether VNIIEF codes are suitable for RBMK type reactor safety assessment computation. The work was carried out in close collaboration with M.I. Rozhdestvensky and L.M. Podlazov, NIKIET employees. The effort involved: (1) cell computations with the WIMS, EKRAN codes (improved modification of the LOMA code) and the S-90 code (VNIIEF Monte Carlo). Cell, polycell, burnup computation; (2) 3D computation of static states with the KORAT-3D and NEUmore » codes and comparison with results of computation with the NESTLE code (USA). The computations were performed in the geometry and using the neutron constants presented by the American party; (3) 3D computation of neutron kinetics with the KORAT-3D and NEU codes. These computations were performed in two formulations, both being developed in collaboration with NIKIET. Formulation of the first problem maximally possibly agrees with one of NESTLE problems and imitates gas bubble travel through a core. The second problem is a model of the RBMK as a whole with imitation of control and protection system controls (CPS) movement in a core.« less

Integrated genomic analysis of recurrence-associated small non-coding RNAs in oesophageal cancer.

PubMed

Jang, Hee-Jin; Lee, Hyun-Sung; Burt, Bryan M; Lee, Geon Kook; Yoon, Kyong-Ah; Park, Yun-Yong; Sohn, Bo Hwa; Kim, Sang Bae; Kim, Moon Soo; Lee, Jong Mog; Joo, Jungnam; Kim, Sang Cheol; Yun, Ju Sik; Na, Kook Joo; Choi, Yoon-La; Park, Jong-Lyul; Kim, Seon-Young; Lee, Yong Sun; Han, Leng; Liang, Han; Mak, Duncan; Burks, Jared K; Zo, Jae Ill; Sugarbaker, David J; Shim, Young Mog; Lee, Ju-Seog

2017-02-01

Oesophageal squamous cell carcinoma (ESCC) is a heterogeneous disease with variable outcomes that are challenging to predict. A better understanding of the biology of ESCC recurrence is needed to improve patient care. Our goal was to identify small non-coding RNAs (sncRNAs) that could predict the likelihood of recurrence after surgical resection and to uncover potential molecular mechanisms that dictate clinical heterogeneity. We developed a robust prediction model for recurrence based on the analysis of the expression profile data of sncRNAs from 108 fresh frozen ESCC specimens as a discovery set and assessment of the associations between sncRNAs and recurrence-free survival (RFS). We also evaluated the mechanistic and therapeutic implications of sncRNA obtained through integrated analysis from multiple datasets. We developed a risk assessment score (RAS) for recurrence with three sncRNAs (microRNA (miR)-223, miR-1269a and nc886) whose expression was significantly associated with RFS in the discovery cohort (n=108). RAS was validated in an independent cohort of 512 patients. In multivariable analysis, RAS was an independent predictor of recurrence (HR, 2.27; 95% CI, 1.26 to 4.09; p=0.007). This signature implies the expression of ΔNp63 and multiple alterations of driver genes like PIK3CA. We suggested therapeutic potentials of immune checkpoint inhibitors in low-risk patients, and Polo-like kinase inhibitors, mammalian target of rapamycin (mTOR) inhibitors, and histone deacetylase inhibitors in high-risk patients. We developed an easy-to-use prognostic model with three sncRNAs as robust prognostic markers for postoperative recurrence of ESCC. We anticipate that such a stratified and systematic, tumour-specific biological approach will potentially contribute to significant improvement in ESCC treatment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Documentation of the Ecological Risk Assessment Computer Model ECORSK.5

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

Anthony F. Gallegos; Gilbert J. Gonzales

1999-06-01

The FORTRAN77 ecological risk computer model--ECORSK.5--has been used to estimate the potential toxicity of surficial deposits of radioactive and non-radioactive contaminants to several threatened and endangered (T and E) species at the Los Alamos National Laboratory (LANL). These analyses to date include preliminary toxicity estimates for the Mexican spotted owl, the American peregrine falcon, the bald eagle, and the southwestern willow flycatcher. This work has been performed as required for the Record of Decision for the construction of the Dual Axis Radiographic Hydrodynamic Test (DARHT) Facility at LANL as part of the Environmental Impact Statement. The model is dependent onmore » the use of the geographic information system and associated software--ARC/INFO--and has been used in conjunction with LANL's Facility for Information Management and Display (FIMAD) contaminant database. The integration of FIMAD data and ARC/INFO using ECORSK.5 allows the generation of spatial information from a gridded area of potential exposure called an Ecological Exposure Unit. ECORSK.5 was used to simulate exposures using a modified Environmental Protection Agency Quotient Method. The model can handle a large number of contaminants within the home range of T and E species. This integration results in the production of hazard indices which, when compared to risk evaluation criteria, estimate the potential for impact from consumption of contaminants in food and ingestion of soil. The assessment is considered a Tier-2 type of analysis. This report summarizes and documents the ECORSK.5 code, the mathematical models used in the development of ECORSK.5, and the input and other requirements for its operation. Other auxiliary FORTRAN 77 codes used for processing and graphing output from ECORSK.5 are also discussed. The reader may refer to reports cited in the introduction to obtain greater detail on past applications of ECORSK.5 and assumptions used in deriving model parameters.« less

A review of football injuries on third and fourth generation artificial turfs compared with natural turf.

PubMed

Williams, Sean; Hume, Patria A; Kara, Stephen

2011-11-01

Football codes (rugby union, soccer, American football) train and play matches on natural and artificial turfs. A review of injuries on different turfs was needed to inform practitioners and sporting bodies on turf-related injury mechanisms and risk factors. Therefore, the aim of this review was to compare the incidence, nature and mechanisms of injuries sustained on newer generation artificial turfs and natural turfs. Electronic databases were searched using the keywords 'artificial turf', 'natural turf', 'grass' and 'inj*'. Delimitation of 120 articles sourced to those addressing injuries in football codes and those using third and fourth generation artificial turfs or natural turfs resulted in 11 experimental papers. These 11 papers provided 20 cohorts that could be assessed using magnitude-based inferences for injury incidence rate ratio calculations pertaining to differences between surfaces. Analysis showed that 16 of the 20 cohorts showed trivial effects for overall incidence rate ratios between surfaces. There was increased risk of ankle injury playing on artificial turf in eight cohorts, with incidence rate ratios from 0.7 to 5.2. Evidence concerning risk of knee injuries on the two surfaces was inconsistent, with incidence rate ratios from 0.4 to 2.8. Two cohorts showed beneficial inferences over the 90% likelihood value for effects of artificial surface on muscle injuries for soccer players; however, there were also two harmful, four unclear and five trivial inferences across the three football codes. Inferences relating to injury severity were inconsistent, with the exception that artificial turf was very likely to have harmful effects for minor injuries in rugby union training and severe injuries in young female soccer players. No clear differences between surfaces were evident in relation to training versus match injuries. Potential mechanisms for differing injury patterns on artificial turf compared with natural turf include increased peak torque and rotational stiffness properties of shoe-surface interfaces, decreased impact attenuation properties of surfaces, differing foot loading patterns and detrimental physiological responses. Changing between surfaces may be a precursor for injury in soccer. In conclusion, studies have provided strong evidence for comparable rates of injury between new generation artificial turfs and natural turfs. An exception is the likely increased risk of ankle injury on third and fourth generation artificial turfs. Therefore, ankle injury prevention strategies must be a priority for athletes who play on artificial turf regularly. Clarification of effects of artificial surfaces on muscle and knee injuries are required given inconsistencies in incidence rate ratios depending on the football code, athlete, gender or match versus training.

An evaluation of the quality of obstetric morbidity coding using an objective assessment tool, the Performance Indicators For Coding Quality (PICQ).

PubMed

Lamb, Mary K; Innes, Kerry; Saad, Patricia; Rust, Julie; Dimitropoulos, Vera; Cumerlato, Megan

The Performance Indicators for Coding Quality (PICQ) is a data quality assessment tool developed by Australia's National Centre for Classification in Health (NCCH). PICQ consists of a number of indicators covering all ICD-10-AM disease chapters, some procedure chapters from the Australian Classification of Health Intervention (ACHI) and some Australian Coding Standards (ACS). The indicators can be used to assess the coding quality of hospital morbidity data by monitoring compliance of coding conventions and ACS; this enables the identification of particular records that may be incorrectly coded, thus providing a measure of data quality. There are 31 obstetric indicators available for the ICD-10-AM Fourth Edition. Twenty of these 31 indicators were classified as Fatal, nine as Warning and two Relative. These indicators were used to examine coding quality of obstetric records in the 2004-2005 financial year Australian national hospital morbidity dataset. Records with obstetric disease or procedure codes listed anywhere in the code string were extracted and exported from the SPSS source file. Data were then imported into a Microsoft Access database table as per PICQ instructions, and run against all Fatal and Warning and Relative (N=31) obstetric PICQ 2006 Fourth Edition Indicators v.5 for the ICD-10- AM Fourth Edition. There were 689,905 gynaecological and obstetric records in the 2004-2005 financial year, of which 1.14% were found to have triggered Fatal degree errors, 3.78% Warning degree errors and 8.35% Relative degree errors. The types of errors include completeness, redundancy, specificity and sequencing problems. It was found that PICQ is a useful initial screening tool for the assessment of ICD-10-AM/ACHI coding quality. The overall quality of codes assigned to obstetric records in the 2004- 2005 Australian national morbidity dataset is of fair quality.

Excessive Consumption of Green Tea as a Risk Factor for Periodontal Disease among Korean Adults.

PubMed

Han, Kyungdo; Hwang, Eunkyung; Park, Jun-Beom

2016-07-02

This study was performed to assess the relationship between the amount of green tea that is consumed and periodontitis. It is based on data obtained from the Korea National Health and Nutrition Examination Survey, conducted between 2008 and 2010. A community periodontal index equal to code 3 was defined as moderate periodontitis, and code 4 was defined as severe periodontitis (n = 16,726). Consumption of green tea less than one cup per day was associated with a decreased prevalence of periodontal disease among Korean adults. The association between the consumption of green tea and periodontal disease was independent of various potential confounding factors, such as age, sex, body mass index, smoking, drinking, exercise, metabolic syndrome, frequency of tooth brushing per day, use of secondary oral products, the number of dental examination per year, diabetes, hypertension, and white blood cell count. Adjusted odds ratio and 95% confidence interval of no consumption was 1.360 (1.156, 1.601) when participants with consumption of two times per week ≤ x < 7 times per week was considered as a reference. However, consumption of one or more cups per day increased the prevalence of moderate and severe periodontitis. In conclusion, excessive consumption of green tea may be considered as a risk factor for periodontal disease among Korean adults.

Excessive Consumption of Green Tea as a Risk Factor for Periodontal Disease among Korean Adults

PubMed Central

Han, Kyungdo; Hwang, Eunkyung; Park, Jun-Beom

2016-01-01

This study was performed to assess the relationship between the amount of green tea that is consumed and periodontitis. It is based on data obtained from the Korea National Health and Nutrition Examination Survey, conducted between 2008 and 2010. A community periodontal index equal to code 3 was defined as moderate periodontitis, and code 4 was defined as severe periodontitis (n = 16,726). Consumption of green tea less than one cup per day was associated with a decreased prevalence of periodontal disease among Korean adults. The association between the consumption of green tea and periodontal disease was independent of various potential confounding factors, such as age, sex, body mass index, smoking, drinking, exercise, metabolic syndrome, frequency of tooth brushing per day, use of secondary oral products, the number of dental examination per year, diabetes, hypertension, and white blood cell count. Adjusted odds ratio and 95% confidence interval of no consumption was 1.360 (1.156, 1.601) when participants with consumption of two times per week ≤ x < 7 times per week was considered as a reference. However, consumption of one or more cups per day increased the prevalence of moderate and severe periodontitis. In conclusion, excessive consumption of green tea may be considered as a risk factor for periodontal disease among Korean adults. PMID:27384581

Kidney Function and Fracture Risk: The Atherosclerosis Risk in Communities (ARIC) Study

PubMed Central

Schneider, Andrea L.C.; Ballew, Shoshana; McAdams DeMarco, Mara; Coresh, Josef; Appel, Lawrence J.; Selvin, Elizabeth; Grams, Morgan E.

2015-01-01

Background People with end-stage renal disease are at high risk of bone fracture. Less is known about fracture risk in milder chronic kidney disease (CKD), and whether CKD-associated fracture risk varies by sex or assessment with alternative kidney markers. Study Design Prospective cohort study. Setting & Participants 10,955 participants from the Atherosclerosis Risk in Communities (ARIC) Study followed up from 1996 to 2011. Predictor Kidney function as assessed by creatinine-based estimated glomerular filtration rate (eGFRcr), urine albumin-creatinine ratio (ACR), and alternative filtration markers. Outcomes Fracture-related hospitalizations determined by diagnostic code. Measurements Baseline kidney markers; hospitalizations identified by self-report during annual telephone contact and active surveillance of local hospital discharge lists. Results Mean age of participants was 63 years, 56% were female, and 22% were black. During a median follow-up of 13 years, there were 722 incident fracture-related hospitalizations. Older age, female sex, and white race were associated with higher risk of fracture (p<0.001). The relationship between eGFRcr and fracture risk was non-linear: below 60 ml/min/1.73 m2, lower eGFRcr was associated with higher fracture risk (adjusted HR per 10 ml/min/1.73 m2 lower, 1.24; 95% CI, 1.05–1.47); there was no statistically significant association above 60 ml/min/1.73 m2 in the primary analysis. In contrast, there was a graded association between other markers of kidney function and subsequent fracture, including ACR (HR per doubling, 1.10; 95% CI, 1.06–1.14), cystatin C–based eGFR (HR per 1-SD decrease, 1.15; 95% CI, 1.06–1.25), and 1/β2-microglobulin (HR per 1-SD decrease, 1.26, 95% CI, 1.15–1.37). Limitations No bone mineral density assessment; one-time measure of kidney function. Conclusions Both low eGFR and higher albuminuria were significant risk factors for fracture in this community-based population. The shape of the association in the upper ranges of eGFR varied by the filtration marker used in estimation. PMID:26250781

Kidney Function and Fracture Risk: The Atherosclerosis Risk in Communities (ARIC) Study.

PubMed

Daya, Natalie; Voskertchian, Annie; Schneider, Andrea L C; Ballew, Shoshana; McAdams DeMarco, Mara; Coresh, Josef; Appel, Lawrence J; Selvin, Elizabeth; Grams, Morgan E

2016-02-01

People with end-stage renal disease are at high risk for bone fracture. Less is known about fracture risk in milder chronic kidney disease and whether chronic kidney disease-associated fracture risk varies by sex or assessment with alternative kidney markers. Prospective cohort study. 10,955 participants from the Atherosclerosis Risk in Communities (ARIC) Study followed up from 1996 to 2011. Kidney function as assessed by creatinine-based estimated glomerular filtration rate (eGFRcr), urine albumin-creatinine ratio, and alternative filtration markers. Fracture-related hospitalizations determined by diagnostic code. Baseline kidney markers; hospitalizations identified by self-report during annual telephone contact and active surveillance of local hospital discharge lists. Mean age of participants was 63 years, 56% were women, and 22% were black. During a median follow-up of 13 years, there were 722 incident fracture-related hospitalizations. Older age, female sex, and white race were associated with higher risk for fracture (P<0.001). The relationship between eGFRcr and fracture risk was nonlinear: <60mL/min/1.73m(2), lower eGFRcr was associated with higher fracture risk (adjusted HR per 10mL/min/1.73m(2) lower, 1.24; 95% CI, 1.05-1.47); there was no statistically significant association for ≥60mL/min/1.73m(2) in the primary analysis. In contrast, there was a graded association between other markers of kidney function and subsequent fracture, including albumin-creatinine ratio (HR per doubling, 1.10; 95% CI, 1.06-1.14), cystatin C-based eGFR (HR per 1-SD decrease, 1.15; 95% CI, 1.06-1.25), and 1/β2-microglobulin (HR per 1-SD decrease, 1.26, 95% CI, 1.15-1.37). No bone mineral density assessment; one-time measurement of kidney function. Both low eGFR and higher albuminuria were significant risk factors for fracture in this community-based population. The shape of the association in the upper ranges of eGFR varied by the filtration marker used in estimation. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Method for the prediction of the effective dose equivalent to the crew of the International Space Station

NASA Astrophysics Data System (ADS)

El-Jaby, Samy; Tomi, Leena; Sihver, Lembit; Sato, Tatsuhiko; Richardson, Richard B.; Lewis, Brent J.

2014-03-01

This paper describes a methodology for assessing the pre-mission exposure of space crew aboard the International Space Station (ISS) in terms of an effective dose equivalent. In this approach, the PHITS Monte Carlo code was used to assess the particle transport of galactic cosmic radiation (GCR) and trapped radiation for solar maximum and minimum conditions through an aluminum shield thickness. From these predicted spectra, and using fluence-to-dose conversion factors, a scaling ratio of the effective dose equivalent rate to the ICRU ambient dose equivalent rate at a 10 mm depth was determined. Only contributions from secondary neutrons, protons, and alpha particles were considered in this analysis. Measurements made with a tissue equivalent proportional counter (TEPC) located at Service Module panel 327, as captured through a semi-empirical correlation in the ISSCREM code, where then scaled using this conversion factor for prediction of the effective dose equivalent. This analysis shows that at this location within the service module, the total effective dose equivalent is 10-30% less than the total TEPC dose equivalent. Approximately 75-85% of the effective dose equivalent is derived from the GCR. This methodology provides an opportunity for pre-flight predictions of the effective dose equivalent and therefore offers a means to assess the health risks of radiation exposure on ISS flight crew.

Maternal abuse history, postpartum depression, and parenting: links with preschoolers' internalizing problems.

PubMed

Madigan, Sheri; Wade, Mark; Plamondon, Andre; Jenkins, Jennifer

2015-01-01

The current study examined a temporal cascade linking mothers' history of abuse with their children's internalizing difficulties through proximal processes such as maternal postnatal depressive symptoms and responsive parenting. Participants consisted of 490 mother-child dyads assessed at three time points when children were, on average, 2 months old at Time 1 (T1), 18 months at Time 2 (T2), and 36 months at Time 3 (T3). Maternal abuse history and depressive symptoms were assessed via questionnaires at T1. Observations of responsive parenting were collected at T2 and were coded using a validated coding scheme. Children's internalizing difficulties were assessed in the preschool period using averaged parental reports. Path analysis revealed that maternal physical abuse was associated with depressive symptoms postnatally, which were in turn associated with children's internalizing behavior at 36 months of age. We also found that the association between physical abuse history and responsive parenting operated indirectly through maternal depressive symptoms. These findings remained after controlling for covariates including socioeconomic status, child gender, and age. After accounting for physical abuse history, sexual abuse history was not associated with child internalizing problems either directly or indirectly through maternal depressive symptoms and/or parenting behavior. Thus, mothers' physical abuse history is a risk factor for relatively poor mental health, which is itself predictive of both later parenting behavior and children's internalizing problems. © 2015 Michigan Association for Infant Mental Health.

TREM2 is associated with increased risk for Alzheimer's disease in African Americans.

PubMed

Jin, Sheng Chih; Carrasquillo, Minerva M; Benitez, Bruno A; Skorupa, Tara; Carrell, David; Patel, Dwani; Lincoln, Sarah; Krishnan, Siddharth; Kachadoorian, Michaela; Reitz, Christiane; Mayeux, Richard; Wingo, Thomas S; Lah, James J; Levey, Allan I; Murrell, Jill; Hendrie, Hugh; Foroud, Tatiana; Graff-Radford, Neill R; Goate, Alison M; Cruchaga, Carlos; Ertekin-Taner, Nilüfer

2015-04-10

TREM2 encodes for triggering receptor expressed on myeloid cells 2 and has rare, coding variants that associate with risk for late-onset Alzheimer's disease (LOAD) in Caucasians of European and North-American origin. This study evaluated the role of TREM2 in LOAD risk in African-American (AA) subjects. We performed exonic sequencing and validation in two independent cohorts of >800 subjects. We selected six coding variants (p.R47H, p.R62H, p.D87N, p.E151K, p.W191X, and p.L211P) for case-control analyses in a total of 906 LOAD cases vs. 2,487 controls. We identified significant LOAD risk association with p.L211P (p=0.01, OR=1.27, 95%CI=1.05-1.54) and suggestive association with p.W191X (p=0.08, OR=1.35, 95%CI=0.97-1.87). Conditional analysis suggests that p.L211P, which is in linkage disequilibrium with p.W191X, may be the stronger variant of the two, but does not rule out independent contribution of the latter. TREM2 p.L211P resides within the cytoplasmic domain and p.W191X is a stop-gain mutation within the shorter TREM-2V transcript. The coding variants within the extracellular domain of TREM2 previously shown to confer LOAD risk in Caucasians were extremely rare in our AA cohort and did not associate with LOAD risk. Our findings suggest that TREM2 coding variants also confer LOAD risk in AA, but implicate variants within different regions of the gene than those identified for Caucasian subjects. These results underscore the importance of investigating different ethnic populations for disease risk variant discovery, which may uncover allelic heterogeneity with potentially diverse mechanisms of action.

Training health and safety committees to use control banding: lessons learned and opportunities for the United States.

PubMed

Bracker, Anne L; Morse, Timothy F; Simcox, Nancy J

2009-05-01

Control banding (CB) is a control-focused risk management model that has received international attention. CB strategies are designed to control workplace chemical exposures after the completion of a qualitative risk assessment. Connecticut was one of the first states to provide training on how to use this control-focused tool. Joint labor/management teams and individuals from 34 workplaces attended a control banding workshop and learned how to use one CB model, the United Kingdom (UK) Health and Safety Executive's Control of Substances Hazardous to Health (COSHH) Essentials Toolkit. After the initial training program the investigators used follow-up workshops, questionnaires, site visit data, and case studies to evaluate the training curriculum and assess the utility and effectiveness of this CB strategy. We found that the model is easily learned, although several areas for improvement were identified. Participants from 10 workplaces used COSHH Essentials to evaluate at least one task. The training curriculum was effective in that the agreement between the exposure variables coded by these workplaces and one of the workshop instructors, a certified industrial hygienist (CIH), were highly concordant. The training curriculum and the model promoted a discussion of risk between workers and managers and resulted in the implementation of improvements in the work environment. The model agreed with both the CIH's and the worksites' qualitative risk assessments 65% of the time, and likely over-controlled for 71% (5/7) of the cases of nonagreement. Feedback from workshop participants benefits the current dialogue on the implications of implementing CB in the United States.

Progress in The Semantic Analysis of Scientific Code

NASA Technical Reports Server (NTRS)

Stewart, Mark

2000-01-01

This paper concerns a procedure that analyzes aspects of the meaning or semantics of scientific and engineering code. This procedure involves taking a user's existing code, adding semantic declarations for some primitive variables, and parsing this annotated code using multiple, independent expert parsers. These semantic parsers encode domain knowledge and recognize formulae in different disciplines including physics, numerical methods, mathematics, and geometry. The parsers will automatically recognize and document some static, semantic concepts and help locate some program semantic errors. These techniques may apply to a wider range of scientific codes. If so, the techniques could reduce the time, risk, and effort required to develop and modify scientific codes.

Probabilistic Anthrax Risk Assessment Tool v. 1.0

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

Knowlton, Robert; Hubbard, Josh

PARAT is a human health risk assessment tool for quantifying the uncertainty associated with inhalational exposures to Bacillus anthracis (Ba), which is the causative agent for contracting anthrax. The tool has a unique set of aerosol transport algorithms to account for indoor-outdoor deposition, re-aerosolization, building infiltration/exfiltration, and ventilation system effects, all of which are coded to preserve mass. PARAT is currently implemented within a Microsoft Excel application along with the Crystal Ball third-party add-on software that provides a Monte Carlo simulation technique for quantifying uncertainty in model predictions. The tool predicts both air and surface concentrations, as well as themore » fraction of the population that would contract a lethal dose from exposure to Ba. The tool can be used by decision makers to support Preliminary Remediaiton Goals (PRGs) to guide sampling and decontamination decisions after a release of Ba. Currently the de facto standard for recovery from a Ba release is a sampling protocol whereby all of the surface samples sent to a laboratory have to meet the requirement of “no culturable growth” on the media. This could lead to some very costly cleanups, as was evidenced following the 2001 anthrax letter attack responses. So PARAT may provide decision makers and risk assessors the ability to negotiate risk-based endpoints for the recovery process.« less

The Space Shuttle Program Pre-Flight Meteoroid and Orbital Debris Risk/Damage Predictions and Post-Flight Damage Assessments

NASA Technical Reports Server (NTRS)

Levin, George M.; Christiansen, Eric L.

1997-01-01

The pre-flight predictions and postflight assessments carried out in relation to a series of Space Shuttle missions are reviewed, and data are presented for the meteoroid and orbital debris damage observed on the Hubble Space Telescope during the 1994 Hubble repair mission. Pre-flight collision risk analyses are carried out prior to each mission, and in the case of an unacceptable risk, the mission profile is altered until the risk is considered to be acceptable. The NASA's BUMPER code is used to compute the probability of damage from debris and meteoroid particle impacts based on the Poisson statistical model for random events. The penetration probability calculation requires information concerning the geometry of the critical systems, the penetration resistance and mission profile parameters. Following each flight, the orbiter is inspected for meteoroid and space debris damage. The emphasis is on areas such as the radiator panels, the windows and the reinforced carbon-carbon structures on the leading wing edges and on the nose cap. The contents of damage craters are analyzed using a scanning electron microscope to determine the nature and origin of the impactor. Hypervelocity impact tests are often performed to simulate the observed damage and to estimate the nature of the damaging particles. The number and type of damage observed provides information concerning the orbital debris environment.

A new approach to assessing affect and the emotional implications of personal genomic testing for common disease risk.

PubMed

O'Neill, Suzanne C; Tercyak, Kenneth P; Baytop, Chanza; Hensley Alford, Sharon; McBride, Colleen M

2015-01-01

Personal genomic testing (PGT) for common disease risk is becoming increasingly frequent, but little is known about people's array of emotional reactions to learning their genomic risk profiles and the psychological harms/benefits of PGT. We conducted a study of post-PGT affect, including positive, neutral, and negative states that may arise after testing. A total of 228 healthy adults received PGT for common disease variants and completed a semistructured research interview within 2 weeks of disclosure. The study participants reported how the PGT results made them feel in their own words. Using an iterative coding process, the responses were organized into three broad affective categories: negative, neutral, and positive affect. Neutral affect was the most prevalent response (53.9%), followed by positive affect (26.9%) and negative affect (19.2%). We found no differences by gender, race, or education. While <20% of participants reported negative affect in response to learning their genomic risk profile for common diseases, a majority experienced either neutral or positive emotions. These findings contribute to the growing evidence that PGT does not impose significant psychological harms. Moreover, they point to a need to better link theories and assessments in both emotional and cognitive processing to capitalize on PGT information for healthy behavior change. © 2015 S. Karger AG, Basel.

Towards Improved Considerations of Risk in Seismic Design (Plinius Medal Lecture)

NASA Astrophysics Data System (ADS)

Sullivan, T. J.

2012-04-01

The aftermath of recent earthquakes is a reminder that seismic risk is a very relevant issue for our communities. Implicit within the seismic design standards currently in place around the world is that minimum acceptable levels of seismic risk will be ensured through design in accordance with the codes. All the same, none of the design standards specify what the minimum acceptable level of seismic risk actually is. Instead, a series of deterministic limit states are set which engineers then demonstrate are satisfied for their structure, typically through the use of elastic dynamic analyses adjusted to account for non-linear response using a set of empirical correction factors. From the early nineties the seismic engineering community has begun to recognise numerous fundamental shortcomings with such seismic design procedures in modern codes. Deficiencies include the use of elastic dynamic analysis for the prediction of inelastic force distributions, the assignment of uniform behaviour factors for structural typologies irrespective of the structural proportions and expected deformation demands, and the assumption that hysteretic properties of a structure do not affect the seismic displacement demands, amongst other things. In light of this a number of possibilities have emerged for improved control of risk through seismic design, with several innovative displacement-based seismic design methods now well developed. For a specific seismic design intensity, such methods provide a more rational means of controlling the response of a structure to satisfy performance limit states. While the development of such methodologies does mark a significant step forward for the control of seismic risk, they do not, on their own, identify the seismic risk of a newly designed structure. In the U.S. a rather elaborate performance-based earthquake engineering (PBEE) framework is under development, with the aim of providing seismic loss estimates for new buildings. The PBEE framework consists of the following four main analysis stages: (i) probabilistic seismic hazard analysis to give the mean occurrence rate of earthquake events having an intensity greater than a threshold value, (ii) structural analysis to estimate the global structural response, given a certain value of seismic intensity, (iii) damage analysis, in which fragility functions are used to express the probability that a building component exceeds a damage state, as a function of the global structural response, (iv) loss analysis, in which the overall performance is assessed based on the damage state of all components. This final step gives estimates of the mean annual frequency with which various repair cost levels (or other decision variables) are exceeded. The realisation of this framework does suggest that risk-based seismic design is now possible. However, comparing current code approaches with the proposed PBEE framework, it becomes apparent that mainstream consulting engineers would have to go through a massive learning curve in order to apply the new procedures in practice. With this in mind, it is proposed that simplified loss-based seismic design procedures are a logical means of helping the engineering profession transition from what are largely deterministic seismic design procedures in current codes, to more rational risk-based seismic design methodologies. Examples are provided to illustrate the likely benefits of adopting loss-based seismic design approaches in practice.

Risk of Sjögren's syndrome in Taiwanese female adults with irregular menstrual cycles: a population-based case-control study.

PubMed

Lu, Ming-Chi; Hsieh, Min-Chih; Koo, Malcolm; Lai, Ning-Sheng

2016-01-01

Primary Sjögren's syndrome (pSS) is a progressive systemic autoimmune disorder with a strong female predominance. Hormonal influences are thought to play a role in the development of pSS. However, no studies have specifically evaluated the association between irregular menstrual cycles and pSS. Therefore, using a health claims database, this study investigated the risk of pSS in women with irregular menstrual cycles. We conducted a case-control study using the Taiwan's National Health Insurance Research Database. A total of 360 patients diagnosed with pSS (International Classification of Diseases, ninth revision, clinical modification, ICD-9-CM code 710.2) between 2001 and 2012 were identified. Controls were frequency-matched at a rate of 5:1 to the cases by five-year age interval and index year. Both cases and controls were retrospectively traced back until 2001 for the diagnosis of irregular menstrual cycles (ICD-9-CM code 626.4). The risk of pSS was assessed using multivariate logistic regression analyses. Irregular menstrual cycles were significantly associated with pSS [adjusted odds ratio, (AOR) = 1.38, p = 0.027], after adjusted for insured amount, urbanization level, and thyroid disorder. In addition, when the data were stratified by three age categories, only the patients in the age category of 45-55 years showed significant association between irregular menstrual cycles and pSS (AOR = 1.74, p = 0.005). In this nationwide, population-based case-control study, we found a significant increased risk of pSS in female patients with irregular menstrual cycles, particularly those in their mid-forties to mid-fifties.

Monitoring the safety of quadrivalent human papillomavirus vaccine: findings from the Vaccine Safety Datalink.

PubMed

Gee, Julianne; Naleway, Allison; Shui, Irene; Baggs, James; Yin, Ruihua; Li, Rong; Kulldorff, Martin; Lewis, Edwin; Fireman, Bruce; Daley, Matthew F; Klein, Nicola P; Weintraub, Eric S

2011-10-26

In 7 large managed care organizations (MCOs), we performed a post-licensure safety assessment of quadrivalent human papillomavirus vaccine (HPV4) among 9-26 year-old female vaccine recipients between August 2006 and October 2009. Sequential analyses were conducted weekly to detect associations between HPV4 exposure and pre-specified outcomes. The pre-specified outcomes identified by ICD-9 codes using computerized data at the participating MCOs included: Guillan-Barré Syndrome (GBS), stroke, venous thromboembolism (VTE), appendicitis, seizures, syncope, allergic reactions, and anaphylaxis. For rare outcomes, historical background rates were used as the comparison group. For more common outcomes, a concurrent unexposed comparison group was utilized. A standardized review of medical records was conducted for all cases of GBS, VTE, and anaphylaxis. A total of 600,558 HPV4 doses were administered during the study period. We found no statistically significant increased risk for the outcomes studied. However, a non-statistically significant relative risk (RR) for VTE ICD-9 codes following HPV4 vaccination of 1.98 was detected among females age 9-17 years. Medical record review of all 8 vaccinated potential VTE cases in this age group revealed that 5 met the standard case definition for VTE. All 5 confirmed cases had known risk factors for VTE (oral contraceptive use, coagulation disorders, smoking, obesity or prolonged hospitalization). In a study of over 600,000 HPV4 vaccine doses administered, no statistically significant increased risk for any of the pre-specified adverse events after vaccination was detected. Further study of a possible association with VTE following HPV4 vaccination is warranted. Published by Elsevier Ltd.

Malnutrition in Hospitals: It Was, Is Now, and Must Not Remain a Problem!

PubMed Central

Konturek, Peter C.; Herrmann, Hans J.; Schink, Kristin; Neurath, Markus F.; Zopf, Yurdagül

2015-01-01

Background Malnutrition is an under-recognized problem in hospitalized patients. Despite systematic screening, the prevalence of malnutrition in the hospital did not decrease in the last few decades. The aim of our study was to evaluate the prevalence of malnutrition and to determine the explicit daily calorie intake of hospitalized patients, to identify the risk factors of developing malnutrition during hospitalization and the effect on the financial reimbursement according to the German DRG-system. Material/Methods 815 hospitalized patients were included in this study. The detection of malnutrition was based on the nutritional-risk-screening (NRS) and subjective-global-assessment (SGA) scores. A trained investigator recorded the daily calorie and fluid intake of each patient. Furthermore, clinical parameters, and the financial reimbursement were evaluated. Results The prevalence of malnutrition was 53.6% according to the SGA and 44.6% according the NRS. During hospitalization, patients received on average 759.9±546.8 kcal/day. The prevalence of malnutrition was increased in patients with hepatic and gastrointestinal disease and with depression or dementia. The most important risk factors for malnutrition were bed rest and immobility (OR=5.88, 95% CI 2.25–15.4). In 84.5% of patient records, malnutrition was not correctly coded, leading to increased financial losses according to the DRG-system (94.908 Euros). Conclusions Hospitalized patients suffer from inadequate nutritional therapy and the risk for developing malnutrition rises during the hospital stay. The early screening of patients for malnutrition would not only improve management of nutritional therapy but also, with adequate coding, improve financial reimbursement according to the DRG-system. PMID:26431510

Tackle characteristics and injury in a cross section of rugby union football.

PubMed

McIntosh, Andrew S; Savage, Trevor N; McCrory, Paul; Fréchède, Bertrand O; Wolfe, Rory

2010-05-01

The tackle is the game event in rugby union most associated with injury. This study's main aims were to measure tackle characteristics from video using a qualitative protocol, to assess whether the characteristics differed by level of play, and to measure the associations between tackle characteristics and injury. A cohort study was undertaken. The cohort comprised male rugby players in the following levels: younger than 15 yr, 18 yr, and 20 yr, grade, and elite (Super 12 and Wallabies). All tackle events and technique characteristics were coded in 77 game halves using a standardized qualitative protocol. Game injuries and missed-game injuries were identified and correlated with tackle events. A total of 6618 tackle events, including 81 resulting in a game injury, were observed and coded in the 77 game halves fully analyzed (145 tackle events per hour). An increase in the proportion of active shoulder tackles was observed from younger than 15 yr (13%) to elite (31%). Younger players engaged in more passive tackles and tended to stay on their feet more than experienced players. Younger than 15 yr rugby players had a significantly lower risk of tackle game injury compared with elite players. No specific tackle technique was observed to be associated with a significantly increased risk of game injury. There was a greater risk of game injury associated with two or more tacklers involved in the tackle event, and the greatest risk was associated with simultaneous contact by tacklers, after adjusting for level of play. Tackle characteristics differed between levels of play. The number of tacklers and the sequence of tackler contact with the ball carrier require consideration from an injury prevention perspective.

The Validation of Macro and Micro Observations of Parent-Child Dynamics Using the Relationship Affect Coding System in Early Childhood.

PubMed

Dishion, Thomas J; Mun, Chung Jung; Tein, Jenn-Yun; Kim, Hanjoe; Shaw, Daniel S; Gardner, Frances; Wilson, Melvin N; Peterson, Jenene

2017-04-01

This study examined the validity of micro social observations and macro ratings of parent-child interaction in early to middle childhood. Seven hundred and thirty-one families representing multiple ethnic groups were recruited and screened as at risk in the context of Women, Infant, and Children (WIC) Nutritional Supplement service settings. Families were randomly assigned to the Family Checkup (FCU) intervention or the control condition at age 2 and videotaped in structured interactions in the home at ages 2, 3, 4, and 5. Parent-child interaction videotapes were micro-coded using the Relationship Affect Coding System (RACS) that captures the duration of two mutual dyadic states: positive engagement and coercion. Macro ratings of parenting skills were collected after coding the videotapes to assess parent use of positive behavior support and limit setting skills (or lack thereof). Confirmatory factor analyses revealed that the measurement model of macro ratings of limit setting and positive behavior support was not supported by the data, and thus, were excluded from further analyses. However, there was moderate stability in the families' micro social dynamics across early childhood and it showed significant improvements as a function of random assignment to the FCU. Moreover, parent-child dynamics were predictive of chronic behavior problems as rated by parents in middle childhood, but not emotional problems. We conclude with a discussion of the validity of the RACS and on methodological advantages of micro social coding over the statistical limitations of macro rating observations. Future directions are discussed for observation research in prevention science.

GERMcode: A Stochastic Model for Space Radiation Risk Assessment

NASA Technical Reports Server (NTRS)

Kim, Myung-Hee Y.; Ponomarev, Artem L.; Cucinotta, Francis A.

2012-01-01

A new computer model, the GCR Event-based Risk Model code (GERMcode), was developed to describe biophysical events from high-energy protons and high charge and energy (HZE) particles that have been studied at the NASA Space Radiation Laboratory (NSRL) for the purpose of simulating space radiation biological effects. In the GERMcode, the biophysical description of the passage of HZE particles in tissue and shielding materials is made with a stochastic approach that includes both particle track structure and nuclear interactions. The GERMcode accounts for the major nuclear interaction processes of importance for describing heavy ion beams, including nuclear fragmentation, elastic scattering, and knockout-cascade processes by using the quantum multiple scattering fragmentation (QMSFRG) model. The QMSFRG model has been shown to be in excellent agreement with available experimental data for nuclear fragmentation cross sections. For NSRL applications, the GERMcode evaluates a set of biophysical properties, such as the Poisson distribution of particles or delta-ray hits for a given cellular area and particle dose, the radial dose on tissue, and the frequency distribution of energy deposition in a DNA volume. By utilizing the ProE/Fishbowl ray-tracing analysis, the GERMcode will be used as a bi-directional radiation transport model for future spacecraft shielding analysis in support of Mars mission risk assessments. Recent radiobiological experiments suggest the need for new approaches to risk assessment that include time-dependent biological events due to the signaling times for activation and relaxation of biological processes in cells and tissue. Thus, the tracking of the temporal and spatial distribution of events in tissue is a major goal of the GERMcode in support of the simulation of biological processes important in GCR risk assessments. In order to validate our approach, basic radiobiological responses such as cell survival curves, mutation, chromosomal aberrations, and representative mouse tumor induction curves are implemented into the GERMcode. Extension of these descriptions to other endpoints related to non-targeted effects and biochemical pathway responses will be discussed.

The Contribution of the Dyadic Parent-Child Interaction Coding System (DPICS) Warm-Up Segments in Assessing Parent-Child Interactions

ERIC Educational Resources Information Center

Shanley, Jenelle R.; Niec, Larissa N.

2011-01-01

This study evaluated the inclusion of uncoded segments in the Dyadic Parent-Child Interaction Coding System, an analogue observation of parent-child interactions. The relationships between warm-up and coded segments were assessed, as well as the segments' associations with parent ratings of parent and child behaviors. Sixty-nine non-referred…

Electric shocks at work in Europe: development of a job exposure matrix.

PubMed

Huss, Anke; Vermeulen, Roel; Bowman, Joseph D; Kheifets, Leeka; Kromhout, Hans

2013-04-01

Electric shocks have been suggested as a potential risk factor for neurological disease, in particular for amyotrophic lateral sclerosis. While actual exposure to shocks is difficult to measure, occurrence and variation of electric injuries could serve as an exposure proxy. We assessed risk of electric injury, using occupational accident registries across Europe to develop an electric shock job-exposure-matrix (JEM). Injury data were obtained from five European countries, and the number of workers per occupation and country from EUROSTAT was compiled at a 3-digit International Standard Classification of Occupations 1988 level. We pooled accident rates across countries with a random effects model and categorised jobs into low, medium and high risk based on the 75th and 90th percentile. We next compared our JEM to a JEM that classified extremely low frequency magnetic field exposure of jobs into low, medium and high. Of 116 job codes, occupations with high potential for electric injury exposure were electrical and electronic equipment mechanics and fitters, building frame workers and finishers, machinery mechanics and fitters, metal moulders and welders, assemblers, mining and construction labourers, metal-products machine operators, ships' decks crews and power production and related plant operators. Agreement between the electrical injury and magnetic field JEM was 67.2%. Our JEM classifies occupational titles according to risk of electric injury as a proxy for occurrence of electric shocks. In addition to assessing risk potentially arising from electric shocks, this JEM might contribute to disentangling risks from electric injury from those of extremely low frequency magnetic field exposure.

Beverage Consumption Patterns of Children Born at Different Risk of Obesity

PubMed Central

Kral, Tanja V.E.; Stunkard, Albert J.; Berkowitz, Robert I.; Stallings, Virginia A.; Moore, Reneé H.; Faith, Myles S.

2010-01-01

Background Increased intake of sugar-sweetened beverages and fruit juice has been associated with overweight in children. Objective This study prospectively assessed beverage consumption patterns and their relationship with weight status in a cohort of children born at different risk for obesity. Methods and Procedures Participants were children born at low risk (n = 27) or high risk (n = 22) for obesity based on maternal prepregnancy BMI (kg/m2). Daily beverage consumption was generated from 3-day food records from children aged 3–6 years and coded into seven beverage categories (milk, fruit juice, fruit drinks, caloric and noncaloric soda, soft drinks including and excluding fruit juice). Child anthropometric measures were assessed yearly. Results High-risk children consumed a greater percentage of daily calories from beverages at age 3, more fruit juice at ages 3 and 4, more soft drinks (including fruit juice) at ages 3–5, and more soda at age 6 compared to low-risk children. Longitudinal analyses showed that a greater 3-year increase in soda intake was associated with an increased change in waist circumference, whereas a greater increase in milk intake was associated with a reduced change in waist circumference. There was no significant association between change in intake from any of the beverage categories and change in BMI z-score across analyses. Discussion Children’s familial predisposition to obesity may differentially affect their beverage consumption patterns. Future research should examine the extent to which dietary factors may play a role in pediatric body fat deposition over time. PMID:18535546

Proximity to traffic, ambient air pollution, and community noise in relation to incident rheumatoid arthritis.

PubMed

De Roos, Anneclaire J; Koehoorn, Mieke; Tamburic, Lillian; Davies, Hugh W; Brauer, Michael

2014-10-01

The risk of rheumatoid arthritis (RA) has been associated with living near traffic; however, there is evidence suggesting that air pollution may not be responsible for this association. Noise, another traffic-generated exposure, has not been studied as a risk factor for RA. We investigated proximity to traffic, ambient air pollution, and community noise in relation to RA in the Vancouver and Victoria regions of British Columbia, Canada. Cases and controls were identified in a cohort of adults that was assembled using health insurance registration records. Incident RA cases from 1999 through 2002 were identified by diagnostic codes in combination with prescriptions and type of physician (e.g., rheumatologist). Controls were matched to RA cases by age and sex. Environmental exposures were assigned to each member of the study population by their residential postal code(s). We estimated relative risks using conditional logistic regression, with additional adjustment for median income at the postal code. RA incidence was increased with proximity to traffic, with an odds ratio (OR) of 1.37 (95% CI: 1.11, 1.68) for residence ≤ 50 m from a highway compared with residence > 150 m away. We found no association with traffic-related exposures such as PM2.5, nitrogen oxides, or noise. Ground-level ozone, which was highest in suburban areas, was associated with an increased risk of RA (OR = 1.26; 95% CI: 1.18, 1.36 per interquartile range increase). Our study confirms a previously observed association of RA risk with proximity to traffic and suggests that neither noise levels nor traffic-related air pollutants are responsible for this relationship. Additional investigation of neighborhood and individual correlates of residence near roadways may provide new insight into risk factors for RA.

Adult Mortality Attributable to Preventable Risk Factors for Non-Communicable Diseases and Injuries in Japan: A Comparative Risk Assessment

PubMed Central

Ikeda, Nayu; Inoue, Manami; Iso, Hiroyasu; Ikeda, Shunya; Satoh, Toshihiko; Noda, Mitsuhiko; Mizoue, Tetsuya; Imano, Hironori; Saito, Eiko; Katanoda, Kota; Sobue, Tomotaka; Tsugane, Shoichiro; Naghavi, Mohsen; Ezzati, Majid; Shibuya, Kenji

2012-01-01

Background The population of Japan has achieved the longest life expectancy in the world. To further improve population health, consistent and comparative evidence on mortality attributable to preventable risk factors is necessary for setting priorities for health policies and programs. Although several past studies have quantified the impact of individual risk factors in Japan, to our knowledge no study has assessed and compared the effects of multiple modifiable risk factors for non-communicable diseases and injuries using a standard framework. We estimated the effects of 16 risk factors on cause-specific deaths and life expectancy in Japan. Methods and Findings We obtained data on risk factor exposures from the National Health and Nutrition Survey and epidemiological studies, data on the number of cause-specific deaths from vital records adjusted for ill-defined codes, and data on relative risks from epidemiological studies and meta-analyses. We applied a comparative risk assessment framework to estimate effects of excess risks on deaths and life expectancy at age 40 y. In 2007, tobacco smoking and high blood pressure accounted for 129,000 deaths (95% CI: 115,000–154,000) and 104,000 deaths (95% CI: 86,000–119,000), respectively, followed by physical inactivity (52,000 deaths, 95% CI: 47,000–58,000), high blood glucose (34,000 deaths, 95% CI: 26,000–43,000), high dietary salt intake (34,000 deaths, 95% CI: 27,000–39,000), and alcohol use (31,000 deaths, 95% CI: 28,000–35,000). In recent decades, cancer mortality attributable to tobacco smoking has increased in the elderly, while stroke mortality attributable to high blood pressure has declined. Life expectancy at age 40 y in 2007 would have been extended by 1.4 y for both sexes (men, 95% CI: 1.3–1.6; women, 95% CI: 1.2–1.7) if exposures to multiple cardiovascular risk factors had been reduced to their optimal levels as determined by a theoretical-minimum-risk exposure distribution. Conclusions Tobacco smoking and high blood pressure are the two major risk factors for adult mortality from non-communicable diseases and injuries in Japan. There is a large potential population health gain if multiple risk factors are jointly controlled. Please see later in the article for the Editors' Summary PMID:22291576

PheProb: probabilistic phenotyping using diagnosis codes to improve power for genetic association studies.

PubMed

Sinnott, Jennifer A; Cai, Fiona; Yu, Sheng; Hejblum, Boris P; Hong, Chuan; Kohane, Isaac S; Liao, Katherine P

2018-05-17

Standard approaches for large scale phenotypic screens using electronic health record (EHR) data apply thresholds, such as ≥2 diagnosis codes, to define subjects as having a phenotype. However, the variation in the accuracy of diagnosis codes can impair the power of such screens. Our objective was to develop and evaluate an approach which converts diagnosis codes into a probability of a phenotype (PheProb). We hypothesized that this alternate approach for defining phenotypes would improve power for genetic association studies. The PheProb approach employs unsupervised clustering to separate patients into 2 groups based on diagnosis codes. Subjects are assigned a probability of having the phenotype based on the number of diagnosis codes. This approach was developed using simulated EHR data and tested in a real world EHR cohort. In the latter, we tested the association between low density lipoprotein cholesterol (LDL-C) genetic risk alleles known for association with hyperlipidemia and hyperlipidemia codes (ICD-9 272.x). PheProb and thresholding approaches were compared. Among n = 1462 subjects in the real world EHR cohort, the threshold-based p-values for association between the genetic risk score (GRS) and hyperlipidemia were 0.126 (≥1 code), 0.123 (≥2 codes), and 0.142 (≥3 codes). The PheProb approach produced the expected significant association between the GRS and hyperlipidemia: p = .001. PheProb improves statistical power for association studies relative to standard thresholding approaches by leveraging information about the phenotype in the billing code counts. The PheProb approach has direct applications where efficient approaches are required, such as in Phenome-Wide Association Studies.

[Assessment of Coding in German Diagnosis Related Groups System in Otorhinolaryngology].

PubMed

Ellies, Maik; Anders, Berit; Seger, Wolfgang

2018-05-14

Prospective analysis of assessment reports in otorhinolaryngology for the period 01-03-2011 to 31-03-2017 by the Health Advisory Boards in Lower Saxony and Bremen, Germany in relation to coding in the G-DRG-System. The assessment reports were documented using a standardized database system developed on the basis of the electronic data exchange (DTA) by the Health Advisory Board in Lower Saxony. In addition, the documentation of the assessment reports according to the G-DRG system was used for assessment. Furthermore, the assessment of a case was evaluated once again on the basis of the present assessment documents and presented as an example in detail. During the period from 01-03-2011 to 31-03-2017, a total of 27,424 cases of inpatient assessments of DRGs according to the G-DRG system were collected in the field of otorhinolaryngology. In 7,259 cases, the DRG was changed, and in 20,175 cases, the suspicion of a DRG-relevant coding error was not justified in the review; thus, a DRG change rate of 26% of the assessments was identified over the time period investigated. There were different kinds of coding errors. In order to improve the coding quality in otorhinolaryngology, in addition to the special consideration of the presented "hit list" by the otorhinolaryngology departments, there should be more intensive cooperation between hospitals and the Health Advisory Boards of the federal states. © Georg Thieme Verlag KG Stuttgart · New York.

Recurrent Coding Sequence Variation Explains Only A Small Fraction of the Genetic Architecture of Colorectal Cancer

PubMed Central

Timofeeva, Maria N.; Kinnersley, Ben; Farrington, Susan M.; Whiffin, Nicola; Palles, Claire; Svinti, Victoria; Lloyd, Amy; Gorman, Maggie; Ooi, Li-Yin; Hosking, Fay; Barclay, Ella; Zgaga, Lina; Dobbins, Sara; Martin, Lynn; Theodoratou, Evropi; Broderick, Peter; Tenesa, Albert; Smillie, Claire; Grimes, Graeme; Hayward, Caroline; Campbell, Archie; Porteous, David; Deary, Ian J.; Harris, Sarah E.; Northwood, Emma L.; Barrett, Jennifer H.; Smith, Gillian; Wolf, Roland; Forman, David; Morreau, Hans; Ruano, Dina; Tops, Carli; Wijnen, Juul; Schrumpf, Melanie; Boot, Arnoud; Vasen, Hans F A; Hes, Frederik J.; van Wezel, Tom; Franke, Andre; Lieb, Wolgang; Schafmayer, Clemens; Hampe, Jochen; Buch, Stephan; Propping, Peter; Hemminki, Kari; Försti, Asta; Westers, Helga; Hofstra, Robert; Pinheiro, Manuela; Pinto, Carla; Teixeira, Manuel; Ruiz-Ponte, Clara; Fernández-Rozadilla, Ceres; Carracedo, Angel; Castells, Antoni; Castellví-Bel, Sergi; Campbell, Harry; Bishop, D. Timothy; Tomlinson, Ian P M; Dunlop, Malcolm G.; Houlston, Richard S.

2015-01-01

Whilst common genetic variation in many non-coding genomic regulatory regions are known to impart risk of colorectal cancer (CRC), much of the heritability of CRC remains unexplained. To examine the role of recurrent coding sequence variation in CRC aetiology, we genotyped 12,638 CRCs cases and 29,045 controls from six European populations. Single-variant analysis identified a coding variant (rs3184504) in SH2B3 (12q24) associated with CRC risk (OR = 1.08, P = 3.9 × 10−7), and novel damaging coding variants in 3 genes previously tagged by GWAS efforts; rs16888728 (8q24) in UTP23 (OR = 1.15, P = 1.4 × 10−7); rs6580742 and rs12303082 (12q13) in FAM186A (OR = 1.11, P = 1.2 × 10−7 and OR = 1.09, P = 7.4 × 10−8); rs1129406 (12q13) in ATF1 (OR = 1.11, P = 8.3 × 10−9), all reaching exome-wide significance levels. Gene based tests identified associations between CRC and PCDHGA genes (P < 2.90 × 10−6). We found an excess of rare, damaging variants in base-excision (P = 2.4 × 10−4) and DNA mismatch repair genes (P = 6.1 × 10−4) consistent with a recessive mode of inheritance. This study comprehensively explores the contribution of coding sequence variation to CRC risk, identifying associations with coding variation in 4 genes and PCDHG gene cluster and several candidate recessive alleles. However, these findings suggest that recurrent, low-frequency coding variants account for a minority of the unexplained heritability of CRC. PMID:26553438

Current and anticipated uses of thermalhydraulic and neutronic codes at PSI

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

Aksan, S.N.; Zimmermann, M.A.; Yadigaroglu, G.

1997-07-01

The thermalhydraulic and/or neutronic codes in use at PSI mainly provide the capability to perform deterministic safety analysis for Swiss NPPs and also serve as analysis tools for experimental facilities for LWR and ALWR simulations. In relation to these applications, physical model development and improvements, and assessment of the codes are also essential components of the activities. In this paper, a brief overview is provided on the thermalhydraulic and/or neutronic codes used for safety analysis of LWRs, at PSI, and also of some experiences and applications with these codes. Based on these experiences, additional assessment needs are indicated, together withmore » some model improvement needs. The future needs that could be used to specify both the development of a new code and also improvement of available codes are summarized.« less

RiskChanges Spatial Decision Support system for the analysis of changing multi-hazard risk

NASA Astrophysics Data System (ADS)

van Westen, Cees; Zhang, Kaixi; Bakker, Wim; Andrejchenko, Vera; Berlin, Julian; Olyazadeh, Roya; Cristal, Irina

2015-04-01

Within the framework of the EU FP7 Marie Curie Project CHANGES and the EU FP7 Copernicus project INCREO a spatial decision support system was developed with the aim to analyse the effect of risk reduction planning alternatives on reducing the risk now and in the future, and support decision makers in selecting the best alternatives. Central to the SDSS are the stakeholders. The envisaged users of the system are organizations involved in planning of risk reduction measures, and that have staff capable of visualizing and analyzing spatial data at a municipal scale. The SDSS should be able to function in different countries with different legal frameworks and with organizations with different mandates. These could be subdivided into Civil protection organization with the mandate to design disaster response plans, Expert organizations with the mandate to design structural risk reduction measures (e.g. dams, dikes, check-dams etc), and planning organizations with the mandate to make land development plans. The SDSS can be used in different ways: analyzing the current level of risk, analyzing the best alternatives for risk reduction, the evaluation of the consequences of possible future scenarios to the risk levels, and the evaluation how different risk reduction alternatives will lead to risk reduction under different future scenarios. The SDSS is developed based on open source software and following open standards, for code as well as for data formats and service interfaces. Code development was based upon open source software as well. The architecture of the system is modular. The various parts of the system are loosely coupled, extensible, using standards for interoperability, flexible and web-based. The Spatial Decision Support System is composed of a number of integrated components. The Risk Assessment component allows to carry out spatial risk analysis, with different degrees of complexity, ranging from simple exposure (overlay of hazard and assets maps) to quantitative analysis (using different hazard types, temporal scenarios and vulnerability curves) resulting into risk curves. The platform does not include a component to calculate hazard maps, and existing hazard maps are used as input data for the risk component. The second component of the SDSS is a risk reduction planning component, which forms the core of the platform. This component includes the definition of risk reduction alternatives (related to disaster response planning, risk reduction measures and spatial planning) and links back to the risk assessment module to calculate the new level of risk if the measure is implemented, and a cost-benefit (or cost-effectiveness/ Spatial Multi Criteria Evaluation) component to compare the alternatives and make decision on the optimal one. The third component of the SDSS is a temporal scenario component, which allows to define future scenarios in terms of climate change, land use change and population change, and the time periods for which these scenarios will be made. The component doesn't generate these scenarios but uses input maps for the effect of the scenarios on the hazard and assets maps. The last component is a communication and visualization component, which can compare scenarios and alternatives, not only in the form of maps, but also in other forms (risk curves, tables, graphs)

Meconium exposure and autism risk.

PubMed

Miller, K M; Xing, G; Walker, C K

2017-02-01

This study aims to determine whether fetal meconium passage is associated with autism. This retrospective birth cohort analysis of 9 945 896 children born in California 1991 to 2008 linked discharge diagnosis and procedure codes for prenatal stressors, meconium-stained amniotic fluid (MSAF) and meconium aspiration syndrome (MAS) with autism diagnoses for 47 277 children through 2012. We assessed the relative risk of autism by meconium status using logistic regression, adjusting for demographic and clinical features. Children exposed to meconium (MSAF and MAS) were more likely to be diagnosed with autism in comparison with unexposed children (0.60% and 0.52%, vs 0.47%, respectively). In adjusted analyses, there was a small increase in autism risk associated with MSAF exposure (adjusted relative risk (aRR) 1.18, 95% confidence interval (CI) 1.12 to 1.25), and a marginal association that failed to achieve significance between MAS and autism (aRR 1.08, 95% CI 0.98 to 1.20). Resuscitation of neonates with respiratory compromise from in utero meconium exposure may mitigate long-term neurodevelopmental damage.

Space Radiation Cancer Risks and Uncertainties for Mars Missions

NASA Technical Reports Server (NTRS)

Cucinotta, F. A.; Schimmerling, W.; Wilson, J. W.; Peterson, L. E.; Badhwar, G. D.; Saganti, P. B.; Dicello, J. F.

2001-01-01

Projecting cancer risks from exposure to space radiation is highly uncertain because of the absence of data for humans and because of the limited radiobiology data available for estimating late effects from the high-energy and charge (HZE) ions present in the galactic cosmic rays (GCR). Cancer risk projections involve many biological and physical factors, each of which has a differential range of uncertainty due to the lack of data and knowledge. We discuss an uncertainty assessment within the linear-additivity model using the approach of Monte Carlo sampling from subjective error distributions that represent the lack of knowledge in each factor to quantify the overall uncertainty in risk projections. Calculations are performed using the space radiation environment and transport codes for several Mars mission scenarios. This approach leads to estimates of the uncertainties in cancer risk projections of 400-600% for a Mars mission. The uncertainties in the quality factors are dominant. Using safety standards developed for low-Earth orbit, long-term space missions (>90 days) outside the Earth's magnetic field are currently unacceptable if the confidence levels in risk projections are considered. Because GCR exposures involve multiple particle or delta-ray tracks per cellular array, our results suggest that the shape of the dose response at low dose rates may be an additional uncertainty for estimating space radiation risks.

Documentation of probabilistic fracture mechanics codes used for reactor pressure vessels subjected to pressurized thermal shock loading: Parts 1 and 2. Final report

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

Balkey, K.; Witt, F.J.; Bishop, B.A.

1995-06-01

Significant attention has been focused on the issue of reactor vessel pressurized thermal shock (PTS) for many years. Pressurized thermal shock transient events are characterized by a rapid cooldown at potentially high pressure levels that could lead to a reactor vessel integrity concern for some pressurized water reactors. As a result of regulatory and industry efforts in the early 1980`s, a probabilistic risk assessment methodology has been established to address this concern. Probabilistic fracture mechanics analyses are performed as part of this methodology to determine conditional probability of significant flaw extension for given pressurized thermal shock events. While recent industrymore » efforts are underway to benchmark probabilistic fracture mechanics computer codes that are currently used by the nuclear industry, Part I of this report describes the comparison of two independent computer codes used at the time of the development of the original U.S. Nuclear Regulatory Commission (NRC) pressurized thermal shock rule. The work that was originally performed in 1982 and 1983 to compare the U.S. NRC - VISA and Westinghouse (W) - PFM computer codes has been documented and is provided in Part I of this report. Part II of this report describes the results of more recent industry efforts to benchmark PFM computer codes used by the nuclear industry. This study was conducted as part of the USNRC-EPRI Coordinated Research Program for reviewing the technical basis for pressurized thermal shock (PTS) analyses of the reactor pressure vessel. The work focused on the probabilistic fracture mechanics (PFM) analysis codes and methods used to perform the PTS calculations. An in-depth review of the methodologies was performed to verify the accuracy and adequacy of the various different codes. The review was structured around a series of benchmark sample problems to provide a specific context for discussion and examination of the fracture mechanics methodology.« less

The impact of ICD-9 revascularization procedure codes on estimates of racial disparities in ischemic stroke.

PubMed

Boan, Andrea D; Voeks, Jenifer H; Feng, Wuwei Wayne; Bachman, David L; Jauch, Edward C; Adams, Robert J; Ovbiagele, Bruce; Lackland, Daniel T

2014-01-01

The use of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9) diagnostic codes can identify racial disparities in ischemic stroke hospitalizations; however, inclusion of revascularization procedure codes as acute stroke events may affect the magnitude of the risk difference. This study assesses the impact of excluding revascularization procedure codes in the ICD-9 definition of ischemic stroke, compared with the traditional inclusive definition, on racial disparity estimates for stroke incidence and recurrence. Patients discharged with a diagnosis of ischemic stroke (ICD-9 codes 433.00-434.91 and 436) were identified from a statewide inpatient discharge database from 2010 to 2012. Race-age specific disparity estimates of stroke incidence and recurrence and 1-year cumulative recurrent stroke rates were compared between the routinely used traditional classification and a modified classification of stroke that excluded primary ICD-9 cerebral revascularization procedures codes (38.12, 00.61, and 00.63). The traditional classification identified 7878 stroke hospitalizations, whereas the modified classification resulted in 18% fewer hospitalizations (n = 6444). The age-specific black to white rate ratios were significantly higher in the modified than in the traditional classification for stroke incidence (rate ratio, 1.50; 95% confidence interval [CI], 1.43-1.58 vs. rate ratio, 1.24; 95% CI, 1.18-1.30, respectively). In whites, the 1-year cumulative recurrence rate was significantly reduced by 46% (45-64 years) and 49% (≥ 65 years) in the modified classification, largely explained by a higher rate of cerebral revascularization procedures among whites. There were nonsignificant reductions of 14% (45-64 years) and 19% (≥ 65 years) among blacks. Including cerebral revascularization procedure codes overestimates hospitalization rates for ischemic stroke and significantly underestimates the racial disparity estimates in stroke incidence and recurrence. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Farm Mapping to Assist, Protect, and Prepare Emergency Responders: Farm MAPPER.

PubMed

Reyes, Iris; Rollins, Tami; Mahnke, Andrea; Kadolph, Christopher; Minor, Gerald; Keifer, Matthew

2014-01-01

Responders such as firefighters and emergency medical technicians who respond to farm emergencies often face complex and unknown environments. They may encounter hazards such as fuels, solvents, pesticides, caustics, and exploding gas storage cylinders. Responders may be unaware of dirt roads within the farm that can expedite their arrival at critical sites or snow-covered manure pits that act as hidden hazards. A response to a farm, unless guided by someone familiar with the operation, may present a risk to responders and post a challenge in locating the victim. This project explored the use of a Web-based farm-mapping application optimized for tablets and accessible via easily accessible on-site matrix barcodes, or quick response codes (QR codes), to provide emergency responders with hazard and resource information to agricultural operations. Secured portals were developed for both farmers and responders, allowing both parties to populate and customize farm maps with icons. Data were stored online and linked to QR codes attached to mailbox posts where emergency responders may read them with a mobile device. Mock responses were conducted on dairy farms to test QR code linking efficacy, Web site security, and field usability. Findings from farmer usability tests showed willingness to enter data as well as ease of Web site navigation and data entry even with farmers who had limited computer knowledge. Usability tests with emergency responders showed ease of QR code connectivity to the farm maps and ease of Web site navigation. Further research is needed to improve data security as well as assess the program's applicability to nonfarm environments and integration with existing emergency response systems. The next phases of this project will expand the program for regional and national use, develop QR code-linked, Web-based extrication guidance for farm machinery for victim entrapment rescue, and create QR code-linked online training videos and materials for limited English proficient immigrant farm workers.

A Stochastic Model of Space Radiation Transport as a Tool in the Development of Time-Dependent Risk Assessment

NASA Technical Reports Server (NTRS)

Kim, Myung-Hee Y.; Nounu, Hatem N.; Ponomarev, Artem L.; Cucinotta, Francis A.

2011-01-01

A new computer model, the GCR Event-based Risk Model code (GERMcode), was developed to describe biophysical events from high-energy protons and heavy ions that have been studied at the NASA Space Radiation Laboratory (NSRL) [1] for the purpose of simulating space radiation biological effects. In the GERMcode, the biophysical description of the passage of heavy ions in tissue and shielding materials is made with a stochastic approach that includes both ion track structure and nuclear interactions. The GERMcode accounts for the major nuclear interaction processes of importance for describing heavy ion beams, including nuclear fragmentation, elastic scattering, and knockout-cascade processes by using the quantum multiple scattering fragmentation (QMSFRG) model [2]. The QMSFRG model has been shown to be in excellent agreement with available experimental data for nuclear fragmentation cross sections

How to secure your servers, code and data

ScienceCinema

Lopienski, Sebastian

2018-04-30

Oral presentation in English, slides in English. Advice and best practices regarding the security of your servers, code and data will be presented. We will also describe how the Computer Security Team can help you reduce the risks.

Administrative database research has unique characteristics that can risk biased results.

PubMed

van Walraven, Carl; Austin, Peter

2012-02-01

The provision of health care frequently creates digitized data--such as physician service claims, medication prescription records, and hospitalization abstracts--that can be used to conduct studies termed "administrative database research." While most guidelines for assessing the validity of observational studies apply to administrative database research, the unique data source and analytical opportunities for these studies create risks that can make them uninterpretable or bias their results. Nonsystematic review. The risks of uninterpretable or biased results can be minimized by; providing a robust description of the data tables used, focusing on both why and how they were created; measuring and reporting the accuracy of diagnostic and procedural codes used; distinguishing between clinical significance and statistical significance; properly accounting for any time-dependent nature of variables; and analyzing clustered data properly to explore its influence on study outcomes. This article reviewed these five issues as they pertain to administrative database research to help maximize the utility of these studies for both readers and writers. Copyright © 2012 Elsevier Inc. All rights reserved.

Spatial Risk Assessments Based on Vector-Borne Disease Epidemiologic Data: Importance of Scale for West Nile Virus Disease in Colorado

PubMed Central

Winters, Anna M.; Eisen, Rebecca J.; Delorey, Mark J.; Fischer, Marc; Nasci, Roger S.; Zielinski-Gutierrez, Emily; Moore, Chester G.; Pape, W. John; Eisen, Lars

2010-01-01

We used epidemiologic data for human West Nile virus (WNV) disease in Colorado from 2003 and 2007 to determine 1) the degree to which estimates of vector-borne disease occurrence is influenced by spatial scale of data aggregation (county versus census tract), and 2) the extent of concordance between spatial risk patterns based on case counts versus incidence. Statistical analyses showed that county, compared with census tract, accounted for approximately 50% of the overall variance in WNV disease incidence, and approximately 33% for the subset of cases classified as West Nile neuroinvasive disease. These findings indicate that sub-county scale presentation provides valuable risk information for stakeholders. There was high concordance between spatial patterns of WNV disease incidence and case counts for census tract (83%) but not for county (50%) or zip code (31%). We discuss how these findings impact on practices to develop spatial epidemiologic data for vector-borne diseases and present data to stakeholders. PMID:20439980

Maternal Reflective Functioning among Mothers with Childhood Maltreatment Histories: Links to Sensitive Parenting and Infant Attachment Security

PubMed Central

Stacks, Ann M.; Muzik, Maria; Wong, Kristyn; Beeghly, Marjorie; Huth-Bocks, Alissa; Irwin, Jessica L.; Rosenblum, Katherine L.

2014-01-01

This study examined relationships among maternal reflective functioning, parenting, infant attachment, and demographic risk in a relatively large (N= 83) socioeconomically diverse sample of women with and without a history of childhood maltreatment and their infants. Most prior research on parental reflective functioning has utilized small homogenous samples. Reflective functioning was assessed with the Parent Development Interview, parenting was coded from videotaped mother-child interactions, and infant attachment was evaluated in Ainsworth's Strange Situation by independent teams of reliable coders masked to maternal history. Reflective functioning was associated with parenting sensitivity and secure attachment, and inversely associated with demographic risk and parenting negativity; however, it was not associated with maternal maltreatment history or PTSD. Parenting sensitivity mediated the relationship between reflective functioning and infant attachment, controlling for demographic risk. Findings are discussed in the context of prior research on reflective functioning and the importance of targeting reflective functioning in interventions. PMID:25028251

[Asbestos exposure in the petrochemical industry and interaction with other occupational risk factors: analysis of the last ten years INAIL data].

PubMed

Innocenzi, Mariano; Saldutti, Elisa; Bindi, Luciano; Di Giacobbe, Andrea; Mercadante, Lucina; Innocenzi, Ludovico

2013-01-01

The present study analyzes the trend of occupational diseases, in particular those asbestos-related, in the petrochemical industry from 2002 to 2011, taking into account the number of diseases claimed to and compensated by the National Institute for Insurance of Workplace Accidents and Occupational Diseases (INAIL), assessing risk factors and possible interactions. To identify the research areas, we selected INAIL cost codes, related to the petrochemical industry. In the last five years, over the total claims submitted by industrial workers, 54% of claims for asbestosis, 76.7% of claims for neoplastic diseases, and 78.6% of claims for pleural plaques have been compensated. In the petrochemical industry, such percentages are respectively 59.2%, 81.6% and 82.7%. These data suggest possible interactions between asbestos and other risk factors, particularly significant in the petrochemical industry, although difficult to identify, as well as an initial underestimation of asbestos exposure in this industry.

Benchmarking NNWSI flow and transport codes: COVE 1 results

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

Hayden, N.K.

1985-06-01

The code verification (COVE) activity of the Nevada Nuclear Waste Storage Investigations (NNWSI) Project is the first step in certification of flow and transport codes used for NNWSI performance assessments of a geologic repository for disposing of high-level radioactive wastes. The goals of the COVE activity are (1) to demonstrate and compare the numerical accuracy and sensitivity of certain codes, (2) to identify and resolve problems in running typical NNWSI performance assessment calculations, and (3) to evaluate computer requirements for running the codes. This report describes the work done for COVE 1, the first step in benchmarking some of themore » codes. Isothermal calculations for the COVE 1 benchmarking have been completed using the hydrologic flow codes SAGUARO, TRUST, and GWVIP; the radionuclide transport codes FEMTRAN and TRUMP; and the coupled flow and transport code TRACR3D. This report presents the results of three cases of the benchmarking problem solved for COVE 1, a comparison of the results, questions raised regarding sensitivities to modeling techniques, and conclusions drawn regarding the status and numerical sensitivities of the codes. 30 refs.« less

An Experiment in Scientific Code Semantic Analysis

NASA Technical Reports Server (NTRS)

Stewart, Mark E. M.

1998-01-01

This paper concerns a procedure that analyzes aspects of the meaning or semantics of scientific and engineering code. This procedure involves taking a user's existing code, adding semantic declarations for some primitive variables, and parsing this annotated code using multiple, distributed expert parsers. These semantic parser are designed to recognize formulae in different disciplines including physical and mathematical formulae and geometrical position in a numerical scheme. The parsers will automatically recognize and document some static, semantic concepts and locate some program semantic errors. Results are shown for a subroutine test case and a collection of combustion code routines. This ability to locate some semantic errors and document semantic concepts in scientific and engineering code should reduce the time, risk, and effort of developing and using these codes.

Polymorphism Thr160Thr in SRD5A1, involved in the progesterone metabolism, modifies postmenopausal breast cancer risk associated with menopausal hormone therapy.

PubMed

Hein, R; Abbas, S; Seibold, P; Salazar, R; Flesch-Janys, D; Chang-Claude, J

2012-01-01

Menopausal hormone therapy (MHT) is associated with an increased breast cancer risk in postmenopausal women, with combined estrogen-progestagen therapy posing a greater risk than estrogen monotherapy. However, few studies focused on potential effect modification of MHT-associated breast cancer risk by genetic polymorphisms in the progesterone metabolism. We assessed effect modification of MHT use by five coding single nucleotide polymorphisms (SNPs) in the progesterone metabolizing enzymes AKR1C3 (rs7741), AKR1C4 (rs3829125, rs17134592), and SRD5A1 (rs248793, rs3736316) using a two-center population-based case-control study from Germany with 2,502 postmenopausal breast cancer patients and 4,833 matched controls. An empirical-Bayes procedure that tests for interaction using a weighted combination of the prospective and the retrospective case-control estimators as well as standard prospective logistic regression were applied to assess multiplicative statistical interaction between polymorphisms and duration of MHT use with regard to breast cancer risk assuming a log-additive mode of inheritance. No genetic marginal effects were observed. Breast cancer risk associated with duration of combined therapy was significantly modified by SRD5A1_rs3736316, showing a reduced risk elevation in carriers of the minor allele (p (interaction,empirical-Bayes) = 0.006 using the empirical-Bayes method, p (interaction,logistic regression) = 0.013 using logistic regression). The risk associated with duration of use of monotherapy was increased by AKR1C3_rs7741 in minor allele carriers (p (interaction,empirical-Bayes) = 0.083, p (interaction,logistic regression) = 0.029) and decreased in minor allele carriers of two SNPs in AKR1C4 (rs3829125: p (interaction,empirical-Bayes) = 0.07, p (interaction,logistic regression) = 0.021; rs17134592: p (interaction,empirical-Bayes) = 0.101, p (interaction,logistic regression) = 0.038). After Bonferroni correction for multiple testing only SRD5A1_rs3736316 assessed using the empirical-Bayes method remained significant. Postmenopausal breast cancer risk associated with combined therapy may be modified by genetic variation in SRD5A1. Further well-powered studies are, however, required to replicate our finding.

Comparison of codes assessing galactic cosmic radiation exposure of aircraft crew.

PubMed

Bottollier-Depois, J F; Beck, P; Bennett, B; Bennett, L; Bütikofer, R; Clairand, I; Desorgher, L; Dyer, C; Felsberger, E; Flückiger, E; Hands, A; Kindl, P; Latocha, M; Lewis, B; Leuthold, G; Maczka, T; Mares, V; McCall, M J; O'Brien, K; Rollet, S; Rühm, W; Wissmann, F

2009-10-01

The assessment of the exposure to cosmic radiation onboard aircraft is one of the preoccupations of bodies responsible for radiation protection. Cosmic particle flux is significantly higher onboard aircraft than at ground level and its intensity depends on the solar activity. The dose is usually estimated using codes validated by the experimental data. In this paper, a comparison of various codes is presented, some of them are used routinely, to assess the dose received by the aircraft crew caused by the galactic cosmic radiation. Results are provided for periods close to solar maximum and minimum and for selected flights covering major commercial routes in the world. The overall agreement between the codes, particularly for those routinely used for aircraft crew dosimetry, was better than +/-20 % from the median in all but two cases. The agreement within the codes is considered to be fully satisfactory for radiation protection purposes.

Using mass media and the Internet as tools to diagnose hepatitis C infections in the general population.

PubMed

Zuure, Freke R; Davidovich, Udi; Coutinho, Roel A; Kok, Gerjo; Hoebe, Christian J P A; van den Hoek, Anneke; Jansen, Peter L M; van Leeuwen-Gilbert, Paula; Verheuvel, Nicole C; Weegink, Christine J; Prins, Maria

2011-03-01

Many individuals with hepatitis C virus (HCV) infection are undiagnosed. This study describes the development and the use and outcomes of a mass media campaign, combined with an Internet risk assessment and an Internet-mediated blood-testing procedure for HCV to identify individuals infected with HCV in the general population. From April 2007 to December 2008, individuals in HCV risk groups were referred to an online, previously validated risk-assessment questionnaire at www.heptest.nl. Individuals at risk could download a referral letter for a free, anonymous HCV blood test in a nonclinical setting. Test results could be obtained online, 1 week later, using a personal log-in code. Anti-HCV-positive participants were requested to visit the Public Health Service for confirmation and RNA testing. Chronically HCV-infected individuals were referred for treatment. Data were analyzed in 2009-2010. The website attracted 40,902 visitors. Of the 9653 who completed the questionnaire, 2553 were at risk for HCV (26.4%). Main reported risk factors were a blood transfusion prior to 1992 and noninjecting drug use. Of the 1480 eligible for the blood test, 420 opted for testing (28%). HCV antibodies were detected in 3.6% (n=15, 95% CI=2.1%, 5.7%); of the 12 with a chronic HCV infection, six began treatment. Internet-mediated risk-based testing for HCV has proved to be a feasible and effective strategy to identify undiagnosed HCV infection in the general population. All HCV-infected individuals belonged to hard-to-reach populations. Test uptake was 28%, which is high for an online project that includes blood testing. Because Internet-mediated testing is low-cost, this strategy holds promise for future screening. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Association between long non-coding RNA polymorphisms and cancer risk: a meta-analysis.

PubMed

Huang, Xin; Zhang, Weiyue; Shao, Zengwu

2018-05-25

Several studies have suggested that long non-coding RNA (lncRNA) gene polymorphisms are associated with cancer risk. In the present study, we conducted a meta-analysis related to studies on the association between lncRNA single-nucleotide polymorphisms (SNPs) and the overall risk of cancer. A total 12 SNPs in five common lncRNA genes were finally included in the meta-analysis. In the lncRNA antisense noncoding RNA in the INK4 locus (ANRIL), the rs1333048 A/C, rs4977574 A/G, and rs10757278 A/G polymorphisms, but not rs1333045 C/T, were correlated with overall cancer risk. Our study also demonstrated that other SNPs were correlated with overall cancer risk, namely, metastasis-associated lung adenocarcinoma transcript 1 (MALAT1, rs619586 A/G), HOXA distal transcript antisense RNA (HOTTIP, rs1859168 A/C) and highly up-regulated in liver cancer (HULC, rs7763881 A/C). Moreover, four prostate cancer‑associated non‑coding RNA 1 (PRNCR1, rs16901946 G/A, rs13252298 G/A, rs1016343 T/C, and rs1456315 G/A) SNPs were in association with cancer risk. No association was found between the PRNCR1 (rs7007694 C/T) SNP and the risk of cancer. In conclusion, our results suggest that several studied lncRNA SNPs are associated with overall cancer risk. Therefore, they might be potential predictive biomarkers for the risk of cancer. More studies based on larger sample sizes and more lncRNA SNPs are warranted to confirm these findings. ©2018 The Author(s).

The Meaning of the Child Interview: A new procedure for assessing and understanding parent-child relationships of 'at-risk' families.

PubMed

Grey, Ben; Farnfield, Steve

2017-04-01

Reder and Duncan's well-known studies of the 1990s on fatal child abuse drew attention to how parental scripts regarding their children could dangerously distort relationships in ways that were sometimes fatal to children. This article reports on a new system for assessing the 'meaning of the child to the parent', called the Meaning of the Child Interview (MotC). Parents are interviewed using the established Parent Development Interview, or equivalent, and the transcript of the interview is then analysed according to parental sensitivity and likely risk to the child. The MotC constructs were developed from those used in observed parent-child interaction (specifically, the CARE-Index) and the form of discourse analysis used in the Dynamic Maturational Model - Adult Attachment Interview, allowing a more systemic and inter-subjective understanding of parenting representations than often put forward. This article discusses the theoretical background to the MotC, gives a brief review of similar measures and then introduces the coding system and patterns of caregiving. The validity of the MotC is addressed elsewhere.

Risk Assessment Update: Russian Segment

NASA Technical Reports Server (NTRS)

Christiansen, Eric; Lear, Dana; Hyde, James; Bjorkman, Michael; Hoffman, Kevin

2012-01-01

BUMPER-II version 1.95j source code was provided to RSC-E- and Khrunichev at January 2012 MMOD TIM in Moscow. MEMCxP and ORDEM 3.0 environments implemented as external data files. NASA provided a sample ORDEM 3.0 g."key" & "daf" environment file set for demonstration and benchmarking BUMPER -II v1.95j installation at the Jan-12 TIM. ORDEM 3.0 has been completed and is currently in beta testing. NASA will provide a preliminary set of ORDEM 3.0 ".key" & ".daf" environment files for the years 2012 through 2028. Bumper output files produced using the new ORDEM 3.0 data files are intended for internal use only, not for requirements verification. Output files will contain these words ORDEM FILE DESCRIPTION = PRELIMINARY VERSION: not for production. The projectile density term in many BUMPER-II ballistic limit equations will need to be updated. Cube demo scripts and output files delivered at the Jan-12 TIM have been updated for the new ORDEM 3.0 data files. Risk assessment results based on ORDEM 3.0 and MEM will be presented for the Russian Segment (RS) of ISS.

Assessment of Programming Language Learning Based on Peer Code Review Model: Implementation and Experience Report

ERIC Educational Resources Information Center

Wang, Yanqing; Li, Hang; Feng, Yuqiang; Jiang, Yu; Liu, Ying

2012-01-01

The traditional assessment approach, in which one single written examination counts toward a student's total score, no longer meets new demands of programming language education. Based on a peer code review process model, we developed an online assessment system called "EduPCR" and used a novel approach to assess the learning of computer…

The relation of environmental contaminants exposure to behavioral indicators in Inuit preschoolers in Arctic Quebec.

PubMed

Plusquellec, P; Muckle, G; Dewailly, E; Ayotte, P; Bégin, G; Desrosiers, C; Després, C; Saint-Amour, D; Poitras, K

2010-01-01

Although lead (Pb) exposure has been identified as an important risk factor in child behavioral development, less is known regarding the relation between child behavior and exposure to polychlorinated biphenyls (PCBs) and mercury (Hg). Inuit children are particularly exposed to these chemicals and the aim of this study was to investigate the association between prenatal and postnatal exposure to Pb, PCBs, Hg and several aspects of behavioral function in Inuit preschoolers. The sample consisted of one hundred and ten 5-year-old Inuit children from Arctic Quebec. An umbilical cord blood sample was used to document prenatal exposure to Pb, PCBs and Hg. Child blood samples were collected at age 5 and the same contaminants were measured. A modified version of the Infant Behavior Rating Scale from the Bayley Scales of Infant Development-II was used to assess child behavior through examiners' ratings. Furthermore, attention, activity and emotional outcomes were assessed through behavioral coding of video recordings taken during fine motor testing. Pb exposure during childhood was associated with examiners ratings of greater impulsivity, irritability and with coding of observed inattention. Prenatal exposure to PCB 153 correlated with the examiners ratings of increased state of unhappiness and anxiety during the testing session, which was corroborated from video coding since cord PCB 153 was related to fewer manifestations of positive affects. No association was found with Hg exposure. These data corroborated those from previous Pb cohort studies and revealed an association between prenatal PCBs exposure and emotional outcomes in preschoolers. 2009 Elsevier Inc. All rights reserved.

A Statistical Analysis of a Traffic-Light Food Rating System to Promote Healthy Nutrition and Body Weight.

PubMed

Larrivee, Sandra; Greenway, Frank L; Johnson, William D

2015-06-30

Restaurant eating while optimizing nutrition and maintaining a healthy weight is challenging. Even when nutritional information is available, consumers often consider only calories. A quick and easy method to rate both caloric density and nutrition is an unmet need. A food rating system created to address that need is assessed in this study. The food rating system categorizes food items into 3 color-coded categories: most healthy (green), medium healthy (yellow), or least healthy (red) based on calorie density and general nutritional quality from national guidelines. Nutritional information was downloaded from 20 popular fast-food chains. Nutritional assessments and the 3 color coded categories were compared using the Wilcoxon and Median tests to demonstrate the significance of nutrition differences. Green foods were significantly lower than yellow foods, which in turn were significantly lower than red foods, for calories and calories from fat, in addition to content of total fat, saturated fat and carbohydrates per 100 g serving weight (all P < .02). The green foods had significantly lower cholesterol than the yellow (P = .0006) and red (P < .0001) foods. Yellow foods had less sugar than red foods (P < .0001). Yellow foods were significantly higher in dietary fiber than red foods (P = .001). The food rating color-coded system identifies food items with superior nutrition, and lower caloric density. The smartphone app, incorporating the system, has the potential to improve nutrition; reduce the risk of developing diabetes, hypertension, heart disease, and stroke; and improve public health. © 2015 Diabetes Technology Society.