Science.gov

Sample records for selected high risk

  1. HIGH-RISK PROGRAM: Information on Selected High-Risk Areas.

    DTIC Science & Technology

    2007-11-02

    United States General Accounting Office GAO Information for House MajorityLeader Richard Armey and Representative Pete Sessions May 1997 GH-RISK ID...Information on Selected High-Risk Areas Corporate Author Or Publisher: General Accounting Office, GAO, Washington, DC 20548 Report Number: GAO/IHR-97-30 Report...Library: 000001 Record ID: 45053 GAO United States General Accounting OfficeWashington, D.C. 20548 Accounting and Information Management Division May

  2. Selecting high-risk micro-scale enterprises using a qualitative risk assessment method.

    PubMed

    Kim, Hyunwook; Park, Dong-Uk

    2006-01-01

    Micro-scale enterprises (MSEs) with less than 5 employees are subject to be covered by the scheme of the regular workplace environmental inspection and medical health examination from 2002 in Korea. Due to limited resources as well as vast number of enterprises to be covered, there is an urgent need to focus these efforts to only those high-risk MSEs. To identify them, a qualitative risk assessment methodology was developed combining the hazardous nature of chemicals and exposure potentials as modeled by the HSE and the risk categorization technique by the AIHA. Risk Index (RI) was determined by combining characteristics specific to chemicals and scale of use of the chemicals. The method was applied to 514 MSEs that were selected from a random sample of 4000 MSEs. A total of 170 out of 514 MSEs studied were included in the final analysis. Current status and characteristics of MSEs were identified and RI was assigned to chemicals in each industry. Based on the distribution of RIs, the high-risk MSEs were selected. These include: wood and products of wood, chemicals and chemical products, basic metals, other machinery and equipment, motor vehicles, trailer and semi-trailer manufacturing, and furniture manufacturing. Since these MSEs are high-risk ones, more attentions should be focused on them. This method can be applied to other workplaces with no previous history of quantitative workplace inspections.

  3. Metabolic risk factors in mice divergently selected for BMR fed high fat and high carb diets

    PubMed Central

    Sadowska, Julita; Gębczyński, Andrzej K.; Konarzewski, Marek

    2017-01-01

    Factors affecting contribution of spontaneous physical activity (SPA; activity associated with everyday tasks) to energy balance of humans are not well understood, as it is not clear whether low activity is related to dietary habits, precedes obesity or is a result of thereof. In particular, human studies on SPA and basal metabolic rates (BMR, accounting for >50% of human energy budget) and their associations with diet composition, metabolic thrift and obesity are equivocal. To clarify these ambiguities we used a unique animal model—mice selected for divergent BMR rates (the H-BMR and L-BMR line type) presenting a 50% between-line type difference in the primary selected trait. Males of each line type were divided into three groups and fed either a high fat, high carb or a control diet. They then spent 4 months in individual cages under conditions emulating human “sedentary lifestyle”, with SPA followed every month and measurements of metabolic risk indicators (body fat mass %, blood lipid profile, fasting blood glucose levels and oxidative damage in the livers, kidneys and hearts) taken at the end of study. Mice with genetically determined high BMR assimilated more energy and had higher SPA irrespective of type of diet. H-BMR individuals were characterized by lower dry body fat mass %, better lipid profile and lower fasting blood glucose levels, but higher oxidative damage in the livers and hearts. Genetically determined high BMR may be a protective factor against diet-induced obesity and most of the metabolic syndrome indicators. Elevated spontaneous activity is correlated with high BMR, and constitutes an important factor affecting individual capability to sustain energy balance even under energy dense diets. PMID:28235091

  4. Metabolic risk factors in mice divergently selected for BMR fed high fat and high carb diets.

    PubMed

    Sadowska, Julita; Gębczyński, Andrzej K; Konarzewski, Marek

    2017-01-01

    Factors affecting contribution of spontaneous physical activity (SPA; activity associated with everyday tasks) to energy balance of humans are not well understood, as it is not clear whether low activity is related to dietary habits, precedes obesity or is a result of thereof. In particular, human studies on SPA and basal metabolic rates (BMR, accounting for >50% of human energy budget) and their associations with diet composition, metabolic thrift and obesity are equivocal. To clarify these ambiguities we used a unique animal model-mice selected for divergent BMR rates (the H-BMR and L-BMR line type) presenting a 50% between-line type difference in the primary selected trait. Males of each line type were divided into three groups and fed either a high fat, high carb or a control diet. They then spent 4 months in individual cages under conditions emulating human "sedentary lifestyle", with SPA followed every month and measurements of metabolic risk indicators (body fat mass %, blood lipid profile, fasting blood glucose levels and oxidative damage in the livers, kidneys and hearts) taken at the end of study. Mice with genetically determined high BMR assimilated more energy and had higher SPA irrespective of type of diet. H-BMR individuals were characterized by lower dry body fat mass %, better lipid profile and lower fasting blood glucose levels, but higher oxidative damage in the livers and hearts. Genetically determined high BMR may be a protective factor against diet-induced obesity and most of the metabolic syndrome indicators. Elevated spontaneous activity is correlated with high BMR, and constitutes an important factor affecting individual capability to sustain energy balance even under energy dense diets.

  5. Selective use of post-mastectomy flap irradiation in high-risk breast cancer patients.

    PubMed

    Asgeirsson, Kristjan S; Holroyd, Ben; Morgan, David A L; Robertson, John F R; Blamey, Roger W; Pinder, Sarah E; Macmillan, R Douglas

    2005-08-01

    The incidence of local recurrence after mastectomy can be reduced by chest wall radiotherapy. However, only a minority of patients are at substantial risk. No UK national guidelines exist for the use of mastectomy flap radiotherapy. This study evaluated a protocol, whereby only high-risk patients were treated with post-mastectomy flap radiotherapy; identified histologically by grade, vascular invasion and nodal status. All women treated by simple mastectomy for invasive breast cancer at the Nottingham Breast Unit from January 1993 to December 1995 were studied (n=292). Postoperative flap radiotherapy was given to 147 high-risk women (50.3%). Median follow-up was 76 months. Overall, 12 women (4.1%) developed a chest wall recurrence; six were single spot recurrences and the remaining six were either multiple spot (n=3) or field change (field change dermal invasion, n=3). The chest wall recurrence rate was 2.7% in those treated with radiotherapy. A low rate of local recurrence has been achieved with selective use of mastectomy flap radiotherapy.

  6. CD34-selected allogeneic hematopoietic stem cell transplantation for patients with relapsed, high-risk multiple myeloma

    PubMed Central

    Smith, Eric; Devlin, Sean M.; Orlando, Evelyn; Landau, Heather; Lesokhin, Alex M.; Chung, David J.; Hassoun, Hani; Lendvai, Nikoletta; Landgren, Ola; Giralt, Sergio; Chari, Ajai; Jagannath, Sundar; Koehne, Guenther

    2016-01-01

    We report results of a retrospective analysis of 44 patients with relapsed and high-risk multiple myeloma (MM) undergoing allogeneic CD34-selected hematopoietic stem-cell transplantation (CD34-selected HSCT) from human leukocyte antigen (HLA)-compatible donors. Patients had multiply relapsed disease including relapse at <15 months after autologous transplant and most patients (28/44; 65%) also had high-risk cytogenetics. Before transplant, patients received busulfan (0.8 mg/kg X 10 doses), melphalan (70 mg/m2 X 2 days), fludarabine (25 mg/m2 X 5 days), and rabbit anti-thymocyte globulin (2.5 mg/kg X 2 days). Patients with 10/10 HLA-matched donors were treated prophylactically with low doses of donor lymphocyte infusions (0.5 to 1 X 106 CD3+/kg) starting at 4–6 months post CD34-selected HSCT. Acute (grade II–IV) graph-versus-host disease (GVHD) and transplant-related mortality at 12 months were 2% and 18%, respectively. Chronic GVHD was not observed in any patient. Overall and progression-free survival at 2 years was 54% and 31%, respectively. By multivariate analyses, the outcomes of CD34-selected HSCT were influenced by presence of extramedullary disease, disease status prior to CD34-selected HSCT and age. This study demonstrates notable safety and efficacy of CD34-selected HSCT in patients with multiply relapsed MM including those with high-risk cytogenetics. PMID:26325439

  7. A Selected Review of the Literature on Factors and Conditions Driving the High Risk and Dropout Problem. Policy Studies in Language and Cross Cultural Education.

    ERIC Educational Resources Information Center

    Zachman, Jill M.

    This report presents the findings of a review of 45 selected references on issues associated with high risk students and dropouts. The literature was analyzed according to: (1) the manner in which high risk students and dropouts are characterized; (2) the suggested causes and conditions driving the problems of high risk and dropping out; (3) the…

  8. Impact of high-risk conjunctions on Active Debris Removal target selection

    NASA Astrophysics Data System (ADS)

    Lidtke, Aleksander A.; Lewis, Hugh G.; Armellin, Roberto

    2015-10-01

    Space debris simulations show that if current space launches continue unchanged, spacecraft operations might become difficult in the congested space environment. It has been suggested that Active Debris Removal (ADR) might be necessary in order to prevent such a situation. Selection of objects to be targeted by ADR is considered important because removal of non-relevant objects will unnecessarily increase the cost of ADR. One of the factors to be used in this ADR target selection is the collision probability accumulated by every object. This paper shows the impact of high-probability conjunctions on the collision probability accumulated by individual objects as well as the probability of any collision occurring in orbit. Such conjunctions cannot be predicted far in advance and, consequently, not all the objects that will be involved in such dangerous conjunctions can be removed through ADR. Therefore, a debris remediation method that would address such events at short notice, and thus help prevent likely collisions, is suggested.

  9. A Small Molecule Inhibitor Selectively Induces Apoptosis in Cells Transformed by High Risk Human Papilloma Viruses

    PubMed Central

    Lee, Min S.; Qi, Huilin; Chaniewski, Susan; Zheng, Xiaofan; Farr, Glen A.; Esposito, Kim; Harden, David; Lei, Ming; Schweizer, Liang; Friborg, Jacques; Agler, Michele; McPhee, Fiona; Gentles, Robert; Beno, Brett R.; Chupak, Lou; Mason, Stephen

    2016-01-01

    A phenotypic high-throughput cell culture screen was performed to identify compounds that prevented proliferation of the human Papilloma virus type 16 (HPV-16) transformed cell line Ca Ski. A series of quinoxaline compounds exemplified by Compound 1 was identified. Testing against a panel of cell lines demonstrated that Compound 1 selectively inhibited replication of all HPV-16, HPV-18, and HPV-31 transformed cell lines tested with 50% Inhibitory Concentration (IC50) values of 2 to 8 μM relative to IC50 values of 28 to 73 μM in HPV-negative cell lines. Treatment with Compound 1 resulted in a cascade of multiple apoptotic events, including selective activation of effector caspases 3 and 7, fragmentation of cellular DNA, and PARP (poly(ADP-ribose) polymerase) cleavage in HPV-positive cells relative to HPV-negative cells. Unregulated proliferation of HPV transformed cells is dependent on the viral oncogenes, E6 and E7. Treatment with Compound 1 resulted in a decrease in HPV E7 protein in Ca Ski cells. However, the timing of this reduction relative to other effects of compound treatment suggests that this was a consequence, rather than a cause, of the apoptotic cascade. Likewise, compound treatment resulted in no obvious effects on the E6- and E7- mediated down regulation of p53 and Rb, or their downstream effectors, p21 or PCNA. Further investigation of apoptotic signals induced by Compound 1 revealed cleavage of Caspase-8 in HPV-positive cells as early as 2 hours post-treatment, suggesting the compound initiates apoptosis through the extrinsic, death receptor-mediated, pathway of cell death. These studies provide proof of concept that cells transformed by oncogenic Papillomaviruses can be selectively induced to undergo apoptosis by compound treatment. PMID:27280728

  10. High risk for RSV bronchiolitis in late preterms and selected infants affected by rare disorders: a dilemma of specific prevention.

    PubMed

    Manzoni, P; Paes, B; Resch, B; Mejias, A; Ramilo, O; Carbonell-Estrany, X; Bont, L

    2012-05-01

    Respiratory syncytial virus (RSV) is the most frequent aetiologic agent that causes bronchiolitis and lower respiratory tract infection in infants. These infections may be severe and even life-threatening in selected high-risk populations. Traditional, well-established, high-risk populations are preterm infants with or without chronic lung disease and children with congenital heart disease. For these children, RSV prophylaxis using palivizumab, a monoclonal anti-RSV humanised antibody against the F-protein of RSV, has proven safe and efficacious in preventing RSV-related hospitalisation. Recently, a number of rare medical conditions have been associated with the risk of severe RSV infections. Evidence of safety and efficacy of RSV prophylaxis in these populations is lacking. Given the low incidence of these conditions, randomised trials are not feasible. A practical, opinion-based approach to this dilemma is offered in this paper. It is proposed that these rare disorders may qualify for RSV prophylaxis if the association between a specific condition and the risk of severe RSV infection is confirmed in at least 3 independent publications, of which at least 1 includes a prospective cohort study. To facilitate pharmaco-economic analyses, at least one of the three studies must also report on the absolute risk of severe RSV infection in the specified illness. The authors believe that qualification criteria will enable caregivers to target RSV prophylaxis more effectively in children with rare conditions and the proposed approach provides direction for future epidemiological studies on the risk of severe RSV infection in children with these uncommon, medical illnesses.

  11. Selected class I and class II HLA alleles and haplotypes and risk of high-grade cervical intraepithelial neoplasia.

    PubMed

    Ades, Steven; Koushik, Anita; Duarte-Franco, Eliane; Mansour, Nabil; Arseneau, Jocelyne; Provencher, Diane; Gilbert, Lucy; Gotlieb, Walter; Ferenczy, Alex; Coutlée, François; Roger, Michel; Franco, Eduardo L

    2008-06-15

    Human leukocyte antigens (HLAs) present foreign antigens to the immune system and may be important determinants of cervical neoplasia. Previously published associations between HLA and cervical neoplasia exhibit considerable variation in findings. The biomarkers of cervical cancer risk (BCCR) case-control study addressed the role of specific HLA alleles as cofactors in the development of high-grade cervical intraepithelial neoplasia (HG-CIN) based on the most consistent evidence from published literature. Cases (N = 381) were women with histologically-confirmed HG-CIN attending colposcopy clinics and controls (N = 884) were women from outpatient clinics with normal cytological screening smears. Subjects were mainly of French-Canadian descent. Cervical specimens were tested for human papillomavirus (HPV) DNA and HLA genotypes by PGMY L1 consensus primer PCR and a PCR sequence-specific primer method, respectively. Unlike other studies, the DQB1*03 and DRB1*13 allele groups were not associated with risk of HG-CIN. The B7-DRB1*1501-DQB1*0602 haplotype was associated with a 41% overall reduction in HG-CIN risk (odds ratio [OR] = 0.59; 95% confidence interval [CI]: 0.36-0.96), and an 83% reduction in risk of HG-CIN among HPV 16 or HPV 18-positive subjects (OR = 0.17; 95%CI: 0.05-0.54). Paradoxically, however, the same haplotype was associated with HPV 16/18 infection risk among controls (OR = 8.44, 95%CI: 1.12-63.73). In conclusion, the B7-DRB1*1501-DQB1*0602 haplotype was protective against HG-CIN, especially in individuals infected with oncogenic HPV, but the mechanism of the association seems to involve multiple steps in the natural history of HPV and CIN.

  12. Selectively willing and conditionally able: HIV vaccine trial participation among women at "high risk" of HIV infection.

    PubMed

    Voytek, Chelsea D; Jones, Kevin T; Metzger, David S

    2011-08-18

    Efficacy studies of investigational HIV vaccines require enrollment of individuals at 'high risk' for HIV. This paper examines participation in HIV vaccine trials among women at 'high risk' for HIV acquisition. In-depth interviews were conducted with 17 African-American women who use crack cocaine and/or exchange sex for money/drugs to elicit attitudes toward medical research and motivators and deterrents to HIV vaccine trial participation. Interviews were digitally recorded and transcribed; data were coded and compiled into themes. Most women expressed favorable attitudes toward medical research in general. Motivators for trial participation included compensation; personal benefits including information, social services, and the possibility that the trial vaccine could prevent HIV; and altruism. Deterrents included: dislike of needles; distrust; concern about future consequences of participating. In addition, contingencies, care-giving responsibilities, and convenience issues constituted barriers which could impede participation. Respondents described varied, complex perspectives, and individual cases illustrate how these themes played out as women contemplated trial participation. Understanding factors which influence vaccine research participation among women at 'high risk' can aid sites to tailor recruitment procedures to local contexts. Concerns about future reactions can be addressed through sustained community education. Convenience barriers can be ameliorated by providing rides to study visits when necessary, and/or conducting study visits in accessible neighborhood locations. Women in this sample thought carefully about enrolling in HIV vaccine trials given the structural constraints within which they lived. Further research is needed regarding structural factors which influence personal agency and individuals' thinking about research participation.

  13. [Detecting high risk pregnancy].

    PubMed

    Doret, Muriel; Gaucherand, Pascal

    2009-12-20

    Antenatal care is aiming to reduce maternal land foetal mortality and morbidity. Maternal and foetal mortality can be due to different causes. Their knowledge allows identifying pregnancy (high risk pregnancy) with factors associated with an increased risk for maternal and/or foetal mortality and serious morbidity. Identification of high risk pregnancies and initiation of appropriate treatment and/or surveillance should improve maternal and/or foetal outcome. New risk factors are continuously described thanks to improvement in antenatal care and development in biology and cytopathology, increasing complexity in identifying high risk pregnancies. Level of risk can change all over the pregnancy. Ideally, it should be evaluated prior to the pregnancy and at each antenatal visit. Clinical examination is able to screen for intra-uterin growth restriction, pre-eclampsia, threatened for preterm labour; ultrasounds help in the diagnosis of foetal morphological anomalies, foetal chromosomal anomalies, placenta praevia and abnormal foetal growth; biological exams are used to screen for pre-eclampsia, gestational diabetes, trisomy 21 (for which screening method just changed), rhesus immunisation, seroconversion for toxoplasmosis or rubeola, unknown infectious disease (syphilis, hepatitis B, VIH). During pregnancy, most of the preventive strategies have to be initiated during the first trimester or even before conception. Prevention for neural-tube defects, neonatal hypocalcemia and listeriosis should be performed for all women. On the opposite, some measures are concerning only women with risk factors such as prevention for toxoplasmosis, rhesus immunization (which recently changed), tobacco complications and pre-eclampsia and intra-uterine growth factor restriction.

  14. High-School Dropouts in a Working-Class South African Community: Selected Characteristics and Risk-Taking Behaviour.

    ERIC Educational Resources Information Center

    Flisher, Alan J.; Chalton, Derek O.

    1995-01-01

    Project documented characteristics of teenage school dropouts and then compared the prevalence of risk-taking behavior of dropouts with those attending school. Of the sample (n=548), 15% had dropped out. Those still attending school engaged in suicide behavior more frequently than dropouts whereas the latter abused substances more. (RJM)

  15. Association between highly active antiretroviral therapy and selected cardiovascular disease risk factors in sub-Saharan Africa: a systematic review and meta-analysis protocol

    PubMed Central

    Dimala, Christian Akem; Blencowe, Hannah

    2017-01-01

    Introduction The increasing highly active antiretroviral therapy (HAART) coverage in sub-Saharan Africa (SSA) has been associated with increasing cardiovascular disease (CVD) incidence. However, the epidemiology of the association between HAART and CVD risk factors in SSA is sparse. We aim to assess the extent to which HAART is associated with selected cardiovascular risk factors (hypertension, diabetes, dyslipidaemia and metabolic syndrome) in SSA. Methods and analysis This will be a systematic review and meta-analysis of published studies on the association between HAART and CVD risk factors retrieved from Medline, Embase, Popline, Africa-Wide Information, African Index Medicus and the Cochrane library databases. Studies will be screened for eligibility according to the selection criteria by two independent reviewers. Eligible studies will be assessed for the quality of their evidence and risk of bias using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies of the National Health Institute and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, with respect to the measured outcomes (hypertension, diabetes, dyslipidaemia and metabolic syndrome). A data abstraction form will be produced on Epi info V.7 and data analysis done on STATA V.14 statistical software. Summary estimates of measures of effects for the association between HAART use and the outcomes will be derived. Random effects meta-analyses will be performed and I2 statistic used to assess for heterogeneity between studies with respect to measured parameters. Qualitative synthesis will be used where data is insufficient to produce quantitative synthesis. Ethics and dissemination The protocol has been reviewed by the Research Governance & Integrity Office of the Research Ethics Committee of the London School of Hygiene and Tropical Medicine and confirmed as not requiring ethical approval. The findings of this study will be made widely

  16. No evidence for IL1RAPL1 involvement in selected high-risk autism pedigrees from the AGRE data set.

    PubMed

    Allen-Brady, Kristina; Cai, Guiqing; Cannon, Dale; Robison, Reid; McMahon, William M; Coon, Hilary; Buxbaum, Joseph D

    2011-08-01

    Finding predisposition genes for Autism Spectrum Disorder (ASD) has proven challenging, and new methods are needed to aid the process. Using pedigree structure as a strategy to identify ASD predisposition genes, we previously performed a genome-wide linkage scan of 86 selected families from the Autism Resource Exchange (AGRE) that appeared to inherit ASD in a dominant manner. We identified a suggestive linkage peak on chromosome Xp22.11-p21.2 that encompasses the IL1RAPL1 gene, a strong candidate gene for ASD. In this follow-up study, we sequenced the coding regions of the IL1RAPL1 gene in 14 male cases representing one case from each pedigree that showed at least nominal linkage evidence on per pedigree basis to the chromosome X region. We observed no deleterious mutations or deletions in the IL1RAPL1 gene in these 14 ASD cases. A SNP was identified in exon 2 in five cases and a variant of unknown significance was identified in intron 6 in a single case. In conclusion, coding changes of the IL1RAPL1 gene do not appear to be associated with ASD in selected AGRE families with linkage evidence to the chromosome Xp22.11-p21.2 region.

  17. At-Risk Youth: A Selected Bibliography.

    ERIC Educational Resources Information Center

    Crohn, Leslie

    This select bibliography lists books, articles, and reports, almost all of which were published since 1980, on at-risk youth. The following areas are included: (1) general; (2) dropouts; (3) drug and alcohol abusers; (4) youth offenders; (5) teen parents; (6) young children at risk; and (7) unemployed youth. For each item the following information…

  18. High Selectivity Oxygen Delignification

    SciTech Connect

    Lucian A. Lucia

    2005-11-15

    Project Objective: The objectives of this project are as follows: (1) Examine the physical and chemical characteristics of a partner mill pre- and post-oxygen delignified pulp and compare them to lab generated oxygen delignified pulps; (2) Apply the chemical selectivity enhancement system to the partner pre-oxygen delignified pulps under mill conditions (with and without any predetermined amounts of carryover) to determine how efficiently viscosity is preserved, how well selectivity is enhanced, if strength is improved, measure any yield differences and/or bleachability differences; and (3) Initiate a mill scale oxygen delignification run using the selectivity enhancement agent, collect the mill data, analyze it, and propose any future plans for implementation.

  19. High lift selected concepts

    NASA Technical Reports Server (NTRS)

    Henderson, M. L.

    1979-01-01

    The benefits to high lift system maximum life and, alternatively, to high lift system complexity, of applying analytic design and analysis techniques to the design of high lift sections for flight conditions were determined and two high lift sections were designed to flight conditions. The influence of the high lift section on the sizing and economics of a specific energy efficient transport (EET) was clarified using a computerized sizing technique and an existing advanced airplane design data base. The impact of the best design resulting from the design applications studies on EET sizing and economics were evaluated. Flap technology trade studies, climb and descent studies, and augmented stability studies are included along with a description of the baseline high lift system geometry, a calculation of lift and pitching moment when separation is present, and an inverse boundary layer technique for pressure distribution synthesis and optimization.

  20. High Selectivity Oxygen Delignification

    SciTech Connect

    Arthur J. Ragauskas Lucian A. Lucia Hasan Jameel

    2005-09-30

    The overall objective of this program was to develop improved extended oxygen delignification (EOD) technologies for current U.S. pulp mill operations. This was accomplished by: (1) Identifying pulping conditions that optimize O and OO performance; (2) Identifying structural features of lignin that enhance reactivity towards EOD of high kappa pulps; (3) Identifying factors minimizing carbohydrate degradation and improve pulp strength of EOD high kappa pulps; (4) Developing a simple, reproducible method of quantifying yield gains from EOD; and (5) Developing process conditions that significantly reduce the capital requirements of EOD while optimizing the yield benefits. Key research outcomes included, demonstrating the use of a mini-O sequence such as (E+O)Dkf:0.05(E+O) or Dkf:0.05(E+O)(E+O) without interstage washing could capture approximately 60% of the delignification efficiency of a conventional O-stage without the major capital requirements associated with an O-stage for conventional SW kraft pulps. The rate of formation and loss of fiber charge during an O-stage stage can be employed to maximize net fiber charge. Optimal fiber charge development and delignification are two independent parameters and do not parallel each other. It is possible to utilize an O-stage to enhance overall cellulosic fiber charge of low and high kappa SW kraft pulps which is beneficial for physical strength properties. The application of NIR and multi-variant analysis was developed into a rapid and simple method of determining the yield of pulp from an oxygen delignification stage that has real-world mill applications. A focus point of this program was the demonstration that Kraft pulping conditions and oxygen delignification of high and low-kappa SW and HW pulps are intimately related. Improved physical pulp properties and yield can be delivered by controlling the H-factor and active alkali charge. Low AA softwood kraft pulp with a kappa number 30 has an average improvement of 2% in

  1. Group Selection as Behavioral Adaptation to Systematic Risk

    PubMed Central

    Zhang, Ruixun; Brennan, Thomas J.; Lo, Andrew W.

    2014-01-01

    Despite many compelling applications in economics, sociobiology, and evolutionary psychology, group selection is still one of the most hotly contested ideas in evolutionary biology. Here we propose a simple evolutionary model of behavior and show that what appears to be group selection may, in fact, simply be the consequence of natural selection occurring in stochastic environments with reproductive risks that are correlated across individuals. Those individuals with highly correlated risks will appear to form “groups”, even if their actions are, in fact, totally autonomous, mindless, and, prior to selection, uniformly randomly distributed in the population. This framework implies that a separate theory of group selection is not strictly necessary to explain observed phenomena such as altruism and cooperation. At the same time, it shows that the notion of group selection does captures a unique aspect of evolution—selection with correlated reproductive risk–that may be sufficiently widespread to warrant a separate term for the phenomenon. PMID:25353167

  2. [Access to high-risk families through selected actors of the health care system. Results of an explorative questioning of early childhood intervention pilot projects].

    PubMed

    Renner, I

    2010-10-01

    A requirement for preventive child protection is an early and systematic access to high-risk families. Actors of the health care system, in particular doctors in private practice and midwives, are highly accepted within the population and therefore offer perfect requirements to provide this access. For this reason the aim in the context of early childhood intervention is a close cooperation of the Child and Youth Services with doctors and midwives. To what extent can these service providers of the health care system fulfill these expectations? The National Centre on Early Prevention tried to find an answer to this question with the support of 10 pilot projects which were set up within the framework of the action program "Early Prevention and Intervention for Parents and Children and Social Warning Systems". The comprehensive project presentation of selected results, insights and experiences concerning cooperation between agents of the Child and Youth Services and doctors in private practice and midwives is based on explorative written questioning of the 10 projects. The study shows from the point of view of the pilot projects that the cooperation with freelance midwives is promising. In contrast, the cooperation with doctors in private practice does not yet meet the hopes and expectations. To achieve an improvement of this situation, conditions have to be supported which promote a stronger commitment of the medical profession to early childhood intervention.

  3. Perceptions of high risk sports.

    PubMed

    Pedersen, D M

    1997-10-01

    High risk sports were rated as to risk, appeal, and likelihood of participation by 282 men and 162 women. Ascending order of perceived risk was skiing, scuba diving, bungee jumping, rock climbing, motorcycle racing, hang gliding, cliff jumping, and skydiving. Profile analysis showed stated likelihood of participation to be directly related to appeal and inversely related to perceived risk.

  4. Selecting Students at Risk of Academic Difficulties

    ERIC Educational Resources Information Center

    Cummings, Kelli D.; Smolkowski, Keith

    2015-01-01

    This paper aims to translate for practitioners the principles and methods for evaluating screening measures in education, including benchmark goals and cut points, from our technical manuscript "Evaluation of Diagnostic Systems: The Selection of Students at Risk of Academic Difficulties" (this issue). We offer a brief description of…

  5. Sexual selection and the risk of extinction in birds.

    PubMed Central

    Morrow, Edward H; Pitcher, Trevor E

    2003-01-01

    The relationship between sexual selection and extinction risk has rarely been investigated. This is unfortunate because extinction plays a key role in determining the patterns of species richness seen in extant clades, which form the basis of comparative studies into the role that sexual selection may play in promoting speciation. We investigate the extent to which the perceived risk of extinction relates to four different estimates of sexual selection in 1030 species of birds. We find no evidence that the number of threatened species is distributed unevenly according to a social mating system, and neither of our two measures of pre-mating sexual selection (sexual dimorphism and dichromatism) was related to extinction risk, after controlling for phylogenetic inertia. However, threatened species apparently experience more intense post-mating sexual selection, measured as testis size, than non-threatened species. These results persisted after including body size as a covariate in the analysis, and became even stronger after controlling for clutch size (two known correlates of extinction risk). Sexual selection may therefore be a double-edged process-promoting speciation on one hand but promoting extinction on the other. Furthermore, we suggest that it is post-mating sexual selection, in particular, that is responsible for the negative effect of sexual selection on clade size. Why this might be is unclear, but the mean population fitness of species with high intensities of post-mating sexual selection may be especially low if costs associated with multiple mating are high or if the selection load imposed by post-mating selection is higher relative to that of pre-mating sexual selection. PMID:12964981

  6. Selected Risk and Protective Factors Associated with Two or More Lifetime Sexual Intercourse Partners and Non-Condom Use during Last Coitus among U.S. Rural High School Students

    ERIC Educational Resources Information Center

    Yarber, William L.; Milhausen, Robin; Crosby, Richard A.; DiClemente, Ralph J.

    2002-01-01

    This analysis determined the association between 13 selected health risk and protective factors and reporting two or more lifetime sexual intercourse partners and non-condom use for last coitus among sexually experienced U.S. rural high school students. The sample was 569 sexually experienced adolescent females and 561 sexually experienced…

  7. SADA: Ecological Risk Based Decision Support System for Selective Remediation

    EPA Science Inventory

    Spatial Analysis and Decision Assistance (SADA) is freeware that implements terrestrial ecological risk assessment and yields a selective remediation design using its integral geographical information system, based on ecological and risk assessment inputs. Selective remediation ...

  8. NS-018, a selective JAK2 inhibitor, preferentially inhibits CFU-GM colony formation by bone marrow mononuclear cells from high-risk myelodysplastic syndrome patients.

    PubMed

    Kuroda, Junya; Kodama, Ayumi; Chinen, Yoshiaki; Shimura, Yuji; Mizutani, Shinsuke; Nagoshi, Hisao; Kobayashi, Tsutomu; Matsumoto, Yosuke; Nakaya, Yohei; Tamura, Ayako; Kobayashi, Yutaka; Naito, Haruna; Taniwaki, Masafumi

    2014-05-01

    JAK2/STAT signaling promotes survival and expansion of myelodysplastic syndrome (MDS) clones, but little is known about the potential of JAK2/STAT as a therapeutic target in MDS. We investigated the effect of NS-018, a novel antagonist for JAK2, on the colony-forming ability of bone marrow mononuclear cells (BMMNCs) from high-risk MDS patients. NS-018 decreased colony-forming unit-granulocyte/macrophage (CFU-GM) colony numbers from MDS-derived BMMNCs in a dose-dependent manner, and this effect was significantly more potent than against normal BMMNCs. In addition, NS-018 suppressed the phosphorylation of STAT3 in colony-forming cells from MDS patients. Collectively, NS-018 could be a new therapeutic option for high-risk MDS.

  9. Risk-based audit selection of dairy farms.

    PubMed

    van Asseldonk, M A P M; Velthuis, A G J

    2014-02-01

    Dairy farms are audited in the Netherlands on numerous process standards. Each farm is audited once every 2 years. Increasing demands for cost-effectiveness in farm audits can be met by introducing risk-based principles. This implies targeting subpopulations with a higher risk of poor process standards. To select farms for an audit that present higher risks, a statistical analysis was conducted to test the relationship between the outcome of farm audits and bulk milk laboratory results before the audit. The analysis comprised 28,358 farm audits and all conducted laboratory tests of bulk milk samples 12 mo before the audit. The overall outcome of each farm audit was classified as approved or rejected. Laboratory results included somatic cell count (SCC), total bacterial count (TBC), antimicrobial drug residues (ADR), level of butyric acid spores (BAB), freezing point depression (FPD), level of free fatty acids (FFA), and cleanliness of the milk (CLN). The bulk milk laboratory results were significantly related to audit outcomes. Rejected audits are likely to occur on dairy farms with higher mean levels of SCC, TBC, ADR, and BAB. Moreover, in a multivariable model, maxima for TBC, SCC, and FPD as well as standard deviations for TBC and FPD are risk factors for negative audit outcomes. The efficiency curve of a risk-based selection approach, on the basis of the derived regression results, dominated the current random selection approach. To capture 25, 50, or 75% of the population with poor process standards (i.e., audit outcome of rejected), respectively, only 8, 20, or 47% of the population had to be sampled based on a risk-based selection approach. Milk quality information can thus be used to preselect high-risk farms to be audited more frequently.

  10. [A successfully procedure for the high risk redo-aortic valve replacement under profound hypothermic circulatory arrest and selective cerebral perfusion].

    PubMed

    Tanaka, T; Watanabe, T; Koike, H; Nakamura, M; Abe, T

    1998-07-01

    A 45-year-old female with atypical coactation of aorta and aortic regurgitation was treated with aortic valve replacement and extra-anastomic bypass between the ascending aorta and the left common iliac artery using a 12 mm woven dacron graft in 1978. She had complained of palpitation and shortness of breath six years after surgery, cinefluoroscopy demonstrated prosthetic valve dysfunction. Thrombolytic therapy was carried out to improve the valve function, but it did not result in improvement. Therefore, we decided to proceed with re-surgery. During a median sternotomy, massive bleeding from the substernal graft occurred. Therefore, we abandoned the re-surgery at that time. Then, her general condition was getting worse and she had occasional pulmonary edema fifteen years after the initial surgery. She finally underwent redo-aortic valve replacement with the aid of profound hypothermic circulatory arrest and selective cerebral perfusion. There was no cerebral complication after the re-surgery and she is now leading normal life. A median sternotomy under profound hypothermic circulatory arrest and selective cerebral perfusion was a very useful and safe procedure for patients who had risks of inadvertent injury to the aorta or the heart during the re-surgery.

  11. Preoperative Chemotherapy in Patients With Intermediate-Risk Rectal Adenocarcinoma Selected by High-Resolution Magnetic Resonance Imaging: The GEMCAD 0801 Phase II Multicenter Trial

    PubMed Central

    Brown, Gina; Estevan, Rafael; Salud, Antonieta; Montagut, Clara; Maurel, Joan; Safont, Maria Jose; Aparicio, Jorge; Feliu, Jaime; Vera, Ruth; Alonso, Vicente; Gallego, Javier; Martin, Marta; Pera, Miguel; Sierra, Enrique; Serra, Javier; Delgado, Salvadora; Roig, Jose V.; Santos, Jesus; Pericay, Carles

    2014-01-01

    Background. The need for preoperative chemoradiation or short-course radiation in all T3 rectal tumors is a controversial issue. A multicenter phase II trial was undertaken to evaluate the efficacy and safety of neoadjuvant capecitabine and oxaliplatin combined with bevacizumab in patients with intermediate-risk rectal adenocarcinoma. Methods. We recruited 46 patients with T3 rectal adenocarcinoma selected by magnetic resonance imaging (MRI) who were candidates for (R0) resection located in the middle third with clear mesorectal fascia and who were selected by pelvic MRI. Patients received four cycles of neoadjuvant capecitabine and oxaliplatin combined with bevacizumab (final cycle without bevacizumab) before total mesorectal excision (TME). In case of progression, preoperative chemoradiation was planned. The primary endpoint was overall response rate (ORR). Results. On an intent-to-treat analysis, the ORR was 78% (n = 36; 95% confidence interval [CI]: 63%–89%) and no progression was detected. Pathologic complete response was observed in nine patients (20%; 95% CI: 9–33), and T downstaging was observed in 48%. Forty-four patients proceeded to TME, and all had R0 resection. During preoperative therapy, two deaths occurred as a result of pulmonary embolism and diarrhea, respectively, and one patient died after surgery as a result of peritonitis secondary to an anastomotic leak (AL). A 13% rate of AL was higher than expected. The 24-month disease-free survival rate was 75% (95% CI: 60%–85%), and the 2-year local relapse rate was 2% (95% CI: 0%–11%). Conclusion. In this selected population, initial chemotherapy results in promising activity, but the observed toxicity does not support further investigation of this specific regimen. Nevertheless, these early results warrant further testing of this strategy in an enriched population and in randomized trials. PMID:25209376

  12. High temperature size selective membranes

    SciTech Connect

    Yates, S.F.; Swamikannu, A.X.

    1993-09-01

    The high temperature membrane, capable of operation above 550{degree}C, is designed to be a composite membrane composed of a thin layer of a size selective membrane supported by a microporous ceramic support. The kinetic diameters of H{sub 2} and CO{sub 2} are 2.96 {Angstrom} and 4.00 {Angstrom}. The thin layer will be made from CMS whose pore size will be controlled to be less than 4 {Angstrom}. The membrane will be truly size selective and be impermeable to carbon dioxide. The membrane will have higher selectivity than membranes which operate on Knudsen diffusion mechanism. The ceramic support will be fabricated from Allied Signal`s proprietary Blackglas{trademark} resin. The ceramic material, noted for its high thermal and oxidative resistance, has a coefficient of thermal expansion which matches closely that of CMS. The close match will insure mechanical integrity when the membrane is subjected to thermal cycles. The CMS layer will be produced by controlled pyrolysis of polymeric precursors. Pore size will be suitably modified by post-treatments to the carbon. The composite membrane will be tested for its permeation properties at 550{degree}C or higher. Thermal, mechanical and chemical stability of the membrane will be assessed. We have produced several samples of CMS from polymeric precursors. We have initiated work also on the preparation of microporous supports from Blackglas{trademark} resin. We have completed the design of the high temperature membrane pilot plant. The membrane cell was fabricated out of two kinds of stainless steel. The inner parts are made of SS 316 and the outer ring made of SS 420. The greater thermal expansion of the SS 316 will help obtain a leak free seal at the operating temperatures.

  13. Heavier drinking American college students may self-select into study abroad programs: An examination of sex and ethnic differences within a high-risk group.

    PubMed

    Pedersen, Eric R; LaBrie, Joseph W; Hummer, Justin F; Larimer, Mary E; Lee, Christine M

    2010-09-01

    As with other heavier drinking groups, heavier drinking American college students may self-select into study abroad programs with specific intentions to use alcohol in the foreign environment. This cross-sectional study used a sample of 2144 students (mean age=20.00, SD=1.47) to explore differences in alcohol use and related negative consequences among (1) students intending to study abroad while in college, (2) students not intending to study abroad, and (3) students reporting prior study abroad participation. Results revealed that participants with no intention to study abroad drank less and experienced fewer alcohol-related consequences than participants intending to study abroad. In addition, students reporting prior completion of study abroad programs drank more and reported more hazardous alcohol use than those not intending to study abroad. Ethnic and sex differences existed; with White students, males, and females intending to study abroad and non-White students who previously completed study abroad programs demonstrating the most risk. These findings provide empirical support that study abroad students may be a heavier drinking subgroup necessitating intervention prior to beginning programs abroad.

  14. Neuroleptics under high risk conditions.

    PubMed

    Oyewumi, L K

    1983-08-01

    A critical review of various high risk situations in which neuroleptics could be used and have been used in clinical practice is presented. These high risk situations include: women of child bearing age (pregnant women, lactating and/or nursing mothers), the two extremes of life (children and the elderly), patients with sexual dysfunction, patients with tardive dyskinesia, non-psychotic psychiatric patients, physically ill and suicidal patients. The extraordinary applications of these drugs, such as for rapid tranquilization and megadose regimens are examined. The author provides guidelines for the use of neuroleptics in these clinical situations.

  15. Seasonal variations of selected cardiovascular risk factors.

    PubMed

    Kelly, Gregory S

    2005-12-01

    This article reviews research on selected biomarkers of cardiovascular risk - cholesterol and other lipids, C-reactive protein (CRP), fibrinogen, homocysteine - in the attempt to determine the existence of a predictable seasonal chronobiological pattern of variation. Studies dating as far back as the 1930s have reported seasonal variations in cholesterol levels. Statistically significant seasonal changes in lipid levels have been found in individuals irrespective of the country where the research has been conducted, and irrespective of the age, sex, ethnicity, and baseline lipid levels of the study subjects. While not all studies have been in complete agreement on either the amplitude (degree of seasonal change) or month/s of highest lipid levels, a strong winter/summer difference has been found in most studies. Existing evidence for an independent effect of season in variation of CRP is weak. Studies have consistently reported significant seasonal variations in fibrinogen levels. While other biological factors clearly interact to affect fibrinogen variability, seasonality appears to be an independent source of variability. Evidence from several studies points to a lack of seasonal variability in homocysteine levels. Although seasonal variability is just one source of periodicity influencing biological function and assessments in clinical practice, for some biomarkers, including lipids and fibrinogen, it is a source of variability that warrants consideration prior to a decision to treat and in assessing response to interventions.

  16. An Overview. High Risk Series.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC.

    This report provides an overview of efforts undertaken by the U.S. General Accounting Office (GAO) in 1990 to review and report on federal program areas its work identified as high risk because of vulnerabilities to waste, fraud, abuse, and mismanagement. It reviews the current status of efforts to address these concerns. The six categories of…

  17. Risk minimization practices for pregnancy prevention: understanding risk, selecting tools.

    PubMed

    Uhl, Kathleen; Trontell, Anne; Kennedy, Dianne

    2007-03-01

    According to the March of Dimes, approximately 4% (1/28) of babies are born in the US each year with a birth defect. For the majority of birth defects the etiology is unknown, although chemicals, including drug exposures, probably account for less than 1% of all birth defects. The identification of potential human teratogenicity during drug development is important because drug-induced adverse fetal effects are potentially preventable with the application of risk assessment strategies and risk minimization tools and programs to minimize risk of pregnancy exposure while preserving access to drug benefits; risk assessment and risk minimization together comprise risk management. It is important that risk minimization programs intended to limit fetal exposure use a consistent approach and are tailored to the product-specific risk concerns in order to optimize the benefit-risk balance for a particular drug. This paper highlights general considerations in developing specific risk minimization programs to prevent fetal drug exposure including the relative advantages and disadvantages of each strategy.

  18. Risk Selection Threatens Quality Of Care For Certain Patients: Lessons From Europe's Health Insurance Exchanges.

    PubMed

    van de Ven, Wynand P M M; van Kleef, Richard C; van Vliet, Rene C J A

    2015-10-01

    Experience in European health insurance exchanges indicates that even with the best risk-adjustment formulas, insurers have substantial incentives to engage in risk selection. The potentially most worrisome form of risk selection is skimping on the quality of care for underpriced high-cost patients--that is, patients for whom insurers are compensated at a rate lower than the predicted health care expenses of these patients. In this article we draw lessons for the United States from twenty years of experience with health insurance exchanges in Europe, where risk selection is a serious problem. Mistakes by European legislators and inadequate evaluation criteria for risk selection incentives are discussed, as well as strategies to reduce risk selection and the complex trade-off among selection (through quality skimping), efficiency, and affordability. Recommended improvements to the risk-adjustment process in the United States include considering the adoption of risk adjusters used in Europe, investing in the collection of data, using a permanent form of risk sharing, and replacing the current premium "band" restrictions with more flexible restrictions. Policy makers need to understand the complexities of regulating competitive health insurance markets and to prevent risk selection that threatens the provision of good-quality care for underpriced high-cost patients.

  19. Environmental risk assessment of selected pharmaceuticals in Turkey.

    PubMed

    Oğuz, Merve; Mihçiokur, Hamdi

    2014-07-01

    In this study, environmental risks of selected pharmaceuticals were investigated to assess potential hazards. Ciprofloxacin, Clarithromycin, Cefuroxime axetil, antibiotics, Benzalkoniuman antiseptic, Paracetamol, an analgesic, and Naproxen, an anti-inflammatory, were selected due to their high rate of usage in Turkey. Ciprofloxacin was found to have the highest risk due to its high PEC/PNEC ratio (28.636). Benzalkonium, Paracetamol and Clarithromycin have a potential to cause environmental hazards. The biodegradation and biological concentration factors (BCF) of the drugs were also determined using EPA/STWIN and EPA/BCFWIN programs. The results illustrated that these pharmaceuticals are nonbiodegradable in wastewater treatment plants. The BCFs of Benzalkonium and Clarithromycin were found to be very high, 70.790 L/kg and 56.490 L/kg, respectively. It was suggested that alternative treatment methods other than biological ones should be investigated for these pharmaceuticals because of their low biodegradability. Also, unnecessary use of antibiotics is supposed to be discouraged to reduce environmental hazards.

  20. Risk Selection under Public Health Insurance with Opt-Out.

    PubMed

    Panthöfer, Sebastian

    2016-09-01

    This paper studies risk selection between public and private health insurance when some, but not all, individuals can opt out of otherwise mandatory public insurance. Using a theoretical model, I show that public insurance is adversely selected when insurers and insureds are symmetrically informed about health-related risks, and that there can be adverse or advantageous selection when insureds are privately informed. Using data from the German Socio-Economic Panel, I find that (i) public insurance is, on balance, adversely selected under the German public health insurance with opt out scheme, (ii) individuals advantageously select public insurance based on risk aversion and residential location, and (iii) there is suggestive evidence of asymmetric information in the market for private health insurance. Copyright © 2016 John Wiley & Sons, Ltd.

  1. Very high risk localized prostate cancer: definition and outcomes

    PubMed Central

    Sundi, Debasish; Wang, Vinson M.; Pierorazio, Phillip M.; Han, Misop; Bivalacqua, Trinity J.; Ball, Mark W.; Antonarakis, Emmanuel S.; Partin, Alan W.; Schaeffer, Edward M.; Ross, Ashley E.

    2013-01-01

    Purpose Outcomes in men with NCCN high-risk prostate cancer (PCa) can vary substantially--some will have excellent cancer-specific survival, whereas others will experience early metastasis even after aggressive local treatments. Current nomograms, which yield continuous risk probabilities, do not separate high-risk PCa into distinct sub-strata. Here we derive a binary definition of very-high-risk (VHR) localized PCa to aid in risk stratification at diagnosis and selection of therapy. Materials and Methods We queried the Johns Hopkins radical prostatectomy database to identify 753 men with NCCN high-risk localized PCa (Gleason sum 8–10, PSA >20 ng/ml, or clinical stage ≥T3). 28 alternate permutations of adverse grade, stage, and cancer volume were compared by their hazard ratios for metastasis and cancer-specific mortality. VHR criteria with top-ranking hazard ratios were further evaluated by multivariable analyses and inclusion of a clinically meaningful proportion of the high-risk cohort. Results The VHR cohort was best defined by primary pattern 5 present on biopsy, or ≥5 cores with Gleason sum 8–10, or multiple NCCN high-risk features. These criteria encompassed 15.1% of the NCCN high-risk cohort. Compared to other high-risk men, VHR men were at significantly higher risk for metastasis (H.R. 2.75) and cancer-specific mortality (H.R. 3.44) (p <0.001 for both). Among high-risk men, VHR men also had significantly worse 10-year metastasis-free survival (37% vs 78%) and cancer-specific survival (62% vs 90%). Conclusions Men who meet VHR criteria form a subgroup within the current NCCN high-risk classification who have particularly poor oncologic outcomes. Use of these characteristics to distinguish VHR localized PCa may help in counseling and selection optimal candidates for multimodal treatments or clinical trials. PMID:24189998

  2. Favorable Selection, Risk Adjustment, and the Medicare Advantage Program

    PubMed Central

    Morrisey, Michael A; Kilgore, Meredith L; Becker, David J; Smith, Wilson; Delzell, Elizabeth

    2013-01-01

    Objectives To examine the effects of changes in payment and risk adjustment on (1) the annual enrollment and switching behavior of Medicare Advantage (MA) beneficiaries, and (2) the relative costliness of MA enrollees and disenrollees. Data From 1999 through 2008 national Medicare claims data from the 5 percent longitudinal sample of Parts A and B expenditures. Study Design Retrospective, fixed effects regression analysis of July enrollment and year-long switching into and out of MA. Similar regression analysis of the costliness of those switching into (out of) MA in the 6 months prior to enrollment (after disenrollment) relative to nonswitchers in the same county over the same period. Findings Payment generosity and more sophisticated risk adjustment were associated with substantial increases in MA enrollment and decreases in disenrollment. Claims experience of those newly switching into MA was not affected by any of the policy reforms, but disenrollment became increasingly concentrated among high-cost beneficiaries. Conclusions Enrollment is very sensitive to payment levels. The use of more sophisticated risk adjustment did not alter favorable selection into MA, but it did affect the costliness of disenrollees. PMID:23088500

  3. Use of selective chemical extractions as a strategy for the risk assessment in sites with a high level of potentially toxic elements

    NASA Astrophysics Data System (ADS)

    Pérez-Sirvent, Carmen; Martinez Sanchez, Maria Jose; Garcia Lorenzo, Maria Luz; Hernandez Perez, Carmen; Molina Ruiz, Jose; Bech, Jaume

    2016-04-01

    The present study deals with the geochemical fractions of Pb, Cd, Zn and As present on profiles using chemical simple extraction process. This work was conducted on Portman Bay, a site located in the SE Spain and strongly affected by mining activities. Four simple extractions were applied to selected samples in order to evaluate the potential mobility of metals. X-ray diffraction (XRD) and scanning electron microscopy coupled to with an energy-dispersion spectrometry (SEM-EDS) were applied for the characterisation of both the samples and the residues remaining after each extraction, providing additional information about the sediment phases carrying the elements studied. Soil pollution assessment was carried out using the contamination factor (CF) and the pollution load index (PLI) for total contents, and indicators of mobility for each extraction: natural mobility indicator (NMI), acid mine drainage mobility indicator (AMI), oxic mobility indicator (OMI) and anoxic mobility indicator (ANMI). The results obtained after the extractions suggested that the highest PTEs content were extracted in the acidic medium. The mineralogical composition is an important factor that should be taken into account in the evaluation of PTEs mobility, firstly because the mineral phases react differently in the proposed situations depending on their chemical nature, and secondly, because the presence of a particular phase (with different degree of reactivity) depends on the degree of weathering.

  4. High temperature solar selective coatings

    DOEpatents

    Kennedy, Cheryl E

    2014-11-25

    Improved solar collectors (40) comprising glass tubing (42) attached to bellows (44) by airtight seals (56) enclose solar absorber tubes (50) inside an annular evacuated space (54. The exterior surfaces of the solar absorber tubes (50) are coated with improved solar selective coatings {48} which provide higher absorbance, lower emittance and resistance to atmospheric oxidation at elevated temperatures. The coatings are multilayered structures comprising solar absorbent layers (26) applied to the meta surface of the absorber tubes (50), typically stainless steel, topped with antireflective Savers (28) comprising at least two layers 30, 32) of refractory metal or metalloid oxides (such as titania and silica) with substantially differing indices of refraction in adjacent layers. Optionally, at least one layer of a noble metal such as platinum can be included between some of the layers. The absorbent layers cars include cermet materials comprising particles of metal compounds is a matrix, which can contain oxides of refractory metals or metalloids such as silicon. Reflective layers within the coating layers can comprise refractory metal silicides and related compounds characterized by the formulas TiSi. Ti.sub.3SiC.sub.2, TiAlSi, TiAN and similar compounds for Zr and Hf. The titania can be characterized by the formulas TiO.sub.2, Ti.sub.3O.sub.5. TiOx or TiO.sub.xN.sub.1-x with x 0 to 1. The silica can be at least one of SiO.sub.2, SiO.sub.2x or SiO.sub.2xN.sub.1-x with x=0 to 1.

  5. Risk Selection, Risk Adjustment and Choice: Concepts and Lessons from the Americas

    PubMed Central

    Ellis, Randall P.; Fernandez, Juan Gabriel

    2013-01-01

    Interest has grown worldwide in risk adjustment and risk sharing due to their potential to contain costs, improve fairness, and reduce selection problems in health care markets. Significant steps have been made in the empirical development of risk adjustment models, and in the theoretical foundations of risk adjustment and risk sharing. This literature has often modeled the effects of risk adjustment without highlighting the institutional setting, regulations, and diverse selection problems that risk adjustment is intended to fix. Perhaps because of this, the existing literature and their recommendations for optimal risk adjustment or optimal payment systems are sometimes confusing. In this paper, we present a unified way of thinking about the organizational structure of health care systems, which enables us to focus on two key dimensions of markets that have received less attention: what choices are available that may lead to selection problems, and what financial or regulatory tools other than risk adjustment are used to influence these choices. We specifically examine the health care systems, choices, and problems in four countries: the US, Canada, Chile, and Colombia, and examine the relationship between selection-related efficiency and fairness problems and the choices that are allowed in each country, and discuss recent regulatory reforms that affect choices and selection problems. In this sample, countries and insurance programs with more choices have more selection problems. PMID:24284351

  6. Selection of technical risk responses for efficient contingencies

    SciTech Connect

    Kujawski, Edouard

    2002-02-28

    The primary goal of good project risk management should be to successfully deliver projects for the lowest cost at an acceptable level of risk. This requires the systematic development and implementation of a set of Risk Response Actions (RRA) that achieves the lowest total project cost for a given probability of success while meeting technical performance and schedule. We refer to this set as the ''efficient RRA set''. This work presents a practical and mathematically sound approach for determining the efficient RRA set. It builds on some of Markowitz's portfolio selection principles and introduces several conceptual and modeling differences to properly treat project technical risks. The set of RRAs is treated as whole and not just individual risks. The efficient RRA set is determined based on ''Outcome Cost Vs Probability of Success''. The risks and RRAs are characterized using scenarios, decision trees, and cumulative probability distributions. The analysis provides information that enables decision-makers to select the efficient RRA set that explicitly takes their attitude toward project risk into account. Decision-makers should find it both useful and practical for sound decision-making under uncertainty/risk and efficiently optimizing project success. The computations are readily performed using commercially available Monte Carlo simulation tools. The approach is detailed using a realistic but simplified case of a project with two technical risks.

  7. Sexual selection and the risk of extinction in mammals.

    PubMed Central

    Morrow, Edward H.; Fricke, Claudia

    2004-01-01

    Sexual selection is commonly envisaged as a force working in opposition to natural selection, because extravagant or exaggerated traits could apparently have never evolved via natural selection alone. There is good evidence that a selection load imposed by sexual selection may be eased experimentally by restricting the opportunity for it to operate. Sexual selection could therefore potentially play an important role in influencing the risk of extinction that a population faces, thereby contributing to the apparent selectivity of extinctions. Conversely, recent theory predicts that the likelihood of extinction may decrease when sexual selection is operating because it could accelerate the rate of adaptation in concert with natural selection. So far, comparative evidence (coming mostly from birds) has generally indicated support for the former scenario, but the question remains open. The aim of this study was therefore to examine whether the level of sexual selection (measured as residual testes mass and sexual size dimorphism) was related to the risk of extinction that mammals are currently experiencing. We found no evidence for a relationship between these factors, although our analyses may have been confounded by the possible dominating effect of contemporary anthropogenic factors. PMID:15556893

  8. Managing risk selection incentives in health sector reforms.

    PubMed

    Puig-Junoy, J

    1999-01-01

    The object of the paper is to review theoretical and empirical contributions to the optimal management of risk selection incentives ('cream skimming') in health sector reforms. The trade-off between efficiency and risk selection is fostered in health sector reforms by the introduction of competitive mechanisms such as price competition or prospective payment systems. The effects of two main forms of competition in health sector reforms are observed when health insurance is mandatory: competition in the market for health insurance, and in the market for health services. Market and government failures contribute to the assessment of the different forms of risk selection employed by insurers and providers, as the effects of selection incentives on efficiency and their proposed remedies to reduce the impact of these perverse incentives. Two European (Netherlands and Spain) and two Latin American (Chile and Colombia) case studies of health sector reforms are examined in order to observe selection incentives, their effects on efficiency and costs in the health system, and regulation policies implemented in each country to mitigate incentives to 'cream skim' good risks.

  9. Selecting Universal Screening Measures to Identify Students at Risk Academically

    ERIC Educational Resources Information Center

    Salinger, Rachel L.

    2016-01-01

    Universal screening measures can be used to identify students at risk academically due to learning disabilities or other difficulties. Research and legislation support the use of screening measures early in students' education to ensure they receive any supports necessary to bolster their academic achievement. When selecting a screening measure,…

  10. Risk adjustment and risk selection on the sickness fund insurance market in five European countries.

    PubMed

    van de Ven, Wynand P M M; Beck, Konstantin; Buchner, Florian; Chernichovsky, Dov; Gardiol, Lucien; Holly, Alberto; Lamers, Leida M; Schokkaert, Erik; Shmueli, Amir; Spycher, Stephan; Van de Voorde, Carine; van Vliet, René C J A; Wasem, Jürgen; Zmora, Irith

    2003-07-01

    From the mid-1990s citizens in Belgium, Germany, Israel, the Netherlands and Switzerland have a guaranteed periodic choice among risk-bearing sickness funds, who are responsible for purchasing their care or providing them with medical care. The rationale of this arrangement is to stimulate the sickness funds to improve efficiency in health care production and to respond to consumers' preferences. To achieve solidarity, all five countries have implemented a system of risk-adjusted premium subsidies (or risk equalization across risk groups), along with strict regulation of the consumers' direct premium contribution to their sickness fund. In this article we present a conceptual framework for understanding risk adjustment and comparing the systems in the five countries. We conclude that in the case of imperfect risk adjustment-as is the case in all five countries in the year 2001-the sickness funds have financial incentives for risk selection, which may threaten solidarity, efficiency, quality of care and consumer satisfaction. We expect that without substantial improvements in the risk adjustment formulae, risk selection will increase in all five countries. The issue is particularly serious in Germany and Switzerland. We strongly recommend therefore that policy makers in the five countries give top priority to the improvement of the system of risk adjustment. That would enhance solidarity, cost-control, efficiency and client satisfaction in a system of competing, risk-bearing sickness funds.

  11. Choice of hospital for delivery: a comparison of high-risk and low-risk women.

    PubMed Central

    Phibbs, C S; Mark, D H; Luft, H S; Peltzman-Rennie, D J; Garnick, D W; Lichtenberg, E; McPhee, S J

    1993-01-01

    OBJECTIVE. This article tests whether or not the factors that affect hospital choice differ for selected subgroups of the population. DATA SOURCES. 1985 California Office of Statewide Health Planning and Development (OSHPD) discharge abstracts and hospital financial data were used. STUDY DESIGN. Models for hospital choice were estimated using McFadden's conditional logit model. Separate models were estimated for high-risk and low-risk patients, and for high-risk and low-risk women covered either by private insurance or by California Medicaid. The model included independent variables to control for quality, price, ownership, and distance to the hospital. DATA EXTRACTION. Data covered all maternal deliveries in the San Francisco Bay Area in 1985 (N = 61,436). ICD-9 codes were used to classify patients as high-risk or low-risk. The expected payment code on the discharge abstract was used to identify insurance status. PRINCIPAL FINDINGS. The results strongly reject the hypothesis that high-risk and low-risk women have the same choice process. Hospital quality tended to be more important for high-risk than low-risk women. These results also reject the hypothesis that factors influencing choice of hospital are the same for women covered by private insurance as for those covered by Medicaid. Further, high-risk women covered by Medicaid were less likely than high-risk women covered by private insurance to deliver in hospitals with newborn intensive care units. CONCLUSIONS. The results show that the choice factors vary across several broadly defined subgroups of patients with a specific condition. Thus, estimates aggregating all patients may be misleading. Specifically, such estimates will understate actual patient response to quality of care indicators, since patient sensitivity to quality of care varies with the patients' risk status. PMID:8514500

  12. Prediction and Informative Risk Factor Selection of Bone Diseases.

    PubMed

    Li, Hui; Li, Xiaoyi; Ramanathan, Murali; Zhang, Aidong

    2015-01-01

    With the booming of healthcare industry and the overwhelming amount of electronic health records (EHRs) shared by healthcare institutions and practitioners, we take advantage of EHR data to develop an effective disease risk management model that not only models the progression of the disease, but also predicts the risk of the disease for early disease control or prevention. Existing models for answering these questions usually fall into two categories: the expert knowledge based model or the handcrafted feature set based model. To fully utilize the whole EHR data, we will build a framework to construct an integrated representation of features from all available risk factors in the EHR data and use these integrated features to effectively predict osteoporosis and bone fractures. We will also develop a framework for informative risk factor selection of bone diseases. A pair of models for two contrast cohorts (e.g., diseased patients versus non-diseased patients) will be established to discriminate their characteristics and find the most informative risk factors. Several empirical results on a real bone disease data set show that the proposed framework can successfully predict bone diseases and select informative risk factors that are beneficial and useful to guide clinical decisions.

  13. Risk-based selection of SSCs at Peach Bottom

    SciTech Connect

    Krueger, G.A.; Marie, A.J. )

    1993-01-01

    The purpose of identifying risk significant systems, structures, and components (SSCS) that are within the scope of the maintenance rule is to bring a higher level of attention to a subset of those SSCS. These risk-significant SSCs will have specific performance criteria established for them, and failure to meet this performance criteria will result in establishing goals to ensure the necessary improvement in performance. The Peach Bottom individual plant examination (IPE) results were used to provide insights for the verification of proposed probabilistic risk assessment (PRA) methods set forth in the Industry Maintenance Guidelines for Implementation of the Maintenance Rule. The objective of reviewing the methods for selection of SSCs that are considered risk significant was to ensure the methods used are logical, reproducible, and can be consistently applied.

  14. Environmental Influences and Perinatal Risk Factors in High Risk Children.

    ERIC Educational Resources Information Center

    Lindgren, Scott D.; And Others

    Children in a longitudinal high-risk infant follow-up program were evaluated at age 5 to determine whether they demonstrated behavior problems or cognitive deficits exceeding expectations based on conditions in their home environments. Normal expectations were determined through regression analyses on a group of age-matched controls. All high-risk…

  15. Applying the partitioned multiobjective risk method (PMRM) to portfolio selection.

    PubMed

    Reyes Santos, Joost; Haimes, Yacov Y

    2004-06-01

    The analysis of risk-return tradeoffs and their practical applications to portfolio analysis paved the way for Modern Portfolio Theory (MPT), which won Harry Markowitz a 1992 Nobel Prize in Economics. A typical approach in measuring a portfolio's expected return is based on the historical returns of the assets included in a portfolio. On the other hand, portfolio risk is usually measured using volatility, which is derived from the historical variance-covariance relationships among the portfolio assets. This article focuses on assessing portfolio risk, with emphasis on extreme risks. To date, volatility is a major measure of risk owing to its simplicity and validity for relatively small asset price fluctuations. Volatility is a justified measure for stable market performance, but it is weak in addressing portfolio risk under aberrant market fluctuations. Extreme market crashes such as that on October 19, 1987 ("Black Monday") and catastrophic events such as the terrorist attack of September 11, 2001 that led to a four-day suspension of trading on the New York Stock Exchange (NYSE) are a few examples where measuring risk via volatility can lead to inaccurate predictions. Thus, there is a need for a more robust metric of risk. By invoking the principles of the extreme-risk-analysis method through the partitioned multiobjective risk method (PMRM), this article contributes to the modeling of extreme risks in portfolio performance. A measure of an extreme portfolio risk, denoted by f(4), is defined as the conditional expectation for a lower-tail region of the distribution of the possible portfolio returns. This article presents a multiobjective problem formulation consisting of optimizing expected return and f(4), whose solution is determined using Evolver-a software that implements a genetic algorithm. Under business-as-usual market scenarios, the results of the proposed PMRM portfolio selection model are found to be compatible with those of the volatility-based model

  16. Teaching Art to High Risk Groups.

    ERIC Educational Resources Information Center

    Rossol, Monona

    The role of art therapy is considered in working with such high risk groups as the institutionalized, mentally retarded, elderly, visually impaired, physically handicapped, asthmatic, hyper- and hypo-active children, hearing impaired, and patients on mind altering drugs. The special risks of infectious diseases (such as serum hepatitis), and…

  17. Assessing risk to birds from industrial wind energy development via paired resource selection models.

    PubMed

    Miller, Tricia A; Brooks, Robert P; Lanzone, Michael; Brandes, David; Cooper, Jeff; O'Malley, Kieran; Maisonneuve, Charles; Tremblay, Junior; Duerr, Adam; Katzner, Todd

    2014-06-01

    When wildlife habitat overlaps with industrial development animals may be harmed. Because wildlife and people select resources to maximize biological fitness and economic return, respectively, we estimated risk, the probability of eagles encountering and being affected by turbines, by overlaying models of resource selection for each entity. This conceptual framework can be applied across multiple spatial scales to understand and mitigate impacts of industry on wildlife. We estimated risk to Golden Eagles (Aquila chrysaetos) from wind energy development in 3 topographically distinct regions of the central Appalachian Mountains of Pennsylvania (United States) based on models of resource selection of wind facilities (n = 43) and of northbound migrating eagles (n = 30). Risk to eagles from wind energy was greatest in the Ridge and Valley region; all 24 eagles that passed through that region used the highest risk landscapes at least once during low altitude flight. In contrast, only half of the birds that entered the Allegheny Plateau region used highest risk landscapes and none did in the Allegheny Mountains. Likewise, in the Allegheny Mountains, the majority of wind turbines (56%) were situated in poor eagle habitat; thus, risk to eagles is lower there than in the Ridge and Valley, where only 1% of turbines are in poor eagle habitat. Risk within individual facilities was extremely variable; on average, facilities had 11% (SD 23; range = 0-100%) of turbines in highest risk landscapes and 26% (SD 30; range = 0-85%) of turbines in the lowest risk landscapes. Our results provide a mechanism for relocating high-risk turbines, and they show the feasibility of this novel and highly adaptable framework for managing risk of harm to wildlife from industrial development.

  18. Spatially-Correlated Risk in Nature Reserve Site Selection

    PubMed Central

    Albers, Heidi J.; Busby, Gwenlyn M.; Hamaide, Bertrand; Ando, Amy W.; Polasky, Stephen

    2016-01-01

    Establishing nature reserves protects species from land cover conversion and the resulting loss of habitat. Even within a reserve, however, many factors such as fires and defoliating insects still threaten habitat and the survival of species. To address the risk to species survival after reserve establishment, reserve networks can be created that allow some redundancy of species coverage to maximize the expected number of species that survive in the presence of threats. In some regions, however, the threats to species within a reserve may be spatially correlated. As examples, fires, diseases, and pest infestations can spread from a starting point and threaten neighboring parcels’ habitats, in addition to damage caused at the initial location. This paper develops a reserve site selection optimization framework that compares the optimal reserve networks in cases where risks do and do not reflect spatial correlation. By exploring the impact of spatially-correlated risk on reserve networks on a stylized landscape and on an Oregon landscape, this analysis demonstrates an appropriate and feasible method for incorporating such post-reserve establishment risks in the reserve site selection literature as an additional tool to be further developed for future conservation planning. PMID:26789127

  19. Spatially-Correlated Risk in Nature Reserve Site Selection.

    PubMed

    Albers, Heidi J; Busby, Gwenlyn M; Hamaide, Bertrand; Ando, Amy W; Polasky, Stephen

    2016-01-01

    Establishing nature reserves protects species from land cover conversion and the resulting loss of habitat. Even within a reserve, however, many factors such as fires and defoliating insects still threaten habitat and the survival of species. To address the risk to species survival after reserve establishment, reserve networks can be created that allow some redundancy of species coverage to maximize the expected number of species that survive in the presence of threats. In some regions, however, the threats to species within a reserve may be spatially correlated. As examples, fires, diseases, and pest infestations can spread from a starting point and threaten neighboring parcels' habitats, in addition to damage caused at the initial location. This paper develops a reserve site selection optimization framework that compares the optimal reserve networks in cases where risks do and do not reflect spatial correlation. By exploring the impact of spatially-correlated risk on reserve networks on a stylized landscape and on an Oregon landscape, this analysis demonstrates an appropriate and feasible method for incorporating such post-reserve establishment risks in the reserve site selection literature as an additional tool to be further developed for future conservation planning.

  20. Understand Your Risk for High Cholesterol

    MedlinePlus

    ... Aortic Aneurysm More Understand Your Risk for High Cholesterol Updated:Apr 1,2016 LDL (bad) cholesterol is ... content was last reviewed on 04/21/2014. Cholesterol Guidelines: Putting the pieces together Myth vs. Truth – ...

  1. Targeting hunter distribution based on host resource selection and kill sites to manage disease risk

    PubMed Central

    Dugal, Cherie J; van Beest, Floris M; Vander Wal, Eric; Brook, Ryan K

    2013-01-01

    Endemic and emerging diseases are rarely uniform in their spatial distribution or prevalence among cohorts of wildlife. Spatial models that quantify risk-driven differences in resource selection and hunter mortality of animals at fine spatial scales can assist disease management by identifying high-risk areas and individuals. We used resource selection functions (RSFs) and selection ratios (SRs) to quantify sex- and age-specific resource selection patterns of collared (n = 67) and hunter-killed (n = 796) nonmigratory elk (Cervus canadensis manitobensis) during the hunting season between 2002 and 2012, in southwestern Manitoba, Canada. Distance to protected area was the most important covariate influencing resource selection and hunter-kill sites of elk (AICw = 1.00). Collared adult males (which are most likely to be infected with bovine tuberculosis (Mycobacterium bovis) and chronic wasting disease) rarely selected for sites outside of parks during the hunting season in contrast to adult females and juvenile males. The RSFs showed selection by adult females and juvenile males to be negatively associated with landscape-level forest cover, high road density, and water cover, whereas hunter-kill sites of these cohorts were positively associated with landscape-level forest cover and increasing distance to streams and negatively associated with high road density. Local-level forest was positively associated with collared animal locations and hunter-kill sites; however, selection was stronger for collared juvenile males and hunter-killed adult females. In instances where disease infects a metapopulation and eradication is infeasible, a principle goal of management is to limit the spread of disease among infected animals. We map high-risk areas that are regularly used by potentially infectious hosts but currently underrepresented in the distribution of kill sites. We present a novel application of widely available data to target hunter distribution based on host resource

  2. Targeting hunter distribution based on host resource selection and kill sites to manage disease risk.

    PubMed

    Dugal, Cherie J; van Beest, Floris M; Vander Wal, Eric; Brook, Ryan K

    2013-10-01

    Endemic and emerging diseases are rarely uniform in their spatial distribution or prevalence among cohorts of wildlife. Spatial models that quantify risk-driven differences in resource selection and hunter mortality of animals at fine spatial scales can assist disease management by identifying high-risk areas and individuals. We used resource selection functions (RSFs) and selection ratios (SRs) to quantify sex- and age-specific resource selection patterns of collared (n = 67) and hunter-killed (n = 796) nonmigratory elk (Cervus canadensis manitobensis) during the hunting season between 2002 and 2012, in southwestern Manitoba, Canada. Distance to protected area was the most important covariate influencing resource selection and hunter-kill sites of elk (AICw = 1.00). Collared adult males (which are most likely to be infected with bovine tuberculosis (Mycobacterium bovis) and chronic wasting disease) rarely selected for sites outside of parks during the hunting season in contrast to adult females and juvenile males. The RSFs showed selection by adult females and juvenile males to be negatively associated with landscape-level forest cover, high road density, and water cover, whereas hunter-kill sites of these cohorts were positively associated with landscape-level forest cover and increasing distance to streams and negatively associated with high road density. Local-level forest was positively associated with collared animal locations and hunter-kill sites; however, selection was stronger for collared juvenile males and hunter-killed adult females. In instances where disease infects a metapopulation and eradication is infeasible, a principle goal of management is to limit the spread of disease among infected animals. We map high-risk areas that are regularly used by potentially infectious hosts but currently underrepresented in the distribution of kill sites. We present a novel application of widely available data to target hunter distribution based on host resource

  3. Jupiter Exploration: High Risk and High Rewards

    NASA Astrophysics Data System (ADS)

    Kite, Edwin S.

    2004-12-01

    Jupiter exploration is big science, and only the United States can afford self-contained missions to the gas giant and its four planet-sized moons. The Galileo spacecraft, which was recently flown into Jupiter to prevent it from contaminating Europa's ocean, cost $1.6 billion. Despite the failure of its High Gain Antenna (HGA), Galileo discovered briny, subsurface oceans on Europa, Ganymede, and Callisto; globally mapped all four Galilean moons; monitored Io's volcanic activity; carried out a 7-year study of the Jovian magnetosphere; and dropped an atmospheric probe into Jupiter's upper cloud layer. Of these achievements, the most significant is the indirect detection of a deep subsurface liquid-water layer on Europa [Pappalardo et al., 1999; Kivelson et al., 2000]. The case for a Europan ecosystem can be made [e.g., Marion et al., 2004], although it is important to remember the energetic and biogeochemical limits on putative Europan life [e.g., Soare et al., 2002]. Europa's low moment of inertia (0.346 +/- 0.005 MR2) suggests a silicate mantle below the ocean, permitting chemical exchanges between ocean and silicates, as occurs on Earth. Europa's surface is geologically young, likely emplaced 20-180 million years ago. Any recycling of surficial icy crust into the ocean could add oxygen, sulfur, and organic compounds, either impact-delivered or generated in situ by UV irradiation and the implantation of ionized particles from Jupiter's radiation belts.

  4. High risk of permafrost thaw

    SciTech Connect

    Schuur, E.A.G.; Abbott, B.; Koven, C.D,; Riley, W.J.; Subin, Z.M.; al, et

    2011-11-01

    In the Arctic, temperatures are rising fast, and permafrost is thawing. Carbon released to the atmosphere from permafrost soils could accelerate climate change, but the likely magnitude of this effect is still highly uncertain. A collective estimate made by a group of permafrost experts, including myself, is that carbon could be released more quickly than models currently suggest, and at levels that are cause for serious concern. While our models of carbon emission from permafrost thaw are lacking, experts intimately familiar with these landscapes and processes have accumulated knowledge about what they expect to happen, based on both quantitative data and qualitative understanding of these systems. We (the authors of this piece) attempted to quantify this expertise through a survey developed over several years, starting in 2009. Our survey asked experts what percentage of surface permafrost they thought was likely to thaw, how much carbon would be released, and how much of that would be methane, for three time periods and under four warming scenarios that are part of the new IPCC Fifth Assessment Report.

  5. Management of high-risk pregnancy.

    PubMed

    Coco, L; Giannone, T T; Zarbo, G

    2014-08-01

    Today, 88% of pregnancies has a physiological course during which just basic care, while in 12% of cases there is a high-risk pregnancy that requires additional assistance and specific. The approach that should be used is that of supervision in all pregnant women considering their potential to have a normal pregnancy until there is no clear evidence to the contrary. Pregnancy is considered at risk if there are medical conditions that may affect maternal or fetal health or life of the mother, fetus or both. Among the risk factors for pregnancy there is first the woman's age, in fact the increase in high-risk pregnancies in the last 20 years is attributable to the increase in the average age of women who face pregnancy. In addition, the diet is very important during pregnancy and diabetes or autoimmune diseases often lead to the failure of a pregnancy. Risk factors for pregnancy, also, are the complications that occur during its course as hypertension during pregnancy, and infectious diseases. Fears and anxieties typical of a high-risk pregnancy prevent the couple to live happily in the months of gestation. Effective communication, control and early detection are important tools that doctors must be able to ensure that women in order to plan the best treatment strategies and to minimize the risks of maternal and / or fetal.

  6. Solar Selective Coatings for High Temperature Applications

    NASA Technical Reports Server (NTRS)

    Jaworske, Donald A.; Shumway, Dean A.

    2003-01-01

    Solar selective coatings are envisioned for use on minisatellites, for applications where solar energy is to be used to power heat engines or to provide thermal energy for remote regions in the interior of the spacecraft. These coatings are designed to have the combined properties of high solar absorptance and low infrared emittance. The coatings must be durable at elevated temperatures. For thermal bus applications, the temperature during operation is likely to be near 100 C. For heat engine applications. the temperature is expected to be much greater. The objective of this work was to screen candidate solar selective coatings for their high temperature durability. Candidate solar selective coatings were composed of molecular mixtures of metal and dielectric, including: nickel and aluminum oxide, titanium and aluminum oxide, and platinum and aluminum oxide. To identify high temperature durability, the solar absorptance and infrared emittance of the candidate coatings were evaluated initially, and after heating to temperatures in the range of 400 C to 700 C. The titanium and aluminum oxide molecular mixture was found to be the most durable.

  7. Not all risks are equal: the risk taking inventory for high-risk sports.

    PubMed

    Woodman, Tim; Barlow, Matt; Bandura, Comille; Hill, Miles; Kupciw, Dominika; Macgregor, Alexandra

    2013-10-01

    Although high-risk sport participants are typically considered a homogenous risk-taking population, attitudes to risk within the high-risk domain can vary considerably. As no validated measure allows researchers to assess risk taking within this domain, we validated the Risk Taking Inventory (RTI) for high-risk sport across four studies. The RTI comprises seven items across two factors: deliberate risk taking and precautionary behaviors. In Study 1 (n = 341), the inventory was refined and tested via a confirmatory factor analysis used in an exploratory fashion. The subsequent three studies confirmed the RTI's good model-data fit via three further separate confirmatory factor analyses. In Study 2 (n = 518) and in Study 3 (n = 290), concurrent validity was also confirmed via associations with other related traits (sensation seeking, behavioral activation, behavioral inhibition, impulsivity, self-esteem, extraversion, and conscientiousness). In Study 4 (n = 365), predictive validity was confirmed via associations with mean accidents and mean close calls in the high-risk domain. Finally, in Study 4, the self-report version of the inventory was significantly associated with an informant version of the inventory. The measure will allow researchers and practitioners to investigate risk taking as a variable that is conceptually distinct from participation in a high-risk sport.

  8. Effects of Comprehensive, Multiple High-Risk Behaviors Prevention Program on High School Students

    ERIC Educational Resources Information Center

    Collier, Crystal

    2013-01-01

    The purpose of this mixed methods study was to examine the effect of a multiple high-risk behaviors prevention program applied comprehensively throughout an entire school-system involving universal, selective, and indicated levels of students at a local private high school during a 4-year period. The prevention program was created based upon the…

  9. Electroconvulsive therapy during high-risk pregnancy.

    PubMed

    Walker, R; Swartz, C M

    1994-09-01

    Pregnancy increases the risk of injury associated with mental illness. The varieties of malnutrition, substance abuse, and aggression that may accompany mental illness can injure the unborn child in more severe ways than the patient herself. Dangers associated with illness-related behavior can outweight the risks of pharmacotherapy, but no psychotropic drug is approved for use during pregnancy. Failure to produce a prompt or lasting remission of psychiatric symptoms also is a significant possibility with medication. The morbidity from continued illness and the incompletely described adverse effects of psychotropic drugs increases the attractiveness of ECT for severely depressed pregnant patients, especially with associated high-risk conditions. This paper discusses physiologic changes occurring during pregnancy and ECT and reviews contemporary monitors of maternal and fetal well-being. Guidelines are suggested for ECT during regular and high-risk pregnancies. The authors conclude that using additional precautions with high-risk pregnant patients permits ECT to be given with relative safety; medical and obstetric risk factors need not prevent its use.

  10. High-Molecular Compounds (Selected Articles).

    DTIC Science & Technology

    1987-10-30

    34 07 250 HIGH-MOLECULAR COMPOUNIDS (SELECTED ARTICLES)(U) FOREIGN Il TECNOLOGY DIV WIGT-PATTERtSON RFD ON 30 OCT 6? FTD-ID(RS)T- M 2-97 UNCLASSIFIED...one can see, Is quite small and corresponds to such low mobility of molecules, at which the NMR signal is not observed. 5 , - Introduction of...system, which is represented by curve 4 (Fig. 2), located near the axis of the ordinate. The mobility of molecules with this degree of plastification

  11. [Cardiovascular polypill in high risk patients].

    PubMed

    Lafeber, Melvin; Spiering, Wilko; Bots, Michiel L; de Valk, Vincent; Visseren, Frank L J; Grobbee, Diederick E

    2011-01-01

    The initial theoretical concept of a polypill was a fixed-dosed combination pill containing an antiplatelet agent, a cholesterol-lowering agent and multiple blood pressure-lowering agents aimed at the prevention of atherosclerotic vascular disease in the population aged 55 years and up. The reduction in the risk of cardiovascular disease does not depend on the cholesterol level and blood pressure at the start of treatment. The pharmacological reduction in risk factors in individuals with a high risk of atherosclerotic vascular disease is often suboptimal, partly due to the complexity of the guidelines and low adherence to the therapy. A polypill may offer opportunities for improvement. Research has shown that the use of combination products leads to a greater reduction in risk factors than the use of separate substances, possibly through improved adherence to the therapy. The use of a polypill in the prevention of vascular disease in high-risk patients may lead to a more effective reduction in risk, a decrease in costs and a reduction in pharmacological expenditure.

  12. The Psychosis High-Risk State

    PubMed Central

    Fusar-Poli, Paolo; Borgwardt, Stefan; Bechdolf, Andreas; Addington, Jean; Riecher-Rössler, Anita; Schultze-Lutter, Frauke; Keshavan, Matcheri; Wood, Stephen; Ruhrmann, Stephan; Seidman, Larry J.; Valmaggia, Lucia; Cannon, Tyrone; Velthorst, Eva; De Haan, Lieuwe; Cornblatt, Barbara; Bonoldi, Ilaria; Birchwood, Max; McGlashan, Thomas; Carpenter, William; McGorry, Patrick; Klosterkötter, Joachim; McGuire, Philip; Yung, Alison

    2014-01-01

    Context During the past 2 decades, a major transition in the clinical characterization of psychotic disorders has occurred. The construct of a clinical high-risk (HR) state for psychosis has evolved to capture the prepsychotic phase, describing people presenting with potentially prodromal symptoms. The importance of this HR state has been increasingly recognized to such an extent that a new syndrome is being considered as a diagnostic category in the DSM-5. Objective To reframe the HR state in a comprehensive state-of-the-art review on the progress that has been made while also recognizing the challenges that remain. Data Sources Available HR research of the past 20 years from PubMed, books, meetings, abstracts, and international conferences. Study Selection and Data Extraction Critical review of HR studies addressing historical development, inclusion criteria, epidemiologic research, transition criteria, outcomes, clinical and functional characteristics, neurocognition, neuroimaging, predictors of psychosis development, treatment trials, socioeconomic aspects, nosography, and future challenges in the field. Data Synthesis Relevant articles retrieved in the literature search were discussed by a large group of leading worldwide experts in the field. The core results are presented after consensus and are summarized in illustrative tables and figures. Conclusions The relatively new field of HR research in psychosis is exciting. It has the potential to shed light on the development of major psychotic disorders and to alter their course. It also provides a rationale for service provision to those in need of help who could not previously access it and the possibility of changing trajectories for those with vulnerability to psychotic illnesses. PMID:23165428

  13. [Epidemiology of high risk pregnancy in Sousse, Tunisia].

    PubMed

    Bouafia, N; Mahjoub, M; Nouira, A; Ben Aissa, R; Saïdi, H; Guedana, N; Njah, M

    2013-05-01

    This descriptive study assessed the frequency of selected risk factors for high risk pregnancy (HRP) among women in Sousse region. All pregnant women (beyond 28 weeks gestation) giving birth in 4 public maternity hospitals between 15 February 2005 and 15 August 2005 and who had at least 1 risk factorwere enrolled. Data were collected within 24 hours of birth from obstetric and antenatal records and by interview. Of 4660 pregnant women, 1194 (25.6%) had at least 1 risk factor and were considered at-risk pregnancies. Mean age of the at-risk women was 31.3 (SD 5.4) years, 73% were urban residents, 38% had secondary education or higher and 75% were housewives. The mean number of risk factors was 1.5 per woman. The majority of women (59.3%) had 1 risk factor and 30.4% had 2. The mean number of prenatal visits was 4, 68.6% were seen by an obstetrician and 43% used the private sector. Certain factors were inadequately screened: age >35 years, parity >4, previous low birth weight and neonatal death, excessive fundal height and anaemia.

  14. Determination of high-risk cargo

    NASA Astrophysics Data System (ADS)

    Morris, Leo A.; Smith, Douglas E.; Khan, Siraj M.

    1994-10-01

    The approach and methodology used in the determination of the type of cargo containing concealments of commercial quantities of narcotics such as cocaine and heroin is described. This high-risk cargo enters the United States through border crossings at land, seaports and airports. The volume and variety of cargos make it a complex and challenging task for the U.S. Customs Service.

  15. High-Risk Workers: The Eczematous Hand

    PubMed Central

    Barber, Kirk A.

    1989-01-01

    The hand is the most commonly involved site in occupation — related skin disease, and contact eczema is the most common diagnosis. The identification of workers at high risk for this condition is possible and will help in their management and assessment. ImagesFigure 1Figure 2Figure 3 PMID:21248925

  16. Micronutrient requirements of high-risk infants

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Micronutrient requirements are well-established for healthy full-term infants. However, few such recommendations exist for high-risk infants, including full-term infants with a variety of medical disorders or very preterm infants. Key micronutrients considered in this review are calcium, phosphorus,...

  17. Hurricane risk mitigation - High Pressure Gas Facility

    NASA Technical Reports Server (NTRS)

    2008-01-01

    A worker pours concrete as part of a nitrogen risk mitigation project at the High Pressure Gas Facility at Stennis Space Center. The concrete slab will provide the foundation needed to place new pumps at the site and is part of ongoing hurricane-related mitigation work at Stennis.

  18. Innovative Materials for High Risk ABE Students.

    ERIC Educational Resources Information Center

    Connett, Dian; Rathburn, Rene

    This resource book contains innovative group activities, units of instruction, writing packets, and math activities that were developed to serve high-risk adult basic education (ABE) students. Included in the first section are units of study dealing with the following topics: Oregon history, personal health issues, controversial issues in science,…

  19. Intake of selected minerals and risk of premenstrual syndrome.

    PubMed

    Chocano-Bedoya, Patricia O; Manson, Joann E; Hankinson, Susan E; Johnson, Susan R; Chasan-Taber, Lisa; Ronnenberg, Alayne G; Bigelow, Carol; Bertone-Johnson, Elizabeth R

    2013-05-15

    Iron, potassium, zinc, and other minerals might impact the development of premenstrual syndrome (PMS) through multiple mechanisms, but few studies have evaluated these relations. We conducted a case-control study nested within the prospective Nurses' Health Study II (1991-2001). Participants were free from PMS at baseline. After 10 years, 1,057 women were confirmed as PMS cases and 1,968 as controls. Mineral intake was assessed using food frequency questionnaires completed in 1991, 1995, and 1999. After adjustment for calcium intake and other factors, women in the highest quintile of nonheme iron intake had a relative risk of PMS of 0.64 (95% confidence interval (CI): 0.44, 0.92; P for trend = 0.04) compared with women in the lowest quintile. Women in the highest quintile of potassium intake had a relative risk of 1.46 (95% CI: 0.99, 2.15; P for trend = 0.04) compared with women in the lowest quintile. High intake of zinc from supplements was marginally associated with PMS (for intake of ≥25 mg/day vs. none, relative risk = 0.69, 95% CI: 0.46, 1.02; P for trend = 0.05). Intakes of sodium, magnesium, and manganese were unrelated to PMS risk. These findings suggest that dietary minerals may be useful in preventing PMS. Additional studies are needed to confirm these relations.

  20. Early Identification of Educationally High Potential and High Risk Children.

    ERIC Educational Resources Information Center

    Keogh, Barbara K.; Smith, Carol E.

    Early identification of educationally high potential and high risk children was investigated by following the same 49 children from kindergarten entrance through grade five of a regular school program. Kindergarten predictive measures were the Bender Gestalt Test and teachers' evaluations; follow-up measures were yearly standard achievement test…

  1. [Labor monitoring in high-risk situations].

    PubMed

    Houfflin-Debarge, V; Closset, E; Deruelle, P

    2008-02-01

    Intrapartum asphyxia is increased in several situations such as intrauterine growth retardation, preterm labor, postdate pregnancy or maternal diabetes. In all these cases, fetal heart rate monitoring should be preferred to intermittent auscultation. Fetal scalp blood pH or lactates can be used to identify fetuses at risk of intrapartum asphyxia. However, fetal scalp blood sampling should not delay delivery in case of severe abnormal fetal heart rate as fetal asphyxia could occur rapidly in theses high-risk pregnancies. Data is insufficient to recommend fetal pulse oximetry or ECG analysis. Research should be undertaken to evaluate their performance in these situations.

  2. Stabilization of high-risk plaques

    PubMed Central

    Takata, Kohei; Zhang, Bo; Miura, Shin-ichiro; Saku, Keijiro

    2016-01-01

    The prevalence of atherosclerotic cardiovascular diseases (ASCVDs) is increasing globally and they have become the leading cause of death in most countries. Numerous experimental and clinical studies have been conducted to identify major risk factors and effective control strategies for ASCVDs. The development of imaging modalities with the ability to determine the plaque composition enables us to further identify high-risk plaque and evaluate the effectiveness of different treatment strategies. While intensive lipid-lowering by statins can stabilize or even regress plaque by various mechanisms, such as the reduction of lipid accumulation in a necrotic lipid core, the reduction of inflammation, and improvement of endothelial function, there are still considerable residual risks that need to be understood. We reviewed important findings regarding plaque vulnerability and some encouraging emerging approaches for plaque stabilization. PMID:27500090

  3. Predation risk induces changes in nest-site selection and clutch size in the Siberian jay

    PubMed Central

    Eggers, Sönke; Griesser, Michael; Nystrand, Magdalena; Ekman, Jan

    2005-01-01

    Life-history theory predicts that an individual should reduce its reproductive efforts by laying a smaller clutch size when high risk of nest predation reduces the value of current reproduction. Evidence in favour of this ‘nest predation hypothesis’, however, is scarce and based largely on correlative analyses. Here, we manipulated perceived risk of nest predation in the Siberian jay Perisoreus infaustus using playback involving a mixture of calls by corvid nest predators in the vicinity of nest sites. In response to being exposed to this acoustic cue simulating increased risk of nest predation, the jays chose a nest site offering more protective covering and reduced clutch size. This is the first experimental demonstration of clutch size adjustment and nest site selection as a result of phenotypic plasticity in an open nesting passerine reflecting a facultative response to the perceived risk of nest predation. PMID:16608689

  4. Major Risk Factors for Heart Disease: High Blood Cholesterol

    MedlinePlus

    ... Major Risk Factors for Heart Disease High Blood Cholesterol High blood cholesterol is another major risk factor for heart disease ... can do something about. The higher your blood cholesterol level, the greater your risk for developing heart ...

  5. Selective Testing of At-Risk Blood Donors for Trypanosoma cruzi and Plasmodium spp. in Switzerland

    PubMed Central

    Niederhauser, Christoph; Gottschalk, Jochen; Tinguely, Caroline

    2016-01-01

    Summary Background Population migrations and overseas recreational travel to regions at risk for tropical diseases are increasing. A major challenge in non-endemic countries is to decrease the number of blood donor deferrals due those tropical disease pathogens, without compromising the high level of blood safety. The protozoans Trypanosoma cruzi and Plasmodium spp., the causative organisms of Chagas disease (CD) and malaria are becoming a major focus in the blood transfusion community. Methods: National guidelines of the Blood Transfusion Service of the Swiss Red Cross propose an algorithm for dealing with these pathogens, including a mandatory selective serological testing of donors at risk. Results 6,978 donors at risk for CD were tested. Three of them were confirmed anti-T. cruzi -positive, and in one case a transfusion-transmitted infection was highly possible. The specificity of the assay was 99.94%. For malaria 12,887 donors were at risk and 178 were confirmed positive. The specificity of the assays was 92.8%. Conclusion CD and malaria in non-endemic countries may represent a certain risk for blood transfusion. Switzerland chose a selective testing approach. The specificity of the assays is a crucial topic for this approach because it ensures a minimal loss of false-reactive donors and helps towards an easier counselling of implicated donors. PMID:27403088

  6. A High-Risk Screen for Psychiatric Discharge Planning.

    ERIC Educational Resources Information Center

    Christ, Winifred R.; And Others

    1994-01-01

    Tested ability of 16-item high-risk screening list to accurately predict high-risk status by comparing admission and discharge high-risk scores for 448 patients with range of psychiatric disorders. Sixty-six percent of patients rated high risk at admission were identically rated at discharge. (Author/NB)

  7. High-Risk Series: An Update

    DTIC Science & Technology

    2015-02-01

    Interests a • Improving Federal Oversight of Food Safety a • Protecting Public Health through Enhanced Oversight of Medical Products a • Transforming...255 Improving Federal Oversight of Food Safety 262 Protecting Public Health through Enhanced Oversight of Medical Products 268 Contents...has been sufficient for us to narrow the scope of the high-risk issue. Specifically, the Food and Drug Administration (FDA) made progress by

  8. Selected anthropometric variables and aerobic fitness as predictors of cardiovascular disease risk in children

    PubMed Central

    Szmuchrowski, LA; Prado, LS; Couto, BP; Machado, JCQ; Damasceno, VO; Lamounier, JA

    2014-01-01

    The aim of this study was to assess the suitability of body mass index, waist circumference, waist-to-height ratio and aerobic fitness as predictors of cardiovascular risk factor clustering in children. A cross-sectional study was conducted with 290 school boys and girls from 6 to 10 years old, randomly selected. Blood was collected after a 12-hour fasting period. Blood pressure, waist circumference (WC), height and weight were evaluated according to international standards. Aerobic fitness (AF) was assessed by the 20-metre shuttle-run test. Clustering was considered when three of these factors were present: high systolic or diastolic blood pressure, high low-density lipoprotein (LDL) cholesterol, high triglycerides, high plasma glucose, high insulin concentrations and low high-density lipoprotein (HDL) cholesterol. A ROC curve identified the cut-off points of body mass index (BMI), WC, waist-to-height ratio (WHtR) and AF as predictors of risk factor clustering. BMI, WC and WHR resulted in significant areas under the ROC curves, which was not observed for AF. The anthropometric variables were good predictors of cardiovascular risk factor clustering in both sexes, whereas aerobic fitness should not be used to identify cardiovascular risk factor clustering in these children. PMID:26424930

  9. Prion strain interactions are highly selective

    PubMed Central

    Nilsson, K. Peter R.; Joshi-Barr, Shivanjali; Winson, Olivia; Sigurdson, Christina J.

    2010-01-01

    Various misfolded and aggregated neuronal proteins commonly co-exist in neurodegenerative disease, but whether the proteins co-aggregate and alter the disease pathogenesis is unclear. Here we used mixtures of distinct prion strains, which are believed to differ in conformation, to test the hypothesis that two different aggregates interact and change the disease in vivo. We tracked two prion strains in mice histopathologically and biochemically, as well as by spectral analysis of plaque-bound polythiophene acetic acid (PTAA), a conformation-sensitive fluorescent amyloid ligand. We found that prion strains interacted in a highly selective and strain-specific manner, with either (i) no interaction, (ii) hybrid plaque formation, or (iii) blockage of one strain by a second (interference). The hybrid plaques were maintained upon further passage in vivo and each strain seemed to maintain its original conformational properties, suggesting that one strain served only as a scaffold for aggregation of the second strain. These findings not only further our understanding of prion strain interactions, but also directly demonstrate interactions that may occur in other protein aggregate mixtures. PMID:20826672

  10. Solving portfolio selection problems with minimum transaction lots based on conditional-value-at-risk

    NASA Astrophysics Data System (ADS)

    Setiawan, E. P.; Rosadi, D.

    2017-01-01

    Portfolio selection problems conventionally means ‘minimizing the risk, given the certain level of returns’ from some financial assets. This problem is frequently solved with quadratic or linear programming methods, depending on the risk measure that used in the objective function. However, the solutions obtained by these method are in real numbers, which may give some problem in real application because each asset usually has its minimum transaction lots. In the classical approach considering minimum transaction lots were developed based on linear Mean Absolute Deviation (MAD), variance (like Markowitz’s model), and semi-variance as risk measure. In this paper we investigated the portfolio selection methods with minimum transaction lots with conditional value at risk (CVaR) as risk measure. The mean-CVaR methodology only involves the part of the tail of the distribution that contributed to high losses. This approach looks better when we work with non-symmetric return probability distribution. Solution of this method can be found with Genetic Algorithm (GA) methods. We provide real examples using stocks from Indonesia stocks market.

  11. The Effects of an Academic Alternative High School on Academically At-Risk Students

    ERIC Educational Resources Information Center

    Winningham, Mark L.

    2012-01-01

    In a causal-comparative research design, this study investigated the effectiveness of an academic alternative school in improving at-risk student outcomes in a selected county school system in the Upper Cumberland region of Tennessee. The academic alternative high school was compared to a traditional high school serving at-risk populations.…

  12. Interrupting the Inter-Generational Cycle in High Risk Adolescent Pregnancy.

    ERIC Educational Resources Information Center

    Stirtzinger, Ruth; McDermid, Stephanie; Grusec, Joan; Bernardini, Silvia; Quinlan, Kathy; Marshall, Michelle

    2002-01-01

    Describes the creation of a parenting course for high-risk adolescent mothers. This study supports direction away from 'knowledge-only' prevention/interventions with high risk adolescents and advocates the integration of this type of mental health/education parenting course with secondary school health class curricula using selected, trained…

  13. Sexual Selection and Predator Avoidance in the Acoustic Lepidoptera: Discriminating Females Take Fewer Risks

    DTIC Science & Technology

    2003-07-01

    UNCLASSIFIED Defense Technical Information Center Compilation Part Notice ADP022934 TITLE: Sexual Selection and Predator Avoidance in the Acoustic...technical report. The following component part numbers comprise the compilation report: ADP022883 thru ADP023022 UNCLASSIFIED Sexual Selection and...a fundamental expectation of sexual selection theory that mating activities incur risk. Normally, these risks are considered from the perspective of

  14. Diabetes and Amoebiasis: a high risk encounter.

    PubMed

    Bredin, C; Margery, J; Bordier, L; Mayaudon, H; Dupuy, O; Vergeau, B; Bauduceau, B

    2004-02-01

    Amoebiasis is the second most common parasitic disease worldwIde. It occurs mainly in developing countries. A high percentage of people in countries where it is endemic are asymptomatic carriers. It results in severe disease that can be fatal in rare cases. Diabetics are at increased risk of exposure as travel to countries where it is endemic becomes more frequent, as indicated by the present case. This patient suffered from amoebiasis that produced an amoeboma which is most rare in cases of colonic amoebiasis. The clinical picture was that of an occluding gut tumor, but it was treated only with drugs. Retrospective studies show that diabetics are at increased risk of suffering severe complications after amoebic infection. The frequency and severity of this diabetes-amoeba association requires patients to take prophylactic measures, especially when travelling in developing countries.

  15. High-risk sex offenders may not be high risk forever.

    PubMed

    Hanson, R Karl; Harris, Andrew J R; Helmus, Leslie; Thornton, David

    2014-10-01

    This study examined the extent to which sexual offenders present an enduring risk for sexual recidivism over a 20-year follow-up period. Using an aggregated sample of 7,740 sexual offenders from 21 samples, the yearly recidivism rates were calculated using survival analysis. Overall, the risk of sexual recidivism was highest during the first few years after release, and decreased substantially the longer individuals remained sex offense-free in the community. This pattern was particularly strong for the high-risk sexual offenders (defined by Static-99R scores). Whereas the 5-year sexual recidivism rate for high-risk sex offenders was 22% from the time of release, this rate decreased to 4.2% for the offenders in the same static risk category who remained offense-free in the community for 10 years. The recidivism rates of the low-risk offenders were consistently low (1%-5%) for all time periods. The results suggest that offense history is a valid, but time-dependent, indicator of the propensity to sexually reoffend. Further research is needed to explain the substantial rate of desistance by high-risk sexual offenders.

  16. Early Brain changes May Help Predict Autism Among High-Risk Infants

    MedlinePlus

    ... Media Resources Interviews & Selected Staff Profiles Multimedia Early brain changes may help predict autism among high-risk ... Share this: Page Content NIH-funded researchers link brain changes at 6 and 12 months of age ...

  17. Selectively predictive calcium supplementation using NCCN risk stratification system after thyroidectomy with differentiated thyroid cancer

    PubMed Central

    Sun, Ronghao; Zhang, Jie; Zhang, Fenghua; Fan, Jinchuan; Yuan, Ying; Li, Chao

    2015-01-01

    Background: Hypocalcemia is a common complication following thyroidectomy. To explore reasonable and simple methods for predicting postoperative hypocalcemia and identify the optimal strategies for selective calcium supplement are meaningful for surgeon. Methods: Based on the NCCN risk stratification system, patients were divided into 4 groups (A-D): low-risk group A, who only underwent limited thyroidectomy (LT) and high-risk groups B, C and D, who had received total thyroidectomy (TT) and selective central and/or lateral neck dissection (SND). After surgery, group C patients were orally given calcium gluconate and group D patients were intravenously given calcium 2 g/day for 7 days, while group B patients did not receive any calcium supplement. Serum calcium and parathyroid hormone (PTH) levels were collected before and after surgery. The incidence of asymptomatic and symptomatic hypocalcemia in each group was recorded. Results: A total of 132 patients with differentiated thyroid carcinoma (DTC) were included who received surgical treatment. No a significant change was observed in serum calcium and PTH levels in group A, while significant decreases in serum calcium and PTH levels were seen in group B (P < 0.05). Intravenous calcium supplement in group D resulted in a more rapid recovery in serum calcium levels (P < 0.05). The incidences of symptomatic hypocalcemia and asymptomatic hypocalcemia were significantly lower in group A and group D respectively compared to the other groups (All P values < 0.05). In group B, a highest asymptomatic and symptomatic hypocalcemia incidence was detected. Conclusion: Selective calcium supplementation for DTC based on NCCN risk stratification system could be recommended for the high-risk patients. PMID:26885165

  18. Selecting a risk-based tool to aid in decision making

    SciTech Connect

    Bendure, A.O.

    1995-03-01

    Selecting a risk-based tool to aid in decision making is as much of a challenge as properly using the tool once it has been selected. Failure to consider customer and stakeholder requirements and the technical bases and differences in risk-based decision making tools will produce confounding and/or politically unacceptable results when the tool is used. Selecting a risk-based decisionmaking tool must therefore be undertaken with the same, if not greater, rigor than the use of the tool once it is selected. This paper presents a process for selecting a risk-based tool appropriate to a set of prioritization or resource allocation tasks, discusses the results of applying the process to four risk-based decision-making tools, and identifies the ``musts`` for successful selection and implementation of a risk-based tool to aid in decision making.

  19. Ozone Health Risk Assessment for Selected Urban Areas

    EPA Pesticide Factsheets

    The health risk assessment described in this report estimated various health effects associated with O3 exposures as well as the reduced risks for one O3 season associated with just meeting the current O3 NAAQS.

  20. Selecting suitable solid organ transplant donors: Reducing the risk of donor-transmitted infections.

    PubMed

    Jr, Christopher S Kovacs; Koval, Christine E; van Duin, David; de Morais, Amanda Guedes; Gonzalez, Blanca E; Avery, Robin K; Mawhorter, Steven D; Brizendine, Kyle D; Cober, Eric D; Miranda, Cyndee; Shrestha, Rabin K; Teixeira, Lucileia; Mossad, Sherif B

    2014-06-24

    Selection of the appropriate donor is essential to a successful allograft recipient outcome for solid organ transplantation. Multiple infectious diseases have been transmitted from the donor to the recipient via transplantation. Donor-transmitted infections cause increased morbidity and mortality to the recipient. In recent years, a series of high-profile transmissions of infections have occurred in organ recipients prompting increased attention on the process of improving the selection of an appropriate donor that balances the shortage of needed allografts with an approach that mitigates the risk of donor-transmitted infection to the recipient. Important advances focused on improving donor screening diagnostics, using previously excluded high-risk donors, and individualizing the selection of allografts to recipients based on their prior infection history are serving to increase the donor pool and improve outcomes after transplant. This article serves to review the relevant literature surrounding this topic and to provide a suggested approach to the selection of an appropriate solid organ transplant donor.

  1. Selecting suitable solid organ transplant donors: Reducing the risk of donor-transmitted infections

    PubMed Central

    Jr, Christopher S Kovacs; Koval, Christine E; van Duin, David; de Morais, Amanda Guedes; Gonzalez, Blanca E; Avery, Robin K; Mawhorter, Steven D; Brizendine, Kyle D; Cober, Eric D; Miranda, Cyndee; Shrestha, Rabin K; Teixeira, Lucileia; Mossad, Sherif B

    2014-01-01

    Selection of the appropriate donor is essential to a successful allograft recipient outcome for solid organ transplantation. Multiple infectious diseases have been transmitted from the donor to the recipient via transplantation. Donor-transmitted infections cause increased morbidity and mortality to the recipient. In recent years, a series of high-profile transmissions of infections have occurred in organ recipients prompting increased attention on the process of improving the selection of an appropriate donor that balances the shortage of needed allografts with an approach that mitigates the risk of donor-transmitted infection to the recipient. Important advances focused on improving donor screening diagnostics, using previously excluded high-risk donors, and individualizing the selection of allografts to recipients based on their prior infection history are serving to increase the donor pool and improve outcomes after transplant. This article serves to review the relevant literature surrounding this topic and to provide a suggested approach to the selection of an appropriate solid organ transplant donor. PMID:25032095

  2. High risk factors of pancreatic carcinoma.

    PubMed

    Camara, Soriba Naby; Yin, Tao; Yang, Ming; Li, Xiang; Gong, Qiong; Zhou, Jing; Zhao, Gang; Yang, Zhi-Yong; Aroun, Tajoo; Kuete, Martin; Ramdany, Sonam; Camara, Alpha Kabinet; Diallo, Aissatou Taran; Feng, Zhen; Ning, Xin; Xiong, Jiong-Xin; Tao, Jing; Qin, Qi; Zhou, Wei; Cui, Jing; Huang, Min; Guo, Yao; Gou, Shan-Miao; Wang, Bo; Liu, Tao; Olivier, Ohoya Etsaka Terence; Conde, Tenin; Cisse, Mohamed; Magassouba, Aboubacar Sidiki; Ballah, Sneha; Keita, Naby Laye Moussa; Souare, Ibrahima Sory; Toure, Aboubacar; Traore, Sadamoudou; Balde, Abdoulaye Korse; Keita, Namory; Camara, Naby Daouda; Emmanuel, Dusabe; Wu, He-Shui; Wang, Chun-You

    2016-06-01

    Over the past decades, cancer has become one of the toughest challenges for health professionals. The epidemiologists are increasingly directing their research efforts on various malignant tumor worldwide. Of note, incidence of cancers is on the rise more quickly in developed countries. Indeed, great endeavors have to be made in the control of the life-threatening disease. As we know it, pancreatic cancer (PC) is a malignant disease with the worst prognosis. While little is known about the etiology of the PC and measures to prevent the condition, so far, a number of risk factors have been identified. Genetic factors, pre-malignant lesions, predisposing diseases and exogenous factors have been found to be linked to PC. Genetic susceptibility was observed in 10% of PC cases, including inherited PC syndromes and familial PC. However, in the remaining 90%, their PC might be caused by genetic factors in combination with environmental factors. Nonetheless, the exact mechanism of the two kinds of factors, endogenous and exogenous, working together to cause PC remains poorly understood. The fact that most pancreatic neoplasms are diagnosed at an incurable stage of the disease highlights the need to identify risk factors and to understand their contribution to carcinogenesis. This article reviews the high risk factors contributing to the development of PC, to provide information for clinicians and epidemiologists.

  3. The scale-dependent impact of wolf predation risk on resource selection by three sympatric ungulates.

    PubMed

    Kittle, Andrew M; Fryxell, John M; Desy, Glenn E; Hamr, Joe

    2008-08-01

    Resource selection is a fundamental ecological process impacting population dynamics and ecosystem structure. Understanding which factors drive selection is vital for effective species- and landscape-level management. We used resource selection probability functions (RSPFs) to study the influence of two forms of wolf (Canis lupus) predation risk, snow conditions and habitat variables on white-tailed deer (Odocoileus virginianus), elk (Cervus elaphus) and moose (Alces alces) resource selection in central Ontario's mixed forest French River-Burwash ecosystem. Direct predation risk was defined as the frequency of a predator's occurrence across the landscape and indirect predation risk as landscape features associated with a higher risk of predation. Models were developed for two winters, each at two spatial scales, using a combination of GIS-derived and ground-measured data. Ungulate presence was determined from snow track transects in 64 16- and 128 1-km(2) resource units, and direct predation risk from GPS radio collar locations of four adjacent wolf packs. Ungulates did not select resources based on the avoidance of areas of direct predation risk at any scale, and instead exhibited selection patterns that tradeoff predation risk minimization with forage and/or mobility requirements. Elk did not avoid indirect predation risk, while both deer and moose exhibited inconsistent responses to this risk. Direct predation risk was more important to models than indirect predation risk but overall, abiotic topographical factors were most influential. These results indicate that wolf predation risk does not limit ungulate habitat use at the scales investigated and that responses to spatial sources of predation risk are complex, incorporating a variety of anti-predator behaviours. Moose resource selection was influenced less by snow conditions than cover type, particularly selection for dense forest, whereas deer showed the opposite pattern. Temporal and spatial scale

  4. Principles for the selection of doses in chronic rodent bioassays. ILSI Risk Science Working Group on Dose Selection.

    PubMed

    Foran, J A

    1997-01-01

    Dose selection in chronic rodent bioassays has been one of the most debated issues in risk assessment. The Committee on Risk Assessment Methods of the National Research Council attempted, but failed, in 1993 to reach consensus on how to select doses for chronic rodent bioassays. However, a more recent effort conducted by the ILSI Risk Science Institute has resulted in a consensus set of principles for dose selection, including selection of the highest dose for chronic rodent bioassays. The principles encourage a move away from sole reliance on a maximum tolerated dose (MTD), as it has been traditionally defined (primarily by body weight and histopathology), and toward the use of sound scientific and toxicologic principles for the selection of all doses in the chronic bioassay. Specifically, the principles recommend that dose selection for chronic studies must be based on sound toxicologic principles; dose selection should consider human exposure; dose selection should be based on a variety of endpoints and effects derived from prechronic studies; and dose selection should consider physicochemical and other factors. Implementation of the principles internationally will have two important benefits; improvement in the quality and consistency of the rodent bioassay and international harmonization of dose selection procedures.

  5. Fetal and umbilical Doppler ultrasound in high-risk pregnancies

    PubMed Central

    Alfirevic, Zarko; Stampalija, Tamara; Gyte, Gillian ML

    2014-01-01

    Background Abnormal blood flow patterns in fetal circulation detected by Doppler ultrasound may indicate poor fetal prognosis. It is also possible false positive Doppler ultrasound findings could encourage inappropriate early delivery. Objectives The objective of this review was to assess the effects of Doppler ultrasound used to assess fetal well-being in high-risk pregnancies on obstetric care and fetal outcomes. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (September 2009) and the reference lists of identified studies. Selection criteria Randomised and quasi-randomised controlled trials of Doppler ultrasound for the investigation of umbilical and fetal vessels waveforms in high-risk pregnancies compared to no Doppler ultrasound. Data collection and analysis Two authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction. Data entry was checked. Main results Eighteen completed studies involving just over 10,000 women were included. The trials were generally of unclear quality with some evidence of possible publication bias. The use of Doppler ultrasound in high-risk pregnancy was associated a reduction in perinatal deaths (risk ratio (RR) 0.71, 95% confidence interval (CI) 0.52 to 0.98, 16 studies, 10,225 babies, 1.2% versus 1.7 %, numbers needed to treat = 203; 95%CI 103 to 4352). There were also fewer inductions of labour (average RR 0.89, 95% CI 0.80 to 0.99, 10 studies, 5633 women, random effects) and fewer caesarean sections (RR 0.90, 95% CI 0.84 to 0.97, 14 studies, 7918 women). No difference was found in operative vaginal births (RR 0.95, 95% CI 0.80 to 1.14, four studies, 2813 women) nor in Apgar scores less than seven at five minutes (RR 0.92, 95% CI 0.69 to 1.24, seven studies, 6321 babies). Authors’ conclusions Current evidence suggests that the use of Doppler ultrasound in high-risk pregnancies reduced the risk of perinatal deaths and resulted in less

  6. Risk selection in a regulated health insurance market: a review of the concept, possibilities and effects.

    PubMed

    van Kleef, Richard C; van de Ven, Wynand P M M; van Vliet, René C J A

    2013-12-01

    The Dutch basic health insurance is based on the principles of regulated competition. This implies that insurers and providers compete on price and quality while the regulator sets certain rules to achieve public objectives such as solidarity. Two regulatory aspects of this scheme are that insurers are not allowed to risk rate their premiums and are compensated for predictable variation in individual medical expenses (i.e., risk equalization). Research, however, indicates that the current risk equalization is imperfect, which confronts insurers and consumers with incentives for risk selection. The goal of this paper is to review the concept, possibilities and potential effects of risk selection in the Dutch basic health insurance. We conclude that the possibilities for risk selection are numerous and a potential threat to solidarity, efficiency and quality of care. Regulators should be aware that measurement of risk selection is a methodological and data-demanding challenge.

  7. A risk-based decision support framework for selection of appropriate safety measure system for underground coal mines.

    PubMed

    Samantra, Chitrasen; Datta, Saurav; Mahapatra, Siba Sankar

    2017-03-01

    In the context of underground coal mining industry, the increased economic issues regarding implementation of additional safety measure systems, along with growing public awareness to ensure high level of workers safety, have put great pressure on the managers towards finding the best solution to ensure safe as well as economically viable alternative selection. Risk-based decision support system plays an important role in finding such solutions amongst candidate alternatives with respect to multiple decision criteria. Therefore, in this paper, a unified risk-based decision-making methodology has been proposed for selecting an appropriate safety measure system in relation to an underground coal mining industry with respect to multiple risk criteria such as financial risk, operating risk, and maintenance risk. The proposed methodology uses interval-valued fuzzy set theory for modelling vagueness and subjectivity in the estimates of fuzzy risk ratings for making appropriate decision. The methodology is based on the aggregative fuzzy risk analysis and multi-criteria decision making. The selection decisions are made within the context of understanding the total integrated risk that is likely to incur while adapting the particular safety system alternative. Effectiveness of the proposed methodology has been validated through a real-time case study. The result in the context of final priority ranking is seemed fairly consistent.

  8. Integrating Professional and Folk Models of HIV Risk: YMSM's Perceptions of High-Risk Sex

    ERIC Educational Resources Information Center

    Kubicek, Katrina; Carpineto, Julie; McDavitt, Bryce; Weiss, George; Iverson, Ellen F.; Au, Chi-Wai; Kerrone, Dustin; Martinez, Miguel; Kipke, Michele D.

    2008-01-01

    Risks associated with HIV are well documented in research literature. Although a great deal has been written about high-risk sex, little research has been conducted to examine how young men who have sex with men (YMSM) perceive and define high-risk sexual behavior. In this study, we compare the "professional" and "folk" models of HIV risk based on…

  9. Youth Risk Behavior Surveillance National Alternative High School Youth Risk Behavior Survey, United States, 1998.

    ERIC Educational Resources Information Center

    Grunbaum, Jo Anne; Kann, Laura; Kinchen, Steven A.; Ross, James G.; Gowda, Vani R.; Collins, Janet L.; Kolbe, Lloyd J.

    2000-01-01

    The 1998 National Alternative High School Youth Risk Behavior Survey measured health risk behaviors at alternative high schools. Many alternative students engaged in behaviors that made them high-risk for serious problems (e.g., motor vehicle safety, violence, nutrition, sexuality, exercise, and substance abuse). Their prevalence of high risk…

  10. The increasing threat of Pseudomonas aeruginosa high-risk clones.

    PubMed

    Oliver, Antonio; Mulet, Xavier; López-Causapé, Carla; Juan, Carlos

    2015-01-01

    The increasing prevalence of chronic and hospital-acquired infections produced by multidrug-resistant (MDR) or extensively drug-resistant (XDR) Pseudomonas aeruginosa strains is associated with significant morbidity and mortality. This growing threat results from the extraordinary capacity of this pathogen for developing resistance through chromosomal mutations and from the increasing prevalence of transferable resistance determinants, particularly those encoding carbapenemases or extended-spectrum β-lactamases (ESBLs). P. aeruginosa has a nonclonal epidemic population structure, composed of a limited number of widespread clones which are selected from a background of a large quantity of rare and unrelated genotypes that are recombining at high frequency. Indeed, recent concerning reports have provided evidence of the existence of MDR/XDR global clones, denominated high-risk clones, disseminated in hospitals worldwide; ST235, ST111, and ST175 are likely those more widespread. Noteworthy, the vast majority of infections by MDR, and specially XDR, strains are produced by these and few other clones worldwide. Moreover, the association of high-risk clones, particularly ST235, with transferable resistance is overwhelming; nearly 100 different horizontally-acquired resistance elements and up to 39 different acquired β-lactamases have been reported so far among ST235 isolates. Likewise, MDR internationally-disseminated epidemic strains, such as the Liverpool Epidemic Strain (LES, ST146), have been noted as well among cystic fibrosis patients. Here we review the population structure, epidemiology, antimicrobial resistance mechanisms and virulence of the P. aeruginosa high-risk clones. The phenotypic and genetic factors potentially driving the success of high-risk clones, the aspects related to their detection in the clinical microbiology laboratory and the implications for infection control and public health are also discussed.

  11. Linking habitat selection and predation risk to spatial variation in survival.

    PubMed

    DeCesare, Nicholas J; Hebblewhite, Mark; Bradley, Mark; Hervieux, David; Neufeld, Lalenia; Musiani, Marco

    2014-03-01

    A central assumption underlying the study of habitat selection is that selected habitats confer enhanced fitness. Unfortunately, this assumption is rarely tested, and in some systems, gradients of predation risk may more accurately characterize spatial variation in vital rates than gradients described by habitat selection studies. Here, we separately measured spatial patterns of both resource selection and predation risk and tested their relationships with a key demographic trait, adult female survival, for a threatened ungulate, woodland caribou (Rangifer tarandus caribou Gmelin). We also evaluated whether exposure to gradients in both predation risk and resource selection value was manifested temporally through instantaneous or seasonal effects on survival outcomes. We used Cox proportional hazards spatial survival modelling to assess the relative support for 5 selection- and risk-based definitions of habitat quality, as quantified by woodland caribou adult female survival. These hypotheses included scenarios in which selection ideally mirrored survival, risk entirely drove survival, non-ideal selection correlated with survival but with additive risk effects, an ecological trap with maladaptive selection and a non-spatial effect of annual variation in weather. Indeed, we found positive relationships between the predicted values of a resource selection function (RSF) and survival, yet subsequently incorporating an additional negative effect of predation risk greatly improved models further. This revealed a positive, but non-ideal relationship between selection and survival. Gradients in these covariates were also shown to affect individual survival probability at multiple temporal scales. Exposure to increased predation risk had a relatively instantaneous effect on survival outcomes, whereas variation in habitat suitability predicted by an RSF had both instantaneous and longer-term seasonal effects on survival. Predation risk was an additive source of hazard

  12. Advanced Risk Analysis for High-Performing Organizations

    DTIC Science & Technology

    2006-01-01

    using traditional risk analysis techniques. Mission Assurance Analysis Protocol (MAAP) is one technique that high performers can use to identify and mitigate the risks arising from operational complexity....The operational environment for many types of organizations is changing. Changes in operational environments are driving the need for advanced risk ... analysis techniques. Many types of risk prevalent in today’s operational environments (e.g., event risks, inherited risk) are not readily identified

  13. Built Environment, Selected Risk Factors and Major Cardiovascular Disease Outcomes: A Systematic Review

    PubMed Central

    Malambo, Pasmore; Kengne, Andre P.; De Villiers, Anniza; Lambert, Estelle V.; Puoane, Thandi

    2016-01-01

    Introduction Built environment attributes have been linked to cardiovascular disease (CVD) risk. Therefore, identifying built environment attributes that are associated with CVD risk is relevant for facilitating effective public health interventions. Objective To conduct a systematic review of literature to examine the influence of built environmental attributes on CVD risks. Data Source Multiple database searches including Science direct, CINAHL, Masterfile Premier, EBSCO and manual scan of reference lists were conducted. Inclusion Criteria Studies published in English between 2005 and April 2015 were included if they assessed one or more of the neighborhood environmental attributes in relation with any major CVD outcomes and selected risk factors among adults. Data Extraction Author(s), country/city, sex, age, sample size, study design, tool used to measure neighborhood environment, exposure and outcome assessments and associations were extracted from eligible studies. Results Eighteen studies met the inclusion criteria. Most studies used both cross-sectional design and Geographic Information System (GIS) to assess the neighborhood environmental attributes. Neighborhood environmental attributes were significantly associated with CVD risk and CVD outcomes in the expected direction. Residential density, safety from traffic, recreation facilities, street connectivity and high walkable environment were associated with physical activity. High walkable environment, fast food restaurants, supermarket/grocery stores were associated with blood pressure, body mass index, diabetes mellitus and metabolic syndrome. High density traffic, road proximity and fast food restaurants were associated with CVDs outcomes. Conclusion This study confirms the relationship between neighborhood environment attributes and CVDs and risk factors. Prevention programs should account for neighborhood environmental attributes in the communities where people live. PMID:27880835

  14. Reducing cardiometabolic risk through selective antagonism of CB1 receptors.

    PubMed

    Van Gaal, Luc

    2007-01-01

    Over the past 15 years, research on the endogenous cannabinoid (CB) system-now usually referred to as the endocannabinoid system (ECS)-has identified the significant effects of the ECS on the regulation of food intake and lipid and glucose metabolism in animals and humans. Endocannabinoids are endogenous lipids capable of binding to endogenous CB1 and CB2 receptors. CB1 receptors are present in the hypothalamic nuclei, which are involved in the control of energy balance and body weight, and in the mesolimbic system, which mediates the motivation to consume palatable food, as well as in adipocytes, the gut, and the liver. In the recent Rimonabant in Obesity (RIO)-Europe study, treatment with the first CB1 receptor antagonist, rimonabant, led to sustained, clinically meaningful weight loss and a reduction in waist circumference. Patients treated with rimonabant also demonstrated statistically significant improvement in high-density lipoprotein cholesterol levels, triglyceride levels, and insulin resistance, as well as a reduced overall prevalence of metabolic syndrome. Results of this and other studies support the role of endocannabinoids in the development and maintenance of obesity. In addition, these findings suggest that CB1 receptor antagonists such as rimonabant may offer a potential new approach to managing obesity and associated cardiometabolic risk factors.

  15. Selected Aspects Of The Risk In The Supply Chain In Context Of The Supplier Quality Management

    NASA Astrophysics Data System (ADS)

    Koblen, Ivan; Lestyánszka Škůrková, Katarína

    2015-06-01

    The introductory part of the paper underlines the importance of "Risk-based thinking" in the Quality Management System (QMS) and risk in the supply chain, as a principle part of the QMS. After introducing the key terms, the authors focused on the principle part of the article - explanation of the external and internal supply chain risks and the main factors concerning the supply risks, demand risks and environmental risks (as cardinal types of external supply chain risks) as well as the manufacturing and process risks, network/planning and control risks (as most important types of internal supply chain risks). The authors inform on the selected supply chain risk management tools, especially on those which are linked to the appropriate utilization of quality management tools.

  16. 9 CFR 121.10 - Restricting access to select agents and toxins; security risk assessments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... and toxins; security risk assessments. 121.10 Section 121.10 Animals and Animal Products ANIMAL AND... Restricting access to select agents and toxins; security risk assessments. (a) An individual or entity... Administrator or the HHS Secretary following a security risk assessment by the Attorney General. (b)...

  17. 9 CFR 121.10 - Restricting access to select agents and toxins; security risk assessments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... and toxins; security risk assessments. 121.10 Section 121.10 Animals and Animal Products ANIMAL AND... Restricting access to select agents and toxins; security risk assessments. (a) An individual or entity... Administrator or the HHS Secretary following a security risk assessment by the Attorney General. (b)...

  18. 9 CFR 121.10 - Restricting access to select agents and toxins; security risk assessments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... and toxins; security risk assessments. 121.10 Section 121.10 Animals and Animal Products ANIMAL AND... Restricting access to select agents and toxins; security risk assessments. (a) An individual or entity... Administrator or the HHS Secretary following a security risk assessment by the Attorney General. (b)...

  19. 42 CFR 73.10 - Restricting access to select agents and toxins; security risk assessments.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...; security risk assessments. 73.10 Section 73.10 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH... access to select agents and toxins; security risk assessments. (a) An individual or entity required to... Administrator, following a security risk assessment by the Attorney General. (b) An individual will be deemed...

  20. 42 CFR 73.10 - Restricting access to select agents and toxins; security risk assessments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...; security risk assessments. 73.10 Section 73.10 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH... access to select agents and toxins; security risk assessments. (a) An individual or entity required to... Administrator, following a security risk assessment by the Attorney General. (b) An individual will be deemed...

  1. 42 CFR 73.10 - Restricting access to select agents and toxins; security risk assessments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...; security risk assessments. 73.10 Section 73.10 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH... access to select agents and toxins; security risk assessments. (a) An individual or entity required to... Administrator, following a security risk assessment by the Attorney General. (b) An individual will be deemed...

  2. 9 CFR 121.10 - Restricting access to select agents and toxins; security risk assessments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... and toxins; security risk assessments. 121.10 Section 121.10 Animals and Animal Products ANIMAL AND... Restricting access to select agents and toxins; security risk assessments. (a) An individual or entity... Administrator or the HHS Secretary following a security risk assessment by the Attorney General. (b)...

  3. 42 CFR 73.10 - Restricting access to select agents and toxins; security risk assessments.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...; security risk assessments. 73.10 Section 73.10 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH... access to select agents and toxins; security risk assessments. (a) An individual or entity required to... Administrator, following a security risk assessment by the Attorney General. (b) An individual will be deemed...

  4. 42 CFR 73.10 - Restricting access to select agents and toxins; security risk assessments.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...; security risk assessments. 73.10 Section 73.10 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH... access to select agents and toxins; security risk assessments. (a) An individual or entity required to... Administrator, following a security risk assessment by the Attorney General. (b) An individual will be deemed...

  5. Habitat Selection and Risk of Predation: Re-colonization by Lynx had Limited Impact on Habitat Selection by Roe Deer

    PubMed Central

    Samelius, Gustaf; Andrén, Henrik; Kjellander, Petter; Liberg, Olof

    2013-01-01

    Risk of predation is an evolutionary force that affects behaviors of virtually all animals. In this study, we examined how habitat selection by roe deer was affected by risk of predation by Eurasian lynx – the main predator of roe deer in Scandinavia. Specifically, we compared how habitat selection by roe deer varied (1) before and after lynx re-established in the study area and (2) in relation to habitat-specific risk of predation by lynx. All analyses were conducted at the spatial and temporal scales of home ranges and seasons. We did not find any evidence that roe deer avoided habitats in which the risk of predation by lynx was greatest and information-theoretic model selection showed that re-colonization by lynx had limited impact on habitat selection by roe deer despite lynx predation causing 65% of known mortalities after lynx re-colonized the area. Instead we found that habitat selection decreased when habitat availability increased for 2 of 5 habitat types (a pattern referred to as functional response in habitat selection). Limited impact of re-colonization by lynx on habitat selection by roe deer in this study differs from elk in North America altering both daily and seasonal patterns in habitat selection at the spatial scales of habitat patches and home ranges when wolves were reintroduced to Yellowstone National Park. Our study thus provides further evidence of the complexity by which animals respond to risk of predation and suggest that it may vary between ecosystems and predator-prey constellations. PMID:24069419

  6. Habitat selection and risk of predation: re-colonization by lynx had limited impact on habitat selection by roe deer.

    PubMed

    Samelius, Gustaf; Andrén, Henrik; Kjellander, Petter; Liberg, Olof

    2013-01-01

    Risk of predation is an evolutionary force that affects behaviors of virtually all animals. In this study, we examined how habitat selection by roe deer was affected by risk of predation by Eurasian lynx - the main predator of roe deer in Scandinavia. Specifically, we compared how habitat selection by roe deer varied (1) before and after lynx re-established in the study area and (2) in relation to habitat-specific risk of predation by lynx. All analyses were conducted at the spatial and temporal scales of home ranges and seasons. We did not find any evidence that roe deer avoided habitats in which the risk of predation by lynx was greatest and information-theoretic model selection showed that re-colonization by lynx had limited impact on habitat selection by roe deer despite lynx predation causing 65% of known mortalities after lynx re-colonized the area. Instead we found that habitat selection decreased when habitat availability increased for 2 of 5 habitat types (a pattern referred to as functional response in habitat selection). Limited impact of re-colonization by lynx on habitat selection by roe deer in this study differs from elk in North America altering both daily and seasonal patterns in habitat selection at the spatial scales of habitat patches and home ranges when wolves were reintroduced to Yellowstone National Park. Our study thus provides further evidence of the complexity by which animals respond to risk of predation and suggest that it may vary between ecosystems and predator-prey constellations.

  7. Risk Factors Associated with Incident Syphilis in a Cohort of High-Risk Men in Peru

    PubMed Central

    Konda, Kelika A.; Roberts, Chelsea P.; Maguiña, Jorge L.; Leon, Segundo R.; Clark, Jesse L.; Coates, Thomas J.; Caceres, Carlos F.; Klausner, Jeffrey D.

    2016-01-01

    Background Syphilis is concentrated among high-risk groups, but the epidemiology of syphilis reinfection is poorly understood. We characterized factors associated with syphilis incidence, including reinfection, in a high-risk cohort in Peru. Methods Participants in the NIMH CPOL trial were assessed at baseline and 2 annual visits with HIV/STI testing and behavioral surveys. Participants diagnosed with syphilis also attended 4- and 9-month visits. All participants underwent syphilis testing with RPR screening and TPPA confirmation. Antibiotic treatment was provided according to CDC guidelines. Reinfection was defined as a 4-fold titer increase or recurrence of seroreactivity after successful treatment with subsequent negative RPR titers. The longitudinal analysis used a Possion generalized estimating equations model with backward selection of variables in the final model (criteria P <0.02). Results Of 2,709 participants, 191 (7.05%) were RPR-reactive (median 1:8, range 1:1–1:1024) with TPPA confirmation. There were 119 total cases of incident syphilis, which included both reinfection and first-time incident cases. In the bivariate analysis, the oldest 2 quartiles of age (incidence ratio (IR) 3.84; P <0.001 and IR 8.15; P <0.001) and being MSM/TW (IR 6.48; P <0.001) were associated with higher risk of incident syphilis infection. Of the sexual risk behaviors, older age of sexual debut (IR 12.53; P <0.001), not being in a stable partnership (IR 1.56, P = 0.035), higher number of sex partners (IR 3.01; P <0.001), unprotected sex in the past 3 months (IR 0.56; P = 0.003), HIV infection at baseline (IR 3.98; P <0.001) and incident HIV infection during the study period (IR 6.26; P = 0.003) were all associated with incident syphilis. In the multivariable analysis, older age group (adjusted incidence ratio (aIR) 6.18; P <0.001), men reporting having sex with a man (aIR 4.63; P <0.001), and incident HIV infection (aIR 4.48; P = 0.008) were significantly associated

  8. Modeling biotic habitat high risk areas

    USGS Publications Warehouse

    Despain, D.G.; Beier, P.; Tate, C.; Durtsche, B.M.; Stephens, T.

    2000-01-01

    Fire, especially stand replacing fire, poses a threat to many threatened and endangered species as well as their habitat. On the other hand, fire is important in maintaining a variety of successional stages that can be important for approach risk assessment to assist in prioritizing areas for allocation of fire mitigation funds. One example looks at assessing risk to the species and biotic communities of concern followed by the Colorado Natural Heritage Program. One looks at the risk to Mexican spottled owls. Another looks at the risk to cutthroat trout, and a fourth considers the general effects of fire and elk.

  9. High Electron Mobility Transistors (HEMT). Selected Papers

    DTIC Science & Technology

    2010-06-01

    phase shifts experienced by the incident electron aElectronic mail: linzhou@asu.edu. FIG. 1. Cross-sectional high-resolution TEM image recorded in 112...strongly diffracting condition and has a uniform potential through its projected thickness, then the relationship between the holographic phase shift ...of AFRL-RY-WP-TR-2010-1178. 15. SUBJECT TERMS microelectronics, heterostructure, holography , modeling/simulation 16. SECURITY CLASSIFICATION OF

  10. Early Molecular Stratification of High-risk Primary Biliary Cholangitis.

    PubMed

    Hardie, Claire; Green, Kile; Jopson, Laura; Millar, Ben; Innes, Barbara; Pagan, Sarah; Tiniakos, Dina; Dyson, Jessica; Haniffa, Muzlifah; Bigley, Venetia; Jones, David E; Brain, John; Walker, Lucy J

    2016-12-01

    High-risk primary biliary cholangitis (PBC), defined by inadequate response at one year to Ursodeoxycholic acid (UDCA), is associated with disease progression and liver transplantation. Stratifying high-risk patients early would facilitate improved approaches to care. Using long-term follow-up data to define risk at presentation, 6 high-risk PBC patients and 8 low-risk patients were identified from biopsy, transplant and biochemical archival records. Formalin-fixed paraffin-embedded (FFPE) liver biopsies taken at presentation were graded (Scheuer and Nakanuma scoring) and gene expression analysed using the NanoString® nCounter PanCancer Immunity 770-gene panel. Principle component analysis (PCA) demonstrated discrete gene expression clustering between controls and high- and low-risk PBC. High-risk PBC was characterised by up-regulation of genes linked to T-cell activation and apoptosis, INF-γ signalling and leukocyte migration and down-regulation of those linked to the complement pathway. CDKN1a, up-regulated in high-risk PBC, correlated with significantly increased expression of its gene product, the senescence marker p21(WAF1/Cip), by biliary epithelial cells. Our findings suggest high- and low-risk PBC are biologically different from disease outset and senescence an early feature in high-risk disease. Identification of a high-risk 'signal' early from standard FFPE tissue sections has clear clinical utility allowing for patient stratification and second-line therapeutic intervention.

  11. High Pain Tolerance Tied to 'Silent' Heart Attack Risk

    MedlinePlus

    ... 162666.html High Pain Tolerance Tied to 'Silent' Heart Attack Risk Unusual symptoms include upper back or jaw ... be at increased risk of having a "silent" heart attack, a new study hints. Chest pain is one ...

  12. Bleeding risk under selective serotonin reuptake inhibitor (SSRI) antidepressants: A meta-analysis of observational studies.

    PubMed

    Laporte, Silvy; Chapelle, Céline; Caillet, Pascal; Beyens, Marie-Noëlle; Bellet, Florelle; Delavenne, Xavier; Mismetti, Patrick; Bertoletti, Laurent

    2017-04-01

    Selective serotonin reuptake inhibitors (SSRIs) have been reported to be potentially associated with an increased risk of bleeding. A meta-analysis of observational studies was conducted to quantify this risk. Case-control and cohort studies investigating bleeding risk under SSRI therapy were retrieved by searching the Medline, Pascal, Google Scholar and Scopus databases. Case-control studies were included if they reported bleeding incidents with and without the use of SSRIs and cohort studies were included if they reported the rate of bleeds among SSRI users and non-users. The main outcome was severe bleeding, whatever the site. Only data concerning SSRI belonging to the ATC class N06AB were used. For both case-control and cohort studies, we recorded the adjusted effect estimates and their 95% confidence intervals (CI). Pooled adjusted odds ratio (OR) estimates were computed for case-control and cohort studies using an inverse-variance model. Meta-analysis of the adjusted ORs of 42 observational studies showed a significant association between SSRI use and the risk of bleeding [OR 1.41 (95% CI 1.27-1.57), random effect model, p<0.0001]. The association was found for the 31 case-control studies (1,255,073 patients), with an increased risk of 41% of bleeding [OR 1.41 (95% CI 1.25-1.60)], as well as for the 11 cohort studies including 187,956 patients [OR 1.36 (95% CI 1.12-1.64)]. Subgroup analyses showed that the association remained constant whatever the characteristics of studies. This meta-analysis shows an increased risk of bleeding of at least 36% (from 12% to 64%) based on the high-level of observational studies with SSRIs use.

  13. Spatial ecology of refuge selection by an herbivore under risk of predation

    USGS Publications Warehouse

    Wilson, Tammy L.; Rayburn, Andrew P.; Edwards, Thomas C.

    2012-01-01

    Prey species use structures such as burrows to minimize predation risk. The spatial arrangement of these resources can have important implications for individual and population fitness. For example, there is evidence that clustered resources can benefit individuals by reducing predation risk and increasing foraging opportunity concurrently, which leads to higher population density. However, the scale of clustering that is important in these processes has been ignored during theoretical and empirical development of resource models. Ecological understanding of refuge exploitation by prey can be improved by spatial analysis of refuge use and availability that incorporates the effect of scale. We measured the spatial distribution of pygmy rabbit (Brachylagus idahoensis) refugia (burrows) through censuses in four 6-ha sites. Point pattern analyses were used to evaluate burrow selection by comparing the spatial distribution of used and available burrows. The presence of food resources and additional overstory cover resources was further examined using logistic regression. Burrows were spatially clustered at scales up to approximately 25 m, and then regularly spaced at distances beyond ~40 m. Pygmy rabbit exploitation of burrows did not match availability. Burrows used by pygmy rabbits were likely to be located in areas with high overall burrow density (resource clusters) and high overstory cover, which together minimized predation risk. However, in some cases we observed an interaction between either overstory cover (safety) or understory cover (forage) and burrow density. The interactions show that pygmy rabbits will use burrows in areas with low relative burrow density (high relative predation risk) if understory food resources are high. This points to a potential trade-off whereby rabbits must sacrifice some safety afforded by additional nearby burrows to obtain ample forage resources. Observed patterns of clustered burrows and non-random burrow use improve

  14. Microhabitat Selection by Marine Mesoconsumers in a Thermally Heterogeneous Habitat: Behavioral Thermoregulation or Avoiding Predation Risk?

    PubMed Central

    Vaudo, Jeremy J.; Heithaus, Michael R.

    2013-01-01

    Habitat selection decisions by consumers has the potential to shape ecosystems. Understanding the factors that influence habitat selection is therefore critical to understanding ecosystem function. This is especially true of mesoconsumers because they provide the link between upper and lower tropic levels. We examined the factors influencing microhabitat selection of marine mesoconsumers – juvenile giant shovelnose rays (Glaucostegus typus), reticulate whiprays (Himantura uarnak), and pink whiprays (H. fai) – in a coastal ecosystem with intact predator and prey populations and marked spatial and temporal thermal heterogeneity. Using a combination of belt transects and data on water temperature, tidal height, prey abundance, predator abundance and ray behavior, we found that giant shovelnose rays and reticulate whiprays were most often found resting in nearshore microhabitats, especially at low tidal heights during the warm season. Microhabitat selection did not match predictions derived from distributions of prey. Although at a course scale, ray distributions appeared to match predictions of behavioral thermoregulation theory, fine-scale examination revealed a mismatch. The selection of the shallow nearshore microhabitat at low tidal heights during periods of high predator abundance (warm season) suggests that this microhabitat may serve as a refuge, although it may come with metabolic costs due to higher temperatures. The results of this study highlight the importance of predators in the habitat selection decisions of mesoconsumers and that within thermal gradients, factors, such as predation risk, must be considered in addition to behavioral thermoregulation to explain habitat selection decisions. Furthermore, increasing water temperatures predicted by climate change may result in complex trade-offs that might have important implications for ecosystem dynamics. PMID:23593501

  15. Risk Management in High Adventure Outdoor Pursuits.

    ERIC Educational Resources Information Center

    Cinnamon, Jerry

    This paper outlines management guidelines for outdoor adventure pursuits based on analysis of accident case studies in the literature. Managing risk, to a large degree, involves managing human errors related to natural environmental hazards. The knowledge needed to manage risk may be gained through personal experience (the most dangerous way),…

  16. Protecting military personnel from high risk dietary supplements.

    PubMed

    Deuster, Patricia A; Lieberman, Harris R

    2016-01-01

    It is legal tomarketmost naturally occurring substances as dietary supplements in the USA without manufacturers demonstrating they are safe or effective, and an endless variety of ingredients, from esoteric botanicals to unapproved pharmaceuticals, can be found in dietary supplements. Use of certain supplements can pose a risk, but since a robust reporting systemdoes not exist in the USA it is difficult to know which are problematic and the number of adverse events (AE) resulting from their use. Certain populations, includingmilitary personnel, aremore likely to use dietary supplements than the general population. Approximately 70% of military personnel take dietary supplements while about 50% of civilians do. Service members prefer supplements purported to enhance physical performance such as supposedly natural stimulants, protein and amino acids, and combination products. Since some of thesemay be problematic, Servicemembers are probably at higher risk of injury than the general population. Ten percent of military populations appear to be taking potentially risky supplements, and the US Department of Defense (DoD) has taken variousmeasures to protect uniformed personnel including education, policy changes, and restricting sales. Actions taken include launching Operation Supplement Safety (OPSS), introducing a High Risk Supplement list, educating health care professionals on reporting AE thatmight be associated with dietary supplements, recommending policy for reporting AE, and developing an online AE reporting system. OPSS is a DoD-wide effort to educate service members, leaders, health care providers, military families, and retirees on how to safely select supplements

  17. Evaluation of Risk Management Strategies for a Low-Cost, High-Risk Project

    NASA Technical Reports Server (NTRS)

    Shishko, Robert; Jorgensen, Edward J.

    1996-01-01

    This paper summarizes work in progress to define and implement a risk management process tailored to a low-cost, high-risk, NASA mission -the Microrover Flight Experiment (MFEX, commonly called the Mars microrover).

  18. Exemestane Reduces Breast Cancer Risk in High-Risk Postmenopausal Women

    Cancer.gov

    Clinical trial results presented at the 2011 ASCO annual meeting showed that the aromatase inhibitor exemestane—used to treat early and advanced breast cancer—substantially reduced the risk of invasive breast cancer in high-risk postmenopausal women.

  19. Systemic Immunomodulatory Strategies in High-risk Corneal Transplantation

    PubMed Central

    Abud, Tulio B.; Di Zazzo, Antonio; Kheirkhah, Ahmad; Dana, Reza

    2017-01-01

    The cornea is the most commonly transplanted tissue in the body. Although corneal grafts generally have high success rates, transplantation onto inflamed and vascularized host beds, or so-called high-risk corneal transplantation, has a high rate of graft rejection. The management of this high-risk corneal transplantation is challenging and involves numerous measures. One of the key measures to prevent graft rejection in these cases is the use of systemic immunosuppressive agents. In this article, we will review the systemic immunosuppressive agents most commonly used for high-risk corneal transplantation, which include corticosteroids, cysclosporine A, tacrolimus, mycophenolate mofetil, and rapamycin. Benefits, risks, and published data on the use of these medications for high-risk corneal transplantation will be detailed. We will also summarize novel immunoregulatory approaches that may be used to prevent graft rejection in high-risk corneal transplantation. PMID:28299010

  20. Systemic Immunomodulatory Strategies in High-risk Corneal Transplantation.

    PubMed

    Abud, Tulio B; Di Zazzo, Antonio; Kheirkhah, Ahmad; Dana, Reza

    2017-01-01

    The cornea is the most commonly transplanted tissue in the body. Although corneal grafts generally have high success rates, transplantation onto inflamed and vascularized host beds, or so-called high-risk corneal transplantation, has a high rate of graft rejection. The management of this high-risk corneal transplantation is challenging and involves numerous measures. One of the key measures to prevent graft rejection in these cases is the use of systemic immunosuppressive agents. In this article, we will review the systemic immunosuppressive agents most commonly used for high-risk corneal transplantation, which include corticosteroids, cysclosporine A, tacrolimus, mycophenolate mofetil, and rapamycin. Benefits, risks, and published data on the use of these medications for high-risk corneal transplantation will be detailed. We will also summarize novel immunoregulatory approaches that may be used to prevent graft rejection in high-risk corneal transplantation.

  1. Tips for selecting highly efficient cyclones

    SciTech Connect

    Amrein, D.L.

    1995-05-01

    Cyclone dust collectors have been used--and misused--all over the world for more than 100 years. One reason for the misuse is a common perception among users that all cyclones are created equal--that is, as long as a cyclone resembles a cylinder with an attached cone, it will do its job. However, to maximize separation efficiency in a specific application requires a precise cyclone design, engineered to exact fit many possible variables. A well-designed cyclone, for instance, can achieve efficiencies as high s 99.9+% when operated properly within the envelope of its specifications. Nonetheless, cyclones are often used only as first-stage filters for performing crude separations, with final collections being carried out by more-costly baghouses and scrubbers. Compared with baghouses and scrubbers, cyclones have two important considerations in their favor. One, they are almost invariably safer--in terms of the potential for generating fires and explosions--than fabric filters. Second, cyclones have lower maintenance costs since there are no filter media to replace. The paper discusses the operation, design, and troubleshooting of cyclones.

  2. How can the regulator show evidence of (no) risk selection in health insurance markets? Conceptual framework and empirical evidence.

    PubMed

    van de Ven, Wynand P M M; van Vliet, René C J A; van Kleef, Richard C

    2017-03-01

    If consumers have a choice of health plan, risk selection is often a serious problem (e.g., as in Germany, Israel, the Netherlands, the United States of America, and Switzerland). Risk selection may threaten the quality of care for chronically ill people, and may reduce the affordability and efficiency of healthcare. Therefore, an important question is: how can the regulator show evidence of (no) risk selection? Although this seems easy, showing such evidence is not straightforward. The novelty of this paper is two-fold. First, we provide a conceptual framework for showing evidence of risk selection in competitive health insurance markets. It is not easy to disentangle risk selection and the insurers' efficiency. We suggest two methods to measure risk selection that are not biased by the insurers' efficiency. Because these measures underestimate the true risk selection, we also provide a list of signals of selection that can be measured and that, in particular in combination, can show evidence of risk selection. It is impossible to show the absence of risk selection. Second, we empirically measure risk selection among the switchers, taking into account the insurers' efficiency. Based on 2-year administrative data on healthcare expenses and risk characteristics of nearly all individuals with basic health insurance in the Netherlands (N > 16 million) we find significant risk selection for most health insurers. This is the first publication of hard empirical evidence of risk selection in the Dutch health insurance market.

  3. Parental prey selection affects risk-taking behaviour and spatial learning in avian offspring.

    PubMed

    Arnold, Kathryn E; Ramsay, Scot L; Donaldson, Christine; Adam, Aileen

    2007-10-22

    Early nutrition shapes life history. Parents should, therefore, provide a diet that will optimize the nutrient intake of their offspring. In a number of passerines, there is an often observed, but unexplained, peak in spider provisioning during chick development. We show that the proportion of spiders in the diet of nestling blue tits, Cyanistes caeruleus, varies significantly with the age of chicks but is unrelated to the timing of breeding or spider availability. Moreover, this parental prey selection supplies nestlings with high levels of taurine particularly at younger ages. This amino acid is known to be both vital and limiting for mammalian development and consequently found in high concentrations in placenta and milk. Based on the known roles of taurine in mammalian brain development and function, we then asked whether by supplying taurine-rich spiders, avian parents influence the stress responsiveness and cognitive function of their offspring. To test this, we provided wild blue tit nestlings with either a taurine supplement or control treatment once daily from the ages of 2-14 days. Then pairs of size- and sex-matched siblings were brought into captivity for behavioural testing. We found that juveniles that had received additional taurine as neonates took significantly greater risks when investigating novel objects than controls. Taurine birds were also more successful at a spatial learning task than controls. Additionally, those individuals that succeeded at a spatial learning task had shown intermediate levels of risk taking. Non-learners were generally very risk-averse controls. Early diet therefore has downstream impacts on behavioural characteristics that could affect fitness via foraging and competitive performance. Fine-scale prey selection is a mechanism by which parents can manipulate the behavioural phenotype of offspring.

  4. Selected Issues Associated with the Risk Assessment Process for Pesticides with Persistent, Bioaccumulative, and Toxic Characteristics

    EPA Science Inventory

    This Scientific Advisory Panel meeting will address selected scientific issues associated with assessing the potential ecological risks resulting from use of a pesticide active ingredient which has persistent, bioaccumulative, and toxic (PBT) characteristics. EPA will pose speci...

  5. Understanding high magnitude flood risk: evidence from the past

    NASA Astrophysics Data System (ADS)

    MacDonald, N.

    2009-04-01

    The average length of gauged river flow records in the UK is ~25 years, which presents a problem in determining flood risk for high-magnitude flood events. Severe floods have been recorded in many UK catchments during the past 10 years, increasing the uncertainty in conventional flood risk estimates based on river flow records. Current uncertainty in flood risk has implications for society (insurance costs), individuals (personal vulnerability) and water resource managers (flood/drought risk). An alternative approach is required which can improve current understanding of the flood frequency/magnitude relationship. Historical documentary accounts are now recognised as a valuable resource when considering the flood frequency/magnitude relationship, but little consideration has been given to the temporal and spatial distribution of these records. Building on previous research based on British rivers (urban centre): Ouse (York), Trent (Nottingham), Tay (Perth), Severn (Shrewsbury), Dee (Chester), Great Ouse (Cambridge), Sussex Ouse (Lewes), Thames (Oxford), Tweed (Kelso) and Tyne (Hexham), this work considers the spatial and temporal distribution of historical flooding. The selected sites provide a network covering many of the largest river catchments in Britain, based on urban centres with long detailed documentary flood histories. The chronologies offer an opportunity to assess long-term patterns of flooding, indirectly determining periods of climatic variability and potentially increased geomorphic activity. This research represents the first coherent large scale analysis undertaken of historical multi-catchment flood chronologies, providing an unparalleled network of sites, permitting analysis of the spatial and temporal distribution of historical flood patterns on a national scale.

  6. Strong Signature of Natural Selection within an FHIT Intron Implicated in Prostate Cancer Risk

    PubMed Central

    Ding, Yan; Larson, Garrett; Rivas, Guillermo; Lundberg, Cathryn; Geller, Louis; Ouyang, Ching; Weitzel, Jeffrey; Archambeau, John; Slater, Jerry; Daly, Mary B.; Benson, Al B.; Kirkwood, John M.; O'Dwyer, Peter J.; Sutphen, Rebecca; Stewart, James A.; Johnson, David; Nordborg, Magnus; Krontiris, Theodore G.

    2008-01-01

    Previously, a candidate gene linkage approach on brother pairs affected with prostate cancer identified a locus of prostate cancer susceptibility at D3S1234 within the fragile histidine triad gene (FHIT), a tumor suppressor that induces apoptosis. Subsequent association tests on 16 SNPs spanning approximately 381 kb surrounding D3S1234 in Americans of European descent revealed significant evidence of association for a single SNP within intron 5 of FHIT. In the current study, re-sequencing and genotyping within a 28.5 kb region surrounding this SNP further delineated the association with prostate cancer risk to a 15 kb region. Multiple SNPs in sequences under evolutionary constraint within intron 5 of FHIT defined several related haplotypes with an increased risk of prostate cancer in European-Americans. Strong associations were detected for a risk haplotype defined by SNPs 138543, 142413, and 152494 in all cases (Pearson's χ2 = 12.34, df 1, P = 0.00045) and for the homozygous risk haplotype defined by SNPs 144716, 142413, and 148444 in cases that shared 2 alleles identical by descent with their affected brothers (Pearson's χ2 = 11.50, df 1, P = 0.00070). In addition to highly conserved sequences encompassing SNPs 148444 and 152413, population studies revealed strong signatures of natural selection for a 1 kb window covering the SNP 144716 in two human populations, the European American (π = 0.0072, Tajima's D = 3.31, 14 SNPs) and the Japanese (π = 0.0049, Fay & Wu's H = 8.05, 14 SNPs), as well as in chimpanzees (Fay & Wu's H = 8.62, 12 SNPs). These results strongly support the involvement of the FHIT intronic region in an increased risk of prostate cancer. PMID:18953408

  7. Risk factors and effect of selective removal on retroviral infections prevalence in Belgian stray cats.

    PubMed

    Garigliany, M; Jolly, S; Dive, M; Bayrou, C; Berthemin, S; Robin, P; Godenir, R; Petry, J; Dahout, S; Cassart, D; Thiry, E; Desmecht, D; Saegerman, C

    2016-01-09

    The aim of this study was to evaluate the effect of several risk/protective factors and predictors on the prevalence of feline immunodeficiency virus (FIV) and feline leukaemia virus (FeLV) infections in 302 stray cats captured during a trap-neuter-release programme in a mixed urban-rural area from Belgium, from 2010 to 2012. The impact of selective removal of FIV-positive cats on the apparent prevalence in the remaining population over this three-year period was also assessed. The seroprevalences over three years were 18.8 per cent for FIV and 0.7 per cent for FeLV. For FIV, the seroprevalence decreased significantly from the first year of the programme (2010; 30.5 per cent) to the last (2012; 13.1 per cent). Sex (male) and age (adult and old cats) were risk factors, while the year of sampling (years 2011 and 2012) was a protective factor. Age, sex and location were the most relevant predictors of FIV status. The data presented in this study revealed a very high FIV seroprevalence in Belgian stray cats, while FeLV was almost absent. The selective removal of positive cats had a drastic effect on the FIV seroprevalence in the remaining cat population.

  8. Risk stratification and selection for statin therapy: going beyond Framingham.

    PubMed

    Fitchett, David H; Mancini, G B John; Gregoire, Jean; Anderson, Todd; McPherson, Ruth

    2014-06-01

    Decisions for statin therapy in the primary prevention of atherosclerotic cardiovascular disease are generally made using the 10-year Framingham Risk Score (FRS). Even when a family history of premature cardiovascular disease is taken into account, there is often ambiguity about the need for statin therapy for patients with a 10-year FRS of 5%-19% and low-density lipoprotein cholesterol <3.5 mmol/L. Current Canadian dyslipidemia guidelines recommend consideration of a diversity of other factors, including biochemical measurements and imaging studies to help determine whether the calculated FRS might be misleadingly low and whether statin therapy might, therefore, be prudent. However, efficient use of the plethora of secondary factors makes this decision process itself potentially ambiguous. This brief summary provides a practical approach for using clinical information, basic biochemical tests, and more specialized tests, such as carotid ultrasound and coronary artery calcium scoring, to identify groups of patients at greater risk for atherosclerotic cardiovascular disease than suggested by the FRS.

  9. Who takes risks in high-risk sports? A typological personality approach.

    PubMed

    Castanier, Carole; Le Scanff, Christine; Woodman, Tim

    2010-12-01

    We investigated the risk-taking behaviors of 302 men involved in high-risk sports (downhill skiing mountaineering rock climbing, paragliding, or skydiving). The sportsmen were classified using a typological approach to personality based on eight personality types, which were constructed from combinations of neuroticism, extraversion, and conscientiousness. Results showed that personality types with a configuration of low conscientiousness combined with high extraversion and/or high neuroticism (impulsive, hedonistic, insecure) were greater risk-takers. Conversely, personality types with a configuration of high conscientiousness combined with low extraversion and/or high extraversion (skeptic, brooder, entrepreneur) were lower risk-takers. Results are discussed in the context of typology and other approaches to understanding who takes risks in high-risk domains.

  10. Linking habitat selection and predation risk to spatial variation in survival

    PubMed Central

    DeCesare, Nicholas J; Hebblewhite, Mark; Bradley, Mark; Hervieux, David; Neufeld, Lalenia; Musiani, Marco; Mysterud, Atle

    2014-01-01

    1. A central assumption underlying the study of habitat selection is that selected habitats confer enhanced fitness. Unfortunately, this assumption is rarely tested, and in some systems, gradients of predation risk may more accurately characterize spatial variation in vital rates than gradients described by habitat selection studies. 2. Here, we separately measured spatial patterns of both resource selection and predation risk and tested their relationships with a key demographic trait, adult female survival, for a threatened ungulate, woodland caribou (Rangifer tarandus caribou Gmelin). We also evaluated whether exposure to gradients in both predation risk and resource selection value was manifested temporally through instantaneous or seasonal effects on survival outcomes. 3. We used Cox proportional hazards spatial survival modelling to assess the relative support for 5 selection- and risk-based definitions of habitat quality, as quantified by woodland caribou adult female survival. These hypotheses included scenarios in which selection ideally mirrored survival, risk entirely drove survival, non-ideal selection correlated with survival but with additive risk effects, an ecological trap with maladaptive selection and a non-spatial effect of annual variation in weather. 4. Indeed, we found positive relationships between the predicted values of a resource selection function (RSF) and survival, yet subsequently incorporating an additional negative effect of predation risk greatly improved models further. This revealed a positive, but non-ideal relationship between selection and survival. Gradients in these covariates were also shown to affect individual survival probability at multiple temporal scales. Exposure to increased predation risk had a relatively instantaneous effect on survival outcomes, whereas variation in habitat suitability predicted by an RSF had both instantaneous and longer-term seasonal effects on survival. 5. Predation risk was an additive source

  11. A Model for Investigating Predictive Validity at Highly Selective Institutions.

    ERIC Educational Resources Information Center

    Gross, Alan L.; And Others

    A statistical model for investigating predictive validity at highly selective institutions is described. When the selection ratio is small, one must typically deal with a data set containing relatively large amounts of missing data on both criterion and predictor variables. Standard statistical approaches are based on the strong assumption that…

  12. Risk-Taking, Safety and Older People. Selected Bibliographies on Ageing 3.

    ERIC Educational Resources Information Center

    Jackson, Wendy, Comp.

    This annotated bibliography, which was developed as part of a series of selected bibliographies on aging for Great Britain's Centre for Policy on Ageing, contains a total of 368 entries organized under the following subject headings: risk (identification, nature, responsibilities, risk taking, security); environmental safety (hazards, design,…

  13. An integrated methodology for assessment and selection of the project risk response actions.

    PubMed

    Seyedhoseini, Seyed Mohammad; Noori, Siamak; Hatefi, Mohammad Ali

    2009-05-01

    In a systematic process of project risk management, after risk assessment is implemented, the risk analysts encounter the phase of assessment and selection of the project risk response actions (RA). As indicated by many researchers, there are less systematic and well-developed solutions in the area of risk response assessment and selection. The present article introduces a methodology including a modeling approach with the objective of selecting a set of RA that minimizes the undesirable deviation from achieving the project scope. The developed objective function comprises the three key success criteria of a project, namely, time, quality, and cost. Our model integrates overall project management into the project risk response planning (P2RP). Furthermore, the proposed model stresses on an equivalent importance for both "risk" and "response." We believe that applying the proposed model helps the project risk analyst in most effective and efficient manner dealing with his or her complicated RA selection problems. The application of the proposed model was implemented in projects in the construction industry in which it showed tremendous time, cost, and quality improvements.

  14. Perceived Risk in College Selection: Differences in Evaluative Criteria Used by Students and Parents

    ERIC Educational Resources Information Center

    Warwick, Jacquelyn; Mansfield, Phylis M.

    2003-01-01

    Students and parents base college selection on how well the college will overcome the perceived financial, social, psychological, physical, and functional risks associated with the college experience. Nineteen criteria associated with these risks were evaluated for significant differences between students and parents as well as for their level of…

  15. Occurrence of selected pharmaceuticals in river water in Japan and assessment of their environmental risk.

    PubMed

    Komori, K; Suzuki, Y; Minamiyama, M; Harada, A

    2013-06-01

    The existence of pharmaceuticals in the water environment is thought to be a potential problem for aquatic organisms. In this study, we conducted a nationwide survey to clarify the occurrence of 24 selected pharmaceuticals in major Japanese rivers and evaluated their environmental risk to aquatic organisms. We found a total of 22 substances in river waters at concentrations from several nanograms per liter to several micrograms per liter. We found the highest, which was 2.4 μg/L of caffeine, followed by 1.5 μg/L of crotamiton and 1.4 μg/L of sulpiride. We conducted an environmental risk assessment of the 22 pharmaceuticals detected in river water, for which predicted no-effect concentration (PNEC) values for crustacea and algae had been obtained. The measured environmental concentration/PNEC values of four substances, caffeine, carbamazepine, clarithromycin, and ketoprofen, exceeded 0.1 with the maximum value of 9.0 for clarithromycin. As clarithromycin exhibits a high environmental risk to aquatic organisms, particular attention is required.

  16. Cancer risk factors for selecting cohorts for large-scale chemoprevention trials.

    PubMed

    Greenwald, P

    1996-01-01

    for cancer; and chemopreventive agent selection and development. A comprehensive database is being established to support the PTDN's decision-making process and will help to determine which agents investigated in preclinical and early phase clinical trials should move to large-scale testing. Cohorts for large-scale chemoprevention trials include individuals who are determined to be at high risk as a result of genetic predisposition, carcinogenic exposure, or the presence of biomarkers indicative of increased risk. Current large-scale trials in well-defined, high-risk populations include the Breast Cancer Prevention Trial (tamoxifen), the Prostate Cancer Prevention Trial (finasteride), and the N-(4-hydroxyphenyl) retinamide (4-HPR) breast cancer prevention study being conducted in Milan. Biomarker studies will provide valuable information for refining the design and facilitating the implementation of future large-scale trials. For example, potential biomarkers are being assessed at biopsy in women with ductal carcinoma in situ (DCIS). The women are then randomized to either placebo, tamoxifen, 4-HPR, or tamoxifen plus 4-HPR for 2-4 weeks, at which time surgery is performed and the biomarkers reassessed to determine biomarker modulation by the interventions. For prostate cancer, modulation of prostatic intraepithelial neoplasia (PIN) by 4-HPR and difluoromethylornithine is being investigated; similar studies are being planned for oltipraz, dehydroepiandrosterone, and vitamin E plus selenomethionine. The validation of biomarkers as surrogate endpoints for cancer incidence in high-risk cohorts will allow more agents to be evaluated in shorter studies that use fewer subjects to achieve the desired statistical power.

  17. Youth Risk Behavior Surveillance System: Selected 2011 National Health Risk Behaviors and Health Outcomes by Sex

    ERIC Educational Resources Information Center

    Centers for Disease Control and Prevention, 2011

    2011-01-01

    The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

  18. Prevalence of High-Risk Human Papillomavirus Among Older Women

    PubMed Central

    Lindau, Stacy Tessler; Drum, Melinda L.; Gaumer, Elyzabeth; Surawska, Hanna; Jordan, Jeanne A.

    2009-01-01

    Objective To estimate the prevalence, genotypes, and individual-level correlates of high-risk human papillomavirus (HPV) among women aged 57–85. Methods Community-residing women (n=1550), aged 57–85, were drawn from a nationally-representative probability sample. In-home interviews and biomeasures, including a self-collected vaginal specimen, were obtained between 2005 and 2006. Specimens were analyzed for high-risk HPV DNA using probe hybridization and signal amplification (hc2); of 1,028 specimens provided, 1,010 were adequate for analysis. All samples testing positive were analyzed for HPV DNA by L1 consensus polymerase chain reaction followed by type-specific hybridization. Results The overall population-based weighted estimate of high-risk HPV prevalence by hc2 was 6.0% (95% confidence interval [CI] = 4.5 to 7.9). Current marital and smoking status, frequency of sexual activity, history of cancer, and hysterectomy were associated with high-risk HPV positivity. Among high-risk HPV+ women, 63% had multiple type infections. HPV 16 or 18 was present in 17.4% of all high-risk HPV+ women. The most common high-risk genotypes among high-risk HPV+ women were HPV 61 (19.1%), 31 (13.1%), 52 (12.9%), 58 (12.5%), 83 (12.3%), 66(12.0%), 51 (11.7%), 45 (11.2%), 56 (10.3%), 53 (10.2%), 16 (9.7%), and 62 (9.2%). Being married and having an intact uterus were independently associated with lower prevalence of high-risk HPV. Among unmarried women, current sexual activity and smoking were independently and positively associated with high-risk HPV infection. Conclusions In this nationally representative population, nearly 1 in 16 women aged 57–85 were found to have high-risk HPV and prevalence was stable across older age groups. PMID:18978096

  19. Selective high affinity polydentate ligands and methods of making such

    DOEpatents

    DeNardo, Sally; DeNardo, Gerald; Balhorn, Rodney

    2010-02-16

    This invention provides novel polydentate selective high affinity ligands (SHALs) that can be used in a variety of applications in a manner analogous to the use of antibodies. SHALs typically comprise a multiplicity of ligands that each bind different region son the target molecule. The ligands are joined directly or through a linker thereby forming a polydentate moiety that typically binds the target molecule with high selectivity and avidity.

  20. The Risk of Adverse Impact in Selections Based on a Test with Known Effect Size

    ERIC Educational Resources Information Center

    De Corte, Wilfried; Lievens, Filip

    2005-01-01

    The authors derive the exact sampling distribution function of the adverse impact (AI) ratio for single-stage, top-down selections using tests with known effect sizes. Subsequently, it is shown how this distribution function can be used to determine the risk that a future selection decision on the basis of such tests will result in an outcome that…

  1. Group-size-mediated habitat selection and group fusion-fission dynamics of bison under predation risk.

    PubMed

    Fortin, Daniel; Fortin, Marie-Eve; Beyer, Hawthorne L; Duchesne, Thierry; Courant, Sabrina; Dancose, Karine

    2009-09-01

    For gregarious animals the cost-benefit trade-offs that drive habitat selection may vary dynamically with group size, which plays an important role in foraging and predator avoidance strategies. We examined how habitat selection by bison (Bison bison) varied as a function of group size and interpreted these patterns by testing whether habitat selection was more strongly driven by the competing demands of forage intake vs. predator avoidance behavior. We developed an analytical framework that integrated group size into resource selection functions (RSFs). These group-size-dependent RSFs were based on a matched case-control design and were estimated using conditional logistic regression (mixed and population-averaged models). Fitting RSF models to bison revealed that bison groups responded to multiple aspects of landscape heterogeneity and that selection varied seasonally and as a function of group size. For example, roads were selected in summer, but not in winter. Bison groups avoided areas of high snow water equivalent in winter. They selected areas composed of a large proportion of meadow area within a 700-m radius, and within those areas, bison selected meadows. Importantly, the strength of selection for meadows varied as a function of group size, with stronger selection being observed in larger groups. Hence the bison-habitat relationship depended in part on the dynamics of group formation and division. Group formation was most likely in meadows. In contrast, risk of group fission increased when bison moved into the forest and was higher during the time of day when movements are generally longer and more variable among individuals. We also found that stronger selection for meadows by large rather than small bison groups was caused by longer residence time in individual meadows by larger groups and that departure from meadows appears unlikely to result from a depression in food intake rate. These group-size-dependent patterns were consistent with the hypothesis

  2. Carbon nanotube nanoweb-bioelectrode for highly selective dopamine sensing.

    PubMed

    Zhao, Jie; Zhang, Weimin; Sherrell, Peter; Razal, Joselito M; Huang, Xu-Feng; Minett, Andrew I; Chen, Jun

    2012-01-01

    A highly sensitive and selective dopamine sensor was fabricated with the unique 3D carbon nanotube nanoweb (CNT-N) electrode. The as-synthesised CNT-N was modified by oxygen plasma to graft functional groups in order to increase selective electroactive sites at the CNT sidewalls. This electrode was characterized physically and electrochemically using HRSEM, Raman, FT-IR, and cyclic voltammetry (CV). Our investigations indicated that the O(2)-plasma treated CNT-N electrode could serve as a highly sensitive biosensor for the selective sensing of dopamine (DA, 1 μM to 20 μM) in the presence of ascorbic acid (AA, 1000 μM).

  3. Selecting first-line bevacizumab-containing therapy for advanced breast cancer: TURANDOT risk factor analyses

    PubMed Central

    Brodowicz, T; Lang, I; Kahan, Z; Greil, R; Beslija, S; Stemmer, S M; Kaufman, B; Petruzelka, L; Eniu, A; Anghel, R; Koynov, K; Vrbanec, D; Pienkowski, T; Melichar, B; Spanik, S; Ahlers, S; Messinger, D; Inbar, M J; Zielinski, C

    2014-01-01

    Background: The randomised phase III TURANDOT trial compared first-line bevacizumab–paclitaxel (BEV–PAC) vs bevacizumab–capecitabine (BEV–CAP) in HER2-negative locally recurrent/metastatic breast cancer (LR/mBC). The interim analysis revealed no difference in overall survival (OS; primary end point) between treatment arms; however, progression-free survival (PFS) and objective response rate were significantly superior with BEV–PAC. We sought to identify patient populations that may be most appropriately treated with one or other regimen. Methods: Patients with HER2-negative LR/mBC who had received no prior chemotherapy for advanced disease were randomised to either BEV–PAC (bevacizumab 10 mg kg−1 days 1 and 15 plus paclitaxel 90 mg m−2 days 1, 8 and 15 q4w) or BEV–CAP (bevacizumab 15 mg kg−1 day 1 plus capecitabine 1000 mg m−2 bid days 1–14 q3w). The study population was categorised into three cohorts: triple-negative breast cancer (TNBC), high-risk hormone receptor-positive (HR+) and low-risk HR+. High- and low-risk HR+ were defined, respectively, as having ⩾2 vs ⩽1 of the following four risk factors: disease-free interval ⩽24 months; visceral metastases; prior (neo)adjuvant anthracycline and/or taxane; and metastases in ⩾3 organs. Results: The treatment effect on OS differed between cohorts. Non-significant OS trends favoured BEV–PAC in the TNBC cohort and BEV–CAP in the low-risk HR+ cohort. In all three cohorts, there was a non-significant PFS trend favouring BEV–PAC. Grade ⩾3 adverse events were consistently less common with BEV–CAP. Conclusions: A simple risk factor index may help in selecting bevacizumab-containing regimens, balancing outcome, safety profile and patient preference. Final OS results are expected in 2015 (ClinicalTrials.gov NCT00600340). PMID:25268370

  4. Selection from fixed term to permanent employment: prospective study on health, job satisfaction, and behavioural risks

    PubMed Central

    Virtanen, M; Kivimaki, M; Elovainio, M; Vahtera, J

    2002-01-01

    Study objective: To examine health, job satisfaction, and behavioural risks as antecedents of selection from fixed term to permanent employment. Design: Prospective cohort study of change in employment contract during a two year period. Self reported health, recorded sickness absence, job satisfaction, behavioural risks, demographics, and occupational characteristics were assessed at baseline. Setting: Hospital staff in two Finnish hospital districts. Participants: A cohort of 526 hospital employees (54 men, 472 women) aged 20 to 58 years with a fixed term job contract at baseline. Main results: During the follow up period, 137 became permanently employed. Men, employees in higher positions, full time workers, and those with five to eight years in the employ of the hospital were more likely to become permanently employed. After adjusting for these factors, obtaining a permanent job contract was predicted by self rated good health (odds ratio (OR) 3.90; 95% confidence intervals (CI) 1.34 to 11.36), non-caseness of psychological distress (OR 1.80; 95% CI 1.01 to 3.20), high job satisfaction (OR 1.86; CI 1.17 to 2.94), and non-sedentary life style (OR 2.64; CI 1.29 to 5.41), compared with the rest of the cohort. Conclusions: Investigation of fixed term employees yields new information about selective mechanisms in employment mobility. Good health seems to promote the chances for a fixed term employee to reach a better labour market status. These results correspond to earlier research on selective mechanisms in other forms of employment mobility and provide a partial explanation for the socioeconomic gradient of health. PMID:12177087

  5. High-risk pregnancy and the rheumatologist.

    PubMed

    Soh, May Ching; Nelson-Piercy, Catherine

    2015-04-01

    Rheumatologists are increasingly involved in the care of young women who, in the age of biologic therapy, are now gaining control of their rheumatic diseases and attempting pregnancy. With careful planning, most women with rheumatic diseases have successful pregnancies. This article focuses specifically on the highest-risk pregnancies and controversial areas. We discuss the women at risk of complications, the types of maternal and fetal complications, the treatments that can be used in pregnancy (and breastfeeding) and longer-term outcomes that could affect the mother. SLE, RA, ANCA-associated vasculitides, large vessel vasculitis (e.g. Takayasu's) and other CTDs (e.g. scleroderma) are among the conditions covered. The evidence and controversies regarding the recommendations for the use of biologics in pregnancy are discussed. The role of the rheumatologist in pregnancy planning and caring for the pregnant and post-partum woman as part of the multidisciplinary team is discussed.

  6. A Prevention Program for Middle-School High Risk Youth.

    ERIC Educational Resources Information Center

    Gittman, Elizabeth; Cassata, Marian

    A 5-year federally funded substance abuse prevention program targeted 426 high risk middle-school youth from 4 school districts in Nassau County, New York. Combining a child-centered model with a systemic approach, the program's goal was to prevent or delay the onset of alcohol and other drug use. High-risk youth were identified by school…

  7. Serving Teenage Mothers and Their High-Risk Infants

    ERIC Educational Resources Information Center

    Levenson, Phyllis; And Others

    1978-01-01

    Describes the program of the Demonstration and Training Center for High Risk or Mentally Retarded Infants of Teenage Mothers (ITAM), which aims at providing stimulation to the high-risk infant in order to enhance his/her development, and to offer educational and supportive programs for the teenage mother. (CM)

  8. 40 CFR 35.6790 - High risk recipients.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false High risk recipients. 35.6790 Section 35.6790 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE... Actions Other Administrative Requirements for Cooperative Agreements § 35.6790 High risk recipients....

  9. 15 CFR 14.14 - High risk special award conditions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false High risk special award conditions. 14.14 Section 14.14 Commerce and Foreign Trade Office of the Secretary of Commerce UNIFORM...-PROFIT, AND COMMERCIAL ORGANIZATIONS Pre-Award Requirements § 14.14 High risk special award...

  10. Connecting with Students to Limit High-Risk Behaviors.

    ERIC Educational Resources Information Center

    Mendler, Allen N.

    2002-01-01

    Many youth use substances and engage in other high-risk behaviors in an attempt to allay the emptiness accompanying broken belongings. Schools can play important roles in fostering connections and creating the natural high that comes from success. (Author)

  11. 78 FR 15746 - Compendium of Analyses To Investigate Select Level 1 Probabilistic Risk Assessment End-State...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-12

    ... COMMISSION Compendium of Analyses To Investigate Select Level 1 Probabilistic Risk Assessment End-State... document entitled: Compendium of Analyses to Investigate Select Level 1 Probabilistic Risk Assessment End..., select ``ADAMS Public Documents'' and then select ``Begin Web- based ADAMS Search.'' For problems...

  12. Rates of violence in patients classified as high risk by structured risk assessment instruments

    PubMed Central

    Singh, Jay P.; Fazel, Seena; Gueorguieva, Ralitza; Buchanan, Alec

    2014-01-01

    Background Rates of violence in persons identified as high risk by structured risk assessment instruments (SRAIs) are uncertain and frequently unreported by validation studies. Aims To analyse the variation in rates of violence in individuals identified as high risk by SRAIs. Method A systematic search of databases (1995-2011) was conducted for studies on nine widely used assessment tools. Where violence rates in high-risk groups were not published, these were requested from study authors. Rate information was extracted, and binomial logistic regression was used to study heterogeneity. Results Information was collected on 13 045 participants in 57 samples from 47 independent studies. Annualised rates of violence in individuals classified as high risk varied both across and within instruments. Rates were elevated when population rates of violence were higher, when a structured professional judgement instrument was used and when there was a lower proportion of men in a study. Conclusions After controlling for time at risk, the rate of violence in individuals classified as high risk by SRAIs shows substantial variation. In the absence of information on local base rates, assigning predetermined probabilities to future violence risk on the basis of a structured risk assessment is not supported by the current evidence base. This underscores the need for caution when such risk estimates are used to influence decisions related to individual liberty and public safety. PMID:24590974

  13. Public and private health insurance in Germany: the ignored risk selection problem.

    PubMed

    Grunow, Martina; Nuscheler, Robert

    2014-06-01

    We investigate risk selection between public and private health insurance in Germany. With risk-rated premiums in the private system and community-rated premiums in the public system, advantageous selection in favor of private insurers is expected. Using 2000 to 2007 data from the German Socio-Economic Panel Study (SOEP), we find such selection. While private insurers are unable to select the healthy upon enrollment, they profit from an increase in the probability to switch from private to public health insurance of those individuals who have experienced a negative health shock. To avoid distorted competition between the two branches of health care financing, risk-adjusted transfers from private to public insurers should be instituted.

  14. Risk-Informed Decision Making: Application to Technology Development Alternative Selection

    NASA Technical Reports Server (NTRS)

    Dezfuli, Homayoon; Maggio, Gaspare; Everett, Christopher

    2010-01-01

    NASA NPR 8000.4A, Agency Risk Management Procedural Requirements, defines risk management in terms of two complementary processes: Risk-informed Decision Making (RIDM) and Continuous Risk Management (CRM). The RIDM process is used to inform decision making by emphasizing proper use of risk analysis to make decisions that impact all mission execution domains (e.g., safety, technical, cost, and schedule) for program/projects and mission support organizations. The RIDM process supports the selection of an alternative prior to program commitment. The CRM process is used to manage risk associated with the implementation of the selected alternative. The two processes work together to foster proactive risk management at NASA. The Office of Safety and Mission Assurance at NASA Headquarters has developed a technical handbook to provide guidance for implementing the RIDM process in the context of NASA risk management and systems engineering. This paper summarizes the key concepts and procedures of the RIDM process as presented in the handbook, and also illustrates how the RIDM process can be applied to the selection of technology investments as NASA's new technology development programs are initiated.

  15. Automated frame selection process for high-resolution microendoscopy

    NASA Astrophysics Data System (ADS)

    Ishijima, Ayumu; Schwarz, Richard A.; Shin, Dongsuk; Mondrik, Sharon; Vigneswaran, Nadarajah; Gillenwater, Ann M.; Anandasabapathy, Sharmila; Richards-Kortum, Rebecca

    2015-04-01

    We developed an automated frame selection algorithm for high-resolution microendoscopy video sequences. The algorithm rapidly selects a representative frame with minimal motion artifact from a short video sequence, enabling fully automated image analysis at the point-of-care. The algorithm was evaluated by quantitative comparison of diagnostically relevant image features and diagnostic classification results obtained using automated frame selection versus manual frame selection. A data set consisting of video sequences collected in vivo from 100 oral sites and 167 esophageal sites was used in the analysis. The area under the receiver operating characteristic curve was 0.78 (automated selection) versus 0.82 (manual selection) for oral sites, and 0.93 (automated selection) versus 0.92 (manual selection) for esophageal sites. The implementation of fully automated high-resolution microendoscopy at the point-of-care has the potential to reduce the number of biopsies needed for accurate diagnosis of precancer and cancer in low-resource settings where there may be limited infrastructure and personnel for standard histologic analysis.

  16. Automated frame selection process for high-resolution microendoscopy

    PubMed Central

    Ishijima, Ayumu; Schwarz, Richard A.; Shin, Dongsuk; Mondrik, Sharon; Vigneswaran, Nadarajah; Gillenwater, Ann M.; Anandasabapathy, Sharmila; Richards-Kortum, Rebecca

    2015-01-01

    Abstract. We developed an automated frame selection algorithm for high-resolution microendoscopy video sequences. The algorithm rapidly selects a representative frame with minimal motion artifact from a short video sequence, enabling fully automated image analysis at the point-of-care. The algorithm was evaluated by quantitative comparison of diagnostically relevant image features and diagnostic classification results obtained using automated frame selection versus manual frame selection. A data set consisting of video sequences collected in vivo from 100 oral sites and 167 esophageal sites was used in the analysis. The area under the receiver operating characteristic curve was 0.78 (automated selection) versus 0.82 (manual selection) for oral sites, and 0.93 (automated selection) versus 0.92 (manual selection) for esophageal sites. The implementation of fully automated high-resolution microendoscopy at the point-of-care has the potential to reduce the number of biopsies needed for accurate diagnosis of precancer and cancer in low-resource settings where there may be limited infrastructure and personnel for standard histologic analysis. PMID:25919426

  17. The Dark Side of the Moon: Meta-analytical Impact of Recruitment Strategies on Risk Enrichment in the Clinical High Risk State for Psychosis

    PubMed Central

    Fusar-Poli, Paolo; Schultze-Lutter, Frauke; Cappucciati, Marco; Rutigliano, Grazia; Bonoldi, Ilaria; Stahl, Daniel; Borgwardt, Stephan; Riecher-Rössler, Anita; Addington, Jean; Perkins, Diana O.; Woods, Scott W.; McGlashan, Thomas; Lee, Jimmy; Klosterkötter, Joachim; Yung, Alison R.; McGuire, Philip

    2016-01-01

    Background: The individual risk of developing psychosis after being tested for clinical high-risk (CHR) criteria (posttest risk of psychosis) depends on the underlying risk of the disease of the population from which the person is selected (pretest risk of psychosis), and thus on recruitment strategies. Yet, the impact of recruitment strategies on pretest risk of psychosis is unknown. Methods: Meta-analysis of the pretest risk of psychosis in help-seeking patients selected to undergo CHR assessment: total transitions to psychosis over the pool of patients assessed for potential risk and deemed at risk (CHR+) or not at risk (CHR−). Recruitment strategies (number of outreach activities per study, main target of outreach campaign, and proportion of self-referrals) were the moderators examined in meta-regressions. Results: 11 independent studies met the inclusion criteria, for a total of 2519 (CHR+: n = 1359; CHR−: n = 1160) help-seeking patients undergoing CHR assessment (mean follow-up: 38 months). The overall meta-analytical pretest risk for psychosis in help-seeking patients was 15%, with high heterogeneity (95% CI: 9%–24%, I 2 = 96, P < .001). Recruitment strategies were heterogeneous and opportunistic. Heterogeneity was largely explained by intensive (n = 11, β = −.166, Q = 9.441, P = .002) outreach campaigns primarily targeting the general public (n = 11, β = −1.15, Q = 21.35, P < .001) along with higher proportions of self-referrals (n = 10, β = −.029, Q = 4.262, P = .039), which diluted pretest risk for psychosis in patients undergoing CHR assessment. Conclusions: There is meta-analytical evidence for overall risk enrichment (pretest risk for psychosis at 38monhts = 15%) in help-seeking samples selected for CHR assessment as compared to the general population (pretest risk of psychosis at 38monhts=0.1%). Intensive outreach campaigns predominantly targeting the general population and a higher proportion of self-referrals diluted the pretest risk

  18. Quantification of mammographic masking risk with volumetric breast density maps: how to select women for supplemental screening

    NASA Astrophysics Data System (ADS)

    Holland, Katharina; van Gils, Carla H.; Wanders, Johanna OP; Mann, Ritse M.; Karssemeijer, Nico

    2016-03-01

    The sensitivity of mammograms is low for women with dense breasts, since cancers may be masked by dense tissue. In this study, we investigated methods to identify women with density patterns associated with a high masking risk. Risk measures are derived from volumetric breast density maps. We used the last negative screening mammograms of 93 women who subsequently presented with an interval cancer (IC), and, as controls, 930 randomly selected normal screening exams from women without cancer. Volumetric breast density maps were computed from the mammograms, which provide the dense tissue thickness at each location. These were used to compute absolute and percentage glandular tissue volume. We modeled the masking risk for each pixel location using the absolute and percentage dense tissue thickness and we investigated the effect of taking the cancer location probability distribution (CLPD) into account. For each method, we selected cases with the highest masking measure (by thresholding) and computed the fraction of ICs as a function of the fraction of controls selected. The latter can be interpreted as the negative supplemental screening rate (NSSR). Between the models, when incorporating CLPD, no significant differences were found. In general, the methods performed better when CLPD was included. At higher NSSRs some of the investigated masking measures had a significantly higher performance than volumetric breast density. These measures may therefore serve as an alternative to identify women with a high risk for a masked cancer.

  19. Preoperative patient assessment: Identifying patients at high risk.

    PubMed

    Boehm, O; Baumgarten, G; Hoeft, A

    2016-06-01

    Postoperative mortality remains alarmingly high with a mortality rate ranging between 0.4% and 4%. A small subgroup of multimorbid and/or elderly patients undergoing different surgical procedures naturally confers the highest risk of complications and perioperative death. Therefore, preoperative assessment should identify these high-risk patients and stratify them to individualized monitoring and treatment throughout all phases of perioperative care. A "tailored" perioperative approach might help further reduce perioperative morbidity and mortality. This article aims to elucidate individual morbidity-specific risks. It further suggests approaches to detect patients at the risk of perioperative complications.

  20. Temperature selectivity in reversed-phase high performance liquid chromatography.

    PubMed

    Dolan, John W

    2002-08-02

    Column temperature plays two important roles in reversed-phase high-performance liquid chromatography (RP-HPLC): control of retention (k) and control of selectivity (a). While changes in retention as a function of temperature are ubiquitous, selectivity changes for any given solute pair are more pronounced for ionized samples and samples with more polar substituents. With many samples, column temperature can be selected in a manner that optimizes resolution. The selectivity effects observed for temperature changes in RP-HPLC generally are complementary to those observed for mobile phase strength changes, so it is often possible to improve resolution by simultaneous optimization of temperature and mobile phase percent organic or gradient steepness. Computer simulation is a powerful tool for such optimization experiments. This paper reviews the influence of temperature on chromatographic selectivity for RP-HPLC.

  1. Super-surface selective nanomembranes providing simultaneous high permeation flux and high selectivity

    DOEpatents

    Hu, Michael Z.; Simpson, John T.; Aytug, Tolga; Paranthaman, Mariappan Parans; Sturgeon, Matthew R.

    2016-04-12

    Superhydrophobic membrane structures having a beneficial combination of throughput and a selectivity. The membrane structure can include a porous support substrate; and a membrane layer adherently disposed on and in contact with the porous support substrate. The membrane layer can include a nanoporous material having a superhydrophobic surface. The superhydrophobic surface can include a textured surface, and a modifying material disposed on the textured surface. Methods of making and using the membrane structures.

  2. Incisional Reinforcement in High-Risk Patients

    PubMed Central

    Feldmann, Timothy F.; Young, Monica T.; Pigazzi, Alessio

    2014-01-01

    Hernia formation after surgical procedures continues to be an important cause of surgical morbidity. Incisional reinforcement at the time of the initial operation has been used in some patient populations to reduce the risk of subsequent hernia formation. In this article, reinforcement techniques in different surgical wounds are examined to identify situations in which hernia formation may be prevented. Mesh use for midline closure, pelvic floor reconstruction, and stoma site reinforcement is discussed. Additionally, the use of retention sutures, closure of the open abdomen, and reinforcement after component separation are examined using current literature. Although existing studies do not support the routine use of mesh reinforcement for all surgical incisions, certain patient populations appear to benefit from reinforcement with lower rates of subsequent hernia formation. The identification and characterization of these groups will guide the future use of mesh reinforcement in surgical incisions. PMID:25435823

  3. Recent Positive Selection Drives the Expansion of a Schizophrenia Risk Nonsynonymous Variant at SLC39A8 in Europeans

    PubMed Central

    Li, Ming; Wu, Dong-Dong; Yao, Yong-Gang; Huo, Yong-Xia; Liu, Jie-Wei; Su, Bing; Chasman, Daniel I.; Chu, Audrey Y.; Huang, Tao; Qi, Lu; Zheng, Yan; Luo, Xiong-Jian

    2016-01-01

    Natural selection has played important roles in optimizing complex human adaptations. However, schizophrenia poses an evolutionary paradox during human evolution, as the illness has strongly negative effects on fitness, but persists with a prevalence of ~0.5% across global populations. Recent studies have identified numerous risk variations in diverse populations, which might be able to explain the stable and high rate of schizophrenia morbidity in different cultures and regions, but the questions about why the risk alleles derived and maintained in human gene pool still remain unsolved. Here, we studied the evolutionary pattern of a schizophrenia risk variant rs13107325 (P < 5.0×10−8 in Europeans) in the SLC39A8 gene. We found the SNP is monomorphic in Asians and Africans with risk (derived) T-allele totally absent, and further evolutionary analyses showed the T-allele has experienced recent positive selection in Europeans. Subsequent exploratory analyses implicated that the colder environment in Europe was the likely selective pressures, ie, when modern humans migrated “out of Africa” and moved to Europe mainland (a colder and cooler continent than Africa), new alleles derived due to positive selection and protected humans from risk of hypertension and also helped them adapt to the cold environment. The hypothesis was supported by our pleiotropic analyses with hypertension and energy intake as well as obesity in Europeans. Our data thus provides an intriguing example to illustrate a possible mechanism for maintaining schizophrenia risk alleles in the human gene pool, and further supported that schizophrenia is likely a product caused by pleiotropic effect during human evolution. PMID:26006263

  4. Preserved Coronary Flow Reserve Effectively Excludes High-Risk Coronary Artery Disease on Angiography

    PubMed Central

    Naya, Masanao; Murthy, Venkatesh L.; Taqueti, Viviany R.; Foster, Courtney R.; Klein, Josh; Garber, Mariya; Dorbala, Sharmila; Hainer, Jon; Blankstein, Ron; Resnic, Frederick; Di Carli, Marcelo F.

    2014-01-01

    Myocardial perfusion imaging has limited sensitivity for the detection of high-risk coronary artery disease (CAD). We tested the hypothesis that a normal coronary flow reserve (CFR) would be helpful for excluding the presence of high-risk CAD on angiography. Methods We studied 290 consecutive patients undergoing 82Rb PET within 180 d of invasive coronary angiography. High-risk CAD on angiography was defined as 2-vessel disease (≥70% stenosis), including the proximal left anterior descending artery; 3-vessel disease; or left main CAD (≥50% stenosis). Patients with prior Q wave myocardial infarction, elevated troponin levels between studies, prior coronary artery bypass grafting, a left ventricular ejection fraction of less than 40%, or severe valvular heart disease were excluded. Results Fifty-five patients (19%) had high-risk CAD on angiography. As expected, the trade-off between the sensitivity and the specificity of the CFR for identifying high-risk CAD varied substantially depending on the cutoff selected. In multivariable analysis, a binary CFR of less than or equal to 1.93 provided incremental diagnostic information for the identification of high-risk CAD beyond the model with the Duke clinical risk score (>25%), percentage of left ventricular ischemia (>10%), transient ischemic dilation index (>1.07), and change in the left ventricular ejection fraction during stress (<2) (P = 0.0009). In patients with normal or slightly to moderately abnormal results on perfusion scans (<10% of left ventricular mass) during stress (n = 136), a preserved CFR (>1.93) excluded high-risk CAD with a high sensitivity (86%) and a high negative predictive value (97%). Conclusion A normal CFR has a high negative predictive value for excluding high-risk CAD on angiography. Although an abnormal CFR increases the probability of significant obstructive CAD, it cannot reliably distinguish significant epicardial stenosis from nonobstructive, diffuse atherosclerosis or microvascular

  5. Heading for the hills: risk avoidance drives den site selection in African wild dogs.

    PubMed

    Jackson, Craig R; Power, R John; Groom, Rosemary J; Masenga, Emmanuel H; Mjingo, Ernest E; Fyumagwa, Robert D; Røskaft, Eivin; Davies-Mostert, Harriet

    2014-01-01

    Compared to their main competitors, African wild dogs (Lycaon pictus) have inferior competitive abilities and interspecific competition is a serious fitness-limiting factor. Lions (Panthera leo) are the dominant large carnivore in African savannah ecosystems and wild dogs avoid them both spatially and temporally. Wild dog young are particularly vulnerable and suffer high rates of mortality from lions. Since lions do not utilize all parts of the landscape with an equal intensity, spatial variation in lion densities can be exploited by wild dogs both during their general ranging behaviour, but more specifically when they are confined to a den with vulnerable young. Since patches of rugged terrain are associated with lower lion densities, we hypothesized that these comparatively safe habitats should be selected by wild dogs for denning. We investigated the relationship between the distribution of 100 wild dog den sites and the occurrence of rugged terrain in four wild dog populations located in Tanzania, Zimbabwe and South Africa. A terrain ruggedness index was derived from a 90 m digital elevation model and used to map terrain ruggedness at each site. We compared characteristics of actual and potential (random) den sites to determine how wild dogs select den sites. The distributions of wild dog dens were strongly associated with rugged terrain and wild dogs actively selected terrain that was more rugged than that available on average. The likelihood of encountering lions is reduced in these habitats, minimizing the risk to both adults and pups. Our findings have important implications for the conservation management of the species, especially when assessing habitat suitability for potential reintroductions. The simple technique used to assess terrain ruggedness may be useful to investigate habitat suitability, and even predict highly suitable denning areas, across large landscapes.

  6. Occurrence and preliminarily environmental risk assessment of selected pharmaceuticals in the urban rivers, China

    PubMed Central

    Zhou, Haidong; Ying, Tianqi; Wang, Xuelian; Liu, Jianbo

    2016-01-01

    Twelve selected pharmaceuticals including antibiotics, analgesics, antiepileptics and lipid regulators were analysed and detected in water samples collected from 18 sampling sections along the three main urban rivers in Yangpu District of Shanghai, China during four sampling campaigns. Besides, algal growth inhibition test was conducted to preliminarily assess the eco-toxicology induced by the target pharmaceuticals in the rivers. Mean levels for most of target compounds were generally below 100 ng/L at sampling sections, with the exception of caffeine and paracetamol presenting considerably high concentration. The detected pharmaceuticals in the urban rivers ranged from risk assessment showed that the presence of azithromycin, clarithromycin and caffeine may present an ecotoxicological risk in the urban rivers. For other tested pharmaceuticals the inhibition effects of single substances in the urban aquatic environment, based on the algae inhibition tests, were very imperceptible. PMID:27713558

  7. Occurrence and preliminarily environmental risk assessment of selected pharmaceuticals in the urban rivers, China

    NASA Astrophysics Data System (ADS)

    Zhou, Haidong; Ying, Tianqi; Wang, Xuelian; Liu, Jianbo

    2016-10-01

    Twelve selected pharmaceuticals including antibiotics, analgesics, antiepileptics and lipid regulators were analysed and detected in water samples collected from 18 sampling sections along the three main urban rivers in Yangpu District of Shanghai, China during four sampling campaigns. Besides, algal growth inhibition test was conducted to preliminarily assess the eco-toxicology induced by the target pharmaceuticals in the rivers. Mean levels for most of target compounds were generally below 100 ng/L at sampling sections, with the exception of caffeine and paracetamol presenting considerably high concentration. The detected pharmaceuticals in the urban rivers ranged from risk assessment showed that the presence of azithromycin, clarithromycin and caffeine may present an ecotoxicological risk in the urban rivers. For other tested pharmaceuticals the inhibition effects of single substances in the urban aquatic environment, based on the algae inhibition tests, were very imperceptible.

  8. Risk Factors for High Blood Pressure

    MedlinePlus

    ... to achieve target blood pressure goals with treatment. Overweight You are more likely to develop prehypertension or high blood pressure if you’re overweight or obese . The terms “overweight” and “obese” refer ...

  9. ANDROS: A code for Assessment of Nuclide Doses and Risks with Option Selection

    SciTech Connect

    Begovich, C.L.; Sjoreen, A.L.; Ohr, S.Y.; Chester, R.O.

    1986-11-01

    ANDROS (Assessment of Nuclide Doses and Risks with Option Selection) is a computer code written to compute doses and health effects from atmospheric releases of radionuclides. ANDROS has been designed as an integral part of the CRRIS (Computerized Radiological Risk Investigation System). ANDROS reads air concentrations and environmental concentrations of radionuclides to produce tables of specified doses and health effects to selected organs via selected pathways (e.g., ingestion or air immersion). The calculation may be done for an individual at a specific location or for the population of the whole assessment grid. The user may request tables of specific effects for every assessment grid location. Along with the radionuclide concentrations, the code requires radionuclide decay data, dose and risk factors, and location-specific data, all of which are available within the CRRIS. This document is a user manual for ANDROS and presents the methodology used in this code.

  10. Perovskite for the highly selective enrichment of phosphopeptides.

    PubMed

    Li, Xiao-Shui; Chen, Xi; Sun, Huan; Yuan, Bi-Feng; Feng, Yu-Qi

    2015-01-09

    Selective and effective enrichment of phosphopeptides from complex samples is essential in phosphoproteome study by mass spectrometry (MS). In this work, we compared perovskites (MgTiO3, CaTiO3, SrTiO3, BaTiO3 and CaZrO3) with metal oxides (ZrO2 and TiO2) in their capability for the selective enrichment of phosphopeptides. It was found here that perovskites exhibited higher selectivity towards phosphopeptides than commonly used ZrO2 and TiO2, even though they all have high affinity to phosphopeptides. As for perovskites, CaTiO3 exhibited better selectivity for enrichment of phosphopeptides than SrTiO3, MgTiO3, BaTiO3 and CaZrO3, which might be ascribed to their crystal structures and electrophilic abilities. Moreover, to further confirm the performance of CaTiO3, CaTiO3 and TiO2 were applied to the enrichment of phosphopeptides from tryptic digest of proteins of human Jurkat-T cell lysate, respectively. The results showed CaTiO3 has much higher selectivity than TiO2 in the enrichment of phosphopeptides from the complex biological sample. Taken together, here we show that CaTiO3 is an excellent material for the highly selective enrichment of phosphopeptides and it could be potentially used in the large-scale phosphoproteome study.

  11. A benefit/risk approach towards selecting appropriate pharmaceutical dosage forms - an application for paediatric dosage form selection.

    PubMed

    Sam, Tom; Ernest, Terry B; Walsh, Jennifer; Williams, Julie L

    2012-10-05

    The design and selection of new pharmaceutical dosage forms involves the careful consideration and balancing of a quality target product profile against technical challenges and development feasibility. Paediatric dosage forms present particular complexity due to the diverse patient population, patient compliance challenges and safety considerations of this vulnerable population. This paper presents a structured framework for assessing the comparative benefits and risks of different pharmaceutical design options against pre-determined criteria relating to (1) efficacy, (2) safety and (3) patient access. This benefit/risk framework has then been applied to three hypothetical, but realistic, scenarios for paediatric dosage forms in order to explore its utility in guiding dosage form design and formulation selection. The approach allows a rigorous, systematic and qualitative assessment of the merits and disadvantages of each dosage form option and helps identify mitigating strategies to modify risk. The application of a weighting and scoring system to the criteria depending on the specific case could further refine the analysis and aid decision-making. In this paper, one case study is scored for illustrative purposes. However, it is acknowledged that in real development scenarios, the generation of actual data considering the very specific situation for the patient/product/developer would come into play to drive decisions on the most appropriate dosage form strategy.

  12. Patterns of population differentiation and natural selection on the celiac disease background risk network.

    PubMed

    Sams, Aaron; Hawks, John

    2013-01-01

    Celiac disease is a common small intestinal inflammatory condition induced by wheat gluten and related proteins from rye and barley. Left untreated, the clinical presentation of CD can include failure to thrive, malnutrition, and distension in juveniles. The disease can additionally lead to vitamin deficiencies, anemia, and osteoporosis. Therefore, CD potentially negatively affected fitness in past populations utilizing wheat, barley, and rye. Previous analyses of CD risk variants have uncovered evidence for positive selection on some of these loci. These studies also suggest the possibility that risk for common autoimmune conditions such as CD may be the result of positive selection on immune related loci in the genome to fight infection. Under this evolutionary scenario, disease phenotypes may be a trade-off from positive selection on immunity. If this hypothesis is generally true, we can expect to find a signal of natural selection when we survey across the network of loci known to influence CD risk. This study examines the non-HLA autosomal network of gene loci associated with CD risk in Europe. We reject the null hypothesis of neutrality on this network of CD risk loci. Additionally, we can localize evidence of selection in time and space by adding information from the genome of the Tyrolean Iceman. While we can show significant differentiation between continental regions across the CD network, the pattern of evidence is not consistent with primarily recent (Holocene) selection across this network in Europe. Further localization of ancient selection on this network may illuminate the ecological pressures acting on the immune system during this critically interesting phase of our evolution.

  13. Brachytherapy boost and cancer-specific mortality in favorable high-risk versus other high-risk prostate cancer

    PubMed Central

    Muralidhar, Vinayak; Xiang, Michael; Orio, Peter F.; Martin, Neil E.; Beard, Clair J.; Feng, Felix Y.; Hoffman, Karen E.

    2016-01-01

    Purpose Recent retrospective data suggest that brachytherapy (BT) boost may confer a cancer-specific survival benefit in radiation-managed high-risk prostate cancer. We sought to determine whether this survival benefit would extend to the recently defined favorable high-risk subgroup of prostate cancer patients (T1c, Gleason 4 + 4 = 8, PSA < 10 ng/ml or T1c, Gleason 6, PSA > 20 ng/ml). Material and methods We identified 45,078 patients in the Surveillance, Epidemiology, and End Results database with cT1c-T3aN0M0 intermediate- to high-risk prostate cancer diagnosed 2004-2011 treated with external beam radiation therapy (EBRT) only or EBRT plus BT. We used multivariable competing risks regression to determine differences in the rate of prostate cancer-specific mortality (PCSM) after EBRT + BT or EBRT alone in patients with intermediate-risk, favorable high-risk, or other high-risk disease after adjusting for demographic and clinical factors. Results EBRT + BT was not associated with an improvement in 5-year PCSM compared to EBRT alone among patients with favorable high-risk disease (1.6% vs. 1.8%; adjusted hazard ratio [AHR]: 0.56; 95% confidence interval [CI]: 0.21-1.52, p = 0.258), and intermediate-risk disease (0.8% vs. 1.0%, AHR: 0.83, 95% CI: 0.59-1.16, p = 0.270). Others with high-risk disease had significantly lower 5-year PCSM when treated with EBRT + BT compared with EBRT alone (3.9% vs. 5.3%; AHR: 0.73; 95% CI: 0.55-0.95; p = 0.022). Conclusions Brachytherapy boost is associated with a decreased rate of PCSM in some men with high-risk prostate cancer but not among patients with favorable high-risk disease. Our results suggest that the recently-defined “favorable high-risk” category may be used to personalize therapy for men with high-risk disease. PMID:26985191

  14. Who Takes Risks in High-Risk Sports? A Typological Personality Approach

    ERIC Educational Resources Information Center

    Castanier, Carole; Le Scanff, Christine; Woodman, Tim

    2010-01-01

    We investigated the risk-taking behaviors of 302 men involved in high-risk sports (downhill skiing, mountaineering, rock climbing, paragliding, or skydiving). The sportsmen were classified using a typological approach to personality based on eight personality types, which were constructed from combinations of neuroticism, extraversion, and…

  15. Predicting the Unpredictable? Identifying High-Risk versus Low-Risk Parents with Intellectual Disabilities

    ERIC Educational Resources Information Center

    McGaw, Sue; Scully, Tamara; Pritchard, Colin

    2010-01-01

    Objectives: This study set out to identify risk factors affecting parents with intellectual disabilities (IDs) by determining: (i) whether perception of family support differs between parents with IDs, referring professionals, and a specialist parenting service; (ii) whether multivariate familial and demographic factors differentiates "high-risk"…

  16. A Preventive Dental Program for "High Risk" Children

    ERIC Educational Resources Information Center

    Meskin, Lawrence H.; And Others

    1977-01-01

    A dental health program in an elementary school succeeded in identifying children considered to be "high risk" in oral health and, through treatment and education, significantly improved their dental health. (JD)

  17. Treating Patients with High-Risk Smoldering Myeloma

    Cancer.gov

    In this phase III clinical trial, patients with smoldering myeloma classified as high risk for progression will be randomly assigned to undergo standard observation or six 4-week courses of treatment with the drug lenalidomide.

  18. Identification of the high risk emergency surgical patient: Which risk prediction model should be used?

    PubMed Central

    Stonelake, Stephen; Thomson, Peter; Suggett, Nigel

    2015-01-01

    Introduction National guidance states that all patients having emergency surgery should have a mortality risk assessment calculated on admission so that the ‘high risk’ patient can receive the appropriate seniority and level of care. We aimed to assess if peri-operative risk scoring tools could accurately calculate mortality and morbidity risk. Methods Mortality risk scores for 86 consecutive emergency laparotomies, were calculated using pre-operative (ASA, Lee index) and post-operative (POSSUM, P-POSSUM and CR-POSSUM) risk calculation tools. Morbidity risk scores were calculated using the POSSUM predicted morbidity and compared against actual morbidity according to the Clavien–Dindo classification. Results The actual mortality was 10.5%. The average predicted risk scores for all laparotomies were: ASA 26.5%, Lee Index 2.5%, POSSUM 29.5%, P-POSSUM 18.5%, CR-POSSUM 10.5%. Complications occurred following 67 laparotomies (78%). The majority (51%) of complications were classified as Clavien–Dindo grade 2–3 (non-life-threatening). Patients having a POSSUM morbidity risk of greater than 50% developed significantly more life-threatening complications (CD 4–5) compared with those who predicted less than or equal to 50% morbidity risk (P = 0.01). Discussion Pre-operative risk stratification remains a challenge because the Lee Index under-predicts and ASA over-predicts mortality risk. Post-operative risk scoring using the CR-POSSUM is more accurate and we suggest can be used to identify patients who require intensive care post-operatively. Conclusions In the absence of accurate risk scoring tools that can be used on admission to hospital it is not possible to reliably audit the achievement of national standards of care for the ‘high-risk’ patient. PMID:26468369

  19. Selective Serotonin Reuptake Inhibitor Use during Pregnancy and the Risk of Autism Spectrum Disorders: A Review

    PubMed Central

    Boukhris, Takoua; Bérard, Anick

    2015-01-01

    Antidepressants are widely used during pregnancy. Several studies have shown that the use of antidepressants during pregnancy is linked to adverse outcomes, including congenital malformations, prematurity, and low birth weight. However, there is a knowledge gap regarding the potential association between gestational exposure to antidepressants and the risk of autism spectrum disorders (ASD). The etiology of ASD remains unclear, although studies have implicated genetic predispositions and environmental risk factors in the development of ASD in children. In this review, we describe the association between gestational use of antidepressants, specifically selective serotonin reuptake inhibitors, and the risk of ASD. PMID:27617119

  20. Assessment of high cardiovascular risk profiles for the clinician.

    PubMed

    Whayne, Thomas F

    2013-07-01

    Diabetes mellitus (DM) is a major cardiovascular (CV) risk factor. General Framingham Risk Profile (GFRP) and World Health Organization/International Society of Hypertension (WHO/ISH) charts were used to assess CV risk in DM in Oman. The GFRP identified more patients with medium-risk DM; GFRP and WHO/ISH identified essentially equal numbers at very high risk. These were then used to evaluate statin usage in Oman, including economics. Google lists innumerable tools from organizations, hospitals, practitioners, magazines, societies, clinics, and medical associations. The GFRP and WHO/ISH calculations provided useful DM assessment of populations in Oman. Other major risk models are Adult Treatment Panel III, based on Framingham, and Reynolds Risk Score; the latter incorporates other factors such as family history, high-sensitivity C-reactive protein, and hemoglobin A(1c) (in DM). These models are useful in assessing specific populations. Individual practitioners with limited time may just evaluate patients as low, medium, and high CV risk based on general knowledge and then treat.

  1. Prophylactic liver transplantation for high-risk recurrent hepatocellular carcinoma

    PubMed Central

    Yang, Po-Chih; Ho, Cheng-Maw; Hu, Rey-Heng; Ho, Ming-Chih; Wu, Yao-Ming; Lee, Po-Huang

    2016-01-01

    time goes by. Regarding tumor-related factors, histopathological features of the resected specimen are used mostly for determining the prognosis of early HCC recurrences. Such prognostic factors include the presence of microvascular invasion, poor tumor differentiation, the presence of microsatellites, the presence of multiple tumors, and the presence of the gene-expressing signature associated with aggressive HCC. These prognostic factors might be used as a selection tool for SLT or prophylactic LT, while remaining mindful of the fact that most of them are also prognostic factors for post-transplant HCC recurrence. Regarding underlying liver disease-related factors, progression of chronic viral hepatitis and high viral load may contribute to the development of late (de novo) HCC recurrence as a consequence of sustained inflammatory reaction. However, correlation between the severity of liver fibrosis and tumor recurrence is still controversial. Some prognostic scoring systems that integrate these three factors have been proposed to predict recurrence patterns after LR for HCC. Theoretically, after excluding patients with high risk of post-transplant HCC recurrence, either by observation of a cancer-free period or by measurement of biological factors (such as alpha fetoprotein), prophylactic LT following curative resection of HCC could be considered for selected patients with high risk of recurrence to provide longer survival. PMID:27872682

  2. Highly functionalized 7-azaindoles as selective PPAR gamma modulators.

    PubMed

    Debenham, Sheryl D; Chan, Audrey; Lau, Fiona Waiyu; Liu, Weiguo; Wood, Harold B; Lemme, Karen; Colwell, Lawrence; Habulihaz, Bahanu; Akiyama, Taro E; Einstein, Monica; Doebber, Thomas W; Sharma, Neelam; Wang, Chaunlin F; Wu, Margaret; Berger, Joel P; Meinke, Peter T

    2008-09-01

    A series of highly functionalized 3-aroyl and 3-phenoxy-2-methyl-7-azaindoles have been identified, which are potent selective PPARgamma modulators (SPPARgammaMs). Addition of substituents at the 6-position of the 7-azaindoles improves in vitro potency and pharmacokinetics. 7-Azaindoles have significantly improved off-target profiles compared to the parent indole series.

  3. High selectivity ZIF-93 hollow fiber membranes for gas separation.

    PubMed

    Cacho-Bailo, Fernando; Caro, Guillermo; Etxeberría-Benavides, Miren; Karvan, Oğuz; Téllez, Carlos; Coronas, Joaquín

    2015-06-30

    Zeolitic imidazolate framework-93 (ZIF-93) continuous membranes were synthesized on the inner side of P84 co-polyimide hollow fiber supports by microfluidics. MOFs and polymers showed high compatibility and the membrane exhibited H2-CH4 and CO2-CH4 separation selectivities of 97 (100 °C) and 17 (35 °C), respectively.

  4. Prospective Evaluation of Intraprostatic Inflammation and Focal Atrophy as a Predictor of Risk of High-Grade Prostate Cancer and Recurrence after Prostatectomy

    DTIC Science & Technology

    2014-07-01

    attained education (SELECT), race/ethnicity (SELECT), family history of prostate cancer (SELECT), body mass index (SELECT), waist circumference (PCPT...Inflammation and Focal Atrophy as a Predictor of Risk of High-Grade Prostate Cancer and Recurrence after Prostatectomy PRINCIPAL INVESTIGATOR...Prospective Evaluation of Intraprostatic Inflammation and Focal Atrophy as a Predictor of Risk of High-Grade Prostate Cancer and Recurrence after

  5. Use of Selective Cyclooxygenase-2 Inhibitors, Other Analgesics, and Risk of Glioma

    PubMed Central

    Seliger, Corinna; Meier, Christoph R.; Becker, Claudia; Jick, Susan S.; Bogdahn, Ulrich; Hau, Peter; Leitzmann, Michael F.

    2016-01-01

    Background Selective cyclooxygenase-2 (COX-2) inhibitors are analgesic, antipyretic, and anti-inflammatory drugs. They have been found to inhibit the development of glioma in laboratory investigations. Whether these drugs reduce the risk of glioma incidence in humans is unknown. Methods We conducted a matched case-control analysis using the U.K.-based Clinical Practice Research Datalink (CPRD). We identified 2,469 cases matched to 24,690 controls on age, sex, calendar time, general practice, and number of years of active history in the CPRD prior to the index date. We conducted conditional logistic regression analyses to determine relative risks, estimated as odds ratios (ORs) with 95% confidence intervals (CIs) of glioma in relation to use of selective COX-2 inhibitors, adjusted for several confounding variables. Results Use of selective COX-2 inhibitors was unrelated to risk of glioma (adjusted OR for 1–9 versus 0 prescriptions = 1.02; 95% CI = 0.92–1.13, 10–29 versus 0 prescriptions = 1.01; 95% CI = 0.80–1.28, ≥30 versus 0 prescriptions = 1.16; 95% CI = 0.86–1.55). Trends for increasing numbers of prescriptions for other non-steroidal anti-inflammatory drugs (NSAIDs), and non-NSAID analgesics were also not associated with glioma risk. Conclusion Further epidemiologic studies are needed to confirm the null relation of use of selective COX-2 inhibitors to glioma risk and to explain the discrepancy between laboratory investigations and our observational study. Impact: Use of selective COX-2 inhibitors is unrelated to glioma risk. PMID:26871579

  6. Review of screening for pancreatic cancer in high risk individuals.

    PubMed

    Stoita, Alina; Penman, Ian D; Williams, David B

    2011-05-21

    Pancreatic cancer is difficult to diagnose at an early stage and is associated with a very poor survival. Ten percent of pancreatic cancers result from genetic susceptibility and/or familial aggregation. Individuals from families with multiple affected first-degree relatives and those with a known cancer-causing genetic mutation have been shown to be at much higher risk of developing pancreatic cancer. Recent efforts have focused on detecting disease at an earlier stage to improve survival in these high-risk groups. This article reviews high-risk groups, screening methods, and current screening programs and their results.

  7. Review of screening for pancreatic cancer in high risk individuals

    PubMed Central

    Stoita, Alina; Penman, Ian D; Williams, David B

    2011-01-01

    Pancreatic cancer is difficult to diagnose at an early stage and is associated with a very poor survival. Ten percent of pancreatic cancers result from genetic susceptibility and/or familial aggregation. Individuals from families with multiple affected first-degree relatives and those with a known cancer-causing genetic mutation have been shown to be at much higher risk of developing pancreatic cancer. Recent efforts have focused on detecting disease at an earlier stage to improve survival in these high-risk groups. This article reviews high-risk groups, screening methods, and current screening programs and their results. PMID:21633635

  8. Factoring attitudes towards armed conflict risk into selection of protected areas for conservation.

    PubMed

    Hammill, E; Tulloch, A I T; Possingham, H P; Strange, N; Wilson, K A

    2016-03-30

    The high incidence of armed conflicts in biodiverse regions poses significant challenges in achieving international conservation targets. Because attitudes towards risk vary, we assessed different strategies for protected area planning that reflected alternative attitudes towards the risk of armed conflicts. We find that ignoring conflict risk will deliver the lowest return on investment. Opting to completely avoid conflict-prone areas offers limited improvements and could lead to species receiving no protection. Accounting for conflict by protecting additional areas to offset the impacts of armed conflicts would not only increase the return on investment (an effect that is enhanced when high-risk areas are excluded) but also increase upfront conservation costs. Our results also demonstrate that fine-scale estimations of conflict risk could enhance the cost-effectiveness of investments. We conclude that achieving biodiversity targets in volatile regions will require greater initial investment and benefit from fine-resolution estimates of conflict risk.

  9. Factoring attitudes towards armed conflict risk into selection of protected areas for conservation

    PubMed Central

    Hammill, E.; Tulloch, A. I. T.; Possingham, H. P.; Strange, N.; Wilson, K. A.

    2016-01-01

    The high incidence of armed conflicts in biodiverse regions poses significant challenges in achieving international conservation targets. Because attitudes towards risk vary, we assessed different strategies for protected area planning that reflected alternative attitudes towards the risk of armed conflicts. We find that ignoring conflict risk will deliver the lowest return on investment. Opting to completely avoid conflict-prone areas offers limited improvements and could lead to species receiving no protection. Accounting for conflict by protecting additional areas to offset the impacts of armed conflicts would not only increase the return on investment (an effect that is enhanced when high-risk areas are excluded) but also increase upfront conservation costs. Our results also demonstrate that fine-scale estimations of conflict risk could enhance the cost-effectiveness of investments. We conclude that achieving biodiversity targets in volatile regions will require greater initial investment and benefit from fine-resolution estimates of conflict risk. PMID:27025894

  10. Prevalence of antibodies to Brucella spp. and risk factors related to high-risk occupational groups in Eritrea.

    PubMed Central

    Omer, M. K.; Assefaw, T.; Skjerve, E.; Tekleghiorghis, T.; Woldehiwet, Z.

    2002-01-01

    In a study of three high-risk occupational groups using Rose Bengal and complement fixation tests, the highest prevalence (7.1%) was found among dairy farm workers and owners in randomly selected dairy-cattle farms, followed by veterinary personnel (4.5%) and inhabitants in pastoralist areas (3.0%). There was no evidence for significant differences between the three populations. Among dairy farm workers, a higher risk was associated with the presence of sheep in the farm (OR = 13.2, CI = 2.2-76.7). In the pastoral area, a high risk was linked to having close contact with animals (OR = 6.32, CI = 0.88-infinity), while a reduced risk was seen for contact with cattle (OR = 0.18, CI = 0-1.30). Symptoms suggestive of brucellosis were more commonly observed among the dairy farm workers, mainly found in the highlands, than among the pastoralist area inhabitants, where malaria is prevalent. The study documents not only the presence of serological and clinical evidence of human brucellosis, but also risk factors related to it in Eritrea, for the first time. PMID:12211600

  11. High opportunity for postcopulatory sexual selection under field conditions.

    PubMed

    Turnell, Biz R; Shaw, Kerry L

    2015-08-01

    In polygamous systems, male fitness is determined not only by mating success but also by fertilization success. Despite the growing interest over the past several decades in postcopulatory sexual selection, its relative importance compared to precopulatory sexual selection remains a subject of debate. Here, we use extensive behavioral observations of a seminatural population of Hawaiian swordtail crickets, Laupala cerasina, and molecular paternity assignment to measure the opportunities for pre- and postcopulatory selection. Because postcopulatory selection has the potential to operate at multiple stages, we also separately attribute its effects to factors specific to mating events versus factors specific to males. We find that variance in postcopulatory success is over four times as great as variance in precopulatory success, with most of it unexplained by male mating order or the number of nuptial gifts given. Surprisingly, we also find that male singing effort is under postcopulatory selection, suggesting that males who sing more frequently also have more competitive ejaculates. Our results are consistent with the hypothesis that high polyandry levels promote greater relative postcopulatory selection. They also highlight the need for detailed behavioral observations under conditions as natural as possible when measuring mating and reproductive success.

  12. Development and Testing of High-Temperature Solar Selective Coatings

    SciTech Connect

    Kennedy, C.; Price, H.

    2005-01-01

    The Solar Energy Technologies Program is working to reduce the cost of parabolic trough solar power technology. System studies show that increasing the operating temperature of the solar field from 390 to >450 C will result in improved performance and cost reductions. This requires the development of new more-efficient selective coatings that have both high solar absorptance (>0.96) and low thermal emittance (<0.07) and are thermally stable above 450 C, ideally in air. Potential selective coatings were modeled, identified for laboratory prototyping, and manufactured at NREL. Optimization of the samples and high-temperature durability testing will be performed. Development of spectrally selective materials depends on reliable characterization of their optical properties. Protocols for testing the thermal/optical properties of selective coatings were developed and a round-robin experiment was conducted to verify and document the reflectance and high-temperature emittance measurements. The development, performance, and durability of these materials and future work will be described.

  13. Risk-Targeted Selection of Agricultural Holdings for Post-Epidemic Surveillance: Estimation of Efficiency Gains

    PubMed Central

    Handel, Ian G.; de C. Bronsvoort, Barend M.; Forbes, John F.; Woolhouse, Mark E. J.

    2011-01-01

    Current post-epidemic sero-surveillance uses random selection of animal holdings. A better strategy may be to estimate the benefits gained by sampling each farm and use this to target selection. In this study we estimate the probability of undiscovered infection for sheep farms in Devon after the 2001 foot-and-mouth disease outbreak using the combination of a previously published model of daily infection risk and a simple model of probability of discovery of infection during the outbreak. This allows comparison of the system sensitivity (ability to detect infection in the area) of arbitrary, random sampling compared to risk-targeted selection across a full range of sampling budgets. We show that it is possible to achieve 95% system sensitivity by sampling, on average, 945 farms with random sampling and 184 farms with risk-targeted sampling. We also examine the effect of ordering samples by risk to expedite return to a disease-free status. Risk ordering the sampling process results in detection of positive farms, if present, 15.6 days sooner than with randomly ordered sampling, assuming 50 farms are tested per day. PMID:21674022

  14. 9 CFR 121.10 - Restricting access to select agents and toxins; security risk assessments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Restricting access to select agents and toxins; security risk assessments. 121.10 Section 121.10 Animals and Animal Products ANIMAL AND... intelligence agency of committing a crime set forth in 18 U.S.C. 2332b(g)(5); knowing involvement with...

  15. In Utero Exposure to Selective Serotonin Reuptake Inhibitors and Risk for Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Gidaya, Nicole B.; Lee, Brian K.; Burstyn, Igor; Yudell, Michael; Mortensen, Erik L.; Newschaffer, Craig J.

    2014-01-01

    We investigated whether there is an association between increased risk for autism spectrum disorders (ASD) and selective serotonin reuptake inhibitors (SSRIs) used during pregnancy. This study used Denmark's health and population registers to obtain information regarding prescription drugs, ASD diagnosis, and health and socioeconomic status. There…

  16. Automating Risk Assessments of Hazardous Material Shipments for Transportation Routes and Mode Selection

    SciTech Connect

    Barbara H. Dolphin; William D. RIchins; Stephen R. Novascone

    2010-10-01

    The METEOR project at Idaho National Laboratory (INL) successfully addresses the difficult problem in risk assessment analyses of combining the results from bounding deterministic simulation results with probabilistic (Monte Carlo) risk assessment techniques. This paper describes a software suite designed to perform sensitivity and cost/benefit analyses on selected transportation routes and vehicles to minimize risk associated with the shipment of hazardous materials. METEOR uses Monte Carlo techniques to estimate the probability of an accidental release of a hazardous substance along a proposed transportation route. A METEOR user selects the mode of transportation, origin and destination points, and charts the route using interactive graphics. Inputs to METEOR (many selections built in) include crash rates for the specific aircraft, soil/rock type and population densities over the proposed route, and bounding limits for potential accident types (velocity, temperature, etc.). New vehicle, materials, and location data are added when available. If the risk estimates are unacceptable, the risks associated with alternate transportation modes or routes can be quickly evaluated and compared. Systematic optimizing methods will provide the user with the route and vehicle selection identified with the lowest risk of hazardous material release. The effects of a selected range of potential accidents such as vehicle impact, fire, fuel explosions, excessive containment pressure, flooding, etc. are evaluated primarily using hydrocodes capable of accurately simulating the material response of critical containment components. Bounding conditions that represent credible accidents (i.e; for an impact event, velocity, orientations, and soil conditions) are used as input parameters to the hydrocode models yielding correlation functions relating accident parameters to component damage. The Monte Carlo algorithms use random number generators to make selections at the various decision

  17. High risk cohort study for psychiatric disorders in childhood: rationale, design, methods and preliminary results.

    PubMed

    Salum, Giovanni Abrahão; Gadelha, Ary; Pan, Pedro Mario; Moriyama, Tais Silveira; Graeff-Martins, Ana Soledade; Tamanaha, Ana Carina; Alvarenga, Pedro; Valle Krieger, Fernanda; Fleitlich-Bilyk, Bacy; Jackowski, Andrea; Sato, João Ricardo; Brietzke, Elisa; Polanczyk, Guilherme Vanoni; Brentani, Helena; de Jesus Mari, Jair; Do Rosário, Maria Conceição; Manfro, Gisele Gus; Bressan, Rodrigo Affonseca; Mercadante, Marcos Tomanik; Miguel, Eurípedes Constantino; Rohde, Luis Augusto

    2015-03-01

    The objective of this study is to present the rationale, methods, design and preliminary results from the High Risk Cohort Study for the Development of Childhood Psychiatric Disorders. We describe the sample selection and the components of each phases of the study, its instruments, tasks and procedures. Preliminary results are limited to the baseline phase and encompass: (i) the efficacy of the oversampling procedure used to increase the frequency of both child and family psychopathology; (ii) interrater reliability and (iii) the role of differential participation rate. A total of 9937 children from 57 schools participated in the screening procedures. From those 2512 (random = 958; high risk = 1554) were further evaluated with diagnostic instruments. The prevalence of any child mental disorder in the random strata and high-risk strata was 19.9% and 29.7%. The oversampling procedure was successful in selecting a sample with higher family rates of any mental disorders according to diagnostic instruments. Interrater reliability (kappa) for the main diagnostic instrument range from 0.72 (hyperkinetic disorders) to 0.84 (emotional disorders). The screening instrument was successful in selecting a sub-sample with "high risk" for developing mental disorders. This study may help advance the field of child psychiatry and ultimately provide useful clinical information.

  18. Effect of selective serotonin reuptake inhibitors on bleeding risk in patients with atrial fibrillation taking warfarin.

    PubMed

    Quinn, Gene R; Singer, Daniel E; Chang, Yuchiao; Go, Alan S; Borowsky, Leila H; Udaltsova, Natalia; Fang, Margaret C

    2014-08-15

    Selective serotonin reuptake inhibitor (SSRI) medications have been linked to increased bleeding risk; however, the actual association among warfarin, SSRI exposure, and bleeding risk has not been well-established. We studied the AnTicoagulation and Risk factors In Atrial fibrillation cohort of 13,559 adults with atrial fibrillation, restricted to the 9,186 patients contributing follow-up time while taking warfarin. Exposure to SSRIs and tricyclic antidepressants (TCAs) was assessed from pharmacy database dispensing data. The main outcome was hospitalization for major hemorrhage. Results were adjusted for bleeding risk and time in international normalized ratio range >3. We identified 461 major hemorrhages during 32,888 person-years of follow-up, 45 events during SSRI use, 12 during TCA-only use, and 404 without either medication. Hemorrhage rates were higher during periods of SSRI exposure compared with periods on no antidepressants (2.32 per 100 person-years vs 1.35 per 100 person-years, p <0.001) and did not differ between TCA exposure and no antidepressants (1.30 per 100 person-years on TCAs, p = 0.94). After adjustment for underlying bleeding risk and time in international normalized ratio range >3, SSRI exposure was associated with an increased rate of hemorrhage compared with no antidepressants (adjusted relative risk 1.41, 95% confidence interval 1.04 to 1.92, p = 0.03), whereas TCA exposure was not (adjusted relative risk 0.82, 95% confidence interval 0.46 to 1.46, p = 0.50). In conclusion, SSRI exposure was associated with higher major hemorrhage risk in patients taking warfarin, and this risk should be considered when selecting antidepressant treatments in those patients.

  19. Estimating the Contribution of Selected Risk Factors in Attributable Burden to Stroke in Iran

    PubMed Central

    Karami, M; Soori, H; Monfared, A Bahadori

    2012-01-01

    Background: Knowledge of the magnitude of avoidable burden by risk factors is needed for health policy, priority setting, and preventing stroke. The aim of this study was to estimate the contribution of selected risk factors including hypertension, overweight, obesity, tobacco use, and physical inactivity to the attributable burden of stroke in Iran. Methods: The World Health Organization Comparative Risk Assessment (CRA) methodology was employed to calculate the Potential Impact Fraction (PIF) and percentage of avoidable burden of stroke, which attributed to its risk factors among Iranian adults in 2009. Prevalence of risk factors was obtained from the 5th STEPS survey of chronic disease risk factors which conducted in 2009. PIF was estimated on both theoretical minimum and feasible minimum risk. A simulation procedure incorporating sources of uncertainty was used to estimate the uncertainties for the attributable burden. Results: About 15.7% (95% uncertainty intervals: 5.8- 23.5) of attributable Disability Adjusted Life Years (DALYs) to stroke in adult males and 15.8% (95% uncertainty intervals: 5.8- 23.5) in adult females are avoidable after changing the current prevalence (16.0% and 16.1% for males and females, respectively) of hypertension to 10% in both sexes. Conclusion: This work highlighted the important role of hypertension and overweight. Accordingly, policy makers are advised to consider these risk factors once implementing interventional program in Iran. PMID:23113182

  20. Highly Z-Selective Metathesis Homocoupling of Terminal Olefins

    PubMed Central

    Jiang, Annie J.; Zhao, Yu; Schrock, Richard R.; Hoveyda, Amir H.

    2009-01-01

    Mo and W MonoAryloxide-Pyrrolide (MAP) olefin metathesis catalysts can couple terminal olefins to give as high as >98% Z-products in moderate to high yields with as little as 0.2% catalyst. Results are reported for 1-hexene, 1-octene, allylbenzene, allyltrimethylsilane, methyl-10-undecenoate, methyl-9-decenoate, allylB(pinacolate), allylOBenzyl, allylNHTosyl, and allylNHPh. It is proposed that high Z-selectivity is achieved because a large aryloxide only allows metallacyclobutanes to form that contain adjacent cis substituents and because isomerization of Z-product to E-product can be slow in that same steric environment. PMID:19919135

  1. Risk of having BRCA1 mutation in high-risk women with triple-negative breast cancer: a meta-analysis.

    PubMed

    Tun, N M; Villani, G; Ong, K; Yoe, L; Bo, Z M

    2014-01-01

    Testing for BRCA1 mutation has important clinical implications such as identifying risk of second primary cancers and risk of cancer in the family. This study seeks to quantify the risk of having BRCA1 mutation in female breast cancer patients with triple-negative phenotype compared with those with other phenotypes. We undertook a search of MEDLINE and EMBASE databases for relevant studies through 10 May 2013. Outcomes were calculated and reported as risk ratio and risk difference. 12 studies comprising 2533 breast cancer patients were included in the analysis. It was found that almost all eligible studies were performed on high-risk population with breast cancer. By analyzing the incidence rates of BRCA1 mutation in patients with triple-negative breast cancer (TNBC) and non-TNBC, our meta-analysis provides a relative risk of 5.65 [95% confidence interval (CI), 4.15-7.69] and risk difference of 0.22 (95% CI, 0.15-0.29). This implies that, in selected population with high-risk features, women with TNBC are approximately five and a half times more likely to have BRCA1 mutation compared with non-TNBC phenotype, and approximately two in nine women with TNBC harbor BRCA1 mutation. Triple-negative phenotype significantly increases the risk of having BRCA1 mutation in high-risk breast cancer patients compared with non-TNBC.

  2. Identifying Patients at Risk of High Healthcare Utilization

    PubMed Central

    Sheets, Lincoln; Popejoy, Lori; APRN, GCNS-BC; Khalilia, Mohammed; Petroski, Greg; Parker, Jerry C.

    2016-01-01

    Objective. To develop a systematic and reproducible way to identify patients at increased risk for higher healthcare costs. Methods. Medical records were analyzed for 9,581 adults who were primary care patients in the University of Missouri Health System and who were enrolled in Medicare or Medicaid. Patients were categorized into one of four risk tiers as of October 1, 2013, and the four tiers were compared on demographic characteristics, number of healthcare episodes, and healthcare charges in the year before and the year after cohort formation. Results. The mean number of healthcare episodes and the sum of healthcare charges in the year following cohort formation were higher for patients in the higher-risk tiers. Conclusions. Retrospective information that is easily extracted from medical records can be used to create risk tiers that provide highly useful information about the prospective risk of healthcare utilization and costs. PMID:28269910

  3. Cyclic cholecystokinin analogues with high selectivity for central receptors.

    PubMed Central

    Charpentier, B; Pelaprat, D; Durieux, C; Dor, A; Reibaud, M; Blanchard, J C; Roques, B P

    1988-01-01

    Taking as a model the N-terminal folding of the cholecystokinin tyrosine-sulfated octapeptide [CCK-8; Asp-Tyr(SO3H)-Met-Gly-Trp-Met-Asp-Phe-NH2] deduced from conformational studies, two cyclic cholecystokinin (CCK) analogues were synthesized by conventional peptide synthesis: Boc-D-Asp-Tyr(SO3H)-Ahx-D-Lys-Trp-Ahx-Asp-Phe-NH2 [compound I (Ahx, 2-aminohexanoic acid)] and Boc-gamma-D-Glu-Tyr(SO3H)-Ahx-D-Lys-Trp-Ahx-Asp-Phe-NH2 (compound II). The binding characteristics of these peptides were investigated on brain cortex membranes and pancreatic acini of guinea pig. Compounds I and II were competitive inhibitors of [3H]Boc[Ahx28,31]CCK-(27-33) binding to central CCK receptors and showed a high degree of selectivity for these binding sites (compound I: Ki for pancreas/Ki for brain, 179; compound II: Ki for pancreas/Ki for brain, 1979). This high selectivity was associated with a high affinity for central CCK receptors (compound I: Ki, 5.1 nM; compound II: Ki, 0.49 nM). Similar affinities and selectivities were found when 125I Bolton-Hunter-labeled CCK-8 was used as a ligand. Moreover, these compounds were only weakly active in the stimulation of amylase release from guinea pig pancreatic acini (EC50 greater than 10,000 nM) and were unable to induce contractions in the guinea pig ileum (to 10(-6) M). The two cyclic CCK analogues, therefore, appear to be synthetic ligands exhibiting both high affinity and high selectivity for central CCK binding sites. These compounds could help clarify the respective role of central and peripheral receptors for various CCK-8-induced pharmacological effects. PMID:3162318

  4. Psychosis Prevention: A Modified Clinical High Risk Perspective From the Recognition and Prevention (RAP) Program

    PubMed Central

    Cornblatt, Barbara A.; Carrión, Ricardo E.; Auther, Andrea; McLaughlin, Danielle; Olsen, Ruth H.; John, Majnu; Correll, Christoph U.

    2016-01-01

    Objective Early intervention and prevention of psychosis remain a major challenge. Prediction would be greatly advanced with improved ability to identify individuals at true risk, which, at present, is moderate at best. The authors tested a modified strategy to improve prediction by selecting a more homogeneous high-risk sample (attenuated positive symptom criteria only, age range of mid-teens to early 20s) than is currently standard, combined with a systematic selection of neurodevelopmental deficits. Method A sample of 101 treatment-seeking adolescents (mean age, 15.9 years) at clinical high risk for psychosis were followed clinically for up to 5 years (mean follow-up time, 3.0 years, SD=1.6). Adolescents were included only if they exhibited one or more attenuated positive symptoms at moderate to severe, but not psychotic, severity levels. Cox regression was used to derive a risk index. Results The overall conversion rate to psychosis was 28.3%. The final predictor model, with a positive predictive validity of 81.8%, consisted of four variables: disorganized communication, suspiciousness, verbal memory deficits, and decline in social functioning during follow-up. Significant effects also suggest narrowing the risk age range to 15–22 years. Conclusions Clinical high risk criteria that emphasize disorganized communication and suspiciousness while also including compromised verbal memory and declining social functioning have the potential to improve predictive accuracy compared with attenuated positive symptoms used alone. On the resulting risk index (a weighted combination of the predictors), low scores were interpreted as signifying minimal risk, with little treatment necessary, high scores as suggesting aggressive intervention, and intermediate scores, although less informative, as supporting psychosocial treatment. PMID:26046336

  5. Comprehensive brain MRI segmentation in high risk preterm newborns.

    PubMed

    Yu, Xintian; Zhang, Yanjie; Lasky, Robert E; Datta, Sushmita; Parikh, Nehal A; Narayana, Ponnada A

    2010-11-08

    Most extremely preterm newborns exhibit cerebral atrophy/growth disturbances and white matter signal abnormalities on MRI at term-equivalent age. MRI brain volumes could serve as biomarkers for evaluating the effects of neonatal intensive care and predicting neurodevelopmental outcomes. This requires detailed, accurate, and reliable brain MRI segmentation methods. We describe our efforts to develop such methods in high risk newborns using a combination of manual and automated segmentation tools. After intensive efforts to accurately define structural boundaries, two trained raters independently performed manual segmentation of nine subcortical structures using axial T2-weighted MRI scans from 20 randomly selected extremely preterm infants. All scans were re-segmented by both raters to assess reliability. High intra-rater reliability was achieved, as assessed by repeatability and intra-class correlation coefficients (ICC range: 0.97 to 0.99) for all manually segmented regions. Inter-rater reliability was slightly lower (ICC range: 0.93 to 0.99). A semi-automated segmentation approach was developed that combined the parametric strengths of the Hidden Markov Random Field Expectation Maximization algorithm with non-parametric Parzen window classifier resulting in accurate white matter, gray matter, and CSF segmentation. Final manual correction of misclassification errors improved accuracy (similarity index range: 0.87 to 0.89) and facilitated objective quantification of white matter signal abnormalities. The semi-automated and manual methods were seamlessly integrated to generate full brain segmentation within two hours. This comprehensive approach can facilitate the evaluation of large cohorts to rigorously evaluate the utility of regional brain volumes as biomarkers of neonatal care and surrogate endpoints for neurodevelopmental outcomes.

  6. High Frequency Performance of SiGeC HBTs with Selectively & Non-Selectively Grown Collector

    NASA Astrophysics Data System (ADS)

    Suvar, Erdal; Haralson, Erik; Radamson, Henry H.; Wang, Yong-Bin; Malm, B. Gunnar; Östling, Mikael

    2004-01-01

    Two high-frequency heterojunction bipolar transistor (HBT) architectures based on SiGeC have been fabricated and characterized. Different collector designs were applied either by using selective epitaxial growth doped with phosphorous or by nonselective epitaxial growth doped with arsenic. Both designs have a nonselectively deposited SiGeC base doped with boron and a poly-crystalline emitter doped with phosphorous. Both HBT designs exhibit similar electrical characteristics with a peak DC current gain of around 1600 and a BVCEO of 1.8V. The cut-off frequency (fT) and maximum frequency of oscillation (fmax) vary from 40 80GHz and 15 30GHz, respectively, depending on lateral design relations. Good high frequency performance for a device with a selectively grown collector is demonstrated for the first time.

  7. The airway epithelium undergoes metabolic reprogramming in individuals at high risk for lung cancer

    PubMed Central

    Rahman, S.M. Jamshedur; Ji, Xiangming; Zimmerman, Lisa J.; Li, Ming; Harris, Bradford K.; Hoeksema, Megan D.; Trenary, Irina A.; Zou, Yong; Qian, Jun; Slebos, Robbert J.C.; Beane, Jennifer; Spira, Avrum; Shyr, Yu; Eisenberg, Rosana; Liebler, Daniel C.; Young, Jamey D.; Massion, Pierre P.

    2016-01-01

    The molecular determinants of lung cancer risk remain largely unknown. Airway epithelial cells are prone to assault by risk factors and are considered to be the primary cell type involved in the field of cancerization. To investigate risk-associated changes in the bronchial epithelium proteome that may offer new insights into the molecular pathogenesis of lung cancer, proteins were identified in the airway epithelial cells of bronchial brushing specimens from risk-stratified individuals by shotgun proteomics. Differential expression of selected proteins was validated by parallel reaction monitoring mass spectrometry in an independent set of individual bronchial brushings. We identified 2,869 proteins, of which 312 proteins demonstrated a trend in expression. Pathway analysis revealed enrichment of carbohydrate metabolic enzymes in high-risk individuals. Glucose consumption and lactate production were increased in human bronchial epithelial BEAS2B cells treated with cigarette smoke condensate for 7 months. Increased lipid biosynthetic capacity and net reductive carboxylation were revealed by metabolic flux analyses of [U-13C5] glutamine in this in vitro model, suggesting profound metabolic reprogramming in the airway epithelium of high-risk individuals. These results provide a rationale for the development of potentially new chemopreventive strategies and selection of patients for surveillance programs. PMID:27882349

  8. Telomerase activation by genomic rearrangements in high-risk neuroblastoma.

    PubMed

    Peifer, Martin; Hertwig, Falk; Roels, Frederik; Dreidax, Daniel; Gartlgruber, Moritz; Menon, Roopika; Krämer, Andrea; Roncaioli, Justin L; Sand, Frederik; Heuckmann, Johannes M; Ikram, Fakhera; Schmidt, Rene; Ackermann, Sandra; Engesser, Anne; Kahlert, Yvonne; Vogel, Wenzel; Altmüller, Janine; Nürnberg, Peter; Thierry-Mieg, Jean; Thierry-Mieg, Danielle; Mariappan, Aruljothi; Heynck, Stefanie; Mariotti, Erika; Henrich, Kai-Oliver; Gloeckner, Christian; Bosco, Graziella; Leuschner, Ivo; Schweiger, Michal R; Savelyeva, Larissa; Watkins, Simon C; Shao, Chunxuan; Bell, Emma; Höfer, Thomas; Achter, Viktor; Lang, Ulrich; Theissen, Jessica; Volland, Ruth; Saadati, Maral; Eggert, Angelika; de Wilde, Bram; Berthold, Frank; Peng, Zhiyu; Zhao, Chen; Shi, Leming; Ortmann, Monika; Büttner, Reinhard; Perner, Sven; Hero, Barbara; Schramm, Alexander; Schulte, Johannes H; Herrmann, Carl; O'Sullivan, Roderick J; Westermann, Frank; Thomas, Roman K; Fischer, Matthias

    2015-10-29

    Neuroblastoma is a malignant paediatric tumour of the sympathetic nervous system. Roughly half of these tumours regress spontaneously or are cured by limited therapy. By contrast, high-risk neuroblastomas have an unfavourable clinical course despite intensive multimodal treatment, and their molecular basis has remained largely elusive. Here we have performed whole-genome sequencing of 56 neuroblastomas (high-risk, n = 39; low-risk, n = 17) and discovered recurrent genomic rearrangements affecting a chromosomal region at 5p15.33 proximal of the telomerase reverse transcriptase gene (TERT). These rearrangements occurred only in high-risk neuroblastomas (12/39, 31%) in a mutually exclusive fashion with MYCN amplifications and ATRX mutations, which are known genetic events in this tumour type. In an extended case series (n = 217), TERT rearrangements defined a subgroup of high-risk tumours with particularly poor outcome. Despite a large structural diversity of these rearrangements, they all induced massive transcriptional upregulation of TERT. In the remaining high-risk tumours, TERT expression was also elevated in MYCN-amplified tumours, whereas alternative lengthening of telomeres was present in neuroblastomas without TERT or MYCN alterations, suggesting that telomere lengthening represents a central mechanism defining this subtype. The 5p15.33 rearrangements juxtapose the TERT coding sequence to strong enhancer elements, resulting in massive chromatin remodelling and DNA methylation of the affected region. Supporting a functional role of TERT, neuroblastoma cell lines bearing rearrangements or amplified MYCN exhibited both upregulated TERT expression and enzymatic telomerase activity. In summary, our findings show that remodelling of the genomic context abrogates transcriptional silencing of TERT in high-risk neuroblastoma and places telomerase activation in the centre of transformation in a large fraction of these tumours.

  9. Combined blockade of VEGFR-3 and VLA-1 markedly promotes high-risk corneal transplant survival.

    PubMed

    Zhang, Hui; Grimaldo, Sammy; Yuen, Don; Chen, Lu

    2011-08-17

    PURPOSE. High-risk corneal transplantation refers to grafting performed on inflamed and highly vascularized host beds. It represents a clinical dilemma because the rejection rate can be as high as 90%, irrespective of current treatment modalities. This study was conducted to investigate whether combined blockade of VEGFR-3 (vascular endothelial growth factor receptor-3) and VLA-1 (very late antigen-1) promotes high-risk transplant survival and how it correlates with corneal lymphangiogenesis and hemangiogenesis before and after transplantation. METHODS. High-risk corneal transplantation was performed between normal C57BL/6 (donor) and inflamed BALB/c (recipient) mice. The recipients were randomized to receive intraperitoneal injections of VEGFR-3 and VLA-1-neutralizing antibodies or their controls twice a week for up to 8 weeks after transplantation. Corneal grafts were evaluated by ophthalmic slit-lamp biomicroscopy and analyzed by Kaplan-Meier survival curve. Additionally, whole-mount corneas before and after transplantation were examined by immunofluorescent microscopic assays, and the correlation between lymphatic or blood vessel distribution and transplant outcome was analyzed. RESULTS. The combined blockade markedly promotes 90% survival of high-risk transplants. This strategy specifically modified host beds by selective inhibition of lymphangiogenesis but not hemangiogenesis. A strong correlation was also identified between high-risk transplant rejection and severe lymphatic invasion reaching the donor-graft border. CONCLUSIONS. These novel findings not only provide a new and potentially powerful strategy to promote high-risk transplant survival, they also confirm a critical role of high-degree lymphangiogenesis in mediating high-risk transplant rejection. Results from this study may also shed new light on our understanding and management of other lymphatic- and immune-related diseases in general.

  10. Cumulative Experiences of Violence among High-Risk Urban Youth

    ERIC Educational Resources Information Center

    Taylor, Catherine A.; Boris, Neil W.; Heller, Sherryl Scott; Clum, Gretchen A.; Rice, Janet C.; Zeanah, Charles H.

    2008-01-01

    This study examines type-specific and cumulative experiences of violence among a vulnerable population of youth. Sixty high-risk, shelter-dwelling, urban youth were interviewed regarding their history of childhood maltreatment, exposure to community violence (ECV), and experience with intimate partner violence (IPV). Results show a high prevalence…

  11. Best self visualization method with high-risk youth.

    PubMed

    Schussel, Lorne; Miller, Lisa

    2013-08-01

    The healing process of the Best Self Visualization Method (BSM) is described within the framework of meditation, neuroscience, and psychodynamic theory. Cases are drawn from the treatment of high-risk youth, who have histories of poverty, survival of sexual and physical abuse, and/or current risk for perpetrating abuse. Clinical use of BSM is demonstrated in two case illustrations, one of group psychotherapy and another of individual therapy.

  12. High-temperature corrosion: Issues in alloy selection

    NASA Astrophysics Data System (ADS)

    Lai, George Y.

    1991-11-01

    This article examines the modes of high-temperature corrosion that are often responsible for equipment failures in a variety of industries, including aerospace and gas turbines; heat treating; mineral and metallurgical processing; chemical processing; refining and petrochemical processing; ceramic, electronic, and glass manufacturing; automotive; pulp and paper; waste incineration; and power generation and energy conversion. Corrosion data related to each corrosion mode are reviewed to provide readers with a brief materials selection guide.

  13. Selecting Salient Features in High Feature to Exemplar Ratio Conditions

    DTIC Science & Technology

    2002-03-01

    We present an approach for identifying salient input features in high feature to exemplar ratio conditions. Basically we modify the SNR saliency...screening algorithm to improve the solution of the optimal salient feature subset problem. We propose that applying the SNR method to randomly selected...subsets (SRSS) has a superior potential to identify the salient features than the traditional SNR algorithm has. Two experimental studies are provided

  14. HIFU therapy for patients with high risk prostate cancer

    NASA Astrophysics Data System (ADS)

    Solovov, V. A.; Vozdvizhenskiy, M. O.; Matysh, Y. S.

    2017-03-01

    Objectives. Patients with high-risk prostate cancer undergoing radical prostatectomy, external beam radiation therapy (EBRT) combined with androgen deprivation therapy (ADT) or ADT alone. The widely accepted definition of high-risk prostate was first proposed by D'Amico based on a pretreatment Gleason score of ≥8, clinical stage T3, PSA level ≥20 ng/mL. There is no trial that compares traditional methods of treatment of such patients with HIFU therapy. Here we explored the effectiveness of the HIFU in multimodal treatment for patients with high risk prostate cancer. Materials & Methods. 701 patients with high risk prostate cancer were treated in our center between September 2007 and December 2013. Gleason score were 8-10, stage T3N0M0, age 69 (58-86) years, mean PSA before treatment 43.3 (22.1-92.9) ng/ml, mean prostate volume - 59.3 (38-123) cc. 248 patients were treated by HIFU. We compare this group of patients with patients who undertook EBRT: number 196, and ADT: number 257. Mean follow-up time 58 months (6-72). Results. The 5-year overall survival rates in patients after HIFU were 73.8 %, after EBRT - 63.0 % and after ADT - 18.1%. Conclusions. Our experience showed that HIFU therapy in combined treatment were successful for high risk prostate cancer.

  15. High prevalence of blood-borne virus infections and high-risk behaviour among injecting drug users in Tallinn, Estonia

    PubMed Central

    Uusküla, Anneli; McNutt, Louise Anne; Dehovitz, Jack; Fischer, Krista; Heimer, Robert

    2010-01-01

    Summary The HIV epidemic in Estonia is rapidly expanding, and injection drug users (IDUs) are the major risk group contributing to the expansion. A convenience sample of 159 IDUs visiting syringe-exchange programmes (SEPs) was selected to quantify the association of HIV-risk behaviours and blood-borne infections. A high prevalence of HIV, hepatitis B core antibody (HBVcore), hepatitis B surface antigen (HbsAg) and hepatitis C virus antibodies (56, 85.1, 21.3, and 96.2%, respectively) was associated with high-risk injections, unsafe sexual behaviour and alcohol abuse. These findings emphasize the importance of evidence-based secondary prevention among the HIV-infected, especially given the uncertain sustainability of antiretroviral and substance abuse treatments. PMID:17326862

  16. Prevalence of chemopreventive agent use among hospitalised women at high risk for breast cancer: a cross-sectional study

    PubMed Central

    Khaliq, Waseem; Jelovac, Danijela; Wright, Scott M

    2016-01-01

    Objective To characterise the current usage of chemoprevention agents among hospitalised women who are at higher risk for breast cancer. Study design A cross-sectional study. Setting Academic hospital at Baltimore. Participants A bedside survey of 250 women aged 50–75 years was conducted who were cancer-free at the time of study enrolment and hospitalised to a general medicine service. Reproductive history, family history for breast cancer, chemopreventive agents use and medical comorbidities data was collected for all patients. χ2 and t-tests were used to analyse population characteristics. Primary outcome measures Prevalence of women at high risk for developing breast cancer (5-year Gail risk score ≥1.7) and their chemopreventive agent use. Results Mean age for the study population was 61.5 years (SD 7.5), and mean 5-year Gail risk score was 1.67 (SD 0.88). A third of study population was at high risk for breast cancer. None of the high-risk women (0%) were taking chemoprevention for breast cancer risk reduction, and 23% were at very high risk with 5-year Gail score ≥3%. These women were not recognised as being high risk by their hospital providers and none were referred to the high-risk breast cancer clinics following discharge. Conclusions Many hospitalised women are at high risk for breast cancer and we could not identify even a single woman who was using chemoprevention for risk reduction. Current chemoprevention guidelines may be falling short in their dissemination and implementation. Since women at high risk for breast cancer may only interface with the healthcare system at select points, all healthcare providers must be willing and able to do risk assessment. For those identified to be at high risk, providers must then either engage in chemopreventive counselling or refer patients to providers who are more comfortable working with patients on this critical decision. PMID:27852714

  17. Maternal and foetal outcome of 206 high risk pregnancy cases in border guard hospital, dhaka.

    PubMed

    Shapla, N R; Islam, M A; Shahida, S M; Parveen, Z; Lipe, Y S

    2015-04-01

    This observational study was carried out to identify the various types of high risk pregnancy and to determine the maternal and foetal outcome. The study was carried out on 206 pregnant high risk women in the Gynecology and Obstetrics department of Border Guard Hospital, Dhaka from January 2012 to December 2012. During mentioned period among 598 pregnant women 206 high risk pregnancy cases were randomly selected. Pregnant women (gestational age from 34 weeks upto 40 weeks) having medical condition and pregnancy related high risk factors were included and uncomplicated pregnancy, pregnancy before 37 weeks, post dated pregnancy were excluded from this study. Data was collected from semi structured history sheet and data analysis done by percentage. High risk pregnant women were grouped into three. Group A and Group B includes pregnant women having medical condition before and during pregnancy respectively. Group C consists of pregnant women had pregnancy related high risk issues. Among 206 high risk pregnancy cases majority 47.57% women had medical condition during pregnancy, 31.55% patient had medical condition before pregnancy. Among them majority 30.58% of the patient suffered from pregnancy induced hypertension, 15.04% patients suffered from gestational Diabetes Mellitus and premature rupture of membranes were 12.13%. In this study majority 43.68% of high risk pregnant patients were in age group of 30-35 years, 19.90% pregnant women were in age group of >35 years and 19.40% were in age group of upto 20 years. Among study groups maximum 65.04% of the patients were multiparous. Among 206 study population 60.19% high risk pregnant women were at term at the time of delivery and 39.8% women delivered their babies preterm. Caesarean section was done in 69.41% of high risk pregnant women. After delivery majority 77.66% women had no complication, only 10.19%, 8.25%, 2.91% and 0.97% high risk pregnant women suffered from fever, UTI, abdominal wound infection and post

  18. Beyond sensation seeking: affect regulation as a framework for predicting risk-taking behaviors in high-risk sport.

    PubMed

    Castanier, Carole; Le Scanff, Christine; Woodman, Tim

    2010-10-01

    Sensation seeking has been widely studied when investigating individual differences in the propensity for taking risks. However, risk taking can serve many different goals beyond the simple management of physiological arousal. The present study is an investigation of affect self-regulation as a predictor of risk-taking behaviors in high-risk sport. Risk-taking behaviors, negative affectivity, escape self-awareness strategy, and sensation seeking data were obtained from 265 high-risk sportsmen. Moderated hierarchical regression analysis revealed significant main and interaction effects of negative affectivity and escape self-awareness strategy in predicting risk-taking behaviors: high-risk sportsmen's negative affectivity leads them to adopt risk-taking behaviors only if they also use escape self-awareness strategy. Furthermore, the affective model remained significant when controlling for sensation seeking. The present study contributes to an in-depth understanding of risk taking in high-risk sport.

  19. Health and environmental risk-related impacts of actinide burning on high-level waste disposal

    SciTech Connect

    Forsberg, C.W.

    1992-05-01

    The potential health and environmental risk-related impacts of actinide burning for high-level waste disposal were evaluated. Actinide burning, also called waste partitioning-transmutation, is an advanced method for radioactive waste management based on the idea of destroying the most toxic components in the waste. It consists of two steps: (1) selective removal of the most toxic radionuclides from high-level/spent fuel waste and (2) conversion of those radionuclides into less toxic radioactive materials and/or stable elements. Risk, as used in this report, is defined as the probability of a failure times its consequence. Actinide burning has two potential health and environmental impacts on waste management. Risks and the magnitude of high-consequence repository failure scenarios are decreased by inventory reduction of the long-term radioactivity in the repository. (What does not exist cannot create risk or uncertainty.) Risk may also be reduced by the changes in the waste characteristics, resulting from selection of waste forms after processing, that are superior to spent fuel and which lower the potential of transport of radionuclides from waste form to accessible environment. There are no negative health or environmental impacts to the repository from actinide burning; however, there may be such impacts elsewhere in the fuel cycle.

  20. A risk index for multicriterial selection of a logging system with low environmental impact

    SciTech Connect

    Horodnic, Sergiu Andrei

    2015-02-15

    Setting up the working stages in forest operations is conditioned by environmental protection and forest health requirements. This paper exposes a method for improving the decision-making process by choosing the most environmentally effective logging systems according to terrain configuration and stand characteristics. Such a methodology for selecting machines or logging systems accounting for environment, safety as well as economics, becomes mandatory in the context of sustainable management of forest with multiple functions. Based on analytic hierarchy process analysis the following classification of the environmental performance for four considered alternatives was obtained: skyline system (42.43%), forwarder system (20.22%), skidder system (19.92%) and horse logging system (17.43%). Further, an environmental risk matrix for the most important 28 risk factors specific to any work equipment used in forest operations was produced. In the end, a multicriterial analysis generated a risk index RI ranging between 1.0 and 3.5, which could help choosing the optimal combination of logging system and logging equipment with low environmental impact. In order to demonstrate the usefulness of the proposed approach, a simple application in specific conditions of a harvesting site is presented. - Highlights: • We propose a decision-making algorithm to select eco-friendly logging systems. • Analytic hierarchy process was applied for ranking 4 types of logging systems. • An environmental risk matrix with 28 risk factors in forest operations was made up.

  1. A Primer on High-Throughput Computing for Genomic Selection

    PubMed Central

    Wu, Xiao-Lin; Beissinger, Timothy M.; Bauck, Stewart; Woodward, Brent; Rosa, Guilherme J. M.; Weigel, Kent A.; Gatti, Natalia de Leon; Gianola, Daniel

    2011-01-01

    High-throughput computing (HTC) uses computer clusters to solve advanced computational problems, with the goal of accomplishing high-throughput over relatively long periods of time. In genomic selection, for example, a set of markers covering the entire genome is used to train a model based on known data, and the resulting model is used to predict the genetic merit of selection candidates. Sophisticated models are very computationally demanding and, with several traits to be evaluated sequentially, computing time is long, and output is low. In this paper, we present scenarios and basic principles of how HTC can be used in genomic selection, implemented using various techniques from simple batch processing to pipelining in distributed computer clusters. Various scripting languages, such as shell scripting, Perl, and R, are also very useful to devise pipelines. By pipelining, we can reduce total computing time and consequently increase throughput. In comparison to the traditional data processing pipeline residing on the central processors, performing general-purpose computation on a graphics processing unit provide a new-generation approach to massive parallel computing in genomic selection. While the concept of HTC may still be new to many researchers in animal breeding, plant breeding, and genetics, HTC infrastructures have already been built in many institutions, such as the University of Wisconsin–Madison, which can be leveraged for genomic selection, in terms of central processing unit capacity, network connectivity, storage availability, and middleware connectivity. Exploring existing HTC infrastructures as well as general-purpose computing environments will further expand our capability to meet increasing computing demands posed by unprecedented genomic data that we have today. We anticipate that HTC will impact genomic selection via better statistical models, faster solutions, and more competitive products (e.g., from design of marker panels to realized

  2. A primer on high-throughput computing for genomic selection.

    PubMed

    Wu, Xiao-Lin; Beissinger, Timothy M; Bauck, Stewart; Woodward, Brent; Rosa, Guilherme J M; Weigel, Kent A; Gatti, Natalia de Leon; Gianola, Daniel

    2011-01-01

    High-throughput computing (HTC) uses computer clusters to solve advanced computational problems, with the goal of accomplishing high-throughput over relatively long periods of time. In genomic selection, for example, a set of markers covering the entire genome is used to train a model based on known data, and the resulting model is used to predict the genetic merit of selection candidates. Sophisticated models are very computationally demanding and, with several traits to be evaluated sequentially, computing time is long, and output is low. In this paper, we present scenarios and basic principles of how HTC can be used in genomic selection, implemented using various techniques from simple batch processing to pipelining in distributed computer clusters. Various scripting languages, such as shell scripting, Perl, and R, are also very useful to devise pipelines. By pipelining, we can reduce total computing time and consequently increase throughput. In comparison to the traditional data processing pipeline residing on the central processors, performing general-purpose computation on a graphics processing unit provide a new-generation approach to massive parallel computing in genomic selection. While the concept of HTC may still be new to many researchers in animal breeding, plant breeding, and genetics, HTC infrastructures have already been built in many institutions, such as the University of Wisconsin-Madison, which can be leveraged for genomic selection, in terms of central processing unit capacity, network connectivity, storage availability, and middleware connectivity. Exploring existing HTC infrastructures as well as general-purpose computing environments will further expand our capability to meet increasing computing demands posed by unprecedented genomic data that we have today. We anticipate that HTC will impact genomic selection via better statistical models, faster solutions, and more competitive products (e.g., from design of marker panels to realized

  3. Applying the lessons of high risk industries to health care

    PubMed Central

    Hudson, P

    2003-01-01

    High risk industries such as commercial aviation and the oil and gas industry have achieved exemplary safety performance. This paper reviews how they have managed to do that. The primary reasons are the positive attitudes towards safety and the operation of effective formal safety management systems. The safety culture provides an important explanation of why such organisations perform well. An evolutionary model of safety culture is provided in which there is a range of cultures from the pathological through the reactive to the calculative. Later, the proactive culture can evolve towards the generative organisation, an alternative description of the high reliability organisation. The current status of health care is reviewed, arguing that it has a much higher level of accidents and has a reactive culture, lagging behind both high risk industries studied in both attitude and systematic management of patient risks. PMID:14645741

  4. The cardiovascular polypill in high-risk patients.

    PubMed

    Lafeber, Melvin; Spiering, Wilko; Singh, Kavita; Guggilla, Rama K; Patil, Vinodvenkatesh; Webster, Ruth

    2012-12-01

    Atherosclerotic cardiovascular diseases remain the leading cause of morbidity and mortality in both developed and developing countries. Adequate treatment of vascular risk factors, such as low-density lipoprotein cholesterol and systolic blood pressure are known to reduce the future risk of cardiovascular disease in these patients. However currently, large treatment gaps exist among high-risk individuals, in whom the guidelines recommend concomitant treatment with aspirin, statin, and blood-pressure lowering agents. Combining aspirin, cholesterol, and blood-pressure lowering agents into a single pill called the cardiovascular polypill has been proposed as complementary care in the prevention of cardiovascular diseases in both intermediate- and high-risk patient populations. It is now a decade since the first recommendations to develop and trial cardiovascular polypills. The major scientific debate has been about the appropriate initial target population. This review article focuses on the potential role of fixed-dose combination therapy in different patient populations, outlines the pros and cons of combination therapy, and emphasizes the rationale for trialing their use. Current and planned future cardiovascular polypill trials are summarized and the pre-requisites for implementation of the polypill strategy in both primary and secondary prevention are described. The recent development of combination pills containing off-patent medications holds promise for highly affordable and effective treatment and evidence is emerging on the use of this strategy in high-risk populations.

  5. High-Risk Stress Fractures: Diagnosis and Management.

    PubMed

    McInnis, Kelly C; Ramey, Lindsay N

    2016-03-01

    Stress fractures are common overuse injuries in athletes. They occur during periods of increased training without adequate rest, disrupting normal bone reparative mechanisms. There are a host of intrinsic and extrinsic factors, including biochemical and biomechanical, that put athletes at risk. In most stress fractures, the diagnosis is primarily clinical, with imaging indicated at times, and management focused on symptom-free relative rest with advancement of activity as tolerated. Overall, stress fractures in athletes have an excellent prognosis for return to sport, with little risk of complication. There is a subset of injuries that have a greater risk of fracture progression, delayed healing, and nonunion and are generally more challenging to treat with nonoperative care. Specific locations of high-risk stress fracture include the femoral neck (tension side), patella, anterior tibia, medial malleolus, talus, tarsal navicular, proximal fifth metatarsal, and great toe sesamoids. These sites share a characteristic region of high tensile load and low blood flow. High-risk stress fractures require a more aggressive approach to evaluation, with imaging often necessary, to confirm early and accurate diagnosis and initiate immediate treatment. Treatment consists of nonweight-bearing immobilization, often with a prolonged period away from sport, and a more methodic and careful reintroduction to athletic activity. These stress fractures may require surgical intervention. A high index of suspicion is essential to avoid delayed diagnosis and optimize outcomes in this subset of stress fractures.

  6. Genomic analysis of high-risk smoldering multiple myeloma

    PubMed Central

    López-Corral, Lucía; Mateos, María Victoria; Corchete, Luis A.; Sarasquete, María Eugenia; de la Rubia, Javier; de Arriba, Felipe; Lahuerta, Juan-José; García-Sanz, Ramón; San Miguel, Jesús F.; Gutiérrez, Norma C.

    2012-01-01

    Smoldering myeloma is an asymptomatic plasma cell dyscrasia with a heterogeneous propensity to progress to active myeloma. In order to investigate the biology of smoldering myeloma patients with high risk of progression, we analyzed the genomic characteristics by FISH, SNP-arrays and gene expression profile of a group of patients with high-risk smoldering myeloma included in a multicenter randomized trial. Chromosomal abnormalities detected by FISH and SNP-arrays at diagnosis were not associated to risk of progression to symptomatic myeloma. However, the overexpression of four SNORD genes (SNORD25, SNORD27, SNORD30 and SNORD31) was correlated with shorter time to progression (P<0.03). When plasma cells from high-risk smoldering patients who progressed to symptomatic myeloma were sequentially analyzed, newly acquired lesions together with an increase in the proportion of plasma cells carrying a given abnormality were observed. These findings suggest that gene expression profiling is a valuable technique to identify smoldering myeloma patients with high risk of progression. (Clinical Trials NCT00443235) PMID:22331267

  7. Behavioral Risk Elicits Selective Activation of the Executive System in Adolescents: Clinical Implications

    PubMed Central

    Yaxley, Richard H.; Van Voorhees, Elizabeth E.; Bergman, Sara; Hooper, Stephen R.; Huettel, Scott A.; De Bellis, Michael D.

    2011-01-01

    We investigated adolescent brain processing of decisions under conditions of varying risk, reward, and uncertainty. Adolescents (n = 31) preformed a Decision–Reward Uncertainty task that separates decision uncertainty into behavioral and reward risk, while they were scanned using functional magnetic resonance imaging. Behavioral risk trials involved uncertainty about which action to perform to earn a fixed monetary reward. In contrast, during reward risk the decision that might lead to a reward was known, but the likelihood of earning a reward was probabilistically determined. Behavioral risk trials evoked greater activation than the reward risk and no risk conditions in the anterior cingulate, medial frontal gyrus, bilateral frontal poles, bilateral inferior parietal lobe, precuneus, bilateral superior-middle frontal gyrus, inferior frontal gyrus, and insula. Our results were similar to those of young adults using the same task (Huettel, 2006) except that adolescents did not show significant activation in the posterior supramarginal gyrus during behavioral risk. During the behavioral risk condition regardless of reward outcome, overall mean frontal pole activity showed a positive correlation with age during the behavioral and reward risk conditions suggesting a developmental difference of this region of interest. Additionally, reward response to the Decision–Reward Uncertainty task in adolescents was similar to that seen in young adults (Huettel, 2006). Our data did not show a correlation between age and mean ventral striatum activity during the three conditions. While our results came from a healthy high functioning non-maltreated sample of adolescents, this method can be used to address types of risks and reward processing in children and adolescents with predisposing vulnerabilities and add to the paucity of imaging studies of risk and reward processing during adolescence. PMID:22194728

  8. Identification of high-risk communities for unattended out-of-hospital cardiac arrests using GIS.

    PubMed

    Semple, Hugh M; Cudnik, Michael T; Sayre, Michael; Keseg, David; Warden, Craig R; Sasson, Comilla

    2013-04-01

    Improving survival rates for out of hospital cardiac arrest (OHCA) at the neighborhood level is increasingly seen as priority in US cities. Since wide disparities exist in OHCA rates at the neighborhood level, it is necessary to locate neighborhoods where people are at elevated risk for cardiac arrest and target these for educational outreach and other mitigation strategies. This paper describes a GIS-based methodology that was used to identify communities with high risk for cardiac arrests in Franklin County, Ohio during the period 2004-2009. Prior work in this area used a single criterion, i.e., the density of OHCA events, to define the high-risk areas, and a single analytical technique, i.e., kernel density analysis, to identify the high-risk communities. In this paper, two criteria are used to identify the high-risk communities, the rate of OHCA incidents and the level of bystander CPR participation. We also used Local Moran's I combined with traditional map overlay techniques to add robustness to the methodology for identifying high-risk communities for OHCA. Based on the criteria established for this study, we successfully identified several communities that were at higher risk for OHCA than neighboring communities. These communities had incidence rates of OHCA that were significantly higher than neighboring communities and bystander rates that were significantly lower than neighboring communities. Other risk factors for OHCA were also high in the selected communities. The methodology employed in this study provides for a measurement conceptualization of OHCA clusters that is much broader than what has been previously offered. It is also statistically reliable and can be easily executed using a GIS.

  9. The National Cross-Site Evaluation of High-Risk Youth Programs: Understanding Risk, Protection, and Substance Use among High-Risk Youth. Monograph Series.

    ERIC Educational Resources Information Center

    Springer, J. Fred; Sambrano, Soledad; Sale, Elizabeth; Kasim, Rafa; Hermann, Jack

    This document summarizes findings from the Center for Substance Abuse Prevention's National Cross-Site Evaluation of High-Risk Youth Programs, which identified characteristics associated with strong substance abuse prevention outcomes in 48 prevention programs. Major findings include: as youth age, levels of risk and protection shift considerably,…

  10. The Violence Risk Scale: Predictive Validity and Linking Changes in Risk with Violent Recidivism in a Sample of High-Risk Offenders with Psychopathic Traits

    ERIC Educational Resources Information Center

    Lewis, Kathy; Olver, Mark E.; Wong, Stephen C. P.

    2013-01-01

    The Violence Risk Scale (VRS) uses ratings of static and dynamic risk predictors to assess violence risk, identify targets for treatment, and assess changes in risk following treatment. The VRS was rated pre- and posttreatment on a sample of 150 males, mostly high-risk violent offenders many with psychopathic personality traits. These individuals…

  11. Management of high-risk localized prostate cancer.

    PubMed

    Marciscano, Ariel E; Hardee, Matthew E; Sanfilippo, Nicholas

    2012-01-01

    Traditionally, patients with high-risk localized prostate cancer have been an extremely challenging group to manage due to a significant likelihood of treatment failure and prostate cancer-specific mortality (PCSM). The results of multiple large, prospective, randomized trials have demonstrated that men with high-risk features who are treated in a multimodal fashion at the time of initial diagnosis have improved overall survival. Advances in local treatments such as dose-escalated radiotherapy in conjunction with androgen suppression and postprostatectomy adjuvant radiotherapy have also demonstrated benefits to this subset of patients. However, therapeutic enhancement with the addition of chemotherapy to the primary treatment regimen may help achieve optimal disease control.

  12. Humanized birth in high risk pregnancy: barriers and facilitating factors.

    PubMed

    Behruzi, Roxana; Hatem, Marie; Goulet, Lise; Fraser, William; Leduc, Nicole; Misago, Chizuru

    2010-02-01

    The medical model of childbearing assumes that a pregnancy always has the potential to turn into a risky procedure. In order to advocate humanized birth in high risk pregnancy, an important step involves the enlightenment of the professional's preconceptions on humanized birth in such a situation. The goal of this paper is to identify the professionals' perception of the potential obstacles and facilitating factors for the implementation of humanized care in high risk pregnancies. Twenty-one midwives, obstetricians, and health administrator professionals from the clinical and academic fields were interviewed in nine different sites in Japan from June through August 2008. The interviews were audio taped, and transcribed with the participants' consent. Data was subsequently analyzed using content analysis qualitative methods. Professionals concurred with the concept that humanized birth is a changing and promising process, and can often bring normality to the midst of a high obstetric risk situation. No practice guidelines can be theoretically defined for humanized birth in a high risk pregnancy, as there is no conflict between humanized birth and medical intervention in such a situation. Barriers encountered in providing humanized birth in a high risk pregnancy include factors such as: the pressure of being responsible for the safety of the mother and the fetus, lack of the women's active involvement in the decision making process and the heavy burden of responsibility on the physician's shoulders, potential legal issues, and finally, the lack of midwifery authority in providing care at high risk pregnancy. The factors that facilitate humanized birth in a high risk include: the sharing of decision making and other various responsibilities between the physicians and the women; being caring; stress management, and the fact that the evolution of a better relationship and communication between the health professional and the patient will lead to a stress

  13. Improved detection of microbial risk of releasing genetically modified bacteria in soil by using massive sequencing and antibiotic resistance selection.

    PubMed

    Han, Il; Lee, Tae Kwon; Han, Jungmin; Doan, Tuan Van; Kim, Seong Bo; Park, Joonhong

    2012-08-15

    High-throughput 16S rRNA gene-targeted pyrosequencing was used with commonly used risk assessment techniques to evaluate the potential microbial risk in soil after inoculating genetically modified (GM) Corynebacterium glutamicum. To verify the risk, reference experiments were conducted in parallel using well-defined and frequently used GM Escherichia coli and wild-type strains. The viable cell count showed that the number of GM bacteria in the soil was reduced to below the detection limit within 10 days, while the molecular indicator for GM plasmids was detected throughout the experiment by using quantitative real-time polymerase chain reactions. Subsequent pyrosequencing showed an insignificant influence of the GM bacteria and/or their GM plasmids on the structure of the soil bacterial community this was similar to non-GM wild-type strains. However, pyrosequencing combined with kanamycin-resistant bacteria selection uncovered a potential risk of GM bacteria on the soil bacterial community and pathogens. The results of the improved methodology showed that the microbial risk attributable to GM C. glutamicum was relatively lower than that attributable to the reference GM E. coli.

  14. Simultaneous purifying selection on the ancestral MC1R allele and positive selection on the melanoma-risk allele V60L in south Europeans.

    PubMed

    Martínez-Cadenas, Conrado; López, Saioa; Ribas, Gloria; Flores, Carlos; García, Oscar; Sevilla, Arrate; Smith-Zubiaga, Isabel; Ibarrola-Villaba, Maider; Pino-Yanes, Maria del Mar; Gardeazabal, Jesús; Boyano, Dolores; García de Galdeano, Alicia; Izagirre, Neskuts; de la Rúa, Concepción; Alonso, Santos

    2013-12-01

    In humans, the geographical apportionment of the coding diversity of the pigmentary locus melanocortin-1 receptor (MC1R) is, unusually, higher in Eurasians than in Africans. This atypical observation has been interpreted as the result of purifying selection due to functional constraint on MC1R in high UV-B radiation environments. By analyzing 3,142 human MC1R alleles from different regions of Spain in the context of additional haplotypic information from the 1000 Genomes (1000G) Project data, we show that purifying selection is also strong in southern Europe, but not so in northern Europe. Furthermore, we show that purifying and positive selection act simultaneously on MC1R. Thus, at least in Spain, regions at opposite ends of the incident UV-B radiation distribution show significantly different frequencies for the melanoma-risk allele V60L (a mutation also associated to red hair and fair skin and even blonde hair), with higher frequency of V60L at those regions of lower incident UV-B radiation. Besides, using the 1000G south European data, we show that the V60L haplogroup is also characterized by an extended haplotype homozygosity (EHH) pattern indicative of positive selection. We, thus, provide evidence for an adaptive value of human skin depigmentation in Europe and illustrate how an adaptive process can simultaneously help to maintain a disease-risk allele. In addition, our data support the hypothesis proposed by Jablonski and Chaplin (Human skin pigmentation as an adaptation to UVB radiation. Proc Natl Acad Sci U S A. 2010;107:8962-8968), which posits that habitation of middle latitudes involved the evolution of partially depigmented phenotypes that are still capable of suitable tanning.

  15. Pregnancy is not a risk factor for gallstone disease: Results of a randomly selected population sample

    PubMed Central

    Walcher, Thomas; Haenle, Mark Martin; Kron, Martina; Hay, Birgit; Mason, Richard Andrew; von Schmiesing, Alexa Friederike Alice; Imhof, Armin; Koenig, Wolfgang; Kern, Peter; Boehm, Bernhard Otto; Kratzer, Wolfgang

    2005-01-01

    AIM: To investigate the prevalence, risk factors, and selection of the study population for cholecystolithiasis in an urban population in Germany, in relation to our own findings and to the results in the international literature. METHODS: A total of 2 147 persons (1 111 females, age 42.8 ± 12.7 years; 1 036 males, age 42.3 ± 13.1 years) participating in an investigation on the prevalence of Echinococcus multilocularis were studied for risk factors and prevalence of gallbladder stone disease. Risk factors were assessed by means of a standardized interview and calculation of body mass index (BMI). A diagnostic ultrasound examination of the gallbladder was performed. Data were analyzed by multiple logistic regression, using the SAS statistical software package. RESULTS: Gallbladder stones were detected in 171 study participants (8.0%, n = 2 147). Risk factors for the development of gallbladder stone disease included age, sex, BMI, and positive family history. In a separate analysis of female study participants, pregnancy (yes/no) and number of pregnancies did not exert any influence. CONCLUSION: Findings of the present study confirm that age, female sex, BMI, and positive family history are risk factors for the development of gallbladder stone disease. Pregnancy and the number of pregnancies, however, could not be shown to be risk factors. There seem to be no differences in the respective prevalence for gallbladder stone disease in urban and rural populations. PMID:16425387

  16. Risk by use of hearing protectors--expert programme supports SMEs in appropriate selection and use.

    PubMed

    Liedtke, M

    2005-01-01

    Comprehensive protection by use of PPE against the hazards at work requires more than proper selection based on the protection level needed: The PPE user directive (Council Directive 89/656/EEC, Official Journal of the European Communities L 393, 30/12/1989 p.0018 - 0028) requires an assessment of personal protective equipment itself, which has to consider the risks which may be introduced by use of PPE or use of combinations of PPE. As an example risks which may be introduced by use of hearing protectors are described. Assistance in the assessment required by PPE user directive (Council Directive 89/656/EEC, Official Journal of the European Communities L 393, 30/12/1989 p. 0018 - 0028) and in selection and use of hearing protectors with regard to this assessment is presented.

  17. VARIABLE SELECTION AND PREDICTION WITH INCOMPLETE HIGH-DIMENSIONAL DATA1

    PubMed Central

    Liu, Ying; Wang, Yuanjia; Feng, Yang; Wall, Melanie M.

    2016-01-01

    We propose a Multiple Imputation Random Lasso (mirl) method to select important variables and to predict the outcome for an epidemiological study of Eating and Activity in Teens. In this study 80% of individuals have at least one variable missing. Therefore, using variable selection methods developed for complete data after listwise deletion substantially reduces prediction power. Recent work on prediction models in the presence of incomplete data cannot adequately account for large numbers of variables with arbitrary missing patterns. We propose MIRL to combine penalized regression techniques with multiple imputation and stability selection. Extensive simulation studies are conducted to compare MIRL with several alternatives. MIRL outperforms other methods in high-dimensional scenarios in terms of both reduced prediction error and improved variable selection performance, and it has greater advantage when the correlation among variables is high and missing proportion is high. MIRL is shown to have improved performance when comparing with other applicable methods when applied to the study of Eating and Activity in Teens for the boys and girls separately, and to a subgroup of low social economic status (ses) Asian boys who are at high risk of developing obesity. PMID:27213023

  18. Assessing Individual Risk for High-Risk Colorectal Adenoma at First-Time Screening Colonoscopy

    PubMed Central

    Cao, Yin; Rosner, Bernard A.; Ma, Jing; Tamimi, Rulla M.; Chan, Andrew T.; Fuchs, Charles S.

    2015-01-01

    Assessing risk of colorectal adenoma at first-time colonoscopy that are of higher likelihood of developing advanced neoplasia during surveillance could help tailor first-line colorectal cancer screening. We developed prediction models for high-risk colorectal adenoma (at least one adenoma ≥1 cm, or with advanced histology, or ≥3 adenomas) among 4,881 asymptomatic white men and 17,970 women who underwent colonoscopy as their first-time screening for colorectal cancer in two prospective U.S. studies using logistic regressions. C-statistics and Hosmer-Lemeshow tests were used to evaluate discrimination and calibration. Ten-fold cross-validation was used for internal validation. A total of 330 (6.7%) men and 678 (3.8%) women were diagnosed with high-risk adenoma at first-time screening colonoscopy. The model for men included age, family history of colorectal cancer, BMI, smoking, sitting watching TV/VCR, regular aspirin/NSAID use, physical activity, and a joint term of multivitamin and alcohol. For women, the model included age, family history of colorectal cancer, BMI, smoking, alcohol, beef/pork/lamb as main dish, regular aspirin/NSAID, calcium, and oral contraceptive use. The C-statistic of the model for men was 0.67 and 0.60 for women (0.64 and 0.57 in cross-validation). Both models calibrated well. The predicted risk of high-risk adenoma for men in the top decile was 15.4% vs 1.8% for men in the bottom decile (Odds Ratio[OR]=9.41), and 6.6% vs 2.1% for women (OR=3.48). In summary, we developed and internally validated an absolute risk assessment tool for high-risk colorectal adenoma among the U.S. population that may provide guidance for first-time colorectal cancer screening. PMID:25820865

  19. Assessing individual risk for high-risk colorectal adenoma at first-time screening colonoscopy.

    PubMed

    Cao, Yin; Rosner, Bernard A; Ma, Jing; Tamimi, Rulla M; Chan, Andrew T; Fuchs, Charles S; Wu, Kana; Giovannucci, Edward L

    2015-10-01

    Assessing risk of colorectal adenoma at first-time colonoscopy that are of higher likelihood of developing advanced neoplasia during surveillance could help tailor first-line colorectal cancer screening. We developed prediction models for high-risk colorectal adenoma (at least one adenoma ≥1 cm, or with advanced histology, or ≥3 adenomas) among 4,881 asymptomatic white men and 17,970 women who underwent colonoscopy as their first-time screening for colorectal cancer in two prospective US studies using logistic regressions. C-statistics and Hosmer-Lemeshow tests were used to evaluate discrimination and calibration. Ten-fold cross-validation was used for internal validation. A total of 330 (6.7%) men and 678 (3.8%) women were diagnosed with high-risk adenoma at first-time screening colonoscopy. The model for men included age, family history of colorectal cancer, BMI, smoking, sitting watching TV/VCR, regular aspirin/NSAID use, physical activity, and a joint term of multivitamin and alcohol. For women, the model included age, family history of colorectal cancer, BMI, smoking, alcohol, beef/pork/lamb as main dish, regular aspirin/NSAID, calcium, and oral contraceptive use. The C-statistic of the model for men was 0.67 and 0.60 for women (0.64 and 0.57 in cross-validation). Both models calibrated well. The predicted risk of high-risk adenoma for men in the top decile was 15.4% vs. 1.8% for men in the bottom decile (Odds Ratio [OR] = 9.41), and 6.6% vs. 2.1% for women (OR = 3.48). In summary, we developed and internally validated an absolute risk assessment tool for high-risk colorectal adenoma among the US population that may provide guidance for first-time colorectal cancer screening.

  20. Expectant management with selective delayed intervention for favorable risk prostate cancer.

    PubMed

    Klotz, Laurence

    2002-01-01

    Management options for favorable risk prostate cancer are diverse, varying from a conservative approach (expectant management) to definitive treatment (radical prostatectomy or radiotherapy.) Several studies have suggested that expectant management provides similar 10-year survival rates and quality-adjusted life years compared with radical prostatectomy or radiotherapy. Expectant management alone clearly deprives some patients with potentially curable life-threatening disease of the opportunity for curative therapy. However, every series of conservative management contains a substantial subset of long-term survivors, particularly in the group with favorable clinical parameters. We have conducted a clinical study to evaluate a novel approach in which the choice between a definitive therapy and conservative policy is determined by the rate of PSA increase or the development of early, rapid clinical and/or histologic progression. This strategy, which has never been previously evaluated, offers the powerful attraction of individualizing therapy according to the biological behavior of the cancer. This would mean that patients with slowly growing malignancy would be spared the side effects of radical treatment, while those with more rapidly progressive cancer would still benefit from curative therapy. Doubling time varied widely. In this series of 200 patients, neither grade, stage, nor baseline PSA predicted the PSA doubling time. Thirty-three percent of patients had a PSA doubling time (T(D)) > 10 years. Doubling time appears to be a useful tool to guide treatment intervention for patients managed initially with expectant management. A doubling time of less than 2 years appears to identify patients at high risk for local progression in spite of otherwise favorable prognostic factors. Fifteen to 20% of patients will fall into this category. The remainder have a high chance of remaining free of recurrence and progression for many years. Watchful waiting is clearly

  1. The relationship between health plan advertising and market incentives: evidence of risk-selective behavior.

    PubMed

    Mehrotra, Ateev; Grier, Sonya; Dudley, R Adams

    2006-01-01

    Medicare beneficiaries are now facing advertising from an unprecedented number of health plans that are offering prescription drug coverage. Previous Medicare managed care efforts have been undermined by risk selection, the practice of enrolling healthier and therefore less costly patients. In this study we explore how the content of health plan advertising is related to the competitiveness of the health plan market. We find that increased competition is associated with greater use of advertising that targets healthier patients.

  2. Enhancing risk stratification for use in integrated care: a cluster analysis of high-risk patients in a retrospective cohort study

    PubMed Central

    Vuik, Sabine I; Mayer, Erik; Darzi, Ara

    2016-01-01

    Objective To show how segmentation can enhance risk stratification tools for integrated care, by providing insight into different care usage patterns within the high-risk population. Design A retrospective cohort study. A risk score was calculated for each person using a logistic regression, which was then used to select the top 5% high-risk individuals. This population was segmented based on the usage of different care settings using a k-means cluster analysis. Data from 2008 to 2011 were used to create the risk score and segments, while 2012 data were used to understand the predictive abilities of the models. Setting and participants Data were collected from administrative data sets covering primary and secondary care for a random sample of 300 000 English patients. Main measures The high-risk population was segmented based on their usage of 4 different care settings: emergency acute care, elective acute care, outpatient care and GP care. Results While the risk strata predicted care usage at a high level, within the high-risk population, usage varied significantly. 4 different groups of high-risk patients could be identified. These 4 segments had distinct usage patterns across care settings, reflecting different levels and types of care needs. The 2008–2011 usage patterns of the 4 segments were consistent with the 2012 patterns. Discussion Cluster analyses revealed that the high-risk population is not homogeneous, as there exist 4 groups of patients with different needs across the care continuum. Since the patterns were predictive of future care use, they can be used to develop integrated care programmes tailored to these different groups. Conclusions Usage-based segmentation augments risk stratification by identifying patient groups with different care needs, around which integrated care programmes can be designed. PMID:27993905

  3. Adjuvant radiotherapy for pathological high-risk muscle invasive bladder cancer: time to reconsider?

    PubMed Central

    Baumann, Brian C.; Eapen, Libni J.; Bahl, Amit; Murthy, Vedang; Roubaud, Guilhem; Orré, Mathieu; Efstathiou, Jason A.; Shariat, Shahrokh; Larré, Stephane; Richaud, Pierre; Christodouleas, John P.

    2016-01-01

    Radical cystectomy with extended pelvic lymph-node dissection, associated with neo-adjuvant chemotherapy, remains the standard of care for advanced, non-metastatic muscle-invasive bladder cancer (MIBC). Loco-regional control is a key factor in the outcome of patients since it is related to overall survival (OS), disease-free survival (DFS) and cause-specific survival. The risk of loco-regional recurrence (LRR) is correlated to pathological factors as well as the extent of the lymphadenectomy. In addition, neither pre- nor post-operative chemotherapy have shown a clear impact on LRR-free survival. Several recent publications have led to the development of a nomogram predicting the risk of LRR, in order to identify patients most likely to benefit from adjuvant radiotherapy. Given the high risk of LRR for selected patients and improvements in radiation techniques that can reduce toxicity, there is a growing interest in adjuvant radiotherapy; international cooperative groups have come together to provide the rationale in favor of adjuvant radiotherapy. Clinical trials in order to reduce the risk of pelvic relapse are opened based on this optimizing patient selection. The aim of this critical literature review is to provide an overview of the rationale supporting the studies of adjuvant radiation for patients with pathologic high-risk MIBC. PMID:27785427

  4. Biological effects of static magnetic fields: a selective review with emphasis on risk assessment

    SciTech Connect

    Easterly, C. E.

    1982-04-01

    Rather than focusing on literature per se, the current study determines the status of magnetic field information that is applicable to risk assessment. Hence, an attempt is made to identify both the literature that is useful to the goal of risk assessment and a framework within which risk assessment methodologies can be derived. From this selected review, it is concluded that three areas exist for which adequate information can be found to begin modelling: disease induction, reproduction and development, and cardiovascular response. The first two are supported by a combination of positive and negative findings and the last by a calculational technique which utilizes the physically well-known principle of flow retardation for a conducting fluid moving through a magnetic field.

  5. Risk selection and heterogeneous preferences in health insurance markets with a public option.

    PubMed

    Polyakova, Maria

    2016-09-01

    Conventional wisdom suggests that if private health insurance plans compete alongside a public option, they may endanger the latter's financial stability by cream-skimming good risks. This paper argues that two factors may contribute to the extent of cream-skimming: (i) degree of horizontal differentiation between public and private options when preferences are heterogeneous; (ii) whether contract design encourages choice of private insurance before information about risk is revealed. I explore the role of these factors empirically within the unique institutional setting of the German health insurance system. Using a fuzzy regression discontinuity design to disentangle adverse selection and moral hazard, I find no compelling support for extensive cream-skimming of public option by private insurers despite their ability to fully underwrite risk. A model of demand for private insurance supports the idea that heterogeneity in non-pecuniary preferences and long-term structure of private insurance contracts may be muting cream-skimming in this setting.

  6. Risk-based decision-making framework for the selection of sediment dredging option.

    PubMed

    Manap, Norpadzlihatun; Voulvoulis, Nikolaos

    2014-10-15

    The aim of this study was to develop a risk-based decision-making framework for the selection of sediment dredging option. Descriptions using case studies of the newly integrated, holistic and staged framework were followed. The first stage utilized the historical dredging monitoring data and the contamination level in media data into Ecological Risk Assessment phases, which have been altered for benefits in cost, time and simplicity. How Multi-Criteria Decision Analysis (MCDA) can be used to analyze and prioritize dredging areas based on environmental, socio-economic and managerial criteria was described for the next stage. The results from MCDA will be integrated into Ecological Risk Assessment to characterize the degree of contamination in the prioritized areas. The last stage was later described using these findings and analyzed using MCDA, in order to identify the best sediment dredging option, accounting for the economic, environmental and technical aspects of dredging, which is beneficial for dredging and sediment management industries.

  7. Variable selection in subdistribution hazard frailty models with competing risks data

    PubMed Central

    Do Ha, Il; Lee, Minjung; Oh, Seungyoung; Jeong, Jong-Hyeon; Sylvester, Richard; Lee, Youngjo

    2014-01-01

    The proportional subdistribution hazards model (i.e. Fine-Gray model) has been widely used for analyzing univariate competing risks data. Recently, this model has been extended to clustered competing risks data via frailty. To the best of our knowledge, however, there has been no literature on variable selection method for such competing risks frailty models. In this paper, we propose a simple but unified procedure via a penalized h-likelihood (HL) for variable selection of fixed effects in a general class of subdistribution hazard frailty models, in which random effects may be shared or correlated. We consider three penalty functions (LASSO, SCAD and HL) in our variable selection procedure. We show that the proposed method can be easily implemented using a slight modification to existing h-likelihood estimation approaches. Numerical studies demonstrate that the proposed procedure using the HL penalty performs well, providing a higher probability of choosing the true model than LASSO and SCAD methods without losing prediction accuracy. The usefulness of the new method is illustrated using two actual data sets from multi-center clinical trials. PMID:25042872

  8. Initial ecological risk assessment of eight selected human pharmaceuticals in Japan.

    PubMed

    Yamamoto, Hiroshi; Nakamura, Yudai; Nakamura, Yuki; Kitani, Chise; Imari, Tetsuya; Sekizawa, Jun; Takao, Yuji; Yamashita, Naoyuki; Hirai, Narisato; Oda, Shigeto; Tatarazako, Norihisa

    2007-01-01

    Eight pharmaceuticals were selected on the basis of their domestic consumption in Japan, the excretion ratio of the parent compound and the frequency of detection in the aquatic environment or wastewater treatment plant effluent. Toxicity tests on these pharmaceuticals were conducted using Japanese medaka (Oryzias latipes), daphnia (Daphnia magna), and green algae (Psuedokirchneriella subcapitata). Predicted no effect concentration (PNEC) was calculated using lethal or effect concentration 50 (LC50 or EC50) values and no effect concentration (NOEC) obtained in the toxicity tests for these compounds. Predicted environmental concentration (PEC) was also calculated from annual consumption, the excretion rate of the parent compound, and removal rate in the preliminary batch activated sludge treatment performed in this study. Maximum concentrations found in the aquatic environment or sewage effluent in Japan or foreign countries were also used for another calculation of PEC. Initial risk assessment on the selected pharmaceuticals was performed using the PEC/PNEC ratio. The results of initial risk assessment on the eight selected pharmaceuticals suggest neither urgent nor severe concern for the ecological risk of these compounds, but further study needs to be conducted using chronic toxicity tests, including reproduction inhibition and endocrine disruption assessments.

  9. Clustering of chronic non-communicable disease risk factors among selected Asian populations: levels and determinants

    PubMed Central

    Ahmed, Syed Masud; Hadi, Abdullahel; Razzaque, Abdur; Ashraf, Ali; Juvekar, Sanjay; Ng, Nawi; Kanungsukkasem, Uraiwan; Soonthornthada, Kusol; Van Minh, Hoang; Huu Bich, Tran

    2009-01-01

    Background The major chronic non-communicable diseases (NCDs) operate through a cluster of common risk factors, whose presence or absence determines not only the occurrence and severity of the disease, but also informs treatment approaches. Primary prevention based on mitigation of these common risk factors through population-based programmes is the most cost-effective approach to contain the emerging epidemic of chronic NCDs. Objectives This study was conducted to explore the extent of risk factors clustering for the major chronic NCDs and its determinants in nine INDEPTH Health and Demographic Surveillance System (HDSS) sites of five Asian countries. Design Data originated from a multi-site chronic NCD risk factor prevalence survey conducted in 2005. This cross-sectional survey used a standardised questionnaire developed by the WHO to collect core data on common risk factors such as tobacco use, intake of fruits and vegetables, physical inactivity, blood pressure levels, and body mass index. Respondents included randomly selected sample of adults (25–64 years) living in nine rural HDSS sites in Bangladesh, India, Indonesia, Thailand, and Vietnam. Results Findings revealed a substantial proportion (>70%) of these largely rural populations having three or more risk factors for chronic NCDs. Chronic NCD risk factors clustering was associated with increasing age, being male, and higher educational achievements. Differences were noted among the different sites, both between and within country. Conclusions Since there is an extensive clustering of risk factors for the chronic NCDs in the populations studied, the interventions also need to be based on a comprehensive approach rather than on a single factor to forestall its cumulative effects which occur over time. This can work best if it is integrated within the primary health care system and the HDSS can be an invaluable epidemiological resource in this endeavor. PMID:20027260

  10. High-risk HPV types and head and neck cancer.

    PubMed

    Michaud, Dominique S; Langevin, Scott M; Eliot, Melissa; Nelson, Heather H; Pawlita, Michael; McClean, Michael D; Kelsey, Karl T

    2014-10-01

    Although HPV16 has been strongly implicated in oropharyngeal carcinogenesis, the role of other high-risk HPV types in the etiology of head and neck cancer remains unclear. To date, few data exist addressing the nature of the association between antibodies to oncogenic proteins of non-HPV16 HPVs in relation to head and neck cancer. We examined the relationship between multiple HPV types (HPV6, 11, 16, 18, 31, 33, 45, 52, 58) and head and neck squamous cell carcinoma (HNSCC) in a large population-based case-control study (1069 cases and 1107 controls). Serological measures for HPV types included antibodies to L1, E6 and/or E7. In a secondary analysis, we excluded HPV16 seropositive subjects to examine independent associations with other high-risk HPVs. All analyses were adjusted for age, race, sex, education, smoking and alcohol consumption. Statistically significant associations were observed for HPV16, 18, 33 and 52 and risk of HNSCC after mutually adjusting for HPV types. Among HPV16 seronegative subjects, elevated risks of HNSCC were observed for HPV18 E6 (OR = 4.19, 95% CI = 1.26-14.0), HPV33 E6 (OR = 7.96, 95% CI = 1.56-40.5) and HPV52 E7 (OR = 3.40, 95% CI = 1.16-9.99). When examined by tumor type, associations with HPV18 and HPV33 remained statistically significant for oropharyngeal cancer, and HPV52 was associated with oral cancer. In addition, magnitude of associations for HNSCC increased markedly with increasing number of seropositive high-risk HPV infections. High-risk HPV types, other than HPV16, are likely to be involved in the etiology of HNSCC.

  11. Survival after partial and radical nephrectomy for high-risk disease: A propensity-matched comparison

    PubMed Central

    Maurice, Matthew J.; Zhu, Hui; Kim, Simon; Abouassaly, Robert

    2016-01-01

    Introduction: Increasingly, partial nephrectomy has been applied to high-risk disease without evidence that its survival benefits can be extrapolated to this entity. We aimed to compare overall survival after partial vs. radical nephrectomy in patients with high-risk renal cell carcinoma. Methods: Using the National Cancer Data Base, we identified patients who underwent partial or radical nephrectomy for high-risk disease between 2003 and 2006. High-risk disease was defined as the presence of adverse pathological features within the primary tumour, namely high-grade or unfavourable histology, T3 stage, or both. After matching the partial and radical nephrectomy groups based on propensity scores, 1680, 276, and 76 patients with high-grade or unfavourable histology, T3 stage, or both adverse pathologic features, respectively, were available for analysis. Five-year overall survival was compared after partial vs. radical nephrectomy for each high-risk cohort using the Kaplan-Meier and log rank tests. Results: Partial nephrectomy was associated with a statistically significant improvement in five-year overall survival compared to radical nephrectomy for small tumours (median size 3.0 cm; interquartile range 2.1–4.5 cm) with high-grade or unfavourable histology (87% vs. 81%; p<0.01) or with pT3a stage (82% vs. 71%; p<0.01). For patients concomitantly harbouring both adverse pathologic features, no difference in survival was detected (p=0.21). Conclusions: Partial nephrectomy is associated with survival benefits in patients with adverse pathologic features, suggesting that renal preservation is not only safe, but also potentially beneficial for high-risk disease. Due to inherent selection bias associated with partial nephrectomy use, prospective validation of these findings is needed. PMID:27695581

  12. Venous Thromboembolism Risk and Adequacy of Prophylaxis in High Risk Pregnancy in the Arabian Gulf

    PubMed Central

    Alsayegh, Faisal; Al-Jassar, Waleed; Wani, Salima; Tahlak, Muna; Al-Bahar, Awatef; Al-Kharusi, Lamya; Al-Tamimi, Halima; El-Taher, Faten; Mahmood, Naeema; Al-Zakwani, Ibrahim

    2016-01-01

    Objectives: To estimate the prevalence of venous thromboembolism (VTE) risk factors in pregnancy and the proportion of pregnancies at risk of VTE that received the recommended prophylaxis according to the American College of Chest Physicians (ACCP) 2012 published guidelines in antenatal clinics in the Arabian Gulf. Methods: The evaluation of venous thromboembolism (EVE)-Risk project was a non-interventional, cross-sectional, multi-centre, multi-national study of all eligible pregnant women (≥17 years) screened during antenatal clinics from 7 centres in the Arabian Gulf countries (United Arab Emirates, Kuwait, Bahrain, Qatar and Oman). Pregnant women were recruited during a 3-month period between September and December 2012. Results: Of 4,131 screened pregnant women, 32% (n=1,337) had ≥1 risk factors for VTE. Common VTE risk factors included obesity (76%), multiparity (33%), recurrent miscarriages (9.1%), varicose veins (6.9%), thrombophilia (2.6%), immobilization (2.0%), sickle cell disease (2.8%) and previous VTE (1.6%). Only 8.3% (n=111) of the high risk patients were on the recommended VTE prophylaxis. Enoxaparin was used in 80% (n=89) of the cases followed by tinzaparin (4%; n=4). Antiplatelet agents were prescribed in 11% (n=149) of pregnant women. Of those on anticoagulants (n=111), 59% (n=66) were also co-prescribed antiplatelet agents. Side effects (mainly local bruising at the injection site) were reported in 12% (n=13) of the cases. Conclusion: A large proportion of pregnant women in the Arabian Gulf countries have ≥1 VTE risk factor with even a smaller fraction on prophylaxis. VTE risk assessment must be adopted to identify those at risk who would need VTE prophylaxis. PMID:26517701

  13. Risk factors for FEV1 decline in mild COPD and high-risk populations

    PubMed Central

    Chen, Shujing; Wang, Changhui; Li, Bing; Shi, Guochao; Li, Huiping; Zhang, Jing; Gu, Yutong; Zhou, Jian; Song, Yuanlin; Bai, Chunxue

    2017-01-01

    Background Early diagnosis of COPD is often not achieved due to limited recognition and limited access to the pulmonary function test. Our hypothesis was that lung function decline may be different between populations with mild COPD and those who are at high risk and do not receive treatment. Patients and methods Subjects with mild COPD and those from a high-risk COPD population were recruited from a community-based COPD epidemiological study after obtaining consent. Baseline clinical characteristics, symptom questionnaire, spirometry, low-dose computed tomography (LDCT) chest scan, and blood plasma biomarker data were collected initially and then 1 year later. Results A total of 617 participants were recruited, and 438 eventually completed the first-year follow-up visit; 72 participants (46 males) were in the mild COPD group, and 225 participants (165 males) were in the high-risk group. The mean forced expiratory volume in the first second of expiration (FEV1) decline in the mild COPD group was 129 mL, which was significantly higher than the 30 mL decline in the high-risk population group (P=0.005). Group category (odds ratio [OR] =0.230) and COPD Assessment Test (CAT) score (OR =9.912) were independent risk factors for an FEV1% predicted decline of >15% for all participants. In the mild COPD group, patients with a higher CAT (OR =5.310) and Emphysema Index (OR =5.681) were associated with a FEV1% predicted decline of >15% at the first-year follow-up. No factor showed a significantly predictive effect on FEV1 decline in the high-risk COPD group. Conclusion Group category was an independent influential factor associated with FEV1 decline. PMID:28184155

  14. High-altitude illnesses: physiology, risk factors, prevention, and treatment.

    PubMed

    Taylor, Andrew T

    2011-01-01

    High-altitude illnesses encompass the pulmonary and cerebral syndromes that occur in non-acclimatized individuals after rapid ascent to high altitude. The most common syndrome is acute mountain sickness (AMS) which usually begins within a few hours of ascent and typically consists of headache variably accompanied by loss of appetite, nausea, vomiting, disturbed sleep, fatigue, and dizziness. With millions of travelers journeying to high altitudes every year and sleeping above 2,500 m, acute mountain sickness is a wide-spread clinical condition. Risk factors include home elevation, maximum altitude, sleeping altitude, rate of ascent, latitude, age, gender, physical condition, intensity of exercise, pre-acclimatization, genetic make-up, and pre-existing diseases. At higher altitudes, sleep disturbances may become more profound, mental performance is impaired, and weight loss may occur. If ascent is rapid, acetazolamide can reduce the risk of developing AMS, although a number of high-altitude travelers taking acetazolamide will still develop symptoms. Ibuprofen can be effective for headache. Symptoms can be rapidly relieved by descent, and descent is mandatory, if at all possible, for the management of the potentially fatal syndromes of high-altitude pulmonary and cerebral edema. The purpose of this review is to combine a discussion of specific risk factors, prevention, and treatment options with a summary of the basic physiologic responses to the hypoxia of altitude to provide a context for managing high-altitude illnesses and advising the non-acclimatized high-altitude traveler.

  15. Mortality Related Risk Factors in High-Risk Pulmonary Embolism in the ICU

    PubMed Central

    Ergün, Recai; Çalışkan, Taner; Aydın, Kutlay; Tokur, Murat Emre; Cömert, Bilgin

    2016-01-01

    Introduction. We sought to identify possible risk factors associated with mortality in patients with high-risk pulmonary embolism (PE) after intensive care unit (ICU) admission. Patients and Methods. PE patients, diagnosed with computer tomography pulmonary angiography, were included from two ICUs and were categorized into groups: group 1 high-risk patients and group 2 intermediate/low-risk patients. Results. Fifty-six patients were included. Of them, 41 (73.2%) were group 1 and 15 (26.7%) were group 2. When compared to group 2, need for vasopressor therapy (0 vs 68.3%; p < 0.001) and need for invasive mechanical ventilation (6.7 vs 36.6%; p = 0.043) were more frequent in group 1. The treatment of choice for group 1 was thrombolytic therapy in 29 (70.7%) and anticoagulation in 12 (29.3%) patients. ICU mortality for group 1 was 31.7% (n = 13). In multivariate logistic regression analysis, APACHE II score >18 (OR 42.47 95% CI 1.50–1201.1), invasive mechanical ventilation (OR 30.10 95% CI 1.96–463.31), and thrombolytic therapy (OR 0.03 95% CI 0.01–0.98) were found as independent predictors of mortality. Conclusion. In high-risk PE, admission APACHE II score and need for invasive mechanical ventilation may predict death in ICU. Thrombolytic therapy seems to be beneficial in these patients. PMID:28025592

  16. High-temperature waste-heat-stream selection and characterization

    SciTech Connect

    Wikoff, P.M.; Wiggins, D.J.; Tallman, R.L.; Forkel, C.E.

    1983-08-01

    Four types of industrial high-temperature, corrosive waste heat streams are selected that could yield significant energy savings if improved heat recovery systems were available. These waste heat streams are the flue gases from steel soaking pits, steel reheat furnaces, aluminum remelt furnaces, and glass melting furnaces. Available information on the temperature, pressure, flow, and composition of these flue gases is given. Also reviewed are analyses of corrosion products and fouling deposits resulting from the interaction of these flue gases with materials in flues and heat recovery systems.

  17. Enzymatically active high-flux selectively gas-permeable membranes

    SciTech Connect

    Jiang, Ying-Bing; Cecchi, Joseph L.; Rempe, Susan; FU, Yaqin; Brinker, C. Jeffrey

    2016-01-26

    An ultra-thin, catalyzed liquid transport medium-based membrane structure fabricated with a porous supporting substrate may be used for separating an object species such as a carbon dioxide object species. Carbon dioxide flux through this membrane structures may be several orders of magnitude higher than traditional polymer membranes with a high selectivity to carbon dioxide. Other gases such as molecular oxygen, molecular hydrogen, and other species including non-gaseous species, for example ionic materials, may be separated using variations to the membrane discussed.

  18. ORGANOPHOSPHATE PESTICIDE EXPOSURES - WHERE ARE THE HIGH RISK CHILDREN?

    EPA Science Inventory

    Methods to identify children at high-risk for organophosphate (OP) pesticide exposure are difficult to develop because biological markers reflect only recent "snapshots" of exposure due to the short half-life of OP compounds (generally about 24 hours). We conducted a series of p...

  19. Intervening with High-Risk Families via Infant Daycare.

    ERIC Educational Resources Information Center

    Ramey, Craig T.; Farran, Dale C.

    A longitudinal study was conducted at the Frank Porter Graham Center NC to explore the use of educational day care and related services as a mechanism for preparing socially disadvantaged children for success in later public schooling. Infant children of mothers who met a criterion score on a high risk index were randomly assigned to either an…

  20. The High-Risk (Disturbed and Disturbing) College Student

    ERIC Educational Resources Information Center

    Hollingsworth, Kathy R.; Dunkle, John H.; Douce, Louise

    2009-01-01

    The disturbed and disturbing college student causes the most vexing concerns for student affairs administrators. The Assessment-Intervention of Student Problems (AISP) model offers a useful and easily understood framework for dealing with the various challenges of this high-risk student population. This chapter focuses on changes that have…

  1. High VWF, low ADAMTS13 puts women at risk.

    PubMed

    Bender, Markus

    2012-02-09

    In this issue of Blood, Andersson and colleagues reveal in a case-control study that highVWF and low ADAMTS13 plasma levels are each a risk factor for ischemic stroke and myocardial infarction, and that the combination of both results in a joint effect.

  2. Process Writing for High-Risk and Learning Disabled Students.

    ERIC Educational Resources Information Center

    Zaragoza, Nina

    1987-01-01

    Discusses the major elements of writing process instruction and the positive influence they have on learning-disabled and inner-city high-risk students. Argues that such process-writing programs might serve as a preventative measure for children likely to be categorized as learning disabled in the future. (HTH)

  3. Big Books from Little Voices: Reaching High Risk Beginning Readers.

    ERIC Educational Resources Information Center

    Trachtenburg, Phyllis; Ferruggia, Ann

    1989-01-01

    Discusses how interactive, whole class techniques (using a student-generated Big Book adaptation of "Corduroy") improved the reading skills of high risk first grade readers. Describes several activities, including sight word strategies, decoding techniques, and word processing, and suggests 27 Big Books for use with these activities. (MM)

  4. Staying Alive! Training High-Risk Teams for Self Correction

    NASA Technical Reports Server (NTRS)

    Slack, Kelley; Noe, Raymond; Weaver, Sallie

    2011-01-01

    Research examining teams working in high-risk operations has been lacking. The present symposium showcases research on team training that helps to optimize team performance in environments characterized by life or death situations arising spontaneously after long periods of mundane activity by pulling experts from diverse areas of industry: space flight, health care, and medical simulation.

  5. High Risk Drinking among Non-Affiliated College Students

    ERIC Educational Resources Information Center

    Smith, Margaret; Finneran, John; Droppa, Marj

    2014-01-01

    This study investigated the high risk drinking practices of unaffiliated college students who are not involved in formal athletics, fraternities, or sororities. Using a qualitative research design, the investigators interviewed students at a northeast public college in fall 2010 to learn about unaffiliated students' drinking experiences and their…

  6. Cyberbullying and Its Risk Factors among Chinese High School Students

    ERIC Educational Resources Information Center

    Zhou, Zongkui; Tang, Hanying; Tian, Yuan; Wei, Hua; Zhang, Fengjuan; Morrison, Chelsey M.

    2013-01-01

    Cyberbullying has become a common occurrence among adolescents worldwide; however, it has yet to receive adequate scholarly attention in China, especially in the mainland. The present study investigated the epidemiological characteristics and risk factors of cyberbullying, utilizing a sample of 1,438 high school students from central China.…

  7. A Bridge Course for High-Risk Freshman: Evaluating Outcomes.

    ERIC Educational Resources Information Center

    Hardy, Dorothy C.; Karathanos, Demetrius

    1992-01-01

    Examines outcomes of a "bridge" course for first-year college students that emphasizes personal and psychological adjustment to the university experience to enhance the likelihood of academic success. Findings from 59 high-risk students who completed course suggest that goal of enhancing likelihood of academic success for such students was…

  8. Programs for At-risk High School Students.

    ERIC Educational Resources Information Center

    Ohio State Legislative Office of Education Oversight, Columbus.

    In this report the Ohio Legislative Office of Education Oversight discusses five Ohio programs designed to serve at-risk high school students and examines their possible overlap. The report describes the goals, strategies, and structure of the following programs: (1) Occupational Work Experience (OWE), a 1-year vocational program of classroom…

  9. Troubled Relationships: High-Risk Latina Adolescents and Nonresident Fathers

    ERIC Educational Resources Information Center

    Lopez, Vera; Corona, Rosalie

    2012-01-01

    This qualitative study explored 18 high-risk adolescent Latinas' perceptions of their relationships with nonresident fathers. A number of interrelated factors--early childhood memories, mothers' interpretations, and fathers' behaviors--shaped girls' perceptions, which in turn, influenced how they interacted with fathers. Some girls struggled to…

  10. Explorations in High-Risk Stimulation: Two Modalities in Mothering.

    ERIC Educational Resources Information Center

    Gochman, Eva R. Grubler; Aisenstein, Clara

    An exploratory study of high-risk mothers' interactions with their infants studied modalities of stimulation; vestibular and auditory. It was hypothesized that stimulation would be lower for non-paranoid than for paranoid types, and than for control mothers. Mothers recruited from inner city gynecological clinics were screened for probable…

  11. Unconventional, highly selective CO2 adsorption in zeolite SSZ-13.

    PubMed

    Hudson, Matthew R; Queen, Wendy L; Mason, Jarad A; Fickel, Dustin W; Lobo, Raul F; Brown, Craig M

    2012-02-01

    Low-pressure adsorption of carbon dioxide and nitrogen was studied in both acidic and copper-exchanged forms of SSZ-13, a zeolite containing an 8-ring window. Under ideal conditions for industrial separations of CO(2) from N(2), the ideal adsorbed solution theory selectivity is >70 in each compound. For low gas coverage, the isosteric heat of adsorption for CO(2) was found to be 33.1 and 34.0 kJ/mol for Cu- and H-SSZ-13, respectively. From in situ neutron powder diffraction measurements, we ascribe the CO(2) over N(2) selectivity to differences in binding sites for the two gases, where the primary CO(2) binding site is located in the center of the 8-membered-ring pore window. This CO(2) binding mode, which has important implications for use of zeolites in separations, has not been observed before and is rationalized and discussed relative to the high selectivity for CO(2) over N(2) in SSZ-13 and other zeolites containing 8-ring windows.

  12. High-Risk Behaviors and Hospitalizations Among Gamma Hydroxybutyrate (GHB) Users

    PubMed Central

    Kim, Susan Y.; Anderson, Ilene B.; Dyer, Jo Ellen; Barker, Judith C.; Blanc, Paul D.

    2008-01-01

    Introduction Little is known about behaviors linked to gamma hydroxybutyrate (GHB) morbidity. Methods We surveyed 131 GHB users, using logistic regression to test the associations between the high risk behaviors and hospital treatment for GHB (26 [20%] of subjects). Results Increased risk of GHB hospital treatment was associated with: co-ingestion of ethanol (OR 5.2; 95% CI 1.7–16), driving under the influence of GHB (OR 3.2; 95%, CI 1.3–7.8), use of GHB to treat withdrawal symptoms (OR 2.9; 95% CI 1.1–7.9), and co-ingestion of ketamine (OR 2.7; 95% CI 1.1–6.7). Conclusion Targeted prevention activities could focus on selected high-risk behaviors. PMID:17613970

  13. Widespread signatures of positive selection in common risk alleles associated to autism spectrum disorder

    PubMed Central

    2017-01-01

    The human brain is the outcome of innumerable evolutionary processes; the systems genetics of psychiatric disorders could bear their signatures. On this basis, we analyzed five psychiatric disorders, attention deficit hyperactivity disorder, autism spectrum disorder (ASD), bipolar disorder, major depressive disorder, and schizophrenia (SCZ), using GWAS summary statistics from the Psychiatric Genomics Consortium. Machine learning-derived scores were used to investigate two natural-selection scenarios: complete selection (loci where a selected allele reached fixation) and incomplete selection (loci where a selected allele has not yet reached fixation). ASD GWAS results positively correlated with incomplete-selection (p = 3.53*10−4). Variants with ASD GWAS p<0.1 were shown to have a 19%-increased probability to be in the top-5% for incomplete-selection score (OR = 1.19, 95%CI = 1.11–1.8, p = 9.56*10−7). Investigating the effect directions of minor alleles, we observed an enrichment for positive associations in SNPs with ASD GWAS p<0.1 and top-5% incomplete-selection score (permutation p<10−4). Considering the set of these ASD-positive-associated variants, we observed gene-expression enrichments for brain and pituitary tissues (p = 2.3*10−5 and p = 3*10−5, respectively) and 53 gene ontology (GO) enrichments, such as nervous system development (GO:0007399, p = 7.57*10−12), synapse organization (GO:0050808, p = 8.29*10−7), and axon guidance (GO:0007411, p = 1.81*10−7). Previous genetic studies demonstrated that ASD positively correlates with childhood intelligence, college completion, and years of schooling. Accordingly, we hypothesize that certain ASD risk alleles were under positive selection during human evolution due to their involvement in neurogenesis and cognitive ability. PMID:28187187

  14. Patient selection for TAVI in 2014: is it justified to treat low- or intermediate-risk patients? The cardiologist's view.

    PubMed

    Cribier, Alain; Durand, Eric; Eltchaninoff, Hélène

    2014-09-01

    Twelve years after the first transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS), European and American guidelines, as well as the FDA, indicated that TAVI is the treatment of choice in "inoperable" patients and an alternative option to SAVR in high-risk patients. Recently, there has been a trend in clinical practice and trials to treat "lower" risk patients, and data in this subset of patients suggest better outcomes with TAVI, equivalent to surgery, using propensity matching analysis. The awaited results of the randomised PARTNER II trial with the Edwards XT valve and of the SURTAVI trial with the Medtronic CoreValve will bring an evidence-based comparison of TAVI versus SAVR in this patient population. Refinement in patient selection, new devices and long-term assessment of valve durability should also contribute to an extension of the indication of TAVI to "lower" risk patients. It is likely that the next five to ten years will see this technology become the dominant therapy for AS. At the present time, one might already consider TAVI as an alternative to SAVR in a select subset of very old and otherwise healthy AS patients.

  15. Environmental risk factors associated with bovine tuberculosis among cattle in high-risk areas

    PubMed Central

    Winkler, B.; Mathews, F.

    2015-01-01

    Our research shows that environmental features are important predictors of bovine tuberculosis (bTB) in British cattle herds in high-prevalence regions. Data from 503 case and 808 control farms included in the randomized badger culling trial (RBCT) were analysed. bTB risk increased in larger herds and on farms with greater areas of maize, deciduous woodland and marsh, whereas a higher percentage of boundaries composed of hedgerows decreased the risk. The model was tested on another case–control study outside RBCT areas, and here it had a much smaller predictive power. This suggests that different infection dynamics operate outside high-risk areas, although it is possible that unknown confounding factors may also have played a role. PMID:26559511

  16. Environmental risk factors associated with bovine tuberculosis among cattle in high-risk areas.

    PubMed

    Winkler, B; Mathews, F

    2015-11-01

    Our research shows that environmental features are important predictors of bovine tuberculosis (bTB) in British cattle herds in high-prevalence regions. Data from 503 case and 808 control farms included in the randomized badger culling trial (RBCT) were analysed. bTB risk increased in larger herds and on farms with greater areas of maize, deciduous woodland and marsh, whereas a higher percentage of boundaries composed of hedgerows decreased the risk. The model was tested on another case-control study outside RBCT areas, and here it had a much smaller predictive power. This suggests that different infection dynamics operate outside high-risk areas, although it is possible that unknown confounding factors may also have played a role.

  17. Engineering High-Fidelity Residue Separations for Selective Harvest

    SciTech Connect

    Kevin L. Kenney; Christopher T. Wright; Reed L. Hoskinson; J. Rochard Hess; David J. Muth, Jr.

    2006-07-01

    Composition and pretreatment studies of corn stover and wheat stover anatomical fractions clearly show that some corn and wheat stover anatomical fractions are of higher value than others as a biofeedstock. This premise, along with soil sustainability and erosion control concerns, provides the motivation for the selective harvest concept for separating and collecting the higher value residue fractions in a combine during grain harvest. This study recognizes the analysis of anatomical fractions as theoretical feedstock quality targets, but not as practical targets for developing selective harvest technologies. Rather, practical quality targets were established that identified the residue separation requirements of a selective harvest combine. Data are presented that shows that a current grain combine is not capable of achieving the fidelity of residue fractionation established by the performance targets. However, using a virtual engineering approach, based on an understanding of the fluid dynamics of the air stream separation, the separation fidelity can be significantly improved without significant changes to the harvester design. A virtual engineering model of a grain combine was developed and used to perform simulations of the residue separator performance. The engineered residue separator was then built into a selective harvest test combine, and tests performed to evaluate the separation fidelity. Field tests were run both with and without the residue separator installed in the test combine, and the chaff and straw residue streams were collected during harvest of Challis soft white spring wheat. The separation fidelity accomplished both with and without the residue separator was quantified by laboratory screening analysis. The screening results showed that the engineered baffle separator did a remarkable job of effecting high-fidelity separation of the straw and chaff residue streams, improving the chaff stream purity and increasing the straw stream yield.

  18. Biological Markers of Pseudomonas aeruginosa Epidemic High-Risk Clones

    PubMed Central

    Mulet, Xavier; Cabot, Gabriel; Ocampo-Sosa, Alain A.; Domínguez, M. Angeles; Zamorano, Laura; Juan, Carlos; Tubau, Fe; Rodríguez, Cristina; Moyà, Bartolomé; Peña, Carmen; Martínez-Martínez, Luis

    2013-01-01

    A limited number of Pseudomonas aeruginosa genotypes (mainly ST-111, ST-175, and ST-235), known as high-risk clones, are responsible for epidemics of nosocomial infections by multidrug-resistant (MDR) or extensively drug-resistant (XDR) strains worldwide. We explored the potential biological parameters that may explain the success of these clones. A total of 20 isolates from each of 4 resistance groups (XDR, MDR, ModR [resistant to 1 or 2 classes], and MultiS [susceptible to all antipseudomonals]), recovered from a multicenter study of P. aeruginosa bloodstream infections performed in 10 Spanish hospitals, were analyzed. A further set of 20 XDR isolates belonging to epidemic high-risk clones (ST-175 [n = 6], ST-111 [n = 7], and ST-235 [n = 7]) recovered from different geographical locations was also studied. When unknown, genotypes were documented through multilocus sequence typing. The biological parameters evaluated included twitching, swimming, and swarming motility, biofilm formation, production of pyoverdine and pyocyanin, spontaneous mutant frequencies, and the in vitro competition index (CI) obtained with a flow cytometry assay. All 20 (100%) XDR, 8 (40%) MDR, and 1 (5%) ModR bloodstream isolate from the multicenter study belonged to high-risk clones. No significant differences were observed between clonally diverse ModR and MultiS isolates for any of the parameters. In contrast, MDR/XDR high-risk clones showed significantly increased biofilm formation and mutant frequencies but significantly reduced motility (twitching, swimming, and swarming), production of pyoverdine and pyocyanin, and fitness. The defined biological markers of high-risk clones, which resemble those resulting from adaptation to chronic infections, could be useful for the design of specific treatment and infection control strategies. PMID:23979744

  19. DNA Methylation-Guided Prediction of Clinical Failure in High-Risk Prostate Cancer

    PubMed Central

    Joniau, Steven; Lerut, Evelyne; Laenen, Annouschka; Gevaert, Thomas; Gevaert, Olivier; Spahn, Martin; Kneitz, Burkhard; Gramme, Pierre; Helleputte, Thibault; Isebaert, Sofie; Haustermans, Karin; Bollen, Mathieu

    2015-01-01

    Background Prostate cancer (PCa) is a very heterogeneous disease with respect to clinical outcome. This study explored differential DNA methylation in a priori selected genes to diagnose PCa and predict clinical failure (CF) in high-risk patients. Methods A quantitative multiplex, methylation-specific PCR assay was developed to assess promoter methylation of the APC, CCND2, GSTP1, PTGS2 and RARB genes in formalin-fixed, paraffin-embedded tissue samples from 42 patients with benign prostatic hyperplasia and radical prostatectomy specimens of patients with high-risk PCa, encompassing training and validation cohorts of 147 and 71 patients, respectively. Log-rank tests, univariate and multivariate Cox models were used to investigate the prognostic value of the DNA methylation. Results Hypermethylation of APC, CCND2, GSTP1, PTGS2 and RARB was highly cancer-specific. However, only GSTP1 methylation was significantly associated with CF in both independent high-risk PCa cohorts. Importantly, trichotomization into low, moderate and high GSTP1 methylation level subgroups was highly predictive for CF. Patients with either a low or high GSTP1 methylation level, as compared to the moderate methylation groups, were at a higher risk for CF in both the training (Hazard ratio [HR], 3.65; 95% CI, 1.65 to 8.07) and validation sets (HR, 4.27; 95% CI, 1.03 to 17.72) as well as in the combined cohort (HR, 2.74; 95% CI, 1.42 to 5.27) in multivariate analysis. Conclusions Classification of primary high-risk tumors into three subtypes based on DNA methylation can be combined with clinico-pathological parameters for a more informative risk-stratification of these PCa patients. PMID:26086362

  20. Occurrence and risk assessment of selected phthalates in drinking water from waterworks in China.

    PubMed

    Liu, Xiaowei; Shi, Jianghong; Bo, Ting; Li, Huiyuan; Crittenden, John C

    2015-07-01

    The first nationwide survey of six phthalates (diethyl phthalate (DEP); dimethyl phthalate (DMP); di-n-butyl phthalate (DBP); butyl benzyl phthalate (BBP); bis(2-ethylhexyl) phthalate (DEHP); din-octyl phthalate (DnOP)) in drinking waters from waterworks was conducted across seven geographical zones in China. Of the six target phthalates, DBP and DEHP were the highest abundant phthalates with median (± interquartile range) values of 0.18 ± 0.47 and 0.18 ± 0.97 μg/L, respectively, but did not exceed the limit values in China's Standards for Drinking Water Quality. These phthalates in drinking water were generally higher in the northern regions of China than those in the southern and eastern regions. Based on the investigated concentrations, lifetime exposure risk assessment indicated that phthalates in drinking water did not pose carcinogenic and noncarcinogenic risks to Chinese residents, even under the conservative scenario (with 95th percentile risk). In addition, we found that DEHP contributed the greatest risk to the total exposure risk of all the selected phthalates and oral ingestion was the main exposure route for phthalates in drinking water.

  1. Area-based socioeconomic characteristics of industries at high risk for violence in the workplace.

    PubMed

    Ta, Myduc L; Marshall, Stephen W; Kaufman, Jay S; Loomis, Dana; Casteel, Carri; Land, Kenneth C

    2009-12-01

    This study examined socioeconomic factors associated with the presence of workplaces belonging to industries reported to be at high risk for worker homicide. The proportion of 2004 North Carolina workplaces in high-risk industries was computed following spatial linkage of individual workplaces to 2000 United States Census Block Groups (n = 3,925). Thirty census-derived socioeconomic variables (selected a priori as potentially predictive of violence) were summarized using exploratory factor analysis into poverty/deprivation, human/economic capital, and transience/instability. Multinomial logistic regression models indicate associations between higher proportion of workplaces belonging to high-risk industries and Block Groups with more poverty/deprivation or transience/instability and less human/economic capital. The relationship between human/economic capital and Block Groups proportion of high-risk industry workplaces was modified by levels of transience/instability. Community characteristics therefore contribute to the potential for workplace violence, and future research should continue to understand the relationship between social context and workplace violence risk.

  2. Building an evidence-based multitiered system of supports for high-risk youth and communities.

    PubMed

    Kingston, Beverly E; Mihalic, Sharon F; Sigel, Eric J

    2016-03-01

    The mental, emotional and behavioral health problems of high-risk youth and youth living in high-risk communities are not inevitable and can be prevented. A shift from the nation's focus on treating disease and illness after it occurs to a concentrated effort on preventing the root causes of these problems is needed. Prevention science suggests a comprehensive multitiered approach that provides evidence-based prevention supports for children and youth at each developmental stage and across multiple social contexts is likely to result in the greatest health impact and return on investment. However, actually implementing this approach at a neighborhood level has remained a challenge and an ongoing research gap especially in high-risk communities. This article describes a process and provides a case study example for implementing a comprehensive, multitiered approach in a high-risk community. This includes assessing and prioritizing the specific needs of individuals and communities; selecting evidence-based programs based upon assessed needs; and creating a continuum of programs to improve the health and well-being of youth across developmental age spans, social contexts, and levels of risk. Operational details and challenges for organizing and implementing this comprehensive approach are also described. We estimate that the collective impact of a multitiered evidence-based approach, implemented with fidelity, could conservatively result in a 30 to 40% reduction in problem behaviors. (PsycINFO Database Record

  3. Fabrication of highly selective tungsten oxide ammonia sensors

    SciTech Connect

    Llobet, E.; Molas, G.; Molinas, P.; Calderer, J.; Vilanova, X.; Brezmes, J.; Sueiras, J.E.; Correig, X.

    2000-02-01

    Tungsten oxide is shown to be a very promising material for the fabrication of highly selective ammonia sensors. Films of WO{sub 3} were deposited onto a silicon substrate by means of the drop-coating method. Then, the films were annealed in dry air at two different temperatures (300 and 400 C). X-ray photoelectron spectroscopy was used to investigate the composition of the films. Tungsten appeared both in WO{sub 2} and WO{sub 3} oxidation states, but the second state was clearly dominant. Scanning electron microscopy results showed that the oxide was amorphous or nanocrystalline. The WO{sub 3}-based devices were sensitive to ammonia vapors when operated between 250 and 350 C. The optimal operating temperature for the highest sensitivity to ammonia was 300 C. Furthermore, when the devices were operated at 300 C, their sensitivity to other reducing species such as ethanol, methane, toluene, and water vapor was significantly lower, and this resulted in a high selectivity to ammonia. A model for the sensing mechanisms of the fabricated sensors is proposed.

  4. A highly selective phosphorescence probe for histidine in living bodies.

    PubMed

    Gao, Quankun; Song, Bo; Ye, Zhiqiang; Yang, Liu; Liu, Ruoyang; Yuan, Jingli

    2015-11-14

    In this work, we designed and synthesized a heterobimetallic ruthenium(ii)-nickel(ii) complex, [Ru(bpy)2(phen-DPA)Ni](PF6)4 (Ru-Ni), as a highly selective phosphorescence probe for histidine. The probe exhibited weak emission at 603 nm because the phosphorescence of the Ru(ii) complex can be strongly quenched by the paramagnetic Ni(2+) ion. In the presence of histidine, reaction of Ru-Ni with histidine resulted in the release of nickel(ii) and an enhancement in the phosphorescence intensity at 603 nm. Ru-Ni showed high selectivity for histidine even in the presence of other amino acids and cellular abundant species. Cell imaging experimental results demonstrated that Ru-Ni is membrane permeable, and can be applied for visualizing histidine in live cells. More interestingly, Ru-Ni also can act as a novel reaction-based nuclear staining agent for visualizing exclusively the nuclei of living cells with a significant phosphorescence enhancement. In addition, the potential of the probe for biological applications was confirmed by employing it for phosphorescence imaging of histidine in larval zebrafish and Daphnia magna. These results demonstrated that Ru-Ni would be a useful tool for physiological and pathological studies involving histidine.

  5. Plans, Patterns, and Move Categories Guiding a Highly Selective Search

    NASA Astrophysics Data System (ADS)

    Trippen, Gerhard

    In this paper we present our ideas for an Arimaa-playing program (also called a bot) that uses plans and pattern matching to guide a highly selective search. We restrict move generation to moves in certain move categories to reduce the number of moves considered by the bot significantly. Arimaa is a modern board game that can be played with a standard Chess set. However, the rules of the game are not at all like those of Chess. Furthermore, Arimaa was designed to be as simple and intuitive as possible for humans, yet challenging for computers. While all established Arimaa bots use alpha-beta search with a variety of pruning techniques and other heuristics ending in an extensive positional leaf node evaluation, our new bot, Rat, starts with a positional evaluation of the current position. Based on features found in the current position - supported by pattern matching using a directed position graph - our bot Rat decides which of a given set of plans to follow. The plan then dictates what types of moves can be chosen. This is another major difference from bots that generate "all" possible moves for a particular position. Rat is only allowed to generate moves that belong to certain categories. Leaf nodes are evaluated only by a straightforward material evaluation to help avoid moves that lose material. This highly selective search looks, on average, at only 5 moves out of 5,000 to over 40,000 possible moves in a middle game position.

  6. Embedded CMs work with high-risk patients.

    PubMed

    2014-01-01

    Care managers embedded in primary care clinics work with patients with high-risk diagnoses and multiple visits to the emergency department or hospital. Patients are identified though risk assessments, suggestions from inpatient case management, and requests from primary care clinicians. Care managers call patients before their clinic visits, look for gaps in care and find out patients' questions and concerns, sharing the information with the treating clinicians. Care managers follow patients for four weeks after their visit, helping them meet their health care goals and follow their treatment plan.

  7. Air pollution exposure: Who is at high risk?

    NASA Astrophysics Data System (ADS)

    Peled, Ronit

    2011-04-01

    This article reviews the sub-population groups who are at high risk and first to be harmed by air pollution coming from anthropogenic combustions. Epidemiological studies from the last few decades contributed to the understanding of the different levels of susceptibility to air pollution. Older people and young infants, people who suffer from allergies, pulmonary and heart diseases, pregnant women and newborn babies, and deprived populations that suffer from low socio-economic status have all been described as populations at risk. A better understanding of the role of air pollution on large as well as specific populations' health, will promote a better protection policy.

  8. [Co-payment on prescription drugs in the Spanish public health system: Certainty, risk and selection of risks].

    PubMed

    Simó Miñana, Juan

    2015-12-01

    The model of co-payment on prescription drugs in the Spanish National Health System (NHS) changed on 1 July 2012. For more than three decades that it was not modified. This article provides a brief historical reminder of the evolution of this model of co-payment. The basic characteristics of this model are compared with the model of copayment on prescription drugs of the Administrative Mutualism (Civil Servants). The document provides detailed information on the percentage of effective copayment, fundraising effects, the economic participation of the patient, among others, in both models. Finally, listed pending improvements not addressed by 2012 changes such as the concentration of the co-payment in the active patient population and risk selection promoted by the differences in the financial contribution between the two models of co-payment (NHS and Mutualist).

  9. Radical prostatectomy in high-risk prostate cancer.

    PubMed

    Ischia, Joseph; Gleave, Martin

    2013-03-01

    One consistent finding in the studies regarding treating men with prostate cancer is that men with high-risk disease have the most to gain from treatment with curative intent. Men with high-risk or locally-advanced prostate cancer require treatment to the primary cancer or risk dying prematurely from their disease. Increasingly, combined androgen deprivation therapy + radiation treatment is seen as the standard treatment as a result of prospective studies in this space, and the perceived increased morbidity of radical prostatectomy in the setting of a "low" cure rate as monotherapy. In the absence of a well-conducted randomized trial, there is no definite evidence that one treatment is superior to the other. The advantages of radical prostatectomy are that it provides excellent local control of the primary tumor without an increase in morbidity, accurately stages the disease to guide further therapy, and removes benign sources of prostate-specific antigen so that failures can be promptly identified and subsequent treatment can be initiated in a timely manner. Although several guidelines recommend radiation treatment over radical prostatectomy as first-line treatment, there is no evidence that surgery is inferior and radical prostatectomy should remain part of any informed discussion regarding treatment options for men with high-risk prostate cancer.

  10. Wandering spleen: 'presentation in adolescent with high thrombotic risk'.

    PubMed

    Tchidjou, Hyppolite K; Castelluzzo, Maria A; Messia, Virginia; Luciani, Matteo; Monti, Lidia; Grimaldi, Chiara; Bernardi, Stefania; D'Argenio, Patrizia

    2014-07-01

    The term 'wandering spleen' refers to an abnormal hypermobility of the spleen, which may be congenital or acquired. The absence or abnormal laxity of splenic ligaments combined with an abnormally long and mobile vascular pedicle predispose to complications such as torsion of the splenic pedicle, infarction and splenic vein thrombosis. The clinical presentation of such disease is highly variable. In this case, we describe an asymptomatic case of wandering spleen in high thrombotic risk patients with cavernoma of splenic vein and infarction of the spleen. Physical examination was normal except the enlarged and no tender consistency spleen palpable at left iliac fossa. Ultrasonography revealed enlarged spleniform mass below its normal position suggesting vascular impairment and subsequently has been confirmed by colour Doppler ultrasound and computed tomography. The family history was positive for ischemic thrombotic vascular diseases and the screening for thrombotic risk has revealed hyperhomocysteinemia, thrombophilic homozygous gene mutations for factor V (H1299R) and MTHFR (C677T). For high thrombotic risk, prophylaxis postsplenectomy was suggested according to the international recommendations with subcutaneous low molecular weight heparin, associated with a preventive treatment with acetyl salicylic acid and folic acid along with B-vitamin. This case report may be helpful for clinicians involved in the care of splenectomized patients, because it has shown the importance of an appropriate pre and postoperative antithrombotic management to reduce as soon as possible the risk of thrombotic events in such patients after splenectomy.

  11. Gene-environment correlation in the development of adolescent substance abuse: selection effects of child personality and mediation via contextual risk factors.

    PubMed

    Hicks, Brian M; Johnson, Wendy; Durbin, C Emily; Blonigen, Daniel M; Iacono, William G; McGue, Matt

    2013-02-01

    We used a longitudinal twin design to examine selection effects of personality traits at age 11 on high-risk environmental contexts at age 14 and the extent to which these contexts mediated risk for substance abuse at age 17. Socialization at age 11 (willingness to follow rules and endorse conventional values) predicted exposure to contextual risk at age 14. Contextual risk partially mediated the effect of socialization on substance abuse, though socialization also had a direct effect. In contrast, boldness at age 11 (social engagement and assurance, thrill seeking, and stress resilience) also predicted substance abuse directly but was unrelated to contextual risk. There was substantial overlap in the genetic and shared environmental influences on socialization and contextual risk, and genetic risk in socialization contributed to substance abuse indirectly via increased exposure to contextual risk. This suggests that active gene-environment correlations related to individual differences in socialization contributed to an early, high-risk developmental trajectory for adolescent substance abuse. In contrast, boldness appeared to index an independent and direct genetic risk factor for adolescent substance abuse.

  12. Validation of the High-Risk Pregnancy Stress Scale in a sample of hospitalized Greek high-risk pregnant women.

    PubMed

    Gourounti, Kleanthi; Karpathiotaki, Natassa; Karapanou, Vassiliki; Antzaklis, Panos; Daskalakis, Georgios

    2016-01-01

    The aim of the authors in this study was to determine the psychometric properties of the Greek adaptation of the High-Risk Pregnancy Stress Scale (HRPSS) in a sample of high-risk hospitalized pregnant women. The sample consisted of 133 high-risk pregnant women with gestational age from 9 to 37 weeks. Data were collected between February and June of 2014. HRPSS was "forward-backward" translated from English to Greek. Principal axis factoring with promax rotation was used to test the factor structure of the HRPSS. Measures of state anxiety (STAI) and depressive symptoms (EPDS) were used to assess the convergent validity of the HRPSS. Exploratory factor analysis suggested three factors: concerns of pregnancy, movement restriction, and isolation and restriction of external activities. Construct validity was confirmed by computing correlations between the HRPSS and constructions of anxiety and depressive symptoms. Internal consistency reliability was satisfactory (α = 0.813). The original factor structure of the HRPSS was only partly replicated. The results of the exploratory factor analysis suggested that a three-factor solution instead of a two-factor solution would be the most adequate. The HRPSS is an appropriate measure for assessing the levels of concerns regarding pregnancy outcome, movement restriction, isolation, and external activity restrictions in Greek high-risk pregnant women.

  13. High wall shear stress and high-risk plaque: an emerging concept.

    PubMed

    Eshtehardi, Parham; Brown, Adam J; Bhargava, Ankit; Costopoulos, Charis; Hung, Olivia Y; Corban, Michel T; Hosseini, Hossein; Gogas, Bill D; Giddens, Don P; Samady, Habib

    2017-01-10

    In recent years, there has been a significant effort to identify high-risk plaques in vivo prior to acute events. While number of imaging modalities have been developed to identify morphologic characteristics of high-risk plaques, prospective natural-history observational studies suggest that vulnerability is not solely dependent on plaque morphology and likely involves additional contributing mechanisms. High wall shear stress (WSS) has recently been proposed as one possible causative factor, promoting the development of high-risk plaques. High WSS has been shown to induce specific changes in endothelial cell behavior, exacerbating inflammation and stimulating progression of the atherosclerotic lipid core. In line with experimental and autopsy studies, several human studies have shown associations between high WSS and known morphological features of high-risk plaques. However, despite increasing evidence, there is still no longitudinal data linking high WSS to clinical events. As the interplay between atherosclerotic plaque, artery, and WSS is highly dynamic, large natural history studies of atherosclerosis that include WSS measurements are now warranted. This review will summarize the available clinical evidence on high WSS as a possible etiological mechanism underlying high-risk plaque development.

  14. Prediction of Psychosis in Youth at High Clinical Risk

    PubMed Central

    Cannon, Tyrone D.; Cadenhead, Kristin; Cornblatt, Barbara; Woods, Scott W.; Addington, Jean; Walker, Elaine; Seidman, Larry J.; Perkins, Diana; Tsuang, Ming; McGlashan, Thomas; Heinssen, Robert

    2011-01-01

    Context Early detection and prospective evaluation of individuals who will develop schizophrenia or other psychotic disorders are critical to efforts to isolate mechanisms underlying psychosis onset and to the testing of preventive interventions, but existing risk prediction approaches have achieved only modest predictive accuracy. Objectives To determine the risk of conversion to psychosis and to evaluate a set of prediction algorithms maximizing positive predictive power in a clinical high-risk sample. Design, Setting, and Participants Longitudinal study with a 2½-year follow-up of 291 prospectively identified treatment-seeking patients meeting Structured Interview for Prodromal Syndromes criteria. The patients were recruited and underwent evaluation across 8 clinical research centers as part of the North American Prodrome Longitudinal Study. Main Outcome Measure Time to conversion to a fully psychotic form of mental illness. Results The risk of conversion to psychosis was 35%, with a decelerating rate of transition during the 2½-year follow-up. Five features assessed at baseline contributed uniquely to the prediction of psychosis: a genetic risk for schizophrenia with recent deterioration in functioning, higher levels of unusual thought content, higher levels of suspicion/paranoia, greater social impairment, and a history of substance abuse. Prediction algorithms combining 2 or 3 of these variables resulted in dramatic increases in positive predictive power (ie, 68%–80%) compared with the prodromal criteria alone. Conclusions These findings demonstrate that prospective ascertainment of individuals at risk for psychosis is feasible, with a level of predictive accuracy comparable to that in other areas of preventive medicine. They provide a benchmark for the rate and shape of the psychosis risk function against which standardized preventive intervention programs can be compared. PMID:18180426

  15. 48 CFR 1352.237-70 - Security processing requirements-high or moderate risk contracts.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... requirements for Non-IT Service Contracts are: (i) High Risk—Background Investigation (BI). (ii) Moderate Risk...) High Risk IT—Background Investigation (BI). (ii) Moderate Risk IT—Background Investigation (BI). (b)...

  16. 48 CFR 1352.237-70 - Security processing requirements-high or moderate risk contracts.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... requirements for Non-IT Service Contracts are: (i) High Risk—Background Investigation (BI). (ii) Moderate Risk...) High Risk IT—Background Investigation (BI). (ii) Moderate Risk IT—Background Investigation (BI). (b)...

  17. The High-Redshift Clustering of Photometrically Selected Quasars

    NASA Astrophysics Data System (ADS)

    Timlin, John

    2017-01-01

    We present the data from the Spitzer IRAC Equatorial Survey (SpIES) along with our first high-redshift (2.9high-redshift quasars. Using the infrared data from SpIES and SHELA, and the deep optical data from SDSS, we employ the multi-dimensional Bayesian selection algorithm outlined in Richards et al. 2015 to identify ~5000 high-redshift quasar candidates in this field. We then combine these candidates with spectroscopically confirmed high-redshift quasars and measure the redshift space correlation function and the projected correlation function. Finally, using these results, we compute the linear bias to try to constrain quasar feedback models akin to those in Hopkins et al. 2007.

  18. Prediabetes: A high-risk state for developing diabetes

    PubMed Central

    Tabák, Adam G.; Herder, Christian; Rathmann, Wolfgang; Brunner, Eric J.; Kivimäki, Mika

    2013-01-01

    Summary Prediabetes (or “intermediate hyperglycaemia”), based on glycaemic parameters above normal but below diabetes thresholds is a high risk state for diabetes with an annualized conversion rate of 5%–10%; with similar proportion converting back to normoglycaemia. The prevalence of prediabetes is increasing worldwide and it is projected that >470 million people will have prediabetes in 2030. Prediabetes is associated with the simultaneous presence of insulin resistance and β-cell dysfunction, abnormalities that start before glucose changes are detectable. Observational evidence shows associations of prediabetes with early forms of nephropathy, chronic kidney disease, small fibre neuropathy, diabetic retinopathy, and increased risk of macrovascular disease. Multifactorial risk scores could optimize the estimation of diabetes risk using non-invasive parameters and blood-based metabolic traits in addition to glycaemic values. For prediabetic individuals, lifestyle modification is the cornerstone of diabetes prevention with evidence of a 40%–70% relative risk reduction. Accumulating data also suggests potential benefits from pharmacotherapy. PMID:22683128

  19. A Selective Review of Group Selection in High-Dimensional Models.

    PubMed

    Huang, Jian; Breheny, Patrick; Ma, Shuangge

    2012-01-01

    Grouping structures arise naturally in many statistical modeling problems. Several methods have been proposed for variable selection that respect grouping structure in variables. Examples include the group LASSO and several concave group selection methods. In this article, we give a selective review of group selection concerning methodological developments, theoretical properties and computational algorithms. We pay particular attention to group selection methods involving concave penalties. We address both group selection and bi-level selection methods. We describe several applications of these methods in nonparametric additive models, semiparametric regression, seemingly unrelated regressions, genomic data analysis and genome wide association studies. We also highlight some issues that require further study.

  20. Great expectations: different high-risk activities satisfy different motives.

    PubMed

    Barlow, Matthew; Woodman, Tim; Hardy, Lew

    2013-09-01

    Research on people's motives for engaging in high-risk activities has typically been viewed through the single-focused lens of sensation seeking. We provide evidence that comprehensively challenges that view. First, we develop and confirm the structure of a 3-factor measure of motives: the Sensation Seeking, Emotion Regulation, and Agency Scale (SEAS; Study 1). We then use the SEAS to provide evidence of differential motives for 2 high-risk activities: skydiving and mountaineering. The motive for skydiving is strongly associated with sensation seeking; the motive for mountaineering is strongly associated with emotion regulation and agency but not with sensation seeking (Study 2). We also show that these conclusions cannot be drawn from existing measures of personality and sensation seeking (Study 3). Finally, individuals who are motivated by emotion regulation and agency needs also have greater expectations regarding their emotion regulation and agency. It is these greater expectations that most successfully discriminate mountaineers from skydivers and control participants (Study 4). It is concluded that researchers should no longer consider risk takers as a homogenous sensation-seeking group and that they should consider risk taking as a potential model of human endeavor. The SEAS can be used as a measure of motives for behavior whenever sensation seeking, agency, or emotion regulation is thought to be at the core of such motives, and the results are discussed in the context of encouraging personality researchers to consider the specific spontaneous behaviors that motivate different people.

  1. Concurrent chemoradiation for high-risk prostate cancer.

    PubMed

    Cooper, Benjamin T; Sanfilippo, Nicholas J

    2015-08-10

    There are estimated to be 220800 cases of prostate cancer diagnosed in 2015, making up 26% of all cancer diagnoses. Fortunately, adenocarcinoma of the prostate is often a highly treatable malignancy. Even though the majority of prostate cancer patients present with localized disease, prostate cancer still accounts for over 27000 deaths a year. There is a subset of patients that are likely to recur after locoregional treatment that is thought of as a "high-risk" population. This more aggressive subset includes patients with clinical stage greater than T2b, Gleason score greater than 7, and prostate specific antigen greater than 20 ng/dL. The rate of biochemical relapse in this high risk group is 32%-70% within five years of definitive focal therapy. Given these discouraging outcomes, attempts have been made to improve cure rates by radiation dose escalation, addition of androgen depravation therapy, and addition of chemotherapy either sequentially or concurrently with radiation. One method that has been shown to improve clinical outcomes is the addition of chemotherapy to radiotherapy for definitive treatment. Concurrent chemoradiation with 5-fluorouracil, estramustine phosphate, vincristine, docetaxel, and paclitaxel has been studied in the phase I and/or II setting. These trials have identified the maximum tolerated dose of chemotherapy and radiation that can be safely delivered concurrently and established the safety and feasibility of this technique. This review will focus on the addition of concurrent chemotherapy to radiotherapy in the definitive management of high-risk prostate cancer.

  2. Gang masculinity and high-risk sexual behaviours.

    PubMed

    Dickson-Gomez, Julia; Quinn, Katherine; Broaddus, Michelle; Pacella, Maria

    2017-02-01

    High-risk sexual behaviours include practices such as relationship violence and substance use, which often cluster together among young people in high-risk settings. Youth gang members often show high rates of such behaviours, substance use and relationship violence. This paper draws on data from in-depth interviews with male and female gang members from six different gangs to explore the role of powerful socialising peer groups that set gender, sexual and relationship roles and expectations for their male and female members. High-risk sexual behaviours among gang members included sex with multiple partners and group sex. Gang norms included the belief that male members were sexually insatiable with multiple sexual partners and that female gang members should be sexually available to male members. Alcohol and drugs were seen to have a large influence on sexual desire and the inability to use condoms. Much sexual behaviour with gangs, such as group sex, was viewed with ambivalence and seen as somewhat coercive. Finally, gendered sexual expectations (boys as sexually insatiable and girls as sexually available) made forming long-term romantic relationships problematic for gang members. The influence of gang norms such as these must be addressed in future programmes and interventions with gang members.

  3. Genomic rearrangement screening of the BRCA1 from seventy Iranian high-risk breast cancer families

    PubMed Central

    Sedghi, Maryam; Esfandiari, Elham; Fazel-Najafabadi, Esmat; Salehi, Mansoor; Salavaty, Abbas; Fattahpour, Shirin; Dehghani, Leila; Nouri, Nayerossadat; Mokarian, Fariborz

    2016-01-01

    Background: The second leading cause of cancer deaths in women is breast cancer. Germline mutations in susceptibility breast cancer gene BRCA1 increase the lifetime risk of breast cancer. Eighty-one large genomic rearrangements (LGRs) have been reported up to date in BRCA1 gene, and evaluation of these rearrangements helps with precise risk assessment in high-risk individuals. In this study, we have investigated LGRs in BRCA1 among Iranian high-risk breast cancer families. Materials and Methods: Seventy patients with breast cancer who were identified negative for point mutations or small deletions/insertions of BRCA1 gene were selected. Deletions and duplications of BRCA1 gene were evaluated using multiplex ligation-dependent probe amplification (MLPA). Results: Two deletions, deletion of exons 1A/1B-2 and exon 24, were detected in two patients with breast cancer. The former alteration was found in a woman with a strong family history of breast cancer while the latter one was detected in a woman with early onset of breast cancer. Conclusion: Although our data confirm that LGRs in BRCA1 comprise a relatively small proportion of mutations in hereditary breast cancer in the Iranian population, MLPA analysis might be considered for screening of LGRs in high-risk individuals. It is worth to note that our results are consistent with previous studies in various Asian and European countries. PMID:28163741

  4. A Dioxane Template for Highly Selective Epoxy Alcohol Cyclizations

    PubMed Central

    Mousseau, James J.; Morten, Christopher J.

    2013-01-01

    Ladder polyether natural products are a class of natural products denoted by their high functional group density and large number of well-defined stereocenters. They comprise the toxic component of harmful algal blooms (HABs), having significant negative economic and environmental ramifications. However, their mode of action, namely blocking various cellular ion channels, also denotes their promise as potential anticancer agents. Understanding their potential mode of biosynthesis will not only help with developing ways to limit the damage of HABs, but would also facilitate the synthesis of a range of analogues with interesting biological activity. 1,3-Dioxan-5-ol substrates display remarkable ‘enhanced template effects’ in water-promoted epoxide cyclization processes en route to the synthesis of these ladder polyether natural products. In many cases they provide near complete endo to exo selectivity in the cyclization of epoxy alcohols, thereby strongly favouring the formation of tetrahydropyran (THP) over tetrahydrofuran (THF) rings. The effects of various Brønsted and Lewis acidic and basic conditions are explored to demonstrate the superior selectivity of the template over the previously reported THP-based epoxy alcohols. In addition, the consideration of other synthetic routes are also considered with the goal of gaining rapid access to a plethora of potential starting materials applicable towards the synthesis of ladder polyethers. Finally, cascade sequences with polyepoxides are investigated, further demonstrating the versatility of this new reaction template. PMID:23775936

  5. Radio Selected Clusters of Galaxies at High Redshift

    NASA Astrophysics Data System (ADS)

    Wing, Joshua; Blanton, Elizabeth

    2010-08-01

    Previous studies have shown that three-component radio sources exhibiting some degree of bending between components are likely to be found in galaxy clusters. Often this radio emission is associated with a cD type galaxy at the center of a cluster. We have cross-correlated the Sloan Digital Sky Survey (SDSS) with samples selected from the Faint Images of the Radio Sky at Twenty Centimeters (FIRST) catalog and measured the richness of the cluster environments surrounding three- component sources exhibiting both bent and straight lobes. This has lead to the discovery and classification of a large number of galaxy clusters out to a redshift of z ~ 0.5. For both bent- and straight- lobed sources without an optical counterpart it is likely that the radio emission is associated with a galaxy fainter than m_r=22 (the limiting magnitude of the SDSS) and at a redshift higher than z~0.8. We propose to observe a small sub-sample of these sources with the FLAMINGOS instrument on the Mayall 4-m telescope in an attempt to discover if these sources are located in high redshift (z≳0.8) galaxy clusters. In our visually-selected bent radio source sample, 78% of sources with counterparts in the SDSS are associated with clusters.

  6. Selective serotonin reuptake inhibitors and the risk of osseointegrated implant failure: a cohort study.

    PubMed

    Wu, X; Al-Abedalla, K; Rastikerdar, E; Abi Nader, S; Daniel, N G; Nicolau, B; Tamimi, F

    2014-11-01

    Selective serotonin reuptake inhibitors (SSRIs), the most widely used drugs for the treatment of depression, have been reported to reduce bone formation and increase the risk of bone fracture. Since osseointegration is influenced by bone metabolism, this study aimed to investigate the association between SSRIs and the risk of failures in osseointegrated implants. This retrospective cohort study was conducted on patients treated with dental implants from January 2007 to January 2013. A total of 916 dental implants in 490 patients (94 implants on 51 patients using SSRIs) were used to estimate the risk of failure associated with the use of SSRIs. Data analysis involved Cox proportional hazards, generalized estimating equation models, multilevel mixed effects parametric survival analysis, and Kaplan-Meier analysis. After 3 to 67 mo of follow-up, 38 dental implants failed and 784 succeeded in the nonusers group, while 10 failed and 84 succeeded in the SSRI-users group. The main limitation of this retrospective study was that drug compliance dose and treatment period could not be acquired from the files of the patients. The primary outcome was that compared with nonusers of SSRIs, SSRI usage was associated with an increased risk of dental implants failure (hazard ratio, 6.28; 95% confidence interval, 1.25-31.61; p = .03). The failure rates were 4.6% for SSRI nonusers and 10.6% for SSRI users. The secondary outcomes were that small implant diameters (≤4 mm; p = .02) and smoking habits (p = .01) also seemed to be associated with higher risk of implant failure. Our findings indicate that treatment with SSRIs is associated with an increased failure risk of osseointegrated implants, which might suggest a careful surgical treatment planning for SSRI users.

  7. Selective Serotonin Reuptake Inhibitors and the Risk of Osseointegrated Implant Failure

    PubMed Central

    Wu, X.; Al-Abedalla, K.; Rastikerdar, E.; Abi Nader, S.; Daniel, N.G.; Nicolau, B.; Tamimi, F.

    2014-01-01

    Selective serotonin reuptake inhibitors (SSRIs), the most widely used drugs for the treatment of depression, have been reported to reduce bone formation and increase the risk of bone fracture. Since osseointegration is influenced by bone metabolism, this study aimed to investigate the association between SSRIs and the risk of failures in osseointegrated implants. This retrospective cohort study was conducted on patients treated with dental implants from January 2007 to January 2013. A total of 916 dental implants in 490 patients (94 implants on 51 patients using SSRIs) were used to estimate the risk of failure associated with the use of SSRIs. Data analysis involved Cox proportional hazards, generalized estimating equation models, multilevel mixed effects parametric survival analysis, and Kaplan-Meier analysis. After 3 to 67 mo of follow-up, 38 dental implants failed and 784 succeeded in the nonusers group, while 10 failed and 84 succeeded in the SSRI-users group. The main limitation of this retrospective study was that drug compliance dose and treatment period could not be acquired from the files of the patients. The primary outcome was that compared with nonusers of SSRIs, SSRI usage was associated with an increased risk of dental implants failure (hazard ratio, 6.28; 95% confidence interval, 1.25-31.61; p = .03). The failure rates were 4.6% for SSRI nonusers and 10.6% for SSRI users. The secondary outcomes were that small implant diameters (≤4 mm; p = .02) and smoking habits (p = .01) also seemed to be associated with higher risk of implant failure. Our findings indicate that treatment with SSRIs is associated with an increased failure risk of osseointegrated implants, which might suggest a careful surgical treatment planning for SSRI users. PMID:25186831

  8. Identification of Risk Factors for Recurrence in High-Risk Stage II Colon Cancer

    PubMed Central

    Hatano, Satoshi; Ishida, Hideyuki; Ishibashi, Keiichiro; Kumamoto, Kensuke; Haga, Norihiro; Miura, Ichiro

    2013-01-01

    To identify risk factors for recurrence in patients with stage II colon cancer, Cox proportional hazards regression analysis was performed in 194 patients with stage II colon cancer who underwent curative surgery between April 1997 and December 2008. Thirteen clinical and pathologic factors, including use of fluoropyrimidine-based adjuvant chemotherapy in 113 of the patients (58.2%), were assessed. By multivariate analysis, only obstruction, perforation, and T4-level invasion were identified as independent risk factors affecting disease-free survival (DFS) (P < 0.01). The 5-year DFS rate was 70.6% in patients with one or more risk factors (n = 68) and 96.0% in patients with no risk factors (n = 126) (P < 0.01). These results suggest that obstruction, perforation, and T4-level invasion are suitable candidates for prediction of tumor recurrence in patients with stage II colon cancer. The oxaliplatin-based adjuvant chemotherapy, which has been reported to be effective in stage III colon cancer patients, may improve the prognosis in high-risk stage II colon cancer patients. PMID:23701145

  9. High Power Selective Laser Melting (HP SLM) of Aluminum Parts

    NASA Astrophysics Data System (ADS)

    Buchbinder, D.; Schleifenbaum, H.; Heidrich, S.; Meiners, W.; Bültmann, J.

    Selective Laser Melting (SLM) is one of the Additive Manufacturing (AM) technologies that enables the production of light weight structured components with series identical mechanical properties without the need for part specific tooling or downstream sintering processes, etc. Especially aluminum is suited for such eco-designed components due to its low weight and superior mechanical and chemical properties. However, SLM's state-of-the-art process and cost efficiency is not yet suited for series-production. In order to improve this efficiency it is indispensable to increase the build rate significantly. Thus, aluminum is qualified for high build rate applications using a new prototype machine tool including a 1 kW laser and a multi-beam system.

  10. (R)-(-)-10-methyl-11-hydroxyaporphine: a highly selective serotonergic agonist.

    PubMed

    Cannon, J G; Mohan, P; Bojarski, J; Long, J P; Bhatnagar, R K; Leonard, P A; Flynn, J R; Chatterjee, T K

    1988-02-01

    Prior work in these laboratories identified (+/-)-5-hydroxy-6-methyl-2- (di-n-propylamino)tetralin as a dopaminergic agonist prodrug. The ortho methyl hydroxy aromatic substitution pattern in this molecule has now been incorporated into the aporphine ring system to give a congener of the dopaminergic agonist apomorphine in which the position 10 OH group has been replaced by methyl. Preparation of the target compound involved acid-catalyzed rearrangement of the 3-(1-phenyltetrazolyl) ether of morphine and subsequent molecular modification of the product, the 10-(1-phenyltetrazolyl) ether of (R)-(-)-apomorphine. Surprisingly, the target compound elicited no responses in any assays for effects at dopamine receptors, but rather it displayed pharmacological properties consistent with its being a serotonergic agonist with a high degree of selectivity for 5-HT1A receptors similar to the serotonergic agonist 8-hydroxy-2-(di-n-propylamino)tetralin.

  11. Highly selective CNTFET based sensors using metal diversification methods

    NASA Astrophysics Data System (ADS)

    Bondavalli, P.; Gorintin, L.; Longnos, F.; Feugnet, G.

    2011-10-01

    This contribution deals with Carbon Nanotubes Field Effect transistors (CNTFETs) based gas sensors fabricated using a new dynamic spray based technique for SWCNTs deposition. This technique is compatible with large surfaces, flexible substrates and allows to fabricate high performances transistors exploiting the percolation effect of the SWCNTs networks achieved with extremely reproducible characteristics. Recently, we have been able to achieve extremely selective measurement of NO2 , NH3 and DMMP using four CNTFETS fabricated using different metals as electrodes (Pt, Au, Ti, Pd), exploiting the specific interaction between gas and metal/SWCNT junction. In this way we have identify a sort of electronic fingerprinting of the gas. The time response is evaluated at less than 30sec and the sensitivity can reach 20ppb for NO2, 100ppb for NH3 and 1ppm for DMMP (Di-Methyl-Methyl-Phosphonate).

  12. Stochastic electrotransport selectively enhances the transport of highly electromobile molecules

    PubMed Central

    Kim, Sung-Yon; Cho, Jae Hun; Murray, Evan; Bakh, Naveed; Choi, Heejin; Ohn, Kimberly; Ruelas, Luzdary; Hubbert, Austin; McCue, Meg; Vassallo, Sara L.; Keller, Philipp J.; Chung, Kwanghun

    2015-01-01

    Nondestructive chemical processing of porous samples such as fixed biological tissues typically relies on molecular diffusion. Diffusion into a porous structure is a slow process that significantly delays completion of chemical processing. Here, we present a novel electrokinetic method termed stochastic electrotransport for rapid nondestructive processing of porous samples. This method uses a rotational electric field to selectively disperse highly electromobile molecules throughout a porous sample without displacing the low-electromobility molecules that constitute the sample. Using computational models, we show that stochastic electrotransport can rapidly disperse electromobile molecules in a porous medium. We apply this method to completely clear mouse organs within 1–3 days and to stain them with nuclear dyes, proteins, and antibodies within 1 day. Our results demonstrate the potential of stochastic electrotransport to process large and dense tissue samples that were previously infeasible in time when relying on diffusion. PMID:26578787

  13. Optimum selection of high performance mirror substrates for diamond finishing

    NASA Astrophysics Data System (ADS)

    Woodard, Kenneth S.; Comstock, Lovell E.; Wamboldt, Leonard; Sutherland, James S.

    2016-05-01

    Due to advances in manufacturing processes, the substrate options for high performance diamond machined mirrors are expanding. Fewer compromises have to be made to achieve the needed weight, stiffness and finish while maintaining reasonable costs. In addition to the traditional mirror materials like aluminum and beryllium, there are some less common materials that can now be included in the trade space that fill the cost and performance continuum between wrought aluminum and beryllium mirrors. Aluminum and beryllium, respectively, had been the low cost/fair performance and very high cost/very high performance bounds for substrate selection. These additional substrates provide multiple near net shape blank options and processes, mostly within these bounds, that can be considered in a mirror cost versus performance trade analysis. This paper will include a summary of some advances in manufacturing processes that provide more substrate options for diamond machined mirrors with some sample performance analysis and data. This is merged with the traditional substrate options to illustrate the now larger mirror substrate trade space. Some benchmark structural analysis is provided to back up a generic mirror design trade study.

  14. High Selective Performance of Designed Antibacterial and Anticancer Peptide Amphiphiles.

    PubMed

    Chen, Cuixia; Chen, Yucan; Yang, Cheng; Zeng, Ping; Xu, Hai; Pan, Fang; Lu, Jian Ren

    2015-08-12

    Short designed peptide amphiphiles are attractive at killing bacteria and inhibiting cancer cell growth, and the flexibility in their structural design offers a great potential for improving their potency and biocompatibility to mammalian host cells. Amino acid sequences such as G(IIKK)nI-NH2 (n≥3) have been shown to be membrane lytic, but terminal amino acid modifications could impose a huge influence on their performance. We report in this work how terminal amino acid modifications to G(IIKK)3I-NH2 influence its α-helical structure, membrane penetrating ability, and selective actions against different cell types. Deletion of an N-terminal Gly or a C-terminal Ile did not affect their antibacterial activity much, an observation consistent with their binding behavior to negatively charged membrane lipid monolayers. However, the cytotoxicity against mammalian cells was much worsened by the N-terminal Gly deletion, consistent with an increase in its helical content. Despite little impact on the antibacterial activity of G(IIKK)3I-NH2, deletion of both terminal amino acids greatly reduced its antitumor activity. Cholesterol present in tumor cell membrane-mimic was thought to constrain (IIKK)3-NH2 from penetrating into the cancerous membranes, evident from its lowest surface physical activity at penetrating model lipid membranes. On the other hand, its low toxicity to normal mammalian cells and high antibacterial activity in vitro and in vivo made it an attractive antibacterial agent. Thus, terminal modifications can help rebalance the different interactions involved and are highly effective at manipulating their selective membrane responses.

  15. [Combined Antihypertensive Therapy in Patients at High Risk].

    PubMed

    Lyamina, N P; Kotelnikova, E V; Nalivaeva, A V

    2015-10-01

    Presents opportunities to increase the effectiveness of combination antihypertensive therapy (AHT) in patients with arterial hypertension (AH) and high cardiovascular risk. Displaying increase in the proportion of patients with target blood pressure up to 82.4%; high commitment combined AHT (96%) and medical recommendations for lifestyle changes (54%) using the power of information computer technology (ICT) in order to carry out continuous monitoring of blood pressure and other risk factors (RF), commitment to the patients drug and non-drug assignments. Thus, ICT can be seen as a tool that can give a real idea of the scale and nature of the deviation from the medical recommendations that can serve as a basis for personalized AHT.

  16. Management of High-Risk Localized Prostate Cancer

    PubMed Central

    Marciscano, Ariel E.; Hardee, Matthew E.; Sanfilippo, Nicholas

    2012-01-01

    Traditionally, patients with high-risk localized prostate cancer have been an extremely challenging group to manage due to a significant likelihood of treatment failure and prostate cancer-specific mortality (PCSM). The results of multiple large, prospective, randomized trials have demonstrated that men with high-risk features who are treated in a multimodal fashion at the time of initial diagnosis have improved overall survival. Advances in local treatments such as dose-escalated radiotherapy in conjunction with androgen suppression and postprostatectomy adjuvant radiotherapy have also demonstrated benefits to this subset of patients. However, therapeutic enhancement with the addition of chemotherapy to the primary treatment regimen may help achieve optimal disease control. PMID:22110494

  17. Dual mobility total hip replacement in a high risk population

    PubMed Central

    Luthra, Jatinder Singh; Al Riyami, Amur; Allami, Mohamad Kasim

    2016-01-01

    Objective: The purpose of the study was to evaluate results of dual mobility total replacement in a high risk population who take hip into hyperflexed position while sitting and praying on the floor. Method: The study included 65 (35 primary total replacement and 30 complex total hip replacement) cases of total hip replacement using avantage privilege dual mobility cup system from biomet. A cemented acetabular component and on femoral side a bimetric stem, either cemented or uncemented used depending on the canal type. Ten cases were examined fluoroscopically in follow up. Result: There was dislocation in one patient undergoing complex hip replacement. Fluoroscopy study showed no impingement between the neck of prosthesis and acetabular shell at extremes of all movements. Conclusion: The prevalence of dislocation is low in our high risk population and we consider it preferred concept for patients undergoing complex total hip replacement. PMID:27924742

  18. Threatened and Placed at Risk: High Achieving African American Males in Urban High Schools

    ERIC Educational Resources Information Center

    McGee, Ebony O.

    2013-01-01

    This study investigated the risk and protective factors of 11 high-achieving African American males attending 4 urban charter high schools in a Midwestern city to determine what factors account for their resilience and success in mathematics courses, and in high school more generally. This research was guided by a Phenomenological Variant of…

  19. Failure to acknowledge high suicide risk among veterinarians.

    PubMed

    Skipper, Gregory E; Williams, Jerome B

    2012-01-01

    A high suicide risk has been reported among veterinarians in comparison to the general population. Postulated causes have included depression, substance abuse, work-related stress, reluctance to admit psychiatric problems, and access to lethal drugs and/or familiarity with euthanasia. Members of the Student Chapter of the American Veterinary Medical Association (AVMA), all veterinarians licensed in Alabama, and all US veterinary-association executive directors were surveyed regarding their attitudes concerning mental health issues, including veterinarian suicide. Only 10% of veterinary student respondents (N=58) believed that suicide risk is higher among veterinarians than in the general population. Of the 22 state associations' executive directors who participated in the survey, 37% believed that suicide is a significant concern for veterinarians and only 44% indicated that a veterinary wellness program was available in their respective states. Of the 1,455 licensed veterinarians in Alabama, 701 responded to the survey; 11% of respondents believed that suicide among veterinarians was a problem. In addition, 66% of respondents indicated that they had been "clinically depressed," but 32% of those with depression had not sought treatment. More females (27%) than males (20%) admitted that they had "seriously considered suicide" (p<.01). Female veterinarians were more likely than male veterinarians (15% versus 7%) to indicate that they were "not sure they'd made the right career choice" (p<.001), and 4% of all respondents indicated "definitely not being happy with their career." It is of concern that veterinarians not only have a higher risk of suicide but that they also have fewer support structures. The wide discrepancies between the published risk of suicide for veterinarians and their own views of their risk suggests an inadequate awareness of their own mental health vulnerability which could put them at higher risk.

  20. Learning rate and temperament in a high predation risk environment

    USGS Publications Warehouse

    DePasquale, C.; Wagner, Tyler; Archard, G.A.; Ferguson, B.; Braithwaite, V.A.

    2014-01-01

    Living in challenging environments can influence the behavior of animals in a number of ways. For instance, populations of prey fish that experience frequent, nonlethal interactions with predators have a high proportion of individuals that express greater reaction to risk and increased activity and exploration—collectively known as temperament traits. Temperament traits are often correlated, such that individuals that are risk-prone also tend to be active and explore more. Spatial learning, which requires the integration of many sensory cues, has also been shown to vary in fish exposed to different levels of predation threat. Fish from areas of low predation risk learn to solve spatial tasks faster than fish from high predation areas. However, it is not yet known whether simpler forms of learning, such as learning associations between two events, are similarly influenced. Simple forms of associative learning are likely to be affected by temperament because a willingness to approach and explore novel situations could provide animals with a learning advantage. However, it is possible that routine-forming and inflexible traits associated with risk-prone and increased exploratory behavior may act in the opposite way and make risk-prone individuals poorer at learning associations. To investigate this, we measured temperament in Panamanian bishop fish (Brachyrhaphis episcopi) sampled from a site known to contain many predators. The B. episcopi were then tested with an associative learning task. Within this population, fish that explored more were faster at learning a cue that predicted access to food, indicating a link between temperament and basic learning abilities.

  1. Learning rate and temperament in a high predation risk environment.

    PubMed

    DePasquale, C; Wagner, T; Archard, G A; Ferguson, B; Braithwaite, V A

    2014-11-01

    Living in challenging environments can influence the behavior of animals in a number of ways. For instance, populations of prey fish that experience frequent, nonlethal interactions with predators have a high proportion of individuals that express greater reaction to risk and increased activity and exploration-collectively known as temperament traits. Temperament traits are often correlated, such that individuals that are risk-prone also tend to be active and explore more. Spatial learning, which requires the integration of many sensory cues, has also been shown to vary in fish exposed to different levels of predation threat. Fish from areas of low predation risk learn to solve spatial tasks faster than fish from high predation areas. However, it is not yet known whether simpler forms of learning, such as learning associations between two events, are similarly influenced. Simple forms of associative learning are likely to be affected by temperament because a willingness to approach and explore novel situations could provide animals with a learning advantage. However, it is possible that routine-forming and inflexible traits associated with risk-prone and increased exploratory behavior may act in the opposite way and make risk-prone individuals poorer at learning associations. To investigate this, we measured temperament in Panamanian bishop fish (Brachyrhaphis episcopi) sampled from a site known to contain many predators. The B. episcopi were then tested with an associative learning task. Within this population, fish that explored more were faster at learning a cue that predicted access to food, indicating a link between temperament and basic learning abilities.

  2. [HTLV-I infection in a high-risk group].

    PubMed

    Pujol, E; Ollero, M; Gimeno, A; Colchero, J; Alcoucer, R; Márquez, P

    1990-07-01

    The aim of this study is to detect the presence of HTLV-1 in a high-risk population in west Andalusia. We studied 267 samples of serum from 255 patients: 179 of these patients being intravenous drug-users, 14 had ADVP sexual partners, 16 were inhalation drug-users, 4 were hemophiliacs, 9 had other high-risk habits and 25 hematological patients afflicted with leukemia or lymphoma. All of them were tested for antibodies against HTLV-1 by means of an in vitro qualitative ELISA technique (ELISA Du Pont HTLV-1). The positive results were confirmed by the Western blot technique. Additionally, the p24 antigen and the antibodies against VIH-1 and VIH-2 (ENV/CORE) were analysed, except in the 25 hematological patients. We found 20 serum samples positive to HTLV-1 by ELISA (7.4%), but only 1 (0.3%) was confirmed by the Western blot technique. The prevalence of VIH-1 was 46%; 9% had p24 VIH antigen and 26% had false positive ELISA to VIH-2. We found a statistically significant relationship (p = 0.0005) between positive ELISA to HTLV-1 and antibodies against VIH. We conclude that HTLV-1 has penetrated into the high-risk population of west Andalusia , although not yet to a great degree, and point out the need for seric epidemiological surveillance to prevent the spread of the retrovirus in these groups.

  3. Prognostic Health Monitoring System: Component Selection Based on Risk Criteria and Economic Benefit Assessment

    SciTech Connect

    Binh T. Pham; Vivek Agarwal; Nancy J Lybeck; Magdy S Tawfik

    2012-05-01

    Prognostic health monitoring (PHM) is a proactive approach to monitor the ability of structures, systems, and components (SSCs) to withstand structural, thermal, and chemical loadings over the SSCs planned service lifespans. The current efforts to extend the operational license lifetime of the aging fleet of U.S. nuclear power plants from 40 to 60 years and beyond can benefit from a systematic application of PHM technology. Implementing a PHM system would strengthen the safety of nuclear power plants, reduce plant outage time, and reduce operation and maintenance costs. However, a nuclear power plant has thousands of SSCs, so implementing a PHM system that covers all SSCs requires careful planning and prioritization. This paper therefore focuses on a component selection that is based on the analysis of a component's failure probability, risk, and cost. Ultimately, the decision on component selection depend on the overall economical benefits arising from safety and operational considerations associated with implementing the PHM system.

  4. INSTRUMENTS OF HIGH RISK SEXUAL BEHAVIOR ASSESSMENT: A SYSTEMATIC REVIEW

    PubMed Central

    Mirzaei, Mojtaba; Ahmadi, Khodabakhsh; Saadat, Seyed-Hassan; Ramezani, Mohammad Arash

    2016-01-01

    Background: Sexual behavior is a complex activity affecting all aspects of human’s life. Risky sexual behaviors impose negative outcomes on family, relationships and health. Unsafe sex is the second most leading cause of disability adjusted life years worldwide. Valid and reliable tools for assessment of risky sexual behaviors are necessary for implementing preventive measures. Methods: we searched Medline and the Cochrane Library of Systematic Reviews, with the keywords of “risky sexual behavior assessment”, “sexual risk assessment”, “high risk sexual behavior”, “sexual risk taking”. By reviewing references of the articles, some complementary studies were added. Results: Assessment can be performed by questionnaire or non-questionnaire instruments. Questionnaires vary depending on their target population, evaluation of risky sexual behavior as a whole or focusing on an associated risk factor. In order to avoid usual biases in self reports, objective biomarker assessment of unprotected sex are employed. These markers include prostate specific antigen, chromosome Y DNA and Seminogelin. Conclusion: Risky sexual behavior can be assessed by various subjective and objective methods. While self-reports are more feasible, objective methods offer a higher degree of reliability. Further studies for finding more feasible methods of using biomarkers are recommended. PMID:27047267

  5. Novel computational identification of highly selective biomarkers of pollutant exposure.

    PubMed

    Weisman, David; Liu, Hong; Redfern, Jessica; Zhu, Liya; Colón-Carmona, Adán

    2011-06-15

    The use of in vivo biosensors to acquire environmental pollution data is an emerging and promising paradigm. One major challenge is the identification of highly specific biomarkers that selectively report exposure to a target pollutant, while remaining quiescent under a diverse set of other, often unknown, environmental conditions. This study hypothesized that a microarray data mining approach can identify highly specific biomarkers, and, that the robustness property can generalize to unforeseen environmental conditions. Starting with Arabidopsis thaliana microarray data measuring responses to a variety of treatments, the study used the top scoring pair (TSP) algorithm to identify mRNA transcripts that respond uniquely to phenanthrene, a model polycyclic aromatic hydrocarbon. Subsequent in silico analysis with a larger set of microarray data indicated that the biomarkers remained robust under new conditions. Finally, in vivo experiments were performed with unforeseen conditions that mimic phenanthrene stress, and the biomarkers were assayed using qRT-PCR. In these experiments, the biomarkers always responded positively to phenanthrene, and never responded to the unforeseen conditions, thereby supporting the hypotheses. This data mining approach requires only microarray or next-generation RNA-seq data, and, in principle, can be applied to arbitrary biomonitoring organisms and chemical exposures.

  6. Case Management Reduces Drinking During Pregnancy among High Risk Women

    PubMed Central

    May, Philip A.; Marais, Anna-Susan; Gossage, J. Phillip; Barnard, Ronel; Joubert, Belinda; Cloete, Marise; Hendricks, Natalie; Roux, Sumien; Blom, Annalien; Steenekamp, Jeanetta; Alexander, Theresa; Andreas, Romena; Human, Suzanne; Snell, Cudore; Seedat, Soraya; Parry, Charles C.; Kalberg, Wendy O.; Buckley, David; Blankenship, Jason

    2014-01-01

    Aim Estimate the efficacy of Case Management (CM) for women at high risk for bearing a child with Fetal Alcohol Spectrum Disorders (FASD). Design Women were recruited from antenatal clinics and engaged in 18 months of CM. Setting A South African community with a subculture of heavy, regular, weekend, recreational drinking and high documented rates of FASD. Participants Forty-one women who were high risk for bearing a child with FASD. Measures Statistical analysis of trends in drinking and other risk factors. Findings At intake 87.8% were pregnant, most had previous alcohol-exposed pregnancies, most/all of their friends drink alcohol (67.5%), and 50.0% had stressful lives. CM was particularly valuable for pregnant women, as statistically significant reductions in alcohol risk were obtained for them in multiple variables: total drinks on weekends after six months of CM (p = .026) and estimated peak blood alcohol concentration (BAC) at six (p < .001) and 18 months (p < .001). For participants completing 18 months of CM, AUDIT scores improved significantly by 6-month follow-up (from 19.8 to 9.7, p = .000), and even though rising at 12 and 18 months, AUDIT scores indicate that problematic drinking remained statistically significantly lower than baseline throughout CM. Happiness scale scores correlated significantly with reduced drinking in most time periods. Conclusions An enduring change in drinking behavior is difficult in this social setting. Yet, CM provided by skilled and empathic case managers reduced maternal drinking at critical times, and therefore, alcohol exposure levels to the fetus. PMID:24729823

  7. Combination and selection of traffic safety expert judgments for the prevention of driving risks.

    PubMed

    Cabello, Enrique; Conde, Cristina; de Diego, Isaac Martín; Moguerza, Javier M; Redchuk, Andrés

    2012-11-02

    In this paper, we describe a new framework to combine experts’ judgments for the prevention of driving risks in a cabin truck. In addition, the methodology shows how to choose among the experts the one whose predictions fit best the environmental conditions. The methodology is applied over data sets obtained from a high immersive cabin truck simulator in natural driving conditions. A nonparametric model, based in Nearest Neighbors combined with Restricted Least Squared methods is developed. Three experts were asked to evaluate the driving risk using a Visual Analog Scale (VAS), in order to measure the driving risk in a truck simulator where the vehicle dynamics factors were stored. Numerical results show that the methodology is suitable for embedding in real time systems.

  8. Quantitative breast MRI radiomics for cancer risk assessment and the monitoring of high-risk populations

    NASA Astrophysics Data System (ADS)

    Mendel, Kayla R.; Li, Hui; Giger, Maryellen L.

    2016-03-01

    Breast density is routinely assessed qualitatively in screening mammography. However, it is challenging to quantitatively determine a 3D density from a 2D image such as a mammogram. Furthermore, dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) is used more frequently in the screening of high-risk populations. The purpose of our study is to segment parenchyma and to quantitatively determine volumetric breast density on pre-contrast axial DCE-MRI images (i.e., non-contrast) using a semi-automated quantitative approach. In this study, we retroactively examined 3D DCE-MRI images taken for breast cancer screening of a high-risk population. We analyzed 66 cases with ages between 28 and 76 (mean 48.8, standard deviation 10.8). DCE-MRIs were obtained on a Philips 3.0 T scanner. Our semi-automated DCE-MRI algorithm includes: (a) segmentation of breast tissue from non-breast tissue using fuzzy cmeans clustering (b) separation of dense and fatty tissues using Otsu's method, and (c) calculation of volumetric density as the ratio of dense voxels to total breast voxels. We examined the relationship between pre-contrast DCE-MRI density and clinical BI-RADS density obtained from radiology reports, and obtained a statistically significant correlation [Spearman ρ-value of 0.66 (p < 0.0001)]. Our method within precision medicine may be useful for monitoring high-risk populations.

  9. A novel method to fabricate high permeance, high selectivity thin-film composite membranes

    Technology Transfer Automated Retrieval System (TEKTRAN)

    We report a thin-film composite (TFC) membrane fabrication method based on transfer of a pre-formed, cured active layer onto a microporous support. This method can be used with supports of relatively high pore size and porosity, thus reducing mass transfer resistance from the support. Ethanol-select...

  10. Microbiological sampling plan based on risk classification to verify supplier selection and production of served meals in food service operation.

    PubMed

    Lahou, Evy; Jacxsens, Liesbeth; Van Landeghem, Filip; Uyttendaele, Mieke

    2014-08-01

    Food service operations are confronted with a diverse range of raw materials and served meals. The implementation of a microbial sampling plan in the framework of verification of suppliers and their own production process (functionality of their prerequisite and HACCP program), demands selection of food products and sampling frequencies. However, these are often selected without a well described scientifically underpinned sampling plan. Therefore, an approach on how to set-up a focused sampling plan, enabled by a microbial risk categorization of food products, for both incoming raw materials and meals served to the consumers is presented. The sampling plan was implemented as a case study during a one-year period in an institutional food service operation to test the feasibility of the chosen approach. This resulted in 123 samples of raw materials and 87 samples of meal servings (focused on high risk categorized food products) which were analyzed for spoilage bacteria, hygiene indicators and food borne pathogens. Although sampling plans are intrinsically limited in assessing the quality and safety of sampled foods, it was shown to be useful to reveal major non-compliances and opportunities to improve the food safety management system in place. Points of attention deduced in the case study were control of Listeria monocytogenes in raw meat spread and raw fish as well as overall microbial quality of served sandwiches and salads.

  11. Explanatory Models of Genetics and Genetic Risk among a Selected Group of Students

    PubMed Central

    Goltz, Heather Honoré; Bergman, Margo; Goodson, Patricia

    2016-01-01

    This exploratory qualitative study focuses on how college students conceptualize genetics and genetic risk, concepts essential for genetic literacy (GL) and genetic numeracy (GN), components of overall health literacy (HL). HL is dependent on both the background knowledge and culture of a patient, and lower HL is linked to increased morbidity and mortality for a number of chronic health conditions (e.g., diabetes and cancer). A purposive sample of 86 students from three Southwestern universities participated in eight focus groups. The sample ranged in age from 18 to 54 years, and comprised primarily of female (67.4%), single (74.4%), and non-White (57%) participants, none of whom were genetics/biology majors. A holistic-content approach revealed broad categories concerning participants’ explanatory models (EMs) of genetics and genetic risk. Participants’ EMs were grounded in highly contextualized narratives that only partially overlapped with biomedical models. While higher education levels should be associated with predominately knowledge-based EM of genetic risk, this study shows that even in well-educated populations cultural factors can dominate. Study findings reveal gaps in how this sample of young adults obtains, processes, and understands genetic/genomic concepts. Future studies should assess how individuals with low GL and GN obtain and process genetics and genetic risk information and incorporate this information into health decision making. Future work should also address the interaction of communication between health educators, providers, and genetic counselors, to increase patient understanding of genetic risk. PMID:27376052

  12. [Home care for the high-risk newborn infant].

    PubMed

    Puddu, M

    2010-06-01

    With increased survival of extremely low birth weigh (ELBW) and very ill infants, a lot of them are discharged with unresolved medical issues that complicate their subsequent care. Infants born preterm with low birth weight who require neonatal intensive care experience a much higher rate of hospital readmission and death during the first year after birth compared with healthy term infants. Despite initial hospital care which is one of the most expensive of all kind of hospitalization, home care services are sometimes still sparse though the high risk of this group for failure to thrive, respiratory problems, developmental delays, parenting problems. In addition, societal and economic forces have come to bear on the timing and process of discharge and home care. Moreover it takes time for the family of a high-risk infant to prepare to care for their infant in a home setting and to obtain the necessary support services and mobilize community resources. Careful preparation for discharge, good follow-up and medical home after discharge may reduce these risks.

  13. Bomb survivor selection and consequences for estimates of population cancer risks.

    PubMed

    Little, M P; Charles, M W

    1990-12-01

    Health records of the Japanese bomb survivor population [with the 1965 (T65D) and 1986 (DS86) dosimetry systems] have been analyzed and some evidence found for the selection effect hypothesized by Stewart and Kneale. This is found to be significant in only the first of the periods examined (1950-1958), and the effect diminishes in magnitude thereafter. There are indications that the effect might be an artifact of the T65D dosimetry, in which it is observed more strongly than in the DS86 data. There is no evidence to suggest that selection on this basis might confer correspondingly reduced susceptibility to radiation-induced cancer. If, however, one makes this assumption, as suggested by Stewart and Kneale, then current estimates of population cancer risks might need to be inflated by between 5% and 35% (for excess cancer deaths, Gy-1) or between 8% and 40% (for years of life lost, Gy-1) to account for this. It is likely that these figures, even assuming them not to be simply an artifact of the T65D dosimetry, overestimate the degree of adjustment required to the risk estimates.

  14. Non-traditional risk factors for atherosclerosis in high risk children.

    PubMed

    Blieden, L C; Kuberger, N; Goez, R; Abramov, N; Laron, Z; Weizman, A; Gil-Ad, I

    1996-12-01

    Non-traditional risk factors for atherosclerosis were examined in children whose fathers suffered from myocardial infarction up to age 48. Factors examined were hyperinsulinemia, insulin resistance, lipoprotein(a) [Lp(a)], fibrinogen, cardiovascular hyperreactivity, and autonomic nervous system dysfunction. Hyperinsulinemia was present in five cases (9%) and hypoinsulinemia in two. Insulin output following glucose load was significantly higher in obese children compared with controls. There was an increase in Lp(a) alone in 14 cases (24%) and with low density lipoprotein in 6 cases. Increased fibrinogen and positive correlation with insulin abnormality was present in 29% (76% females) (P >0.02). Cardiac hyperreactivity (increased systolic blood pressure) was present in 9% and increased blood pressure and pulse rate in 17%. Holter monitoring pattern was sympathetic in 39% and parasympathetic in 47% of cases. Thus a number of non-traditional risk factors were found to be higher than normal in a relatively large number of children at high risk for atherosclerosis, with 25 children having more than three risk factors.

  15. Using risk to target HPV vaccines in high-risk, low-resource organizations.

    PubMed

    Small, Stephanie L; Sampselle, Carolyn M; Martyn, Kristy K; Dempsey, Amanda F

    2013-05-01

    Organizations in developed countries with limited financial resources may find it difficult to determine whether it is preferable to use these resources for HPV vaccination, management of HPV-related diseases, or a "hybrid" strategy, such as vaccinating only the highest risk individuals. We determined the organizational costs and clinical impacts of three different organizational approaches to female HPV vaccination in a low-resource setting, including vaccinating everyone, vaccinating no one, or vaccinating only those considered high-risk. To determine patients at highest risk, HPV risk factors were identified using information routinely gathered at the annual preventive maintenance visit. The three vaccination strategies were then compared using a decision tree analysis. The three strategies demonstrated very little difference in cost. However, the least expensive strategy was to vaccinate no one. In contrast, the strategy with the best clinical outcomes was for the organization to vaccinate everyone. Organizations with limited resources must decide how to best allocate these funds to provide the greatest clinical benefits. This study showed little difference in costs but improved clinical outcomes when using the universal HPV vaccination strategy. Thus, the improvement in clinical outcomes when vaccinating everyone may be worth the relatively small increase in cost of vaccinating everyone.

  16. Reducing sexual risk behavior among high risk couples in Northern India

    PubMed Central

    Jones, Deborah; Bagga, Rashmi; Nehra, Ritu; Deepika; Sethi, Sunil; Walia, Kamini; Kumar, Mahendra; Villar-Loubet, Olga; Lopez, Maria; Weiss, Stephen M.

    2013-01-01

    Purpose This study sought to assess the feasibility of conducting a group, culturally tailored behavioral intervention and its impact on sexual barrier use, self efficacy, knowledge, conflict resolution and coping among high risk heterosexual couples in Northern India. Method This pilot study was conducted at the Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India from February 2008 to January 2009. Thirty sexually active high risk couples were drawn from a convenience sample of PGIMER patients attending infectious disease and family planning clinics. Couples participated in one month of 3 weekly gender concordant behavioral intervention groups and were individually administered assessments pre- and post-intervention. The intervention was tailored to the Northern Indian context, and addressed sexual barrier use, HIV/STI transmission and cognitive behavioral skill building focusing on sexual negotiation and communication. Results Participants were a mean age of 32 (men) and 29 (women) years, and the majority had at least 10 years of education. At baseline, the majority reported inconsistent condom use (<100% of the time) (64% of women, 59% of men). Post-intervention, nearly all participants reported consistent use (100% of the time) (100% of men, 97% of women). Participants also reported decreased verbal aggression, increased self efficacy and increased HIV-related knowledge, and women increased their use of positive coping tactics. Conclusions Results highlight the potential to successfully utilize a group intervention to discuss sensitive issues such as sexual risk behavior among both men and women. Strategies to improve condom use and communication without increasing intimate partner violence in high risk couples may be an important adjunct to preventing the development of a generalized epidemic in India. PMID:22648338

  17. Foraging Patch Selection in Winter: A Balance between Predation Risk and Thermoregulation Benefit

    PubMed Central

    Villén-Pérez, Sara; Carrascal, Luis M.; Seoane, Javier

    2013-01-01

    In winter, foraging activity is intended to optimize food search while minimizing both thermoregulation costs and predation risk. Here we quantify the relative importance of thermoregulation and predation in foraging patch selection of woodland birds wintering in a Mediterranean montane forest. Specifically, we account for thermoregulation benefits related to temperature, and predation risk associated with both illumination of the feeding patch and distance to the nearest refuge provided by vegetation. We measured the amount of time that 38 marked individual birds belonging to five small passerine species spent foraging at artificial feeders. Feeders were located in forest patches that vary in distance to protective cover and exposure to sun radiation; temperature and illumination were registered locally by data loggers. Our results support the influence of both thermoregulation benefits and predation costs on feeding patch choice. The influence of distance to refuge (negative relationship) was nearly three times higher than that of temperature (positive relationship) in determining total foraging time spent at a patch. Light intensity had a negligible and no significant effect. This pattern was generalizable among species and individuals within species, and highlights the preponderance of latent predation risk over thermoregulation benefits on foraging decisions of birds wintering in temperate Mediterranean forests. PMID:23874632

  18. Despotism and risk of infanticide influence grizzly bear den-site selection.

    PubMed

    Libal, Nathan S; Belant, Jerrold L; Leopold, Bruce D; Wang, Guiming; Owen, Patricia A

    2011-01-01

    Given documented social dominance and intraspecific predation in bear populations, the ideal despotic distribution model and sex hypothesis of sexual segregation predict adult female grizzly bears (Ursus arctos) will avoid areas occupied by adult males to reduce risk of infanticide. Under ideal despotic distribution, juveniles should similarly avoid adult males to reduce predation risk. Den-site selection and use is an important component of grizzly bear ecology and may be influenced by multiple factors, including risk from conspecifics. To test the role of predation risk and the sex hypothesis of sexual segregation, we compared adult female (n = 142), adult male (n = 36), and juvenile (n = 35) den locations in Denali National Park and Preserve, Alaska, USA. We measured elevation, aspect, slope, and dominant land cover for each den site, and used maximum entropy modeling to determine which variables best predicted den sites. We identified the global model as the best-fitting model for adult female (area under curve (AUC) = 0.926) and elevation as the best predictive variable for adult male (AUC = 0.880) den sites. The model containing land cover and elevation best-predicted juvenile (AUC = 0.841) den sites. Adult females spatially segregated from adult males, with dens characterized by higher elevations (mean= 1,412 m, SE = 52) and steeper slopes (mean = 21.9°, SE = 1.1) than adult male (elevation: mean = 1,209 m, SE = 76; slope: mean = 15.6°, SE = 1.9) den sites. Juveniles used a broad range of landscape attributes but did not avoid adult male denning areas. Observed spatial segregation by adult females supports the sex hypothesis of sexual segregation and we suggest is a mechanism to reduce risk of infanticide. Den site selection of adult males is likely related to distribution of food resources during spring.

  19. Population-based genetic risk prediction and stratification for ovarian cancer: views from women at high risk.

    PubMed

    Rahman, Belinda; Meisel, Susanne F; Fraser, Lindsay; Side, Lucy; Gessler, Sue; Wardle, Jane; Lanceley, Anne

    2015-03-01

    There is an opportunity to improve outcomes for ovarian cancer (OC) through advances in risk stratification, early detection and diagnosis. A population-based OC genetic risk prediction and stratification program is being developed. A previous focus group study with individuals from the general population showed support for the proposed program. This qualitative interview study explores the attitudes of women at high risk of OC. Eight women participated in one-on-one, in-depth, semi-structured interviews to explore: experiences of learning of OC risk, risk perceptions, OC knowledge and awareness, and opinions on risk stratification approach. There was evidence of strong support for the proposed program. Benefits were seen as providing reassurance to women at low risk, and reducing worry in women at high risk through appropriate clinical management. Stratification into 'low' and 'high' risk groups was well-received. Participants were more hesitant about stratification to the 'intermediate' risk group. The data suggest formats to effectively communicate OC risk estimates will require careful thought. Interactions with GPs were highlighted as a barrier to OC risk assessment and diagnosis. These results are encouraging for the possible introduction and uptake of a risk prediction and stratification program for OC in the general population.

  20. Utility of Clinical Risk Stratification in the Selection of Muscle-Invasive Bladder Cancer Patients for Neoadjuvant Chemotherapy: A Retrospective Cohort Study.

    PubMed

    von Rundstedt, Friedrich-Carl; Mata, Douglas A; Kryvenko, Oleksandr N; Shah, Anup A; Jhun, Iny; Lerner, Seth P

    2017-01-27

    Introduction: Level I evidence supports the use of cisplatin-based neoadjuvant chemotherapy (NAC) for muscle-invasive bladder cancer prior to radical cystectomy (RC). On average, 30-40% of patients achieve a complete pathologic response (i.e., stage pT0) after receiving NAC. Some centers risk-stratify patients, suggesting that there may be a higher-risk population that would derive the most benefit from NAC. Recently, a risk-stratification model developed at M.D. Anderson Cancer Center (MDACC) specified criteria for clinical staging and patient selection for NAC. We applied this model to our own RC patient cohort and evaluated our own experience with clinical risk stratification and the effect of NAC on post treatment risk categories. Methods: We retrospectively reviewed the charts of consecutive patients who underwent RC at two institutions between 2004 and 2014 and noted whether or not they received NAC. We determined the clinical stage by reviewing the exam under anesthesia, transurethral resection biopsy (TURBT) pathology, and preoperative imaging. Patients with cT2-T4a node-negative disease were included. Those with sarcomatoid features or adenocarcinoma were excluded. Patients were classified as high risk if they had tumor-associated hydronephrosis, clinical stage≥T3b-T4a disease, variant histology (i.e., micropapillary or small cell), or lymphovascular invasion (LVI), as specified by the MDACC model. Variables were examined for associations with cancer-specific survival (CSS), overall survival (OS), and risk-category reclassification. Results: We identified 166 patients with a median follow-up time of 22.2 months. In all, 117 patients (70.5%) did not receive NAC, 68 (58.1%) of whom we classified as high risk. Among patients not receiving NAC, CSS and OS were significantly decreased in high-risk patients (log-rank test p = 0.01 for both comparisons). The estimated age-adjusted hazard ratios of high-risk classification for cancer-specific and overall

  1. Utility of Clinical Risk Stratification in the Selection of Muscle-Invasive Bladder Cancer Patients for Neoadjuvant Chemotherapy: A Retrospective Cohort Study

    PubMed Central

    von Rundstedt, Friedrich-Carl; Mata, Douglas A.; Kryvenko, Oleksandr N.; Shah, Anup A.; Jhun, Iny; Lerner, Seth P.

    2016-01-01

    Introduction: Level I evidence supports the use of cisplatin-based neoadjuvant chemotherapy (NAC) for muscle-invasive bladder cancer prior to radical cystectomy (RC). On average, 30–40% of patients achieve a complete pathologic response (i.e., stage pT0) after receiving NAC. Some centers risk-stratify patients, suggesting that there may be a higher-risk population that would derive the most benefit from NAC. Recently, a risk-stratification model developed at M.D. Anderson Cancer Center (MDACC) specified criteria for clinical staging and patient selection for NAC. We applied this model to our own RC patient cohort and evaluated our own experience with clinical risk stratification and the effect of NAC on post treatment risk categories. Methods: We retrospectively reviewed the charts of consecutive patients who underwent RC at two institutions between 2004 and 2014 and noted whether or not they received NAC. We determined the clinical stage by reviewing the exam under anesthesia, transurethral resection biopsy (TURBT) pathology, and preoperative imaging. Patients with cT2-T4a node-negative disease were included. Those with sarcomatoid features or adenocarcinoma were excluded. Patients were classified as high risk if they had tumor-associated hydronephrosis, clinical stage≥T3b-T4a disease, variant histology (i.e., micropapillary or small cell), or lymphovascular invasion (LVI), as specified by the MDACC model. Variables were examined for associations with cancer-specific survival (CSS), overall survival (OS), and risk-category reclassification. Results: We identified 166 patients with a median follow-up time of 22.2 months. In all, 117 patients (70.5%) did not receive NAC, 68 (58.1%) of whom we classified as high risk. Among patients not receiving NAC, CSS and OS were significantly decreased in high-risk patients (log-rank test p = 0.01 for both comparisons). The estimated age-adjusted hazard ratios of high-risk classification for cancer-specific and overall

  2. Availability of High School Extracurricular Sports Programs and High-Risk Behaviors

    ERIC Educational Resources Information Center

    Cohen, Deborah A.; Taylor, Stephanie L.; Zonta, Michela; Vestal, Katherine D.; Schuster, Mark A.

    2007-01-01

    Background: The Surgeon General has called for an expansion of school-based extracurricular sports programs to address the obesity epidemic. However, little is known about the availability of and participation in high school extracurricular sports and how participation in these sports is related to high-risk behaviors. Methods: We surveyed Los…

  3. Faster clonal turnover in high-infection habitats provides evidence for parasite-mediated selection.

    PubMed

    Paczesniak, D; Adolfsson, S; Liljeroos, K; Klappert, K; Lively, C M; Jokela, J

    2014-02-01

    According to the Red Queen hypothesis for sex, parasite-mediated selection against common clones counterbalances the reproductive advantage of asexual lineages, which would otherwise outcompete sexual conspecifics. Such selection on the clonal population is expected to lead to a faster clonal turnover in habitats where selection by parasites is stronger. We tested this prediction by comparing the genetic structure of clonal and sexual populations of freshwater snail Potamopyrgus antipodarum between years 2003 and 2007 in three depth-specific habitats in Lake Alexandrina (South Island, New Zealand). These habitats differ in the risk of infection by castrating trematodes and in the relative proportion of sexual individuals. As predicted, we found that the clonal structure changed significantly in shallow and mid-water habitats, where prevalence of infection was high, but not in the deep habitat, where parasite prevalence was low. Additionally, we found that both clonal diversity and evenness of the asexual population declined in the shallow habitat. In contrast, the genetic structure (based on F-statistics) of the coexisting sexual population did not change, which suggests that the change in the clonal structure cannot be related to genetic changes in the sexual population. Finally, the frequency of sexuals had no effect on the diversity of the sympatric clonal population. Taken together, our results show a more rapid clonal turnover in high-infection habitats, which gives support for the Red Queen hypothesis for sex.

  4. Mechanism of substrate selection by a highly specific CRISPR endoribonuclease.

    PubMed

    Sternberg, Samuel H; Haurwitz, Rachel E; Doudna, Jennifer A

    2012-04-01

    Bacteria and archaea possess adaptive immune systems that rely on small RNAs for defense against invasive genetic elements. CRISPR (clustered regularly interspaced short palindromic repeats) genomic loci are transcribed as long precursor RNAs, which must be enzymatically cleaved to generate mature CRISPR-derived RNAs (crRNAs) that serve as guides for foreign nucleic acid targeting and degradation. This processing occurs within the repetitive sequence and is catalyzed by a dedicated Cas6 family member in many CRISPR systems. In Pseudomonas aeruginosa, crRNA biogenesis requires the endoribonuclease Csy4 (Cas6f), which binds and cleaves at the 3' side of a stable RNA stem-loop structure encoded by the CRISPR repeat. We show here that Csy4 recognizes its RNA substrate with an ~50 pM equilibrium dissociation constant, making it one of the highest-affinity protein:RNA interactions of this size reported to date. Tight binding is mediated exclusively by interactions upstream of the scissile phosphate that allow Csy4 to remain bound to its product and thereby sequester the crRNA for downstream targeting. Substrate specificity is achieved by RNA major groove contacts that are highly sensitive to helical geometry, as well as a strict preference for guanosine adjacent to the scissile phosphate in the active site. Collectively, our data highlight diverse modes of substrate recognition employed by Csy4 to enable accurate selection of CRISPR transcripts while avoiding spurious, off-target RNA binding and cleavage.

  5. Highly selective medium for isolation of Listeria monocytogenes from food.

    PubMed

    al-Zoreky, N; Sandine, W E

    1990-10-01

    A new selective medium (Al-Zoreky-Sandine listeria medium [ASLM]) was formulated to recover Listeria monocytogenes from food specimens; the medium completely inhibited common food microflora. Recognition of Listeria colonies is evident by black discoloration of the medium due to esculin hydrolysis without need for special illuminating equipment. The medium contains acriflavin, ceftazidime, and moxalactam as selective agents. Compared with Listeria Selective Agar, ASLM was equally effective in recovering L. monocytogenes. However, ASLM inhibited micrococci, enterococci, and gram-negative bacteria, especially a strain that mimicked L. monocytogenes on Listeria Selective Agar. The new medium was able to recover heat injured cells with only 15% less count than the nonselective medium.

  6. Extreme risk taker who wants to continue taking part in high risk sports after serious injury.

    PubMed

    Pain, M; Kerr, J H

    2004-06-01

    The case is reported of a 40 year old male high risk sport athlete who had seriously injured himself several times and as a result was partially physically disabled and had trouble with mental tasks requiring concentration such as spelling, reading numbers, and writing. The athlete was referred to a sports psychologist. In consultations, it became clear that he was having difficulty reconciling the difference between his life as it used to be and as it would be in the future. Part of his difficulty was dealing with the frustration and anger "outbursts" which resulted from not being able to perform straightforward everyday motor skills. In spite of his injuries and disability, the patient badly wanted to continue participating in extreme sports. Reversal theory is used in the discussion to provide theoretical explanations of the motivation for his extreme risk taking behaviour.

  7. Volumetric Change of Selected Organs at Risk During IMRT for Oropharyngeal Cancer

    SciTech Connect

    Ricchetti, Francesco; Wu Binbin; McNutt, Todd; Wong, John; Forastiere, Arlene; Marur, Shanthi; Starmer, Heather; Sanguineti, Giuseppe

    2011-05-01

    Purpose: To assess volumetric changes of selected organs at risk (OAR) during intensity-modulated radiotherapy (IMRT) for oropharyngeal carcinoma. Materials and Methods: Twenty-six consecutive patients that were treated with definitive IMRT {+-} chemotherapy between November 2007 and November 2008 were selected for the present study. As part of an internal quality assurances program, a repeat kilovolt (KV) computed tomography was planned weekly during the 7-week treatment course. On each available scan, a single observer contoured the parotid submandibular, and thyroid glands (PG/SMG/TG), larynx (L), and constrictor, masticatory, and sternocleidomastoid muscles (CM/MM/SCM) as appropriate. The volume at each scan was compared with the one at planning CT in a pair-wise fashion. p values <0.05 after correction for multiple testing were considered significant. Results: A total of 159 scans was obtained during treatment for a total of 185 scans, including the baseline imaging. All OARs showed statistically significant changes over baseline by week 5. At week 7, the PG showed the largest absolute change with an average reduction of {approx}10 mL followed by both the SCM and MM ({approx}-5 mL). The largest ({approx}-30%) relative change was observed for the salivary glands. L and CM showed a {approx}15% increase in volume during treatment. Conclusion: All selected OAR undergo significant volumetric changes during a course of IMRT for oropharyngeal squamous cell carcinoma.

  8. Intakes of selected nutrients, foods, and phytochemicals and prostate cancer risk in western New York.

    PubMed

    McCann, Susan E; Ambrosone, Christine B; Moysich, Kirsten B; Brasure, John; Marshall, James R; Freudenheim, Jo L; Wilkinson, Gregg S; Graham, Saxon

    2005-01-01

    A number of epidemiological studies have suggested that diet may affect the etiology of prostate cancer, but few have investigated the impact of phytochemical intakes on this cancer. We conducted a case-control study of diet and prostate cancer in western New York involving 433 men with primary, histologically confirmed prostate cancer and 538 population-based controls, frequency matched to cases on age and county of residence. Diet was assessed with a detailed food-frequency questionnaire. We calculated daily intakes of nutrients and the phytochemicals beta-sitosterol, campesterol, stigmasterol, total phytosterols, total lignan precursors, quercetin, and kaempferol based on published food composition data. Odds ratios (ORs) and 95% confidence intervals (CIs) describing the association of prostate cancer risk with selected nutrients, phytochemicals, and food groups were estimated with unconditional logistic regression. Compared with men in the lowest quartile of intake, reduced risks were observed for men in the highest quartile of intake of vitamin C (OR = 0.49; 95% CI = 0.33-0.74), beta-carotene (OR = 0.53; 95% CI = 0.36-0.79), alpha-carotene (OR = 0.67; 95% CI = 0.47-0.97), lutein (OR = 0.55; 95% CI = 0.37-0.81), lycopene (OR = 0.62; 95% CI = 0.42-0.92), total lignan precursors (OR = 0.66; 95% CI = 0.47-0.94), quercetin (OR = 0.64; 95% CI = 0.44-0.92), and total vegetables (OR = 0.53; 95% CI = 0.36-0.79), but weak increased risks were observed for snacks and sweets (OR = 1.46; 95% CI = 0.95-2.23). Estimates associated with nutrients and phytochemicals were attenuated after adjustment for total vegetable intake. Nevertheless, our results support the hypothesis that a phytochemical-rich, plant-based diet is of importance in reducing risks of hormone-related neoplasms.

  9. High-risk food consumption and food safety practices in a Canadian community.

    PubMed

    Nesbitt, Andrea; Majowicz, Shannon; Finley, Rita; Marshall, Barbara; Pollari, Frank; Sargeant, Jan; Ribble, Carl; Wilson, Jeff; Sittler, Nancy

    2009-12-01

    Understanding consumers' high-risk food consumption patterns and food handling in the home is critical in reducing foodborne illness. This study was conducted to determine the prevalence of unsafe food practices of individuals in a Canadian-based population, specifically, high-risk food consumption and home food safety practices. During November 2005 to March 2006, a sample of 2,332 randomly selected residents of the Waterloo Region (Ontario, Canada) participated in a telephone survey of food consumption and food safety. Questions covered consumption of high-risk foods, hand washing practices, safe food handling knowledge, source of food safety education, meat thawing and cooking practices, cross-contamination after raw food preparation, and refrigeration temperatures. Certain high-risk food behaviors were common among respondents and were associated with demographic characteristics. In general, unsafe practices increased with increasing total annual household income level. Males were more likely to report engaging in risky practices than were females. Specific high-risk behaviors of public health concern were reported by elderly individuals (e.g., consuming undercooked eggs), children (e.g., consuming chicken nuggets), and rural residents (e.g., drinking unpasteurized milk). Respondents appeared to know proper food safety practices, but did not put them into practice. Thus, educational programs emphasizing specific practices to improve food safety should be directed to targeted audiences, and they should stress the importance of consumer behavior in the safety of foods prepared at home. Further investigation of consumer perceptions is needed to design such programs to effectively increase the implementation of safe food practices by consumers.

  10. Proteomic profiling of high risk medulloblastoma reveals functional biology.

    PubMed

    Staal, Jerome A; Lau, Ling San; Zhang, Huizhen; Ingram, Wendy J; Hallahan, Andrew R; Northcott, Paul A; Pfister, Stefan M; Wechsler-Reya, Robert J; Rusert, Jessica M; Taylor, Michael D; Cho, Yoon-Jae; Packer, Roger J; Brown, Kristy J; Rood, Brian R

    2015-06-10

    Genomic characterization of medulloblastoma has improved molecular risk classification but struggles to define functional biological processes, particularly for the most aggressive subgroups. We present here a novel proteomic approach to this problem using a reference library of stable isotope labeled medulloblastoma-specific proteins as a spike-in standard for accurate quantification of the tumor proteome. Utilizing high-resolution mass spectrometry, we quantified the tumor proteome of group 3 medulloblastoma cells and demonstrate that high-risk MYC amplified tumors can be segregated based on protein expression patterns. We cross-validated the differentially expressed protein candidates using an independent transcriptomic data set and further confirmed them in a separate cohort of medulloblastoma tissue samples to identify the most robust proteogenomic differences. Interestingly, highly expressed proteins associated with MYC-amplified tumors were significantly related to glycolytic metabolic pathways via alternative splicing of pyruvate kinase (PKM) by heterogeneous ribonucleoproteins (HNRNPs). Furthermore, when maintained under hypoxic conditions, these MYC-amplified tumors demonstrated increased viability compared to non-amplified tumors within the same subgroup. Taken together, these findings highlight the power of proteomics as an integrative platform to help prioritize genetic and molecular drivers of cancer biology and behavior.

  11. Gender Differences in Risk Behaviors Among High School Youth

    PubMed Central

    Haque laz, Tabassum; Rahman, Mahbubur; Berenson, Abbey B.

    2013-01-01

    The US Centers for Disease Control and Prevention's (CDC) Youth Risk Behavior Surveillance System (YRBSS) demonstrates that American youth engage in a wide variety of risky behaviors.1 The frequency and type of these behaviors often differ by a number of factors, such as socioeconomic status, race, and ethnicity. For example, results of the 2011 YRBSS revealed that white high school students were most likely to have texted or e-mailed while driving or been bullied on school property, while black high school students were most likely to have engaged in risky sexual behaviors, to have been physically inactive, and to be obese.1 Conversely, Hispanic high school students were most likely to have ridden with a driver who had been drinking alcohol; to have ever used cocaine, inhalants, or ecstasy; and to have failed to use protection to prevent pregnancy during last sexual intercourse.1 However, it is difficult to discern whether differences in risk-taking behaviors between and among ethnic groups can actually be attributed to differences in group norms, socioeconomic status, or cultural beliefs regarding acceptance or rejection of such behaviors,1 suggesting a need for more comprehensive regional investigations. PMID:24416689

  12. High-potency cannabis and the risk of psychosis

    PubMed Central

    Di Forti, Marta; Morgan, Craig; Dazzan, Paola; Pariante, Carmine; Mondelli, Valeria; Marques, Tiago Reis; Handley, Rowena; Luzi, Sonija; Russo, Manuela; Paparelli, Alessandra; Butt, Alexander; Stilo, Simona A.; Wiffen, Ben; Powell, John; Murray, Robin M.

    2009-01-01

    Background People who use cannabis have an increased risk of psychosis, an effect attributed to the active ingredient Δ9-tetrahydrocannabinol (Δ9-THC). There has recently been concern over an increase in the concentration of Δ9-THC in the cannabis available in many countries. Aims To investigate whether people with a first episode of psychosis were particularly likely to use high-potency cannabis. Method We collected information on cannabis use from 280 cases presenting with a first episode of psychosis to the South London & Maudsley National Health Service (NHS) Foundation Trust, and from 174 healthy controls recruited from the local population. Results There was no significant difference between cases and controls in whether they had ever taken cannabis, or age at first use. However, those in the cases group were more likely to be current daily users (OR = 6.4) and to have smoked cannabis for more than 5 years (OR = 2.1). Among those who used cannabis, 78% of the cases group used high-potency cannabis (sinsemilla, ‘skunk’) compared with 37% of the control group (OR 6.8). Conclusions The finding that people with a first episode of psychosis had smoked higher-potency cannabis, for longer and with greater frequency, than a healthy control group is consistent with the hypothesis that Δ9-THC is the active ingredient increasing risk of psychosis. This has important public health implications, given the increased availability and use of high-potency cannabis. PMID:19949195

  13. [Residual risk: The roles of triglycerides and high density lipoproteins].

    PubMed

    Grammer, Tanja; Kleber, Marcus; Silbernagel, Günther; Scharnagl, Hubert; März, Winfried

    2016-06-01

    In clinical trials, the reduction of LDL-cholesterol (LDL-C) with statins reduces the incidence rate of cardiovascular events by approximately one third. This means, that a sizeable "residual risk" remains. Besides high lipoprotein (a), disorders in the metabolism of triglyceride-rich lipoproteins and high density liproteins have been implicated as effectors of the residual risk. Both lipoprotein parameters correlate inversely with each other. Therefore, the etiological contributions of triglycerides and / or of HDL for developing cardiovascular disease can hardly be estimated from either observational studies or from intervention studies. The largely disappointing results of intervention studies with inhibitors of the cholesteryl ester transfer protein and in particular the available set of genetically-epidemiological studies suggest that in the last decade, the importance of HDL cholesterol has been overvalued, while the importance of triglycerides has been underestimated. High triglycerides not always atherogenic, but only if they are associated with the accumulation relatively cholesterol-enriched, incompletely catabolized remnants of chylomicrons and very low density lipoproteins (familial type III hyperlipidemia, metabolic syndrome, diabetes mellitus). The normalization of the concentration of triglycerides and remnants by inhibiting the expression of apolipoprotein C3 is hence a new, promising therapeutic target.

  14. Pilot study risk assessment for selected problems at the Nevada Test Site (NTS)

    SciTech Connect

    Daniels, J.I.

    1993-06-01

    The Nevada Test Site (NTS) is located in southwestern Nevada, about 105 km (65 mi) northwest of the city of Las Vegas. A series of tests was conducted in the late 1950s and early 1960s at or near the NTS to study issues involving plutonium-bearing devices. These tests resulted in the dispersal of about 5 TBq of [sup 239,24O]Pu on the surficial soils at the test locations. Additionally, underground tests of nuclear weapons devices have been conducted at the NTS since late 1962; ground water beneath the NTS has been contaminated with radionuclides produced by these tests. These two important problems have been selected for assessment. Regarding the plutonium contamination, because the residual [sup 239]Pu decays slowly (half-life of 24,110 y), these sites could represent a long-term hazard if they are not remediated and if institutional controls are lost. To investigate the magnitude of the potential health risks for this no-remediation case, three basic exposure scenarios were defined that could bring individuals in contact with [sup 239,24O]Pu at the sites: (1) a resident living in a subdivision, (2) a resident farmer, and (3) a worker at a commercial facility -- all located at a test site. The predicted cancer risks for the resident farmer were more than a factor of three times higher than the suburban resident at the median risk level, and about a factor of ten greater than the reference worker at a commercial facility. At 100 y from the present, the 5, 50, and 95th percentile risks for the resident farmer at the most contaminated site were 4 x 10[sup [minus]6], 6 x 10[sup [minus]5], and 5 x 10[sup [minus]4], respectively. For the assessment of Pu in surface soil, the principal sources of uncertainty in the estimated risks were population mobility, the relationship between indoor and outdoor contaminant levels, and the dose and risk factors for bone, liver, and lung.

  15. Pilot study risk assessment for selected problems at the Nevada Test Site (NTS)

    SciTech Connect

    Daniels, J.I.; Anspaugh, L.R.; Bogen, K.T.; Daniels, J.I.; Layton, D.W.; Straume, T.; Andricevic, R.; Jacobson, R.L.; Meinhold, A.F.; Holtzman, S.; Morris, S.C.; Hamilton, L.D.

    1993-06-01

    The Nevada Test Site (NTS) is located in southwestern Nevada, about 105 km (65 mi) northwest of the city of Las Vegas. A series of tests was conducted in the late 1950s and early 1960s at or near the NTS to study issues involving plutonium-bearing devices. These tests resulted in the dispersal of about 5 TBq of {sup 239,24O}Pu on the surficial soils at the test locations. Additionally, underground tests of nuclear weapons devices have been conducted at the NTS since late 1962; ground water beneath the NTS has been contaminated with radionuclides produced by these tests. These two important problems have been selected for assessment. Regarding the plutonium contamination, because the residual {sup 239}Pu decays slowly (half-life of 24,110 y), these sites could represent a long-term hazard if they are not remediated and if institutional controls are lost. To investigate the magnitude of the potential health risks for this no-remediation case, three basic exposure scenarios were defined that could bring individuals in contact with {sup 239,24O}Pu at the sites: (1) a resident living in a subdivision, (2) a resident farmer, and (3) a worker at a commercial facility -- all located at a test site. The predicted cancer risks for the resident farmer were more than a factor of three times higher than the suburban resident at the median risk level, and about a factor of ten greater than the reference worker at a commercial facility. At 100 y from the present, the 5, 50, and 95th percentile risks for the resident farmer at the most contaminated site were 4 x 10{sup {minus}6}, 6 x 10{sup {minus}5}, and 5 x 10{sup {minus}4}, respectively. For the assessment of Pu in surface soil, the principal sources of uncertainty in the estimated risks were population mobility, the relationship between indoor and outdoor contaminant levels, and the dose and risk factors for bone, liver, and lung.

  16. Magnetic Resonance Lymphography-Guided Selective High-Dose Lymph Node Irradiation in Prostate Cancer

    SciTech Connect

    Meijer, Hanneke J.M.; Debats, Oscar A.; Kunze-Busch, Martina; Kollenburg, Peter van; Leer, Jan Willem; Witjes, J. Alfred; Kaanders, Johannes H.A.M.; Barentsz, Jelle O.; Lin, Emile N.J.Th. van

    2012-01-01

    Purpose: To demonstrate the feasibility of magnetic resonance lymphography (MRL) -guided delineation of a boost volume and an elective target volume for pelvic lymph node irradiation in patients with prostate cancer. The feasibility of irradiating these volumes with a high-dose boost to the MRL-positive lymph nodes in conjunction with irradiation of the prostate using intensity-modulated radiotherapy (IMRT) was also investigated. Methods and Materials: In 4 prostate cancer patients with a high risk of lymph node involvement but no enlarged lymph nodes on CT and/or MRI, MRL detected pathological lymph nodes in the pelvis. These lymph nodes were identified and delineated on a radiotherapy planning CT to create a boost volume. Based on the location of the MRL-positive lymph nodes, the standard elective pelvic target volume was individualized. An IMRT plan with a simultaneous integrated boost (SIB) was created with dose prescriptions of 42 Gy to the pelvic target volume, a boost to 60 Gy to the MRL-positive lymph nodes, and 72 Gy to the prostate. Results: All MRL-positive lymph nodes could be identified on the planning CT. This information could be used to delineate a boost volume and to individualize the pelvic target volume for elective irradiation. IMRT planning delivered highly acceptable radiotherapy plans with regard to the prescribed dose levels and the dose to the organs at risk (OARs). Conclusion: MRL can be used to select patients with limited lymph node involvement for pelvic radiotherapy. MRL-guided delineation of a boost volume and an elective pelvic target volume for selective high-dose lymph node irradiation with IMRT is feasible. Whether this approach will result in improved outcome for these patients needs to be investigated in further clinical studies.

  17. Pathologic High-risk Lesions, Diagnosis and Management.

    PubMed

    Murray, Melissa

    2016-12-01

    Percutaneous imaging-guided core needle biopsy (CNB) is a less invasive and less expensive alternative to surgical biopsy for the evaluation of breast lesions. After a CNB the radiologist determine if there is concordance between the pathology, imaging, and clinical findings. Patient management after CNB diagnosis of high-risk breast lesion varies. Surgical excision is warranted for lesions yielding a CNB diagnosis of ADH; however controversy exists regarding the need for surgical excision after CNB diagnosis of radial scar, papillary lesion, atypical lobular hyperplasia (ALH), or lobular carcinoma in situ (LCIS). Repeat CNB or surgical excision is warranted if histologic findings and imaging findings are discordant.

  18. Teamwork in high-risk environments analogous to space

    NASA Technical Reports Server (NTRS)

    Kanki, Barbara G.

    1990-01-01

    Mountaineering expeditions combine a number of factors which make them potentially good analogs to the planetary exploration facet of long-duration space missions. A study of mountain climbing teams was conducted in order to evaluate the usefulness of the environment as a space analog and to specifically identify the factors and issues surrounding teamwork and 'successful' team performance in two mountaineering environments. This paper focuses on social/organizational factors, including team size and structure, leadership styles and authority structure which were found in the sample of 22 climb teams (122 individuals). The second major issue discussed is the construction of a valid performance measure in this high-risk environment.

  19. The Effect of Parenting Stress on Child Behavior Problems in High-Risk Children with Prenatal Drug Exposure

    ERIC Educational Resources Information Center

    Bagner, Daniel M.; Sheinkopf, Stephen J.; Miller-Loncar, Cynthia; LaGasse, Linda L.; Lester, Barry M.; Liu, Jing; Bauer, Charles R.; Shankaran, Seetha; Bada, Henrietta; Das, Abhik

    2009-01-01

    Objective: To examine the relationship between early parenting stress and later child behavior in a high-risk sample and measure the effect of drug exposure on the relationship between parenting stress and child behavior. Methods: A subset of child-caregiver dyads (n = 607) were selected from the Maternal Lifestyle Study (MLS), which is a large…

  20. Social and Emotional Components of Book Reading between Caregivers and Their Toddlers in a High-Risk Sample

    ERIC Educational Resources Information Center

    Cross, Jennifer Riedl; Fletcher, Kathryn L.; Speirs Neumeister, Kristie L.

    2011-01-01

    In this collective case study of caregiver behaviors with their toddlers, two-minute videotaped reading interactions were analyzed using a constant comparative method. Twenty-four caregiver-toddler dyads from a high-risk sample of children prenatally exposed to cocaine were selected from a larger sample because they represented the extremes of…

  1. Prevalence of and Risk Factors for Multidrug-Resistant Acinetobacter baumannii Colonization Among High-Risk Nursing Home Residents

    PubMed Central

    Mody, Lona; Gibson, Kristen E.; Horcher, Amanda; Prenovost, Katherine; McNamara, Sara E.; Foxman, Betsy; Kaye, Keith S.; Bradley, Suzanne

    2015-01-01

    OBJECTIVE To characterize the epidemiology of multidrug-resistant (MDR) Acinetobacter baumannii colonization in high-risk nursing home (NH) residents. DESIGN Nested case-control study within a multicenter prospective intervention trial. SETTING Four NHs in Southeast Michigan. PARTICIPANTS Case patients and control subjects were NH residents with an indwelling device (urinary catheter and/or feeding tube) selected from the control arm of the Targeted Infection Prevention study. Cases were residents colonized with MDR (resistant to ≥3 classes of antibiotics) A. baumannii; controls were never colonized with MDR A. baumannii. METHODS For active surveillance cultures, specimens from the nares, oropharynx, groin, perianal area, wounds, and device insertion site(s) were collected upon study enrollment, day 14, and monthly thereafter. A. baumannii strains and their susceptibilities were identified using standard microbiologic methods. RESULTS Of 168 NH residents, 25 (15%) were colonized with MDR A. baumannii. Compared with the 143 controls, cases were more functionally disabled (Physical Self-Maintenance Score >24; odds ratio, 5.1 [95% CI, 1.8–14.9]; P < .004), colonized with Proteus mirabilis (5.8 [1.9–17.9]; P < .003), and diabetic (3.4 [1.2–9.9]; P < .03). Most cases (22 [88%]) were colonized with multiple antibiotic-resistant organisms and 16 (64%) exhibited co-colonization with at least one other resistant gram-negative bacteria. CONCLUSION Functional disability, P. mirabilis colonization, and diabetes mellitus are important risk factors for colonization with MDR A. baumannii in high-risk NH residents. A. baumannii exhibits widespread antibiotic resistance and a preference to colonize with other antibiotic-resistant organisms, meriting enhanced attention and improved infection control practices in these residents. PMID:26072936

  2. Crohn's Disease Risk Alleles on the NOD2 Locus Have Been Maintained by Natural Selection on Standing Variation

    PubMed Central

    Nakagome, Shigeki; Mano, Shuhei; Kozlowski, Lukasz; Bujnicki, Janusz M.; Shibata, Hiroki; Fukumaki, Yasuaki; Kidd, Judith R.; Kidd, Kenneth K.; Kawamura, Shoji; Oota, Hiroki

    2012-01-01

    Risk alleles for complex diseases are widely spread throughout human populations. However, little is known about the geographic distribution and frequencies of risk alleles, which may contribute to differences in disease susceptibility and prevalence among populations. Here, we focus on Crohn's disease (CD) as a model for the evolutionary study of complex disease alleles. Recent genome-wide association studies and classical linkage analyses have identified more than 70 susceptible genomic regions for CD in Europeans, but only a few have been confirmed in non-European populations. Our analysis of eight European-specific susceptibility genes using HapMap data shows that at the NOD2 locus the CD-risk alleles are linked with a haplotype specific to CEU at a frequency that is significantly higher compared with the entire genome. We subsequently examined nine global populations and found that the CD-risk alleles spread through hitchhiking with a high-frequency haplotype (H1) exclusive to Europeans. To examine the neutrality of NOD2, we performed phylogenetic network analyses, coalescent simulation, protein structural prediction, characterization of mutation patterns, and estimations of population growth and time to most recent common ancestor (TMRCA). We found that while H1 was significantly prevalent in European populations, the H1 TMRCA predated human migration out of Africa. H1 is likely to have undergone negative selection because 1) the root of H1 genealogy is defined by a preexisting amino acid substitution that causes serious conformational changes to the NOD2 protein, 2) the haplotype has almost become extinct in Africa, and 3) the haplotype has not been affected by the recent European expansion reflected in the other haplotypes. Nevertheless, H1 has survived in European populations, suggesting that the haplotype is advantageous to this group. We propose that several CD-risk alleles, which destabilize and disrupt the NOD2 protein, have been maintained by natural

  3. Patient selection for TAVI 2015 - TAVI in low-risk patients: fact or fiction?

    PubMed

    Haussig, Stephan; Linke, Axel

    2015-09-01

    For decades, surgical aortic valve replacement (SAVR) has been the standard treatment for severe aortic stenosis (AS). With the clinical introduction of the concept of transcatheter aortic valve implantation (TAVI), a rapid development took place and, based on the results of landmark randomised controlled trials, within a few years TAVI became first-line therapy for inoperable patients with severe AS and an alternative to SAVR in operable high-risk patients. Indeed, data from a recent randomised controlled trial suggest that TAVI is superior to SAVR in higher-risk patients with AS. New TAVI devices have been developed to address current limitations, to optimise results further and to minimise complications. First results using these second-generation valves are promising. However, no data from randomised controlled trials assessing TAVI in younger, low-risk patients are yet available. While we await the results of trials addressing these issues (e.g., SURTAVI [NCT01586910] and PARTNER II [NCT01314313]), recent data from TAVI registries suggest that treatment of low-risk patients is already fact and no longer fiction.

  4. The high-risk plaque initiative: primary prevention of atherothrombotic events in the asymptomatic population.

    PubMed

    Falk, Erling; Sillesen, Henrik; Muntendam, Pieter; Fuster, Valentin

    2011-10-01

    The High-Risk Plaque (HRP) Initiative is a research and development effort to advance the understanding, recognition, and management of asymptomatic individuals at risk for a near-term atherothrombotic event such as myocardial infarction or stroke. Clinical studies using the newest technologies have been initiated, including the BioImage Study in which novel approaches are tested in a typical health plan population. Asymptomatic at-risk individuals were enrolled, including a survey-only group (n = 865), a group undergoing traditional risk factor scoring (n = 718), and a group in which all were assessed for both risk factors and subclinical atherosclerosis (n = 6104). The latter two groups underwent baseline examination in a dedicated mobile facility equipped with advanced imaging tools suitable for noninvasive screening for subclinical atherosclerosis (coronary artery calcium by computed tomography [CT], carotid and aortic disease by ultrasound, and ankle-brachial index). Selected participants were offered advanced imaging (contrast-enhanced CT, magnetic resonance imaging, and positron emission tomography/CT). Plasma, PAXgene RNA, and DNA samples were obtained for biomarker discovery studies. All individuals will be followed until 600 major atherothrombotic events have occurred in those undergoing imaging.

  5. Prevention of suicide and attempted suicide in Denmark. Epidemiological studies of suicide and intervention studies in selected risk groups.

    PubMed

    Nordentoft, Merete

    2007-11-01

    The suicide rates in Denmark have been declining during the last two decades. The decline was relatively larger among women than among men. All age groups experienced a decline except the very young with stable rates and the very old with increasing rates. The Universal, Selective, Indicated (USI) model recommended by Institute of Medicine was used as a framework for the thesis. Universal preventive interventions are directed toward the entire population; selective interventions are directed toward individuals who are at greater risk for suicidal behaviour; and indicated preventions are targeted at individuals who have already begun self-destructive behaviour. At the universal level, a review was carried out to highlight the association between availability of methods for suicide and suicide rate. There were mostly studies of firearms, and the conclusion of the review was that there was clear indication of restricted access to lethal means was associated with decline in suicide with that specific method, and in many cases also with overall suicide mortality. Restricting access is especially important for methods with high case fatality rate. Our own study indicated a beneficial effect on suicide rates of restrictions in access to barbiturates, dextropropoxyphen, domestic gas and car exhaust with high content of carbon monoxide. Although a range of other factors in the society might also be of importance, it was concluded that restrictions in access to dangerous means for suicide were likely to play an important role in reducing suicide rates in Denmark, especially for women. At the selective level, there are several important risk groups such as psychiatric patients, persons with alcohol and drug abuse, persons with newly diagnosed severe physical illness, all who previously attempted suicide, and groups of homeless, institutionalized, prisoners and other socially excluded persons. The thesis focused on homeless persons and psychiatric patients, especially patients

  6. Characterizing and Reaching High-Risk Drinkers Using Audience Segmentation

    PubMed Central

    Moss, Howard B.; Kirby, Susan D.; Donodeo, Fred

    2010-01-01

    Background Market or audience segmentation is widely used in social marketing efforts to help planners identify segments of a population to target for tailored program interventions. Market-based segments are typically defined by behaviors, attitudes, knowledge, opinions, or lifestyles. They are more helpful to health communication and marketing planning than epidemiologically-defined groups because market-based segments are similar in respect to how they behave or might react to marketing and communication efforts. However, market segmentation has rarely been used in alcohol research. As an illustration of its utility, we employed commercial data that describes the sociodemographic characteristics of high-risk drinkers as an audience segment; where they tend to live, lifestyles, interests, consumer behaviors, alcohol consumption behaviors, other health-related behaviors, and cultural values. Such information can be extremely valuable in targeting and planning public health campaigns, targeted mailings, prevention interventions and research efforts. Methods We describe the results of a segmentation analysis of those individuals who self-report consuming five or more drinks per drinking episode at least twice in the last 30-days. The study used the proprietary PRIZM™ audience segmentation database merged with Center for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS) database. The top ten of the 66 PRIZM™ audience segments for this risky drinking pattern are described. For five of these segments we provide additional in-depth details about consumer behavior and the estimates of the market areas where these risky drinkers reside. Results The top ten audience segments (PRIZM clusters) most likely to engage in high-risk drinking are described. The cluster with the highest concentration of binge drinking behavior is referred to as the “Cyber Millenials.” This cluster is characterized as “the nation's tech-savvy singles

  7. Risk factors for gallbladder contractility after cholecystolithotomy in elderly high-risk surgical patients

    PubMed Central

    Wang, Tao; Luo, Hao; Yan, Hong-tao; Zhang, Guo-hu; Liu, Wei-hui; Tang, Li-jun

    2017-01-01

    Objective Cholecystolithiasis is a common disease in the elderly patient. The routine therapy is open or laparoscopic cholecystectomy. In the previous study, we designed a minimally invasive cholecystolithotomy based on percutaneous cholecystostomy combined with a choledochoscope (PCCLC) under local anesthesia. Methods To investigate the effect of PCCLC on the gallbladder contractility function, PCCLC and laparoscope combined with a choledochoscope were compared in this study. Results The preoperational age and American Society of Anesthesiologists (ASA) scores, as well as postoperational lithotrity rate and common biliary duct stone rate in the PCCLC group, were significantly higher than the choledochoscope group. However, the pre- and postoperational gallbladder ejection fraction was not significantly different. Univariable and multivariable logistic regression analyses indicated that the preoperational thickness of gallbladder wall (odds ratio [OR]: 0.540; 95% confidence interval [CI]: 0.317–0.920; P=0.023) and lithotrity (OR: 0.150; 95% CI: 0.023–0.965; P=0.046) were risk factors for postoperational gallbladder ejection fraction. The area under receiver operating characteristics curve was 0.714 (P=0.016; 95% CI: 0.553–0.854). Conclusion PCCLC strategy should be carried out cautiously. First, restricted by the diameter of the drainage tube, the PCCLC should be used only for small gallstones in high-risk surgical patients. Second, the usage of lithotrity should be strictly limited to avoid undermining the gallbladder contractility and increasing the risk of secondary common bile duct stones. PMID:28138229

  8. The Allure of High-Risk Rewards in Huntington’s disease

    PubMed Central

    van Wouwe, Nelleke C.; Kanoff, Kristen E.; Claassen, Daniel O.; Ridderinkhof, K. Richard; Hedera, Peter; Harrison, Madaline B.; Wylie, Scott A.

    2017-01-01

    Objectives Huntington’s disease (HD) is a neurodegenerative disorder that produces a bias toward risky, reward-driven decisions in situations where the outcomes of decisions are uncertain and must be discovered. However, it is unclear whether HD patients show similar biases in decision-making when learning demands are minimized and prospective risks and outcomes are known explicitly. We investigated how risk decision-making strategies and adjustments are altered in HD patients when reward contingencies are explicit. Methods HD (N = 18) and healthy control (HC; N = 17) participants completed a risk-taking task in which they made a series of independent choices between a low-risk/low reward and high-risk/high reward risk options. Results Computational modeling showed that compared to HC, who showed a clear preference for low-risk compared to high-risk decisions, the HD group valued high-risks more than low-risk decisions, especially when high-risks were rewarded. The strategy analysis indicated that when high-risk options were rewarded, HC adopted a conservative risk strategy on the next trial by preferring the low-risk option (i.e., they counted their blessings and then played the surer bet). In contrast, following a rewarded high-risk choice, HD patients showed a clear preference for repeating the high-risk choice. Conclusions These results indicate a pattern of high-risk/high-reward decision bias in HD that persists when outcomes and risks are certain. The allure of high-risk/high-reward decisions in situations of risk certainty and uncertainty expands our insight into the dynamic decision-making deficits that create considerable clinical burden in HD. PMID:26708084

  9. Study of Delinquent, Diverted, and High-Risk Adolescent Girls: Implications for Mental Health Intervention

    ERIC Educational Resources Information Center

    Ruffolo, Mary C.; Sarri, Rosemary; Goodkind, Sara

    2004-01-01

    This study examines risk and protective factors for delinquent, diverted, and high-risk adolescent girls to inform the development of effective mental health prevention and intervention programs. Delinquent, diverted, and high-risk adolescent girls (N = 159) involved or at risk of involvement with the juvenile justice system, who were receiving…

  10. Smell identification in individuals at clinical high risk for schizophrenia.

    PubMed

    Gill, Kelly Elizabeth; Evans, Elizabeth; Kayser, Jürgen; Ben-David, Shelly; Messinger, Julie; Bruder, Gerard; Malaspina, Dolores; Corcoran, Cheryl Mary

    2014-12-15

    Smell identification deficits exist in schizophrenia, and may be associated with its negative symptoms. Less is known about smell identification and its clinical correlates in individuals at clinical high risk (CHR) for schizophrenia and related psychotic disorders. We examined smell identification, symptoms and IQ in 71 clinical high-risk (CHR) subjects and 36 healthy controls. Smell identification was assessed using both the 40-item University of Pennsylvania Smell Identification Test (UPSIT; Doty, R.L., Shaman, P., Kimmelman, C.P., Dann, M.S., 1984. University of Pennsylvania Smell Identification Test: a rapid quantitative olfactory function test for the clinic. Laryngoscope 94, 176-178) and its extracted 12-item Brief Smell Identification Test (Goudsmit, N., Coleman, E., Seckinger, R.A., Wolitzky, R., Stanford, A.D., Corcoran, C., Goetz, R.R., Malaspina, D., 2003. A brief smell identification test discriminates between deficit and non-deficit schizophrenia. Psychiatry Research 120, 155-164). Smell identification did not significantly differ between CHR subjects and controls. Among CHR subjects, smell identification did not predict schizophrenia (N=19; 27%) within 2 years, nor was it associated with negative or positive symptoms. This is the third prospective cohort study to examine smell identification in CHR subjects, and overall, findings are inconclusive, similar to what is found for other disorders in adolescents, such as autism spectrum, attention deficit and anxiety disorders. Smell identification deficit may not have clear utility as a marker of emergent schizophrenia and related psychotic disorders.

  11. Personality differences in high risk sports amateurs and instructors.

    PubMed

    Watson, Alison E; Pulford, Briony D

    2004-08-01

    This study investigated the personality differences of 21 amateurs and 20 instructors who participated in the high risk sports of skydiving, hang-gliding, paragliding, scuba diving, microlighting, and rock climbing, versus those who did not. 38 men and 28 women (M age=32.6 yr., SD= 10.0) were assessed using the Eysenck Personality Questionnaire-Revised, the General Health Questionnaire, the Generalised Self-efficacy Scale, and a Type A/B personality measure. Instructors and Amateurs scored significantly higher on Extroversion and lower on Neuroticism than Nonparticipants; however, they differed from each other on the General Health Questionnaire and Type A/B personality scores. Amateurs scored significantly higher on Psychoticism and Self-efficacy than Instructors and Nonparticipants. In conclusion, these test scores suggest that people who are attracted to high risk sports tend to be at the extroverted and emotionally stable end of the scale, with a tendency to exhibit Type A characteristics; however, Instructors' scores on Psychoticism and Self-efficacy are more akin to those of Nonparticipants.

  12. Neurophysiology for Detection of High Risk for Psychosis

    PubMed Central

    2016-01-01

    Schizophrenia is a complex and often disabling disorder that is characterized by a wide range of social, emotional, and cognitive deficits. Increasing research suggests that the greatest social and cognitive therapeutic impact comes from early identification. The present study applied a well-established neurophysiological paradigm in the schizophrenia literature, mismatch negativity (MMN), to college students identified as high risk (HR) for psychosis to investigate MMN as a potential biomarker for the onset of psychosis. The hypothesis was that HR would exhibit attenuated MMN amplitudes compared to controls, as has been established in individuals with chronic schizophrenia. Participants (N = 121) were separated into Group 1 (controls) (n1 = 72) and Group 2 (HR) (n2 = 49) based on the established cutoff score of the 16-item Prodromal Questionnaire. Participants then completed a time based MMN paradigm during which brain activity was recorded with EEG. For all electrode locations, controls demonstrated significantly more negative amplitudes than HR (Cz: F(1,119) = 8.09, p = .005; Fz: F(1, 119) = 5.74, p = .018; Pz: F(1,119) = 5.88, p = .017). Results suggested that MMN may assist in identifying those who appear high-functioning but may be at risk for later development of psychosis or cognitive and psychological difficulties associated with psychosis. PMID:27579180

  13. Neurophysiology for Detection of High Risk for Psychosis.

    PubMed

    Pantlin, Lara N; Davalos, Deana

    2016-01-01

    Schizophrenia is a complex and often disabling disorder that is characterized by a wide range of social, emotional, and cognitive deficits. Increasing research suggests that the greatest social and cognitive therapeutic impact comes from early identification. The present study applied a well-established neurophysiological paradigm in the schizophrenia literature, mismatch negativity (MMN), to college students identified as high risk (HR) for psychosis to investigate MMN as a potential biomarker for the onset of psychosis. The hypothesis was that HR would exhibit attenuated MMN amplitudes compared to controls, as has been established in individuals with chronic schizophrenia. Participants (N = 121) were separated into Group 1 (controls) (n 1 = 72) and Group 2 (HR) (n 2 = 49) based on the established cutoff score of the 16-item Prodromal Questionnaire. Participants then completed a time based MMN paradigm during which brain activity was recorded with EEG. For all electrode locations, controls demonstrated significantly more negative amplitudes than HR (Cz: F(1,119) = 8.09, p = .005; Fz: F(1, 119) = 5.74, p = .018; Pz: F(1,119) = 5.88, p = .017). Results suggested that MMN may assist in identifying those who appear high-functioning but may be at risk for later development of psychosis or cognitive and psychological difficulties associated with psychosis.

  14. High-Risk Human Papillomavirus Targets Crossroads in Immune Signaling

    PubMed Central

    Tummers, Bart; Van Der Burg, Sjoerd H.

    2015-01-01

    Persistent infections with a high-risk type human papillomavirus (hrHPV) can progress to cancer. High-risk HPVs infect keratinocytes (KCs) and successfully suppress host immunity for up to two years despite the fact that KCs are well equipped to detect and initiate immune responses to invading pathogens. Viral persistence is achieved by active interference with KCs innate and adaptive immune mechanisms. To this end hrHPV utilizes proteins encoded by its viral genome, as well as exploits cellular proteins to interfere with signaling of innate and adaptive immune pathways. This results in impairment of interferon and pro-inflammatory cytokine production and subsequent immune cell attraction, as well as resistance to incoming signals from the immune system. Furthermore, hrHPV avoids the killing of infected cells by interfering with antigen presentation to antigen-specific cytotoxic T lymphocytes. Thus, hrHPV has evolved multiple mechanisms to avoid detection and clearance by both the innate and adaptive immune system, the molecular mechanisms of which will be dealt with in detail in this review. PMID:26008697

  15. Seroprevalence and risk factors for brucellosis in a high-risk group of individuals in Bangladesh.

    PubMed

    Rahman, A K M Anisur; Dirk, Berkvens; Fretin, David; Saegerman, Claude; Ahmed, Muzahed Uddin; Muhammad, Noor; Hossain, Akram; Abatih, Emmanuel

    2012-03-01

    Brucellosis is an occupational hazard of livestock farmers, dairy workers, veterinarians, slaughterhouse workers, and laboratory personnel, all of whom are considered to belong to the high-risk occupational group (HROG). A study was undertaken to determine the seroprevalence of brucellosis, identify risk factors associated with brucellosis seropositivity, and detect Brucella at genus level using real-time polymerase chain reaction (PCR) among people in the HROG in the Dhaka division of Bangladesh. A sample of 500 individuals from the HROG was collected from three districts of Dhaka division of Bangladesh. A multiple random effects logistic regression model was used to identify potential risk factors. Two types of real-time PCR methods were applied to detect Brucella genus-specific DNA using serum from seropositive patients. The prevalence of brucellosis based on the three tests was observed to be 4.4% based on a parallel interpretation. The results of the multiple random effects logistic regression analysis with random intercept for district revealed that the odds of brucellosis seropositivity among individuals who had been in contact with livestock for more than 26 years was about 14 times higher as compared to those who had less than 5 years of contact with livestock. In addition, when the contact was with goats, the odds of brucellosis seropositivity were about 60 times higher as compared to when contact was with cattle only. Noticeable variation in brucellosis seropositivity among humans within the three districts was noted. All of the 13 individuals who tested positive for the serological tests were also positive in two types of real-time PCR using the same serum samples. Livestock farmers of brucellosis positive herds had a significantly higher probability to be seropositive for brucellosis. The study emphasized that contact with livestock, especially goats, is a significant risk factor for the transmission of brucellosis among individuals in the HROG.

  16. Augmenting selective serotonin reuptake inhibitors with clomipramine in obsessive-compulsive disorder: benefits and risks.

    PubMed

    Andrade, Chittaranjan

    2013-12-01

    A small body of literature suggests that clomipramine may usefully augment selective serotonin reuptake inhibitor (SSRI) treatment in obsessive-compulsive disorder (OCD) patients who do not respond to SSRI monotherapy. The combination, however, is associated with the risk of clinically significant drug interactions. Clomipramine can raise the blood levels and hence the adverse effects of most SSRIs, and many SSRIs can raise the blood levels and hence the adverse effects of clomipramine. The latter situation is more important because certain dose-dependent adverse effects of clomipramine, such as seizures, can be life-threatening. This article presents an evidence-based discussion of the pharmacodynamic and pharmacokinetic adverse effects of the SSRI-clomipramine combination along with suggestions for dosing and monitoring when the combination is used in OCD.

  17. Medications Used to Treat Nausea and Vomiting of Pregnancy and the Risk of Selected Birth Defects

    PubMed Central

    Anderka, Marlene; Mitchell, Allen A.; Louik, Carol; Werler, Martha M.; Hernández-Diaz, Sonia; Rasmussen, Sonja A.

    2012-01-01

    Background Nausea and vomiting of pregnancy (NVP) occurs in up to 80% of pregnant women, yet its association with birth outcomes is not clear. Several medications are used for the treatment of NVP; however, data are limited on their possible associations with birth defects. Methods Using data from the National Birth Defects Prevention Study (NBDPS), a multi-site population-based case-control study, we examined whether NVP or its treatment was associated with the most common non-cardiac defects in the NBDPS (non-syndromic cleft lip with or without cleft palate (CL/P), cleft palate alone (CP), neural tube defects (NTDs), and hypospadias) compared to randomly-selected non-malformed live births. Results Among the 4524 cases and 5859 controls included in this study, 67.1% reported first trimester NVP, and 15.4% of them reported using at least one agent for NVP. Nausea and vomiting of pregnancy was not associated with CP or NTDs, but modest risk reductions were observed for CL/P (aOR=0.87, 0.77–0.98), and hypospadias (OR=0.84, 0.72–0.98). In regards to treatments for NVP in the first trimester, the following adjusted associations were observed with an increased risk: proton pump inhibitors and hypospadias (aOR=4.36, 1.21–15.81), steroids and hypospadias (aOR=2.87, 1.03–7.97), and ondansetron and CP (aOR=2.37, 1.18–4.76), while antacids were associated with a reduced risk for CL/P (aOR=0.58, 0.38–0.89). Conclusions Nausea and vomiting of pregnancy was not observed to be associated with an increased risk of birth defects, but possible risks related to three treatments (i.e. proton pump inhibitors, steroids and ondansetron), which could be chance findings, warrant further investigation. PMID:22102545

  18. 2017 Taiwan lipid guidelines for high risk patients.

    PubMed

    Li, Yi-Heng; Ueng, Kwo-Chang; Jeng, Jiann-Shing; Charng, Min-Ji; Lin, Tsung-Hsien; Chien, Kuo-Liong; Wang, Chih-Yuan; Chao, Ting-Hsing; Liu, Ping-Yen; Su, Cheng-Huang; Chien, Shih-Chieh; Liou, Chia-Wei; Tang, Sung-Chun; Lee, Chun-Chuan; Yu, Tse-Ya; Chen, Jaw-Wen; Wu, Chau-Chung; Yeh, Hung-I

    2017-04-01

    In Taiwan, the prevalence of hyperlipidemia increased due to lifestyle and dietary habit changes. Low density lipoprotein cholesterol (LDL-C) and non-high density lipoprotein cholesterol (non-HDL-C) are all significant predicting factors of coronary artery disease in Taiwan. We recognized that lipid control is especially important in patients with existed atherosclerotic cardiovascular diseases (ASCVD), including coronary artery disease (CAD), ischemic stroke and peripheral arterial disease (PAD). Because the risk of ASCVD is high in patients with diabetes mellitus (DM), chronic kidney disease (CKD) and familial hypercholesterolemia (FH), lipid control is also necessary in these patients. Lifestyle modification is the first step to control lipid. Weight reduction, regular physical exercise and limitation of alcohol intake all reduce triglyceride (TG) levels. Lipid-lowering drugs include HMG-CoA reductase inhibitors (statins), cholesterol absorption inhibitors (ezetimibe), proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, nicotinic acids (niacin), fibric acids derivatives (fibrates), and long-chain omega-3 fatty acids. Statin is usually the first line therapy. Combination therapy with statin and other lipid-lowering agents may be considered in some clinical settings. For patients with acute coronary syndrome (ACS) and stable CAD, LDL-C < 70 mg/dL is the major target. A lower target of LDL-C <55 mg/dL can be considered in ACS patients with DM. After treating LDL-C to target, non-HDL-C can be considered as a secondary target for patients with TG ≥ 200 mg/dL. The suggested non-HDL-C target is < 100 mg/dL in ACS and CAD patients. For patients with ischemic stroke or transient ischemic attack presumed to be of atherosclerotic origin, statin therapy is beneficial and LDL-C < 100 mg/dL is the suggested target. For patients with symptomatic carotid stenosis or intracranial arterial stenosis, in addition to antiplatelets and blood pressure control, LDL

  19. Patient selection for TAVI in 2016: should we break through the low-risk barrier?

    PubMed

    Abdelghani, Mohammad; Serruys, Patrick W

    2016-09-18

    The earliest evidence supporting transcatheter aortic valve implantation (TAVI) was derived from its comparison with conservative therapy in inoperable patients and with surgical aortic valve replacement (SAVR) in extremely high risk patients. TAVI had a relative advantage in these situations being less invasive and hence less prone to the classic early postoperative devastating complications. To prove as effective in less fragile and less morbid patients, the long-term durability of the haemodynamic and clinical gains from TAVI needs to be confirmed. In this report we will discuss three aspects of the dilemma of expanding TAVI indications to lower-risk patients: first, available data on early and late outcomes after TAVI; second, durability issues; and third, TAVI complications and procedural refinements.

  20. Artificial intelligence costs, benefits, and risks for selected spacecraft ground system automation scenarios

    NASA Technical Reports Server (NTRS)

    Truszkowski, Walter F.; Silverman, Barry G.; Kahn, Martha; Hexmoor, Henry

    1988-01-01

    In response to a number of high-level strategy studies in the early 1980s, expert systems and artificial intelligence (AI/ES) efforts for spacecraft ground systems have proliferated in the past several years primarily as individual small to medium scale applications. It is useful to stop and assess the impact of this technology in view of lessons learned to date, and hopefully, to determine if the overall strategies of some of the earlier studies both are being followed and still seem relevant. To achieve that end four idealized ground system automation scenarios and their attendant AI architecture are postulated and benefits, risks, and lessons learned are examined and compared. These architectures encompass: (1) no AI (baseline); (2) standalone expert systems; (3) standardized, reusable knowledge base management systems (KBMS); and (4) a futuristic unattended automation scenario. The resulting artificial intelligence lessons learned, benefits, and risks for spacecraft ground system automation scenarios are described.

  1. Artificial intelligence costs, benefits, risks for selected spacecraft ground system automation scenarios

    NASA Technical Reports Server (NTRS)

    Truszkowski, Walter F.; Silverman, Barry G.; Kahn, Martha; Hexmoor, Henry

    1988-01-01

    In response to a number of high-level strategy studies in the early 1980s, expert systems and artificial intelligence (AI/ES) efforts for spacecraft ground systems have proliferated in the past several years primarily as individual small to medium scale applications. It is useful to stop and assess the impact of this technology in view of lessons learned to date, and hopefully, to determine if the overall strategies of some of the earlier studies both are being followed and still seem relevant. To achieve that end four idealized ground system automation scenarios and their attendant AI architecture are postulated and benefits, risks, and lessons learned are examined and compared. These architectures encompass: (1) no AI (baseline), (2) standalone expert systems, (3) standardized, reusable knowledge base management systems (KBMS), and (4) a futuristic unattended automation scenario. The resulting artificial intelligence lessons learned, benefits, and risks for spacecraft ground system automation scenarios are described.

  2. Youth High-Risk Behaviors: Survey and Results.

    ERIC Educational Resources Information Center

    Stevens, Patricia; Griffin, Juree

    2001-01-01

    This article presents results from the Centers for Disease Control and Prevention's Youth Risk Behavior Survey. Results, which may assist in developing appropriate intervention/prevention programs, indicate a critical age for involvement in risk behaviors, gradual increase in risk behaviors over time, and gender differences in risk behaviors. (BF)

  3. At-risk high school seniors: Science remediation for Georgia's High School Graduation Test

    NASA Astrophysics Data System (ADS)

    Carroll, Carolyn M.

    State departments of education have created a system of accountability for the academic achievement of students under the mandate of the No Child Left Behind Act of 2001. The Georgia Department of Education established the Georgia High School Graduation Test (GHSGT) as their method of evaluating the academic achievement of high school students. The GHSGT consist of five sections and students must pass all five sections before students they are eligible to receive a diploma. The purpose of the study was to examine the effects of teacher-lead and computer based remediation for a group of high school seniors who have been unsuccessful in passing the science portion of the GHSGT. The objectives of this study include (a) Identify the most effective method of remediation for at-risk students on the science section of the GHSGT, and (b) evaluate the methods of remediation for at-risk students on the science section of GHSGT available to high school students. The participants of this study were at-risk seniors enrolled in one high school during the 2007-2008 school year. The findings of this research study indicated that at-risk students who participated in both types of remediation, teacher-led and computer-based, scored significantly higher than the computer-based remediation group alone. There was no significant relationship between the test scores and the number of times the students were tested.

  4. A High-Precision Protocol for Identification of Preschool Children at Risk for Persisting Obesity

    PubMed Central

    Timpka, Toomas; Angbratt, Marianne; Bolme, Per; Hermansson, Göran; Häger, Anders; Valter, Lars

    2007-01-01

    Background Recent studies suggest that adolescent adiposity is established already in preadolescence. Earlier studies have confirmed a strong tracking of obesity from adolescence to adulthood. Our aim was to examine the diagnostic accuracy of a population-derived protocol for identification of preschool children at risk for obesity in preadolescence. Methodology/Principal Findings We analysed data obtained for child health surveillance up to age 5 from 5778 children born in a Swedish county in 1991. The basic data set included age, sex, and weight and height measurements from the regular checkups between ages 1.5 and 5. Data not routinely collected in the child health centre setting were disregarded. The children were at age 10 randomly assigned to protocol derivation and validation cohorts and assessed for obesity according to IOTF criteria. The accuracy of predicting obesity in the validation cohort was measured using decision precision, specificity, and sensitivity. The decision protocol selected 1.4% of preschool children as being at obesity risk. The precision of the protocol at age 10 was 82% for girls and 80% for boys, and the specificity was 100% for both boys and girls. The sensitivity was higher for girls (41%) than for boys (21%). The relative risk for obesity at age 10 estimated by the odds ratio for individuals selected by the protocol compared to non-selected peers was 212.6 (95% confidence interval 56.6 to 798.4) for girls and 120.3 (95% CI 24.5 to 589.9) for boys. Conclusion/Significance A simple and inexpensive decision protocol based on BMI values proved to have high precision and specificity for identification of preschool children at risk for obesity persisting into adolescence, while the sensitivity was low especially for boys. Implementation and further evaluations of the protocol in child health centre settings are warranted. PMID:17579709

  5. Mother-Child Interactions in Depressed Children and Children at High Risk and Low Risk for Future Depression

    ERIC Educational Resources Information Center

    Dietz, Laura J.; Birmaher, Boris; Williamson, Douglas E.; Silk, Jennifer S.; Dahl, Ronald E.; Axelson, David A.; Ehmann, Mary; Ryan, Neal D.

    2008-01-01

    A study to investigate the differences in mother and child interactions of depressed children and adolescents, nondepressed high-risk youths, and healthy controls was conducted. Results revealed increased family discord with depressed children whereas intermediate levels of control and disengagement were seen in families with high-risk children.

  6. Dissolved Concentrations, Sources, and Risk Evaluation of Selected Metals in Surface Water from Mangla Lake, Pakistan

    PubMed Central

    Saleem, Muhammad; Iqbal, Javed; Shah, Munir H.

    2014-01-01

    The present study is carried out for the assessment of water quality parameters and selected metals levels in surface water from Mangla Lake, Pakistan. The metal levels (Ca, Cd, Co, Cr, Cu, Fe, K, Li, Mg, Mn, Na, Ni, Pb, Sr, and Zn) were determined by flame atomic absorption spectrophotometry. Average levels of Cd, Co, Cr, Ni, and Pb were higher than the allowable concentrations set by national and international agencies. Principal component analysis indicated significant anthropogenic contributions of Cd, Co, Cr, Ni, and Pb in the water reservoir. Noncarcinogenic risk assessment was then evaluated using Hazard Quotient (HQing/derm) and Hazard Index (HIing/derm) following USEPA methodology. For adults and children, Cd, Co, Cr, and Pb (HQing > 1) emerged as the most important pollutants leading to noncarcinogenic concerns via ingestion route, whereas there was no risk via dermal contact of surface water. This study helps in establishing pollutant loading reduction goal and the total maximum daily loads, and consequently contributes to preserve public health and develop water conservation strategy. PMID:24744690

  7. Inverse Association between Dietary Intake of Selected Carotenoids and Vitamin C and Risk of Lung Cancer

    PubMed Central

    Shareck, Martine; Rousseau, Marie-Claude; Koushik, Anita; Siemiatycki, Jack; Parent, Marie-Elise

    2017-01-01

    While diets rich in fruit and vegetables appear to reduce lung cancer risk, the evidence for individual carotenoid and vitamin intakes has been judged too limited to reach firm conclusions. Data from a case–control study of lung cancer (Montreal, QC, Canada, 1996–2002) were used to investigate the role of dietary intakes of β-carotene, α-carotene, β-cryptoxanthin, lutein/zeaxanthin, lycopene, and vitamin C in lung cancer risk. In-person interviews elicited dietary information from 1,105 incident cases and 1,449 population controls. Usual frequency of consumption of 49 fruits and vegetables 2 years prior to diagnosis/interview was collected. Odds ratios (ORs) and 95% confidence intervals (CIs) between intake variables and lung cancer were estimated using logistic or polytomous regression, adjusting for potential confounding factors including a detailed smoking history. ORs associated with upper versus lower tertiles of intake were 0.66 (95% CI = 0.51–0.84) for β-carotene, 0.70 (95% CI = 0.55–0.90) for α-carotene, 0.65 (95% CI = 0.51–0.84) for β-cryptoxanthin, 0.75 (95% CI = 0.59–0.95) for lycopene, and 0.74 (95% CI = 0.58–0.96) for vitamin C. ORs suggestive of a protective effect were found for elevated intakes of β-carotene, α-carotene, β-cryptoxanthin, and lycopene in male heavy smokers and of vitamin C in female heavy smokers. Selected antioxidants were also associated with a lower risk of lung cancer in female moderate smokers, and of squamous cell carcinoma, adenocarcinoma, and small cell carcinoma. These results suggest that several dietary antioxidants found in common food sources may protect against lung cancer, even among heavy smokers. PMID:28293540

  8. Dietary intakes of selected nutrients and food groups and risk of cervical cancer.

    PubMed

    Ghosh, Chaitali; Baker, Julie A; Moysich, Kirsten B; Rivera, Ruqayyah; Brasure, John R; McCann, Susan E

    2008-01-01

    We investigated the relationships between intakes of selected dietary nutrients and food groups and risk of cervical cancer in a hospital-based, case-control study including 239 cases diagnosed with squamous cell carcinoma of the cervix and 979 hospital patients with nonneoplastic diagnoses who completed a self-administered questionnaire between 1982 and 1998 at Roswell Park Cancer Institute. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by unconditional logistic regression adjusting for age, education, smoking status, use of oral contraceptives, barrier contraceptives and spermicides, family history of cervical cancer, year questionnaire completed, and energy intake. Significant reductions in risk of approximately 40-60% were observed for women in the highest vs. lowest tertiles of dietary fiber (OR=0.59, 95% CI=0.37-0.94), vitamin C (OR=0.52, 95% CI=0.33-0.80), vitamin E (OR=0.44, 95% CI=0.27-0.72), vitamin A (OR=0.47, 95% CI=0.30-0.73), alpha-carotene (OR=0.41, 95% CI=0.27-0.63), beta-carotene (OR=0.44, 95% CI=0.29-0.68), lutein (OR=0.51, 95% CI=0.33-0.79), folate (OR=0.55, 95% CI=0.34-0.88), and total fruit and vegetable intake (OR=0.52, 95% CI=0.34-0.77). Our findings suggest that a diet rich in plant-based nutrients may be important in reducing the risk of cervical cancer.

  9. Long-Term Use of Selective Serotonin Reuptake Inhibitors and Risk of Glaucoma in Depression Patients.

    PubMed

    Chen, Hsin-Yi; Lin, Cheng-Li; Kao, Chia-Hung

    2015-11-01

    This study investigated whether the long-term use of selective serotonin reuptake inhibitors (SSRIs) influences the risk of primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG) in the Chinese ethnic population in Taiwan.The authors retrieved the data under analysis from the National Health Insurance Research Database in Taiwan and identified 26,186 newly diagnosed depression patients without preexisting glaucoma. The study cohort included 13,093 patients with over 1 year of SSRI use, and a comparison cohort of 13,093 patients who had never used SSRIs. The main outcome was a diagnosis of POAG or PACG during follow-up. The authors used univariable and multivariable Cox proportional hazards regression models to assess the effects of SSRIs on the risk of POAG and PACG.The cumulative incidences of POAG and PACG between the SSRI and comparison cohorts exhibited nonsignificant differences (log-rank test P = .52 for POAG, P = .32 for PACG). The overall incidence of POAG in the SSRI cohort was nonsignificantly higher than that in the comparison cohort (1.51 versus 1.39 per 1000 person-years), with an adjusted hazard ratio of 1.07 (95% confidence interval = 0.82-1.40). The overall incidence of PACG in the SSRI cohort was nonsignificantly lower than that in the comparison cohort (0.95 versus 1.11 per 1000 person-years), with an adjusted hazard ratio of 0.85 (95% confidence interval = 0.62-1.18).The long-term use of SSRIs does not influence the risk of POAG or PACG in depression patients.

  10. Inverse Association between Dietary Intake of Selected Carotenoids and Vitamin C and Risk of Lung Cancer.

    PubMed

    Shareck, Martine; Rousseau, Marie-Claude; Koushik, Anita; Siemiatycki, Jack; Parent, Marie-Elise

    2017-01-01

    While diets rich in fruit and vegetables appear to reduce lung cancer risk, the evidence for individual carotenoid and vitamin intakes has been judged too limited to reach firm conclusions. Data from a case-control study of lung cancer (Montreal, QC, Canada, 1996-2002) were used to investigate the role of dietary intakes of β-carotene, α-carotene, β-cryptoxanthin, lutein/zeaxanthin, lycopene, and vitamin C in lung cancer risk. In-person interviews elicited dietary information from 1,105 incident cases and 1,449 population controls. Usual frequency of consumption of 49 fruits and vegetables 2 years prior to diagnosis/interview was collected. Odds ratios (ORs) and 95% confidence intervals (CIs) between intake variables and lung cancer were estimated using logistic or polytomous regression, adjusting for potential confounding factors including a detailed smoking history. ORs associated with upper versus lower tertiles of intake were 0.66 (95% CI = 0.51-0.84) for β-carotene, 0.70 (95% CI = 0.55-0.90) for α-carotene, 0.65 (95% CI = 0.51-0.84) for β-cryptoxanthin, 0.75 (95% CI = 0.59-0.95) for lycopene, and 0.74 (95% CI = 0.58-0.96) for vitamin C. ORs suggestive of a protective effect were found for elevated intakes of β-carotene, α-carotene, β-cryptoxanthin, and lycopene in male heavy smokers and of vitamin C in female heavy smokers. Selected antioxidants were also associated with a lower risk of lung cancer in female moderate smokers, and of squamous cell carcinoma, adenocarcinoma, and small cell carcinoma. These results suggest that several dietary antioxidants found in common food sources may protect against lung cancer, even among heavy smokers.

  11. High Doses of Vitamin D Fail to Cut Cancer Risk, Study Finds

    MedlinePlus

    ... gov/news/fullstory_164325.html High Doses of Vitamin D Fail to Cut Cancer Risk, Study Finds ... March 28, 2017 (HealthDay News) -- High doses of vitamin D supplements may not lower older women's risk ...

  12. Risk assessment of desert pollution on composite high voltage insulators

    PubMed Central

    El-Shahat, Mohammed; Anis, Hussein

    2013-01-01

    Transmission lines located in the desert are subjected to desert climate, one of whose features is sandstorms. With long accumulation of sand and with the advent of moisture from rain, ambient humidity and dew, a conductive layer forms and the subsequent leakage current may lead to surface discharge, which may shorten the insulator life or lead to flashover thus interrupting the power supply. Strategically erected power lines in the Egyptian Sinai desert are typically subject to such a risk, where sandstorms are known to be common especially in the spring. In view of the very high cost of insulator cleaning operation, composite (silicon rubber) insulators are nominated to replace ceramic insulators on transmission lines in Sinai. This paper examines the flow of leakage current on sand-polluted composite insulators, which in turn enables a risk assessment of insulator failure. The study uses realistic data compiled and reported in an earlier research project about Sinai, which primarily included grain sizes of polluting sand as well as their salinity content. The paper also uses as a case study an ABB-designed composite insulator. A three-dimensional finite element technique is used to simulate the insulator and seek the potential and electric field distribution as well as the resulting leakage current flow on its polluted surface. A novel method is used to derive the probabilistic features of the insulator’s leakage current, which in turn enables a risk assessment of insulator failure. This study is expected to help in critically assessing – and thus justifying – the use of this type of insulators in Sinai and similar critical areas. PMID:25685525

  13. Risk assessment of desert pollution on composite high voltage insulators.

    PubMed

    El-Shahat, Mohammed; Anis, Hussein

    2014-09-01

    Transmission lines located in the desert are subjected to desert climate, one of whose features is sandstorms. With long accumulation of sand and with the advent of moisture from rain, ambient humidity and dew, a conductive layer forms and the subsequent leakage current may lead to surface discharge, which may shorten the insulator life or lead to flashover thus interrupting the power supply. Strategically erected power lines in the Egyptian Sinai desert are typically subject to such a risk, where sandstorms are known to be common especially in the spring. In view of the very high cost of insulator cleaning operation, composite (silicon rubber) insulators are nominated to replace ceramic insulators on transmission lines in Sinai. This paper examines the flow of leakage current on sand-polluted composite insulators, which in turn enables a risk assessment of insulator failure. The study uses realistic data compiled and reported in an earlier research project about Sinai, which primarily included grain sizes of polluting sand as well as their salinity content. The paper also uses as a case study an ABB-designed composite insulator. A three-dimensional finite element technique is used to simulate the insulator and seek the potential and electric field distribution as well as the resulting leakage current flow on its polluted surface. A novel method is used to derive the probabilistic features of the insulator's leakage current, which in turn enables a risk assessment of insulator failure. This study is expected to help in critically assessing - and thus justifying - the use of this type of insulators in Sinai and similar critical areas.

  14. Potentially high-risk medication categories and unplanned hospitalizations: a case–time–control study

    PubMed Central

    Lin, Chih-Wan; Wen, Yu-Wen; Chen, Liang-Kung; Hsiao, Fei-Yuan

    2017-01-01

    Empirical data of medication-related hospitalization are very limited. We aimed to investigate the associations between 12 high risk medication categories (diabetic agents, diuretics, nonsteroidal anti-inflammatory drugs (NSAIDs), anticoagulants, antiplatelets, antihypertensives, antiarrhythmics, anticonvulsants, antipsychotics, antidepressants, benzodiazepine (BZD)/Z-hypnotics, and narcotics) and unplanned hospitalizations. A population-based case–time–control study was performed using Taiwan’s National Health Insurance Research Database. Patients who experienced an unplanned hospitalization (index visit) were identified as index subjects and matched to a randomly selected reference visit within users of a specific category of high-risk medication. An unplanned hospitalization was defined as a hospital admission immediately after an emergency department visit. Discordant exposures to the high-risk medication during the case period (1–14 days before the visit) and the control period (366–379 days before the visit) were examined in both index and reference visits. Antipsychotics was associated with the highest risk of unplanned hospitalizations (adjusted OR: 1.54, 95% CI [1.37–1.73]), followed by NSAIDs (1.50, [1.44–1.56]), anticonvulsants (1.34, [1.10–1.64]), diuretics (1.24, [1.15–1.33]), BZD/Z-hypnotics (1.23, [1.16–1.31]), antidepressants (1.17, [1.05–1.31]) and antiplatelets (1.16, [1.07–1.26]). NSAIDs and narcotics were associated with the highest risks of unplanned hospitalizations with a length of stay ≥10 days. These medication categories should be targeted for clinical and policy interventions. PMID:28112193

  15. Optimizing the yield and selectivity of high purity nanoparticle clusters

    NASA Astrophysics Data System (ADS)

    Pease, Leonard F.

    2011-05-01

    Here we investigate the parameters that govern the yield and selectivity of small clusters composed of nanoparticles using a Monte Carlo simulation that accounts for spatial and dimensional distributions in droplet and nanoparticle density and size. Clustering nanoparticles presents a powerful paradigm with which to access properties not otherwise available using individual molecules, individual nanoparticles or bulk materials. However, the governing parameters that precisely tune the yield and selectivity of clusters fabricated via an electrospray droplet evaporation method followed by purification with differential mobility analysis (DMA) remain poorly understood. We find that the product of the electrospray droplet mean diameter to the third power and nanoparticle concentration governs the yield of individual clusters, while the ratio of the nanoparticle standard deviation to the mean diameter governs the selectivity. The resulting, easily accessible correlations may be used to minimize undesirable clustering, such as protein aggregation in the biopharmaceutical industry, and maximize the yield of a particular type of cluster for nanotechnology and energy applications.

  16. Clinical utility of genetic signatures in selecting adjuvant treatment: Risk stratification for early vs. late recurrences.

    PubMed

    Hayes, Daniel F

    2015-11-01

    Adjuvant endocrine therapy (ET) reduces the odds of distant recurrence and mortality by nearly one-half in women with hormone receptor (HR) positive early stage breast cancer. While the risk of recurrence is lower for HR positive than negative patients during the first 5-7 years, HR positive patients suffer ongoing recurrences between 0.5 and 2% year over subsequent years. Extended adjuvant ET further reduces recurrence during this late phase of follow-up. ET is associated with post-menopausal side effects (hot flashes, sexual dysfunction, mood changes, and weight gain), and occasional major toxicities (thrombosis and endometrial cancer with tamoxifen; bone mineral loss and possibly heart disease with AIs) persist throughout therapy. Accurate and reliable estimates of the risk of recurrence after five years of ET for women with prior HR positive breast cancer would permit appropriate extended ET decisions. The risk of long-term relapse is related to lymph node status and size of tumor, but these are relatively crude. Several groups have investigated whether multi-parameter tumor biomarker tests might identify those patients whose risk of recurrence is so low that extended ET is not justified. These assays include IHC4, the 21-gene "OncotypeDX", the 12-gene "Endopredict," the PAM50, and the 2-gene "Breast Cancer Index (BCI)" assays. The clinical validity of all these tests for this use context have been established, with at least one paper for each that shows a statistically significant difference in risk of distant recurrence during the 5-10 years after the initial five years of adjuvant endocrine therapy. However, the stakes are high, and although each of these represents a "prospective retrospective" study, they require further validation in subsequent datasets before they should be considered to have "clinical utility" and are used to withhold potentially life-saving treatment. Perhaps more importantly, the clinical breast cancer community, and especially the

  17. Exposure to high altitude: a risk factor for venous thromboembolism?

    PubMed

    Gupta, Neha; Ashraf, Mohammad Z

    2012-03-01

    There are several genetic and acquired risk factors for venous thromboembolism. Exposure to high altitude (HA), either during air travel, ascension of mountains, or while engaging in sports activities, has been observed to result in a hypercoagulable state, thus predisposing to thromboembolic events. Although several previous studies have suggested that conditions present at HAs contribute to establish a prothrombotic milieu, published reports are contradictory and the exact underlying mechanism remains poorly understood. Results from HA studies also show that environmental conditions at HA such as hypoxia, dehydration, hemoconcentration, low temperature, use of constrictive clothing as well as enforced stasis due to severe weather, would support the occurrence of thrombotic disorders. The three leading factors of Virchow triad, that is, venous stasis, hypercoagulability, and vessel-wall injury, all appear to be present at HA. In synthesis, the large list of environmental variables suggests that a single cause of HA-induced thromboembolic disorders (TED) may not exist, so that this peculiar phenomenon should be seen as a complex or multifactorial trait. Further investigation is needed to understand the risk of TED at HA as well as the possible underlying mechanisms.

  18. High-risk biodegradable waste processing by alkaline hydrolysis.

    PubMed

    Kalambura, Sanja; Voća, Neven; Krička, Tajana; Sindrak, Zoran; Spehar, Ana; Kalambura, Dejan

    2011-09-01

    Biodegradable waste is by definition degraded by other living organisms. Every day, meat industry produces large amounts of a specific type of biodegradable waste called slaughterhouse waste. Traditionally in Europe, this waste is recycled in rendering plants which produce meat and bone meal and fat. However, feeding animals with meat and bone meal has been banned since the outbreaks of bovine spongiform encephalopathy (BSE). In consequence, new slaughterhouse waste processing technologies have been developed, and animal wastes have now been used for energy production. Certain parts of this waste, such as brains and spinal cord, are deemed high-risk substances, because they may be infected with prions. Their treatment is therefore possible only in strictly controlled conditions. One of the methods which seems to bear acceptable health risk is alkaline hydrolysis. This paper presents the results of an alkaline hydrolysis efficiency study. It also proposes reuse of the obtained material as organic fertiliser, as is suggested by the analytical comparison between meat and bone meal and hydrolysate.

  19. Correlates of hopelessness in the high suicide risk police occupation

    PubMed Central

    Violanti, John M.; Andrew, Michael E.; Mnatsakanova, Anna; Hartley, Tara A.; Fekedulegn, Desta; Burchfiel, Cecil M.

    2015-01-01

    Police officers are chronically exposed to work stress. We examined specific stressors that may be associated with hopelessness, a possible risk factor for suicide in this high suicide risk population. The study included 378 officers (276 men and 102 women) with complete data. Analysis of variance was used to estimate mean levels of hopelessness scores as associated with stress, adjusted for age, gender, and race/ ethnicity. Posttraumatic symptoms were tested as a modifier of the association between stress and hopelessness. Increasing stress of administrative practices and lack of support were significantly associated with increasing hopelessness among officers (p < .006 – hopelessness range: 1.64–2.65; and p < .001 – hopelessness range 1.60–2.80, respectively). Posttraumatic stress disorder (PTSD) symptoms significantly modified the association between lack of organizational support and hopelessness (p < .010) with significant association only among individuals with higher PTSD symptoms (p < .001). Results suggest that hopelessness is associated with specific stressors in police work, and this is modified by posttraumatic symptomatology. PMID:26752981

  20. Professional drivers: protection needed for a high-risk occupation.

    PubMed Central

    Baker, S P; Wong, J; Baron, R D

    1976-01-01

    "On the job" motor vehicle deaths number more than 4,000 annually in the U.S. and comprise nearly one-third of all work-related deaths. Yet the Department of Labor has set no standards relating to on-the-road safety of the millions of workers whose jobs entail large amounts of driving, and Department of Transportation standards affecting occupational safety cover only drivers in interstate commerce. Drivers of some commercial vehicles, such as heavy trucks, are at special risk of injury because trucks have usually been exempted for many years from federal motor vehicle safety standards--such as standards for brakes and seatbelts--designed to prevent crashes or protect occupants in crashes. Observations based on a series of 150 fatal crashes involving tractor trailers illustrate the need for better protection of this large population of high-risk workers. Clarification of responsibility within the various federal agencies and application of available knowledge and technology are essential. PMID:937611

  1. Youth Risk Behavior Surveillance System: Selected 2011 National Health Risk Behaviors and Health Outcomes by Race/Ethnicity

    ERIC Educational Resources Information Center

    Centers for Disease Control and Prevention, 2011

    2011-01-01

    The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

  2. High-selectivity and high-deposition rate tungsten CVD freed from chamber cleaning

    SciTech Connect

    Maeda, Y.; Suzuki, H.; Sakoh, T.; Morita, K.; Morita, M.; Ohmi, T. )

    1994-02-01

    A chemical vapor deposition method for tungsten films using a chamber with a cold susceptor is proposed for attaining excellent selectivity and a cleaning-free process. High-rate selective deposition above 1.0 [mu]m/min using the reduction of tungsten hexafluoride by silane is achieved at a substrate temperature of 210 C by using a cold susceptor chilled by water at room temperature. No deposition of tungsten or by-products on the susceptor surface and the inner surface of the chamber is observed, indicating that the newly developed system is free from cleaning. The deposited tungsten film has the alpha-type structure. The lattice constant of the tungsten is changed by the deposition temperature and the flow ratio of silane to tungsten hexafluoride.

  3. Risk of Window Period Hepatitis-C Infection in High Infectious Risk Donors: Systematic Review and Meta-Analysis

    PubMed Central

    Kucirka, Lauren M.; Sarathy, Harini; Govindan, Priyanka; Wolf, Joshua H.; Ellison, Trevor A.; Hart, Leah J.; Montgomery, Robert A.; Ros, R. Lorie; Segev, Dorry L.

    2011-01-01

    The OPTN classifies high infectious risk donors (HRDs) based on criteria originally intended to identify people at risk for HIV infection. These donors are sometimes referred to as "CDC high risk donors" in reference to the CDC-published guidelines adopted by the OPTN. However, these guidelines are also being used to identify deceased donors at increased risk of window period (WP) hepatitis C virus (HCV) infection, although not designed for this purpose. The actual risk of WP HCV infection in HRDs is unknown.We performed a systematic review of 3,476 abstracts and identified 37 eligible estimates of HCV incidence in HRD populations in the United States/Canada. Pooled HCV incidence was derived and used to estimate the risk of WP infection for each HRD category. Risks ranged from 0.26–300.6 per 10,000 donors based on WP for ELISA and 0.027–32.4 based on nucleic acid testing (NAT). Injection drug users were at highest risk (32.4 per 10,000 donors by NAT WP), followed by commercial sex workersand donors exhibiting high risk sexual behavior (12.3:10,000),men who have sex with men (3.5:10,000), incarcerated donors (0.8:10,000), donors exposed to HIV infected blood (0.4:10,000), and hemophiliacs (0.027:10,000). NAT reduced WP risk by approximately 10-fold in each category. PMID:21401874

  4. An Integrated Model for Supplier Selection for a High-Tech Manufacturer

    NASA Astrophysics Data System (ADS)

    Lee, Amy H. I.; Kang, He-Yau; Lin, Chun-Yu

    2011-11-01

    Global competitiveness has become the biggest concern of manufacturing companies, especially in high-tech industries. Improving competitive edges in an environment with rapidly changing technological innovations and dynamic customer needs is essential for a firm to survive and to acquire a decent profit. Thus, the introduction of successful new products is a source of new sales and profits and is a necessity in the intense competitive international market. After a product is developed, a firm needs the cooperation of upstream suppliers to provide satisfactory components and parts for manufacturing final products. Therefore, the selection of suitable suppliers has also become a very important decision. In this study, an analytical approach is proposed to select the most appropriate critical-part suppliers in order to maintain a high reliability of the supply chain. A fuzzy analytic network process (FANP) model, which incorporates the benefits, opportunities, costs and risks (BOCR) concept, is constructed to evaluate various aspects of suppliers. The proposed model is adopted in a TFT-LCD manufacturer in Taiwan in evaluating the expected performance of suppliers with respect to each important factor, and an overall ranking of the suppliers can be generated as a result.

  5. Risk assessment of mineral and heavy metal content of selected tea products from the Ghanaian market.

    PubMed

    Nkansah, Marian Asantewah; Opoku, Francis; Ackumey, Abiathar Abraham

    2016-06-01

    Food consumption is the most likely route of human exposure to metals. Tea (Camellia sinensis L.) is among the most widely consumed non-alcoholic beverages. Concentrations of heavy metals and minerals in tea from 15 different brands in Kumasi, Ghana were measured to assess the health risk associated with their consumption. The mineral and metal contents (Fe, Cu, Zn, Pb, As, Cd) were analyzed using atomic absorption spectrophotometer (Z-8100 polarized Zeeman). The results revealed that the mean concentrations were in the order: Ca > Fe > As > Cd > Zn > Pb. The average contents of Ca, Fe, Zn, Pb, Cd, and As in the samples were 94.08, 6.15, 0.20, 0.16, 0.36, and 1.66 mg/kg, respectively. All the minerals and heavy metals were below the maximum permissible limits stipulated by the World Health Organization (WHO) and US Pharmacopeia (USP). Metal-to-metal correlation indicated strong correlations between As/Zn, Cd/Zn, Cd/As, and Pb/As pairs. Factor analysis demonstrated a clear separation between minerals, grouped on one side, and heavy metals, clustered on another side. Both the target hazard quotient (THQ) and hazard index (HI) levels in green tea were far below 1, suggesting that consumption of green tea should pose no potential risk to human health. However, carcinogenic risk levels for arsenic were high; R > 10(-6). The results showed that residents in Kumasi consume tea could be at risk from exposure to these heavy metals and minerals.

  6. Pertussis immunization in a high-risk postpartum population.

    PubMed

    Healy, C Mary; Rench, Marcia A; Castagnini, Luis A; Baker, Carol J

    2009-09-18

    We provided CDC recommended postpartum tetanus, diphtheria, acellular pertussis (Tdap) immunization to medically underserved, uninsured women in Houston through a standing order protocol. From January 7-April 30, 2008, 1129 of 1570 (72%) postpartum women (93% Hispanic; 11% < or = 19 years) received Tdap before hospital discharge. Tdap uptake was 96.2% in women without self-reported contraindications. Recall of immunization history was inaccurate in 32% of unimmunized women who reported receiving antepartum immunization. Black women refused Tdap more often than other ethnicities (24% versus 8%; P=0.003). Postpartum Tdap immunization was successfully implemented in a high-risk population through a standing order protocol. Barriers to postpartum immunization include inaccurate immunization history and the need for ongoing targeted education.

  7. Cyberbullying in those at Clinical High Risk for psychosis

    PubMed Central

    Magaud, Emilie; Nyman, Karissa; Addington, Jean

    2012-01-01

    Aim Several studies suggest an association between experiences of childhood trauma including bullying and the development of psychotic symptoms. The use of communications technology has created a new media for bullying called ‘cyberbullying’. Research has demonstrated associations between traditional bullying and cyberbullying. Negative effects of cyberbullying appear similar in nature and severity to the reported effects of traditional bullying. Our aim was to examine the prevalence and correlates of cyberbullying in those at clinical high risk (CHR) for psychosis. Methods Fifty young people at CHR for psychosis were administered the Childhood Trauma Questionnaire with added questions about cyberbullying. Results Cyberbullying was reported in 38% of the sample. Those who experienced cyberbullying also reported experiencing previous trauma. Conclusion It is possible that cyberbullying may be a problem for those at CHR of psychosis and due to the vulnerable nature of these young people, may have longitudinal implications. PMID:23343259

  8. Preoperative IABP in high risk patients undergoing CABG.

    PubMed

    Theologou, T; Field, M L

    2011-01-01

    A recent international consensus conference on the reduction in mortality in cardiac anesthesia and intensive care included intraoperative aortic balloon pump among the ancillary (i.e. non-surgical) drugs/techniques/strategies that might influence survival rates in patients undergoing cardiac surgery. The consensus conferences state that "Pre-operative intraoperative aortic balloon pump might reduce 30-day mortality in elective high risk patients undergoing coronary artery bypass surgery unless specifically contraindicated". The authors of this "expert opinion" presents their insights into the use of the preoperative intraoperative aortic balloon pump and conclude that based on available limited randomized controlled trials and clinical experience preoperative intraoperative aortic balloon pump saves lives in unstable patients.

  9. Monitoring of newborns at high risk for brain injury.

    PubMed

    Pisani, Francesco; Spagnoli, Carlotta

    2016-05-14

    Due to the increasing number of surviving preterm newborns and to the recognition of therapeutic hypothermia as the current gold standard in newborns with hypoxic-ischaemic encephalopathy, there has been a growing interest in the implementation of brain monitoring tools in newborns at high risk for neurological disorders.Among the most frequent neurological conditions and presentations in the neonatal period, neonatal seizures and neonatal status epilepticus, paroxysmal non-epileptic motor phenomena, hypoxic-ischaemic encephalopathy, white matter injury of prematurity and stroke require specific approaches to diagnosis. In this review we will describe the characteristics, aims, indications and limitations of routinely available diagnostic techniques such as conventional and amplitude-integrated EEG, evoked potentials, cranial ultrasound and brain MRI. We will conclude by briefly outlining potential future perspectives from research studies.

  10. Empowering High-Risk Clients to Attain a Better Quality of Life: A Career Resiliency Framework

    ERIC Educational Resources Information Center

    Rickwood, Rory R.; Roberts, Jillian; Batten, Suzanne; Marshall, Anne; Massie, Kendra

    2004-01-01

    Career counselors frequently encounter clients who are at high risk for career and life development difficulties. Research suggests there is a connection between resiliency and successful career development in high-risk clients. Many high-risk individuals have poor decision-making skills and lack motivation to succeed in life and career…

  11. Highly recyclable superhydrophobic sponge suitable for the selective sorption of high viscosity oil from water.

    PubMed

    Wang, Jintao; Geng, Guihong

    2015-08-15

    Inspired by the adhesion of marine mussels, a kind of superhydrophobic oil sorbent was successfully fabricated by robustly immobilizing the micro/nanostructure layer onto the sponge skeleton. The as-prepared sponges possess excellent hydrophobicity with the water contact angle of 154°, which enables the sponge to selectively absorb various oils floating on water surface. The oil sorption capacities of as-prepared sponge for a series of oils can reach 18.3-46.8g/g. The absorbed oil can be recovered by mechanical squeezing and the resulting sponge can be recycled more than 70 cycles while still keeping high oil sorption capability. More importantly, the obtained sponge has excellent affinity to the high viscosity oils. Therefore, the as-prepared sponge might find practical applications in the large-scale removal of oils especially high viscosity oils from water surface.

  12. RADIOISOTOPE EXPERIMENTS IN HIGH SCHOOL BIOLOGY, AN ANNOTATED SELECTED BIBLIOGRAPHY.

    ERIC Educational Resources Information Center

    HURLBURT, EVELYN M.

    SELECTED REFERENCES ON THE USE OF RADIOISOTOPES IN BIOLOGY ARE CONTAINED IN THIS ANNOTATED BIBLIOGRAPHY FOR SECONDARY SCHOOL STUDENTS. MATERIALS INCLUDED WERE PUBLISHED AFTER 1960 AND DEAL WITH THE PROPERTIES OF RADIATION, SIMPLE RADIATION DETECTION PROCEDURES, AND TECHNIQUES FOR USING RADIOISOTOPES EXPERIMENTALLY. THE REFERENCES ARE LISTED IN…

  13. Selection of focal earthworm species as non-target soil organisms for environmental risk assessment of genetically modified plants.

    PubMed

    van Capelle, Christine; Schrader, Stefan; Arpaia, Salvatore

    2016-04-01

    By means of a literature survey, earthworm species of significant relevance for soil functions in different biogeographical regions of Europe (Atlantic, Boreal, Mediterranean) were identified. These focal earthworm species, defined here according to the EFSA Guidance Document on the environmental risk assessment (ERA) of genetically modified plants, are typical for arable soils under crop rotations with maize and/or potatoes within the three regions represented by Ireland, Sweden and Spain, respectively. Focal earthworm species were selected following a matrix of four steps: Identification of functional groups, categorization of non-target species, ranking species on ecological criteria, and final selection of focal species. They are recommended as appropriate non-target organisms to assess environmental risks of genetically modified (GM) crops; in this case maize and potatoes. In total, 44 literature sources on earthworms in arable cropping systems including maize or potato from Ireland, Sweden and Spain were collected, which present information on species diversity, individual density and specific relevance for soil functions. By means of condensed literature data, those species were identified which (i) play an important functional role in respective soil systems, (ii) are well adapted to the biogeographical regions, (iii) are expected to occur in high abundances under cultivation of maize or potato and (iv) fulfill the requirements for an ERA test system based on life-history traits. First, primary and secondary decomposers were identified as functional groups being exposed to the GM crops. In a second step, anecic and endogeic species were categorized as potential species. In step three, eight anecic and endogeic earthworm species belonging to the family Lumbricidae were ranked as relevant species: Aporrectodea caliginosa, Aporrectodea rosea, Aporrectodea longa, Allolobophora chlorotica, Lumbricus terrestris, Lumbricus friendi, Octodrilus complanatus and

  14. Review of chemoradiotherapy for high-risk prostate cancer.

    PubMed

    Sanfilippo, Nicholas; Hardee, Matthew E; Wallach, Jonathan

    2011-01-01

    While most newly-diagnosed prostate cancers are well-differentiated tumors that have high probability of cure, there is a subset of patients that present with aggressive malignancies that have significant potential for recurrence and metastasis. Single-modality treatment approaches have demonstrated relatively high failure rates, and multimodality therapy (radiation therapy and hormonal ablation therapy) has become standard of care for these patients. These treatments are not without toxicity, and a significant percentage of patients will become refractory to hormonal therapy. Historically, radiation therapy of prostate cancer was associated with significant genitourinary and gastrointestinal morbidity. With advances in radiation therapy techniques and delivery, the potential for safe dose-escalation has emerged. Further, there is an opportunity for chemotherapeutic agents to play an important syngergistic role in radiosensitizing the tumor cells at the primary site while also addressing micrometastatic disease. Concurrent chemoradiation therapy has become standard treatment for many types of locally advanced tumors, including lung, cervical, esophageal, rectal, and anal malignancies. We present a review of clinical trials examining the role of chemoradiation therapy in high-risk prostate cancer.

  15. Counseling women at high risk for breast cancer.

    PubMed

    Stefanek, M E

    1990-01-01

    Cancer risk analysis is a relatively new clinical service that has developed as more precise information has become available regarding specific risk factors. Both epidemiological and genetic factors contribute substantially to the identification of women at higher risk for developing breast cancer. The definition of what constitutes risk, an understanding of which factors influence risk, and the ability to present risk information clearly are critical features. In addition to providing information about risk and assessing each woman's perception of risk, the emotional issues must be addressed. The focus of intervention should center upon the benefits of early detection, assessment of breast self-examination skills, individualized breast cancer screening recommendations, such as mammography and physical exams, and recommendations for life style changes for possible prevention.

  16. High carotenoids content can enhance resistance of selected Pinctada fucata families to high temperature stress.

    PubMed

    Meng, Zihao; Zhang, Bo; Liu, Baosuo; Li, Haimei; Fan, Sigang; Yu, Dahui

    2017-02-01

    Carotenoids are a class of natural antioxidants widely found in aquatic, and they have significant effects on the growth, survival, and immunity of these organisms. To investigate the mechanisms of carotenoids in high temperature resistance, we observed the immune response of selected pearl oyster Pinctada fucata (Akoya pearl oyster) families with different carotenoids contents to high temperature stress. The results indicated that the survival rate (SR) of P. fucata decreased significantly with increase in temperature from 26 °C to 34 °C and with the decrease of total carotenoids content (TCC); when the TCC was higher, the SR tended to be higher. TCC and total antioxidant capacity (TAC) decreased significantly at 30 °C with increasing stress time. Correlation analysis indicated that TAC was positively and linearly correlated with TCC, and SR was S-type correlated with TCC and TAC. Immune analysis indicated that levels of superoxide dismutase (SOD), catalase (CAT), and malondialdehyde (MDA) in selected families (with higher TCC) under temperature stress (at 30 °C) were generally significantly lower than in the control group (with lowest TCC) and from 0 to 96 h, the levels of each of these substances varied significantly. Levels of SOD, CAT, and MDA within each family first rose from 0 to 3 h, then decreased to their lowest point after 24 h, and then rose again to their highest levels at 96 h. When TCC was higher, the levels of SOD, CAT, and MDA tended to be lower. These findings indicated that carotenoids play an important role in improving survival rates of P. fucata under high temperature stress by enhancing animals' antioxidant system, and could serve as an index for breeding stress-resistant lines in selective breeding practices.

  17. Maternal use of selective serotonin-reuptake inhibitors and risk of persistent pulmonary hypertension of the newborn.

    PubMed

    Alwan, S; Bandoli, G; Chambers, C D

    2016-07-01

    Use of selective serotonin reuptake inhibitors (SSRIs) in late pregnancy has been associated with persistent pulmonary hypertension of the newborn (PPHN), a rare condition with substantial infant mortality and morbidity. Although the increase in absolute risk is small on a population level, it may be of concern to many patients. It remains unclear the extent to which the increased risks reported for PPHN are explained by the underlying maternal illness rather than the use of SSRIs.

  18. Vocational Assessment of At-Risk Hispanic High School Students.

    ERIC Educational Resources Information Center

    Sexton-Radek, Kathy; Paul, Patrice

    Holland's Self-Directed Search (SDS) protocols were used with at-risk Hispanic female and male adolescents were examined to determine their sensitivity to this population. The SDS was completed by 89 at-risk Hispanic students (49 females and 33 males) in grade 9 at a nontraditional school for students who have been deemed at risk for gang and…

  19. Plasma tocopherols and risk of prostate cancer in the Selenium and Vitamin E Cancer Prevention Trial (SELECT).

    PubMed

    Albanes, Demetrius; Till, Cathee; Klein, Eric A; Goodman, Phyllis J; Mondul, Alison M; Weinstein, Stephanie J; Taylor, Philip R; Parnes, Howard L; Gaziano, J Michael; Song, Xiaoling; Fleshner, Neil E; Brown, Powel H; Meyskens, Frank L; Thompson, Ian M

    2014-09-01

    The Selenium and Vitamin E Cancer Prevention Trial (SELECT) showed higher prostate cancer incidence in men supplemented with high-dose α-tocopherol. We, therefore, examined whether presupplementation plasma α-tocopherol or γ-tocopherol was associated with overall or high-grade prostate cancer. A stratified case-cohort sample that included 1,746 incident prostate cancer cases diagnosed through June 2009 and a subcohort of 3,211 men was derived from the SELECT trial of 35,533 men. Plasma was collected at entry from 2001 to 2004, and median follow-up was 5.5 years (range, 0-7.9 years). Incidence of prostate cancer as a function of plasma α-tocopherol, γ-tocopherol, and supplementation with α-tocopherol or selenomethionine was estimated by the hazard ratio (HR). Plasma γ-tocopherol was not associated with prostate cancer. Men with higher α-tocopherol concentrations seemed to have risk similar to that of men with lower concentrations [overall HR for fifth (Q5) vs. first quintile (Q1), 1.21; 95 % confidence interval (CI), 0.88-1.66; P-trend = 0.24; in the trial placebo arm, Q5 HR, 0.85; 95% CI, 0.44-1.62; P-trend = 0.66]. We found a strong positive plasma α-tocopherol association among men receiving the trial selenomethionine supplement [Q5 HR, 2.04; 95% CI, 1.29-3.22; P-trend = 0.005]. A positive plasma α-tocopherol-prostate cancer association also seemed limited to high-grade disease (Gleason grade, 7-10; overall Q5 HR, 1.59; 95% CI, 1.13-2.24; P-trend = 0.001; among men receiving selenomethionine, Q5 HR, 2.12; 95% CI, 1.32-3.40; P-trend = 0.0002). Our findings indicate that higher plasma α-tocopherol concentrations may interact with selenomethionine supplements to increase high-grade prostate cancer risk, suggesting a biologic interaction between α-tocopherol and selenium itself or selenomethionine.

  20. Screening in high-risk group of gestational diabetes mellitus with its maternal and fetal outcomes

    PubMed Central

    Nilofer, Angadi Rajasab; Raju, V. S.; Dakshayini, B. R.; Zaki, Syed Ahmed

    2012-01-01

    Background: Gestational diabetes mellitus (GDM) is a metabolic disorder defined as glucose intolerance with the onset or first recognition during pregnancy. Women with GDM are at increased risk for adverse obstetric and perinatal outcome. The complications associated with GDM can be prevented by early recognition, intense monitoring and proper treatment. Aims: The present study was done to screen the high-risk pregnancy group for GDM, to find the incidence of abnormal results on screening and to correlate the abnormal results with the maternal and fetal outcomes. The study was done in a tertiary care hospital and teaching institute. It was a prospective cohort study. Materials and Methods: Selective screening for GDM was done in 150 pregnant women with high-risk factors. Screening was done with 50 g glucose challenge test (GCT) after 18 weeks, and if GCT was negative then the test was repeated after 28 weeks of pregnancy. The patients who were having an abnormal GCT were subjected to 100 g oral glucose tolerance test (OGTT). All GDM patients were followed up and treated with diet and/or insulin therapy till delivery to know maternal and fetal outcomes. The period of study was from April 2008 to March 2009. Results: 7.3% of study population was OGCT positive. 6% of the study population was OGTT positive. Age >25 years, obesity, family history of DM, and past history of GDM were the risk factors significantly associated with GDM. One newborn had hypoglycemia and one had hyperbilirubinemia. The fetal and maternal outcome in GDM patients was good in our study due to early diagnosis and intervention. Conclusion: Women with GDM are at an increased risk for adverse obstetric and perinatal outcome. The increased morbidity in GDM is preventable by meticulous antenatal care. PMID:22701851

  1. Electrophysiological correlates of decision-making in high-risk versus low-risk conditions of a gambling game.

    PubMed

    Yang, Juan; Zhang, Qinglin

    2011-10-01

    The majority of studies investigating risky decision making focus on the high-conflict condition, and very few consider the low-conflict condition in which there is either a very high or a very low probability of risk. Even though the high-risk condition and low-risk condition are both considered low-conflict decision scenarios and both behavioral outcomes are highly predictable, these conditions still differ in terms of the probabilities of reward and punishment. In the following study, we investigated both behavioral and electrophysiological correlates associated with high- and low-risk conditions within the low-conflict scenario, as well as high-conflict condition, in a modified gambling game. The behavioral results showed that, within the low-conflict scenario, the participants took more time to make the decision in the high-risk condition compared to the low-risk condition. The event-related potentials (ERP) data showed that, during the decision making, the high-risk condition evoked a more negative ERP deflection than did the low-risk condition in the time window of 300-500 ms (N400), which had a frontocentral focus of scalp distribution. The results suggested that the high-risk condition was associated with a higher conflict between the participants' "motivationally based" tendency to want to receive cards and the task instructions, which stated that the face value of the first two cards will strongly predict a low probability of success. It was further speculated that the N400 in the present study might be associated with anticipation of negative rewards, which was functionally equivalent to the FRN (feedback-related negativity) to negative outcomes.

  2. High efficiency in mode-selective frequency conversion.

    PubMed

    Quesada, Nicolás; Sipe, J E

    2016-01-15

    Frequency conversion (FC) is an enabling process in many quantum information protocols. Recently, it has been observed that upconversion efficiencies in single-photon, mode-selective FC are limited to around 80%. In this Letter, we argue that these limits can be understood as time-ordering corrections (TOCs) that modify the joint conversion amplitude of the process. Furthermore, using a simple scaling argument, we show that recently proposed cascaded FC protocols that overcome the aforementioned limitations act as "attenuators" of the TOCs. This observation allows us to argue that very similar cascaded architectures can be used to attenuate TOCs in photon generation via spontaneous parametric downconversion. Finally, by using the Magnus expansion, we argue that the TOCs, which are usually considered detrimental for FC efficiency, can also be used to increase the efficiency of conversion in partially mode-selective FC.

  3. Highly selective luminescent nanostructures for mitochondrial imaging and targeting

    NASA Astrophysics Data System (ADS)

    Fanizza, E.; Iacobazzi, R. M.; Laquintana, V.; Valente, G.; Caliandro, G.; Striccoli, M.; Agostiano, A.; Cutrignelli, A.; Lopedota, A.; Curri, M. L.; Franco, M.; Depalo, N.; Denora, N.

    2016-02-01

    Here a luminescent hybrid nanostructure based on functionalized quantum dots (QDs) is used as a fluorescent imaging agent able to target selectively mitochondria thanks to the molecular recognition of the translocator protein (TSPO). The selective targeting of such an 18 kDa protein mainly located in the outer mitochondrial membrane and overexpressed in several pathological states including neurodegenerative diseases and cancers may provide valuable information for the early diagnosis and therapy of human disorders. In particular, the rational design of amino functionalized luminescent silica coated QD nanoparticles (QD@SiO2 NPs) provides a versatile nanoplatform to anchor a potent and selective TSPO ligand, characterized by a 2-phenyl-imidazo[1,2-a]pyridine acetamide structure along with a derivatizable carboxylic end group, useful to conjugate the TSPO ligand and achieve TSPO-QD@SiO2 NPs by means of a covalent amide bond. The colloidal stability and optical properties of the proposed nanomaterials are comprehensively investigated and their potential as mitochondrial imaging agents is fully assessed. Sub-cellular fractionation, together with confocal laser scanning fluorescence microscopy and co-localization analysis of targeted TSPO-QD@SiO2 NPs in C6 glioma cells overexpressing the TSPO, proves the great potential of these multifunctional nanosystems as in vitro selective mitochondrial imaging agents.Here a luminescent hybrid nanostructure based on functionalized quantum dots (QDs) is used as a fluorescent imaging agent able to target selectively mitochondria thanks to the molecular recognition of the translocator protein (TSPO). The selective targeting of such an 18 kDa protein mainly located in the outer mitochondrial membrane and overexpressed in several pathological states including neurodegenerative diseases and cancers may provide valuable information for the early diagnosis and therapy of human disorders. In particular, the rational design of amino

  4. 7 CFR 331.10 - Restricting access to select agents and toxins; security risk assessments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...; security risk assessments. 331.10 Section 331.10 Agriculture Regulations of the Department of Agriculture... individual is approved by the Administrator or the HHS Secretary following a security risk assessment by the... risk assessment to the Attorney General. (e) An individual's security risk assessment may be...

  5. 7 CFR 331.10 - Restricting access to select agents and toxins; security risk assessments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...; security risk assessments. 331.10 Section 331.10 Agriculture Regulations of the Department of Agriculture... individual is approved by the Administrator or the HHS Secretary following a security risk assessment by the... risk assessment to the Attorney General. (e) An individual's security risk assessment may be...

  6. Relationships between Sports Team Participation and Health-Risk Behaviors among Alternative High School Students

    ERIC Educational Resources Information Center

    Johnson, Karen E.; Eisenberg, Marla E.; Bearinger, Linda H.; Fulkerson, Jayne A.; Sieving, Renee E.

    2014-01-01

    Background: Evidence suggests that sports team participation differentially relates to health-risk behaviors. Few studies have explored relationships among high-risk youth. Purpose: To examine associations between weekly sports team participation and health-risk behaviors (substance use, sexual risk-taking, violence involvement) among alternative…

  7. Novel Prognostic Groups in Thymic Epithelial Tumors: Assessment of Risk and Therapeutic Strategy Selection

    SciTech Connect

    D'Angelillo, Rolando M. Trodella, Lucio; Ramella, Sara; Cellini, Numa; Balducci, Mario; Mantini, Giovanna; Cellini, Francesco; Ciresa, Marzia; Fiore, Michele; Evoli, Amelia; Sterzi, Silvia; Russo, Patrizia; Grozio, Alessia; Cesario, Alfredo; Granone, Pierluigi

    2008-06-01

    Purpose: To assess the role of multimodality treatment on patients with thymic epithelial tumors (TETs) (i.e., thymomas and thymic squamous cell carcinoma) and to define the prognostic classes according to the Masaoka and World Health Organization histologic classification systems. Methods and Materials: Primary surgery was the mainstay of therapy. Extended thymectomy was performed in all cases. The cases were primarily staged according to the Masaoka system. Adjuvant radiotherapy was given to patients diagnosed with Masaoka Stage II, III, and IVA TET. Adjuvant chemotherapy was administered in selected cases. Results: We reviewed the records of 120 patients with TETs, with a mean follow-up of 13.8 years. Of the 120 patients, 98 (81.6%) received adjuvant radiotherapy. Of these 98 patients, Grade 1-2 pulmonary or esophageal toxicity was acute in 12 (12.2%) and late in 8 (8.2%). The median overall survival was 21.6 years. Of the 120 patients, 106 were rediagnosed and reclassified according to the World Health Organization system, and the survival rate was correlated with it. Three different prognostic classes were defined: favorable, Masaoka Stage I and histologic grade A, AB, B1, B2 or Masaoka Stage II and histologic grade A, AB, B1; unfavorable, Stage IV disease or histologic grade C or Stage III and histologic grade B3; intermediate, all other combinations. The 10- and 20-year survival rate was 95% and 81% for the favorable group, 90% and 65% for the intermediate group, and 50% and 0% for the unfavorable group, respectively. Local recurrence, distant recurrence, and tumor-related deaths were also evaluated. Conclusion: The analysis of our experience singled out three novel prognostic classes and the assessment of risk identified treatment selection criteria.

  8. Sex Differences in Children with Autism Spectrum Disorder Identified within a High-Risk Infant Cohort

    ERIC Educational Resources Information Center

    Zwaigenbaum, Lonnie; Bryson, Susan E.; Szatmari, Peter; Brian, Jessica; Smith, Isabel M.; Roberts, Wendy; Vaillancourt, Tracy; Roncadin, Caroline

    2012-01-01

    Sex differences were examined in 3-year-olds with autism spectrum disorders (ASD) ascertained from a high-risk cohort, and high- and low-risk comparison groups. Participants included 319 high-risk siblings and 129 low-risk controls. Eighty-five siblings were diagnosed with ASD, including 57 of 176 boys (32.4%) and 28 of 143 girls (19.6%), implying…

  9. Ownership of High-Risk ("Vicious") Dogs as a Marker for Deviant Behaviors: Implications for Risk Assessment

    ERIC Educational Resources Information Center

    Barnes, Jaclyn E.; Boat, Barbara W.; Putnam, Frank W.; Dates, Harold F.; Mahlman, Andrew R.

    2006-01-01

    This study examined the association between ownership of high-risk ("vicious") dogs and the presence of deviant behaviors in the owners as indicated by court convictions. We also explored whether two characteristics of dog ownership (abiding licensing laws and choice of breed) could be useful areas of inquiry when assessing risk status…

  10. High temperature performance of high-efficiency, multi-layer solar selective coatings for tower applications

    SciTech Connect

    Gray, M. H.; Tirawat, R.; Kessinger, K. A.; Ndione, P. F.

    2015-05-01

    The roadmap to next-generation concentrating solar power plants anticipates a progression to central towers with operating temperatures in excess of 650°C. These higher temperatures are required to drive higher power-cycle efficiencies, resulting in lower cost energy. However, these conditions also place a greater burden on the materials making up the receiver. Any novel absorber material developed for next-generation receivers must be stable in air, cost effective, and survive thousands of heating and cooling cycles. The collection efficiency of a power tower plant can be increased if the energy absorbed by the receiver is maximized while the heat loss from the receiver to the environment is minimized. Thermal radiation losses can be significant (>7% annual energy loss) with receivers at temperatures above 650°C. We present progress toward highly efficient and durable solar selective absorbers (SSAs) intended for operating temperatures from 650°C to 1000°C. Selective efficiency (ηsel) is defined as the energy retained by the absorber, accounting for both absorptance and emittance, relative to the energy incident on the surface. The low emittance layers of multilayer SSAs are binary compounds of refractory metals whose material properties indicate that coatings formed of these materials should be oxidation resistant in air to 800-1200°C. On this basis, we initially developed a solar selective coating for parabolic troughs. This development has been successfully extended to meet the absorptance and emittance objectives for the more demanding, high temperature regime. We show advancement in coating materials, processing and designs resulting in the initial attainment of target efficiencies ηsel > 0.91 for proposed tower conditions. Additionally, spectral measurements show that these coatings continue to perform at targeted levels after cycling to temperatures of 1000°C in environments of nitrogen and forming gas.

  11. High temperature performance of high-efficiency, multi-layer solar selective coatings for tower applications

    DOE PAGES

    Gray, M. H.; Tirawat, R.; Kessinger, K. A.; ...

    2015-05-01

    The roadmap to next-generation concentrating solar power plants anticipates a progression to central towers with operating temperatures in excess of 650°C. These higher temperatures are required to drive higher power-cycle efficiencies, resulting in lower cost energy. However, these conditions also place a greater burden on the materials making up the receiver. Any novel absorber material developed for next-generation receivers must be stable in air, cost effective, and survive thousands of heating and cooling cycles. The collection efficiency of a power tower plant can be increased if the energy absorbed by the receiver is maximized while the heat loss from themore » receiver to the environment is minimized. Thermal radiation losses can be significant (>7% annual energy loss) with receivers at temperatures above 650°C. We present progress toward highly efficient and durable solar selective absorbers (SSAs) intended for operating temperatures from 650°C to 1000°C. Selective efficiency (ηsel) is defined as the energy retained by the absorber, accounting for both absorptance and emittance, relative to the energy incident on the surface. The low emittance layers of multilayer SSAs are binary compounds of refractory metals whose material properties indicate that coatings formed of these materials should be oxidation resistant in air to 800-1200°C. On this basis, we initially developed a solar selective coating for parabolic troughs. This development has been successfully extended to meet the absorptance and emittance objectives for the more demanding, high temperature regime. We show advancement in coating materials, processing and designs resulting in the initial attainment of target efficiencies ηsel > 0.91 for proposed tower conditions. Additionally, spectral measurements show that these coatings continue to perform at targeted levels after cycling to temperatures of 1000°C in environments of nitrogen and forming gas.« less

  12. Biochemical Recurrence Prediction in High-Risk Prostate Cancer Patients, Following Robot-Assisted Radical Prostatectomy

    PubMed Central

    Yamaguchi, Noriya; Yumioka, Tetsuya; Iwamoto, Hideto; Masago, Toshihiko; Morizane, Shuichi; Honda, Masashi; Sejima, Takehiro; Takenaka, Atsushi

    2016-01-01

    Background High-risk prostate cancer treatment has been controversial. Some high-risk prostate cancer patients fail to respond to radical prostatectomy only. Thus, we aimed to investigate the predictive factors for biochemical recurrence (BCR) and identify patients who could achieve sufficient therapeutic effect by radical prostatectomy only. Methods Of 264 medical records reviewed, 141 low-intermediate-risk and 100 high-risk prostate cancer patients, excluding those who had received neoadjuvant hormone therapy, were analyzed. BCR was defined as the first increase in prostate-specific antigen levels (≥ 0.2 ng/mL), with levels not decreasing to undetectable limits, after radical prostatectomy. Log-rank test and Cox proportional hazards regression analyses were performed to determine the prognostic factors. We investigated the perioperative predictive factors for BCR and BCR-free survival rates, with the number of National Comprehensive Cancer Network (NCCN) high-risk factors for high-risk prostate cancer patients who underwent robot-assisted radical prostatectomy. Results Multivariate analyses showed that clinical T3 was significantly associated with BCR [hazard ratio (HR) = 4.052; 95% confidence interval (CI), 1.26–12.99; P = 0.019]. Of the 100 patients, 77 had 1 high-risk factor and 23 had ≥ 2 high-risk factors; the 1-year BCR-free survival rate of patients with 1 high-risk factor and those with ≥ 2 high-risk factors was 94.8% and 69.6%, respectively. Patients with ≥ 2 high-risk factors were significantly associated with BCR (P = 0.002). No difference in BCR rate between patients with 1 high-risk factor and those with low- and intermediate-risk was found. Conclusion High-risk prostate cancer patients with 1 NCCN high-risk factor can be considered for robot-assisted radical prostatectomy treatment only. PMID:28070166

  13. Lifecycle Prognostics Architecture for Selected High-Cost Active Components

    SciTech Connect

    N. Lybeck; B. Pham; M. Tawfik; J. B. Coble; R. M. Meyer; P. Ramuhalli; L. J. Bond

    2011-08-01

    There are an extensive body of knowledge and some commercial products available for calculating prognostics, remaining useful life, and damage index parameters. The application of these technologies within the nuclear power community is still in its infancy. Online monitoring and condition-based maintenance is seeing increasing acceptance and deployment, and these activities provide the technological bases for expanding to add predictive/prognostics capabilities. In looking to deploy prognostics there are three key aspects of systems that are presented and discussed: (1) component/system/structure selection, (2) prognostic algorithms, and (3) prognostics architectures. Criteria are presented for component selection: feasibility, failure probability, consequences of failure, and benefits of the prognostics and health management (PHM) system. The basis and methods commonly used for prognostics algorithms are reviewed and summarized. Criteria for evaluating PHM architectures are presented: open, modular architecture; platform independence; graphical user interface for system development and/or results viewing; web enabled tools; scalability; and standards compatibility. Thirteen software products were identified and discussed in the context of being potentially useful for deployment in a PHM program applied to systems in a nuclear power plant (NPP). These products were evaluated by using information available from company websites, product brochures, fact sheets, scholarly publications, and direct communication with vendors. The thirteen products were classified into four groups of software: (1) research tools, (2) PHM system development tools, (3) deployable architectures, and (4) peripheral tools. Eight software tools fell into the deployable architectures category. Of those eight, only two employ all six modules of a full PHM system. Five systems did not offer prognostic estimates, and one system employed the full health monitoring suite but lacked operations and

  14. Highly selective catalytic process for synthesizing 1-hexene from ethylene

    DOEpatents

    Sen, Ayusman; Murtuza, Shahid; Harkins, Seth B.; Andes, Cecily

    2002-01-01

    Ethylene is trimerized to form 1-hexene, at a selectivity of up to about 99 mole percent, by contacting ethylene, at an ethylene pressure of from about 200-1500 psig and at a reaction temperature of from about 0.degree. C. to about 100.degree. C., with a catalyst comprising a tantalum compound (e.g., TaCl.sub.5) and a alkylating component comprising a metal hydrocarbyl compound or a metal hydrocarbyl halide compound (e.g., Sn(CH.sub.3).sub.4).

  15. Cross-Sectional Association between Length of Incarceration and Selected Risk Factors for Non-Communicable Chronic Diseases in Two Male Prisons of Mexico City

    PubMed Central

    Silverman-Retana, Omar; Lopez-Ridaura, Ruy; Servan-Mori, Edson; Bautista-Arredondo, Sergio; Bertozzi, Stefano M.

    2015-01-01

    Background Mexico City prisons are characterized by overcrowded facilities and poor living conditions for housed prisoners. Chronic disease profile is characterized by low prevalence of self reported hypertension (2.5%) and diabetes (1.8%) compared to general population; 9.5% of male inmates were obese. There is limited evidence regarding on the exposure to prison environment over prisoner’s health status; particularly, on cardiovascular disease risk factors. The objective of this study is to assess the relationship between length of incarceration and selected risk factors for non-communicable chronic diseases (NCDs). Methods and Findings We performed a cross-sectional analysis using data from two large male prisons in Mexico City (n = 14,086). Using quantile regression models we assessed the relationship between length of incarceration and selected risk factors for NCDs; stratified analysis by age at admission to prison was performed. We found a significant negative trend in BMI and WC across incarceration length quintiles. BP had a significant positive trend with a percentage change increase around 5% mmHg. The greatest increase in systolic blood pressure was observed in the older age at admission group. Conclusions This analysis provides insight into the relationship between length of incarceration and four selected risk factors for NCDs; screening for high blood pressure should be guarantee in order to identify at risk individuals and linked to the prison’s health facility. It is important to assess prison environment features to approach potential risk for developing NCDs in this context. PMID:26381399

  16. Highly selective receptive fields in mouse visual cortex.

    PubMed

    Niell, Cristopher M; Stryker, Michael P

    2008-07-23

    Genetic methods available in mice are likely to be powerful tools in dissecting cortical circuits. However, the visual cortex, in which sensory coding has been most thoroughly studied in other species, has essentially been neglected in mice perhaps because of their poor spatial acuity and the lack of columnar organization such as orientation maps. We have now applied quantitative methods to characterize visual receptive fields in mouse primary visual cortex V1 by making extracellular recordings with silicon electrode arrays in anesthetized mice. We used current source density analysis to determine laminar location and spike waveforms to discriminate putative excitatory and inhibitory units. We find that, although the spatial scale of mouse receptive fields is up to one or two orders of magnitude larger, neurons show selectivity for stimulus parameters such as orientation and spatial frequency that is near to that found in other species. Furthermore, typical response properties such as linear versus nonlinear spatial summation (i.e., simple and complex cells) and contrast-invariant tuning are also present in mouse V1 and correlate with laminar position and cell type. Interestingly, we find that putative inhibitory neurons generally have less selective, and nonlinear, responses. This quantitative description of receptive field properties should facilitate the use of mouse visual cortex as a system to address longstanding questions of visual neuroscience and cortical processing.

  17. Using cross-game behavioral markers for early identification of high-risk internet gamblers.

    PubMed

    Braverman, Julia; LaPlante, Debi A; Nelson, Sarah E; Shaffer, Howard J

    2013-09-01

    Using actual gambling behavior provides the opportunity to develop behavioral markers that operators can use to predict the development of gambling-related problems among their subscribers. Participants were 4,056 Internet gamblers who subscribed to the Internet betting service provider bwin.party. Half of this sample included multiple platform gamblers who were identified by bwin.party's Responsible Gambling (RG) program; the other half were controls randomly selected from those who had the same first deposit date. Using the daily aggregated Internet betting transactions for gamblers' first 31 calendar days of online betting activities at bwin.party, we employed a 2-step analytic strategy: (a) applying an exploratory chi-squared automatic interaction detection (CHAID) decision tree method to identify characteristics that distinguished a subgroup of high-risk Internet gamblers from the rest of the sample, and (b) conducting a confirmatory analysis of those characteristics among an independent validation sample. This analysis identified two high-risk groups (i.e., groups in which 90% of the members were identified by bwin.party's RG program): Group 1 engaged in three or more gambling activities and evidenced high wager variability on casino-type games; Group 2 engaged in two different gambling activities and evidenced high variability for live action wagers. This analysis advances an ongoing research program to identify potentially problematic Internet gamblers during the earliest stages of their Internet gambling. Gambling providers and public policymakers can use these results to inform early intervention programs that target high-risk Internet gamblers.

  18. Robust Selection of Cancer Survival Signatures from High-Throughput Genomic Data Using Two-Fold Subsampling

    PubMed Central

    Lee, Sangkyun; Rahnenführer, Jörg; Lang, Michel; De Preter, Katleen; Mestdagh, Pieter; Koster, Jan; Versteeg, Rogier; Stallings, Raymond L.; Varesio, Luigi; Asgharzadeh, Shahab; Schulte, Johannes H.; Fielitz, Kathrin; Schwermer, Melanie; Morik, Katharina; Schramm, Alexander

    2014-01-01

    Identifying relevant signatures for clinical patient outcome is a fundamental task in high-throughput studies. Signatures, composed of features such as mRNAs, miRNAs, SNPs or other molecular variables, are often non-overlapping, even though they have been identified from similar experiments considering samples with the same type of disease. The lack of a consensus is mostly due to the fact that sample sizes are far smaller than the numbers of candidate features to be considered, and therefore signature selection suffers from large variation. We propose a robust signature selection method that enhances the selection stability of penalized regression algorithms for predicting survival risk. Our method is based on an aggregation of multiple, possibly unstable, signatures obtained with the preconditioned lasso algorithm applied to random (internal) subsamples of a given cohort data, where the aggregated signature is shrunken by a simple thresholding strategy. The resulting method, RS-PL, is conceptually simple and easy to apply, relying on parameters automatically tuned by cross validation. Robust signature selection using RS-PL operates within an (external) subsampling framework to estimate the selection probabilities of features in multiple trials of RS-PL. These probabilities are used for identifying reliable features to be included in a signature. Our method was evaluated on microarray data sets from neuroblastoma, lung adenocarcinoma, and breast cancer patients, extracting robust and relevant signatures for predicting survival risk. Signatures obtained by our method achieved high prediction performance and robustness, consistently over the three data sets. Genes with high selection probability in our robust signatures have been reported as cancer-relevant. The ordering of predictor coefficients associated with signatures was well-preserved across multiple trials of RS-PL, demonstrating the capability of our method for identifying a transferable consensus signature

  19. Risky Business: The Science and Art of Radiation Risk Communication in the High Risk Context of Space Travel

    NASA Technical Reports Server (NTRS)

    Elgart, Shona Robin; Shavers, Mark; Huff, Janice; Patel, Zarana; Semones, Edward

    2016-01-01

    Successfully communicating the complex risks associated with radiation exposure is a difficult undertaking; communicating those risks within the high-risk context of space travel is uniquely challenging. Since the potential risks of space radiation exposure are not expected to be realized until much later in life, it is hard to draw comparisons between other spaceflight risks such as hypoxia and microgravity-induced bone loss. Additionally, unlike other spaceflight risks, there is currently no established mechanism to mitigate the risks of incurred radiation exposure such as carcinogenesis. Despite these challenges, it is the duty of the Space Radiation Analysis Group (SRAG) at NASA's Johnson Space Center to provide astronauts with the appropriate information to effectively convey the risks associated with exposure to the space radiation environment. To this end, astronauts and their flight surgeons are provided with an annual radiation risk report documenting the astronaut's individual radiation exposures from space travel, medical, and internal radiological procedures throughout the astronaut's career. In an effort to improve this communication and education tool, this paper critically reviews the current report style and explores alternative report styles to define best methods to appropriately communicate risk to astronauts, flight surgeons, and management.

  20. Defining high-risk individuals in a population-based molecular-epidemiological study of lung cancer.

    PubMed

    Cassidy, Adrian; Myles, Jonathan P; Liloglou, Triantafillos; Duffy, Stephen W; Field, John K

    2006-05-01

    Within the framework of the Liverpool Lung Project (LLP), population-based case-control and prospective cohort studies are in progress to identify molecular and epidemiological risk factors and define populations and individuals most at risk of developing lung cancer. This report describes a strategy for selection of a high-risk population and further provides support for the inclusion of occupational and genetic risk factors in future models. Data from the case-control study (256 incident cases and 314 population controls) were analysed to define a high-risk population. Detailed lifestyle and occupational information were collected during structured interviews. Models were constructed using conditional logistic regression and included terms for age, tobacco consumption and previous respiratory disease. Smoking duration was chosen as the most important predictor of lung cancer risk [>50 years (OR 15.65, 95% CI 6.10-40.15)]. However, such a model would preclude younger individuals. Several combinations of previous respiratory disease were also considered, of which a history of bronchitis, emphysema or pneumonia (BEP) was the most significant (OR 1.86, 95% CI 1.28-2.69). A high-risk subset (based on combinations of smoking duration and BEP) was identified, which have a 4.5-fold greater risk of developing lung cancer (OR 4.5, 95% CI 2.33-8.68). Future refinement of the risk model to include individuals occupationally exposed to asbestos and with the p21 genotypes is discussed. There is real potential for environmental and genetic factors to improve on risk prediction and targeting of susceptible individuals beyond the traditional models based only on smoking and age. The development of a molecular-epidemiological model will inform the development of effective surveillance, early detection and chemoprevention strategies.

  1. Integrating Professional and Folk Models of HIV Risk: YMSM’s Perceptions of High-Risk Sex

    PubMed Central

    Kubicek, Katrina; Carpineto, Julie; McDavitt, Bryce; Weiss, George; Iverson, Ellen F.; Au, Chi-Wai; Kerrone, Dustin; Martinez, Miguel; Kipke, Michele D.

    2009-01-01

    Risks associated with HIV are well documented in research literature. While a great deal has been written about high-risk sex, little research has been conducted to examine how young men who have sex with men (YMSM) perceive and define high-risk sexual behavior. In this study, we compare the “professional’ and “folk” models of HIV-risk based on YMSM’s understanding of high-risk sex and where and how they gathered their understanding of HIV-risk behaviors. The findings reported here emerged from the quantitative and qualitative interviews from the Healthy Young Men’s Study (HYM), a longitudinal study examining risk and protective factors for substance use and sexual risk among an ethnically diverse sample of YMSM. Findings are discussed in relation to framing how service providers and others can increase YMSM’s knowledge of sexual behavior and help them build solid foundations of sexual health education to protect them from STI and HIV infection. PMID:18558819

  2. To kill a kangaroo: understanding the decision to pursue high-risk/high-gain resources.

    PubMed

    Jones, James Holland; Bird, Rebecca Bliege; Bird, Douglas W

    2013-09-22

    In this paper, we attempt to understand hunter-gatherer foraging decisions about prey that vary in both the mean and variance of energy return using an expected utility framework. We show that for skewed distributions of energetic returns, the standard linear variance discounting (LVD) model for risk-sensitive foraging can produce quite misleading results. In addition to creating difficulties for the LVD model, the skewed distributions characteristic of hunting returns create challenges for estimating probability distribution functions required for expected utility. We present a solution using a two-component finite mixture model for foraging returns. We then use detailed foraging returns data based on focal follows of individual hunters in Western Australia hunting for high-risk/high-gain (hill kangaroo) and relatively low-risk/low-gain (sand monitor) prey. Using probability densities for the two resources estimated from the mixture models, combined with theoretically sensible utility curves characterized by diminishing marginal utility for the highest returns, we find that the expected utility of the sand monitors greatly exceeds that of kangaroos despite the fact that the mean energy return for kangaroos is nearly twice as large as that for sand monitors. We conclude that the decision to hunt hill kangaroos does not arise simply as part of an energetic utility-maximization strategy and that additional social, political or symbolic benefits must accrue to hunters of this highly variable prey.

  3. To kill a kangaroo: understanding the decision to pursue high-risk/high-gain resources

    PubMed Central

    Jones, James Holland; Bird, Rebecca Bliege; Bird, Douglas W.

    2013-01-01

    In this paper, we attempt to understand hunter–gatherer foraging decisions about prey that vary in both the mean and variance of energy return using an expected utility framework. We show that for skewed distributions of energetic returns, the standard linear variance discounting (LVD) model for risk-sensitive foraging can produce quite misleading results. In addition to creating difficulties for the LVD model, the skewed distributions characteristic of hunting returns create challenges for estimating probability distribution functions required for expected utility. We present a solution using a two-component finite mixture model for foraging returns. We then use detailed foraging returns data based on focal follows of individual hunters in Western Australia hunting for high-risk/high-gain (hill kangaroo) and relatively low-risk/low-gain (sand monitor) prey. Using probability densities for the two resources estimated from the mixture models, combined with theoretically sensible utility curves characterized by diminishing marginal utility for the highest returns, we find that the expected utility of the sand monitors greatly exceeds that of kangaroos despite the fact that the mean energy return for kangaroos is nearly twice as large as that for sand monitors. We conclude that the decision to hunt hill kangaroos does not arise simply as part of an energetic utility-maximization strategy and that additional social, political or symbolic benefits must accrue to hunters of this highly variable prey. PMID:23884091

  4. Establishing a program for individuals at high risk for breast cancer.

    PubMed

    Cadiz, Fernando; Kuerer, Henry M; Puga, Julio; Camacho, Jamile; Cunill, Eduardo; Arun, Banu

    2013-01-01

    Our need to create a program for individuals at high risk for breast cancer development led us to research the available data on such programs. In this paper, we summarize our findings and our thinking process as we developed our own program. Breast cancer incidence is increasing worldwide. Even though there are known risk factors for breast cancer development, approximately 60% of patients with breast cancer have no known risk factor, although this situation will probably change with further research, especially in genetics. For patients with risk factors based on personal or family history, different models are available for assessing and quantifying risk. Assignment of risk levels permits tailored screening and risk reduction strategies. Potential benefits of specialized programs for women with high breast cancer risk include more cost -effective interventions as a result of patient stratification on the basis of risk; generation of valuable data to advance science; and differentiation of breast programs from other breast cancer units, which can result in increased revenue that can be directed to further improvements in patient care. Guidelines for care of patients at high risk for breast cancer are available from various groups. However, running a high-risk breast program involves much more than applying a guideline. Each high-risk program needs to be designed by its institution with consideration of local resources and country legislation, especially related to genetic issues. Development of a successful high-risk program includes identifying strengths, weaknesses, opportunities, and threats; developing a promotion plan; choosing a risk assessment tool; defining "high risk"; and planning screening and risk reduction strategies for the specific population served by the program. The information in this article may be useful for other institutions considering creation of programs for patients with high breast cancer risk.

  5. EMA-CO chemotherapy for high-risk gestational trophoblastic neoplasia: a clinical analysis of 54 patients.

    PubMed

    Lu, W-G; Ye, F; Shen, Y-M; Fu, Y-F; Chen, H-Z; Wan, X-Y; Xie, X

    2008-01-01

    This study was designed to analyze the outcomes of chemotherapy for high-risk gestational trophoblastic neoplasia (GTN) with EMA-CO regimen as primary and secondary protocol in China. Fifty-four patients with high-risk GTN received 292 EMA/CO treatment cycles between 1996 and 2005. Forty-five patients were primarily treated with EMA-CO, and nine were secondarily treated after failure to other combination chemotherapy. Adjuvant surgery and radiotherapy were used in the selected patients. Response, survival and related risk factors, as well as chemotherapy complications, were retrospectively analyzed. Thirty-five of forty-five patients (77.8%) receiving EMA-CO as first-line treatment achieved complete remission, and 77.8% (7/9) as secondary treatment. The overall survival rate was 87.0% in all high-risk GTN patients, with 93.3% (42/45) as primary therapy and 55.6% (5/9) as secondary therapy. The survival rates were significantly different between two groups (chi(2)= 6.434, P =0.011). Univariate analysis showed that the metastatic site and the number of metastatic organs were significant risk factors, but binomial distribution logistic regression analysis revealed that only the number of metastatic organs was an independent risk factor for the survival rate. No life-threatening toxicity and secondary malignancy were found. EMA-EP regimen was used for ten patients who were resistant to EMA-CO and three who relapsed after EMA-CO. Of those, 11 patients (84.6%) achieved complete remission. We conclude that EMA-CO regimen is an effective and safe primary therapy for high-risk GTN, but not an appropriate second-line protocol. The number of metastatic organs is an independent prognostic factor for the patient with high-risk GTN. EMA-EP regimen is a highly effective salvage therapy for those failing to EMA-CO.

  6. A Novel Ion - selective Polymeric Membrane Sensor for Determining Thallium(I) With High Selectivity

    NASA Astrophysics Data System (ADS)

    Kassim, Anuar; Rezayi, Majid; Ahmadzadeh, Saeid; Rounaghi, Gholamhossein; Mohajeri, Masoomeh; Azah Yusof, Noor; Tee, Tan Wee; Yook Heng, Lee; Halim Abdullah, Abd

    2011-02-01

    Thallium is a toxic metal that introduced into the environment mainly as a waste from the production of zinc, cadmium, and lead and by combustion of coal. Thallium causes gastrointestinal irritation and nerve damage when people are exposed to it for relatively short period of time. For long term, thallium has the potential to cause the following effects: change in blood chemistry, damage to liver, kidney, intestinal and testicular tissue, and hair loss. In this work a membrane was prepared by use of 4'-nitrobenzo -18-crown-6 (4'NB18C6) as an ion carrier, polyvinylchloride (PVC) as a matrix, and diocthylphetalate (DOP) as a plasticizer for making an ion selective electrode for measurement of Tl+ cation in solutions. The amount of 4'-nitrobenzo-18C6 and polyvinylchloride were optimized in the preparation of the membrane. The response of the electrode was Nernstian within the concentration range 1.0 × 10-8 to 1.0 × 10-1M. This sensor displays a drift in Nernstian response for this cation with increasing the amount of ionophore and decreasing the amount of polyvinylchloride.The results of potentiometric measurements showed that, this electrode also responses to Cu2+ Ni2+ and Pb2+ cations, but the electrode has a wider dynamic range and a lower detection limit to Tl+ cation. The effects of various parameters such as pH, different cations interferences, effect of the amount of ionophore and polyvinylchloride and time on response of the coated ion selective electrode were investigated. Finally the constructed electrode was used in complexometric and precipitation titrations of Tl+ cation with EDTA and KBr, respectively. The response of the fabricated electrode at concentration range from 1.0 × 10-8 to 1.0 × 10-1M is linear with a Nernstian slope of 57.27 mV.

  7. Estimated Risk of Developing Selected DSM-IV Disorders among 5-Year-Old Children with Prenatal Cocaine Exposure

    ERIC Educational Resources Information Center

    Morrow, Connie E.; Accornero, Veronica H.; Xue, Lihua; Manjunath, Sudha; Culbertson, Jan L.; Anthony, James C.; Bandstra, Emmalee S.

    2009-01-01

    We estimated childhood risk of developing selected DSM-IV Disorders, including Attention-Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), and Separation Anxiety Disorder (SAD), in children with prenatal cocaine exposure (PCE). Children were enrolled prospectively at birth (n = 476) with prenatal drug exposures documented…

  8. Eye-Tracking Measurements of Language Processing: Developmental Differences in Children at High Risk for ASD

    PubMed Central

    Arunachalam, Sudha; Nelson, Charles A.; Tager-Flusberg, Helen

    2016-01-01

    To explore how being at high risk for autism spectrum disorder (ASD), based on having an older sibling diagnosed with ASD, affects word comprehension and language processing speed, 18-, 24- and 36-month-old children, at high and low risk for ASD were tested in a cross- sectional study, on an eye gaze measure of receptive language that measured how accurately and rapidly the children looked at named target images. There were no significant differences between the high risk ASD group and the low risk control group of 18- and 24-month-olds. However, 36-month-olds in the high risk for ASD group performed significantly worse on the accuracy measure, but not on the speed measure. We propose that the language processing efficiency of the high risk group is not compromised, but other vocabulary acquisition factors might have lead to the high risk 36-month-olds to comprehend significantly fewer nouns on our measure. PMID:26109246

  9. Clustering of and risk factors for the porcine high fever disease in a region of Vietnam.

    PubMed

    Le, H; Poljak, Z; Deardon, R; Dewey, C E

    2012-02-01

    Porcine high fever disease (PHFD) emerged in 2006 in China and spread to Vietnam. Little work has been carried out to investigate PHFD risk factors and space-time dynamics. To fill this gap, we investigated probable cases of PHFD at household level as the outcome. A study area, approximately 100 sq. km, was selected from a province of southern Vietnam that had reported the outbreak of PHFD in 2008. A survey was conducted in the study area to collect information about swine health problems during 2008. The questionnaire included three sections: general information, clinical signs of disease in pigs and production factors believed to be risk factors. Cases were defined at the household level and included interpretation of clinical signs in series. Logistic regression with a random intercept at the hamlet level was used to assess risk factors for PHFD at the household level. Spatial clustering was investigated using the D-function and a Cuzick-Edward's test. Spatial clusters were evaluated using a spatial relative risk surface and the spatial scan statistic using a Bernoulli model. Space-time clustering was explored using a space-time K-function and Knox's test. Space-time clusters were evaluated using a space-time permutation model in SaTScan. Of 955 households with questionnaire data, 33.4% were classified as cases. The statistical significance of space and space-time clustering differed between methods employed. The risk factors associated with occurrence of cases were higher numbers of sows and finishing pigs (log 2 transformed), receiving pigs from an external source and the interaction between using 'water green crop' (WGC) as pig feed and owning ducks with or without direct contact with pigs. The interaction between the presence of ducks and feeding WGC to pigs suggested the involvement of pathogens that might be present in water (environment) and could further replicate in or on ducks.

  10. High-fish consumption and risk prevention: assessment of exposure to methylmercury in Portugal.

    PubMed

    Carvalho, C M L; Matos, A I N M; Mateus, M L; Santos, A P M; Batoreu, M C C

    2008-01-01

    The aim of this study was to evaluate the exposure to methylmercury (MeHg) of potential populations at risk living in Portugal. To ascertain youth exposure, a questionnaire was distributed to 300 students of a middle secondary school in Sesimbra and to 429 students studying in Canecas, selected as the control population. The average number of fish meals consumed by person was 4.1 and 3 per week in Sesimbra and Canecas, respectively. The subpopulations of high intake (PHI) corresponding to those ingesting 7 or more fish meals per week were also analyzed separately, with 17% of the students belonging to the PHI of Sesimbra versus 6.1% in Canecas. Socioeconomic aspects such as relative's professional involvement with fisheries correlated with the higher intakes in Sesimbra. Fish samples were collected in the dock of Sesimbra and total mercury (Hg) was determined by flow injection cold vapor atomic fluorescence spectroscopy (FI-CV-AFS). The mean value found for nonpredators was 0.035 microg/g. Dogfish specimens surpassed the legislated limit for predator species and increased the predators mean to 1 microg/g. The cross-sectional data were integrated with the fish analysis results to estimate the population exposure to MeHg. The indices of risk calculated for youth reached values of 4.5, demonstrating the existence of risk to a part of the population exceeding the provisional tolerable weekly intake (PTWI) level mandated by WHO (1.6 microg/kg bw). The results indicate that monitoring of Hg levels in fish is mandatory and counseling should be provided to populations at risk, encouraging them to prevent the risk.

  11. Evolution of social learning when high expected payoffs are associated with high risk of failure.

    PubMed

    Arbilly, Michal; Motro, Uzi; Feldman, Marcus W; Lotem, Arnon

    2011-11-07

    In an environment where the availability of resources sought by a forager varies greatly, individual foraging is likely to be associated with a high risk of failure. Foragers that learn where the best sources of food are located are likely to develop risk aversion, causing them to avoid the patches that are in fact the best; the result is sub-optimal behaviour. Yet, foragers living in a group may not only learn by themselves, but also by observing others. Using evolutionary agent-based computer simulations of a social foraging game, we show that in an environment where the most productive resources occur with the lowest probability, socially acquired information is strongly favoured over individual experience. While social learning is usually regarded as beneficial because it filters out maladaptive behaviours, the advantage of social learning in a risky environment stems from the fact that it allows risk aversion to be circumvented and the best food source to be revisited despite repeated failures. Our results demonstrate that the consequences of individual risk aversion may be better understood within a social context and suggest one possible explanation for the strong preference for social information over individual experience often observed in both humans and animals.

  12. The antigenic repertoire of premalignant and high-risk lesions.

    PubMed

    Marquez, Juan Pablo; Stanton, Sasha E; Disis, Mary L

    2015-04-01

    Prophylactic vaccines have been a major advance in preventing the development of infections after exposure to pathogens. When contemplating an effective approach to cancer prevention, vaccines offer unique advantages over other more standard approaches: First, once appropriately stimulated, antigen-specific T cells will travel to all sites of disease and eradicate cells bearing the proteins to which the T cells have been primed by vaccination. Second, successful immunization will further result in the development of immunologic memory, providing lifelong immunologic surveillance. There is evidence of an adaptive tumor immune infiltrate even at the earliest stages of breast and colon cancer development. Furthermore, there is measurable immunity to lesion-associated antigens present in patients who will eventually develop malignancy even before cancer is clinically evident. Recent studies are beginning to unmask the preinvasive antigenic repertoire for these two malignancies. Preliminary experiments in transgenic mouse models of mammary and intestinal tumors suggest that immunization against antigens expressed in preinvasive and high-risk lesions may be effective in preventing the development of invasive malignancy.

  13. Global risk of pharmaceutical contamination from highly populated developing countries.

    PubMed

    Rehman, Muhammad Saif Ur; Rashid, Naim; Ashfaq, Muhammad; Saif, Ameena; Ahmad, Nasir; Han, Jong-In

    2015-11-01

    Global pharmaceutical industry has relocated from the west to Asian countries to ensure competitive advantage. This industrial relocation has posed serious threats to the environment. The present study was carried out to assess the possible pharmaceutical contamination in the environment of emerging pharmaceutical manufacturing countries (Bangladesh, China, India and Pakistan). Although these countries have made tremendous progress in the pharmaceutical sector but most of their industrial units discharge wastewater into domestic sewage network without any treatment. The application of untreated wastewater (industrial and domestic) and biosolids (sewage sludge and manure) in agriculture causes the contamination of surface water, soil, groundwater, and the entire food web with pharmaceutical compounds (PCs), their metabolites and transformed products (TPs), and multidrug resistant microbes. This pharmaceutical contamination in Asian countries poses global risks via product export and international traveling. Several prospective research hypotheses including the development of new analytical methods to monitor these PCs/TPs and their metabolites, highly resistant microbial strains, and mixture toxicity as a consequence of pharmaceutical contamination in these emerging pharmaceutical exporters have also been proposed based on the available literature.

  14. Too Few High-Risk Women Tested for Breast Cancer Gene: Survey

    MedlinePlus

    ... html Too Few High-Risk Women Tested for Breast Cancer Gene: Survey Only half got BRCA screen, and ... News) -- Though testing for two genes that raise breast cancer risk has been around for decades, a new ...

  15. Study Shows Aspirin Reduces Colorectal Cancer in Those at High Risk

    Cancer.gov

    Findings from the first large clinical trial of its kind indicate that taking high doses of aspirin daily for at least 2 years substantially reduces the risk of colorectal cancer among people at increased risk of the disease.

  16. Combination of High Ankle–Brachial Index and Hard Coronary Heart Disease Framingham Risk Score in Predicting the Risk of Ischemic Stroke in General Population

    PubMed Central

    Wang, Tong; Kong, Minyi; Chen, Renhua; Liu, Yu; Chen, Jianping; Wang, Zhiyu; Wang, Jingfeng; Huang, Hui

    2014-01-01

    Our previous study showed that the patients with more metabolic risk factors had higher risk of high ankle–brachial index (ABI), but the relationship between high ABI and the risk of severe cardiovascular and cerebrovascular diseases is still under debate. This study aims to evaluate this association in the general population. 1486 subjects of South China were recruited in the study. 61 subjects were defined as high ABI group (ABI≥1.3) and 65 subjects were randomly selected as normal ABI group (0.9Risk Score (FRS) were compared between two groups. The results showed that the 10-year HCHD FRS of high ABI group was significantly higher than normal ABI group (7.87±6.11 vs. 3.98±2.90%, P<0.001). There was a positive correlation between ABI value and HCHD FRS in overweight participants (R = 0.576, P<0.01). The prevalence of ischemic stroke was higher in high ABI group than normal ABI group (21.3% vs. 6.2%, P<0.05), and it was higher in participants with HCHD FRS≥6% than those with HCHD FRS<6% (19.1% vs. 6.9%, P<0.05). Moreover, the prevalence of ischemic stroke was higher in participants with high ABI and HCHD FRS≥6% than those with normal ABI and HCHD FRS<6% (26.7% vs. 4.1%, P<0.05). BMI, hypertension, hsCRP and smoking were proved to be the independent factors and effective predictors for high ABI (P<0.05). In conclusion, high ABI combined with high HCHD FRS should be a potential predictor of ischemic stroke in the general population of South China. PMID:25198106

  17. A Risk Management Framework to Characterize Black Swan Risks: A Case Study of Lightning Effects on Insensitive High Explosives

    NASA Astrophysics Data System (ADS)

    Sanders, Gary A.

    Effective and efficient risk management processes include the use of high fidelity modeling and simulation during the concept exploration phase as part of the technology and risk assessment activities, with testing and evaluation tasks occurring in later design development phases. However, some safety requirements and design architectures may be dominated by the low probability/high consequence "Black Swan" vulnerabilities that require very early testing to characterize and efficiently mitigate. Failure to address these unique risks has led to catastrophic systems failures including the space shuttle Challenger, Deepwater Horizon, Fukushima nuclear reactor, and Katrina dike failures. Discovering and addressing these risks later in the design and development process can be very costly or even lead to project cancellation. This paper examines the need for risk management process adoption of early hazard phenomenology testing to inform the technical risk assessment, requirements definition and conceptual design. A case study of the lightning design vulnerability of the insensitive high explosives being used in construction, mining, demolition, and defense industries will be presented to examine the impact of this vulnerability testing during the concept exploration phase of the design effort. While these insensitive high explosives are far less sensitive to accidental initiation by fire, impact, friction or even electrical stimuli, their full range of sensitivities have not been characterized and ensuring safe engineering design and operations during events such as lightning storms requires vulnerability testing during the risk assessment phase.

  18. Evaluation of the personalized bar-code identification card to verify high-risk, high-alert medications.

    PubMed

    Thomas, Maria

    2013-09-01

    An effective intervention to decrease medication errors related to high-risk, high-alert medications is to implement double checks and second verification using the five rights of medication administration. To evaluate the effectiveness and use of the Personalized Bar-Code Identification card in verifying high-risk, high-alert medications, the High-Risk, High-Alert Medication Verification Audit Tool was used to collect data from the medical records of patients who received high-risk, high-alert medications in four ICUs. Data were collected for administered high-risk, high-alert medication, primary registered nurses who administered the high-risk, high-alert medication, and secondary registered nurses who verified the medication. The percentage of medications that were "not verified," "Personalized Bar-Code Identification verified," and "verified" using a method other than the Personalized Bar-Code Identification was calculated and compared using Z tests for two proportions. The percentage of Personalized Bar-Code Identification-verified medications (83.5%) was significantly higher than the percentage of medications that were not verified (10.9%) (Z = 38.43, P < .05). Also, the difference between the proportion of the Personalized Bar-Code Identification-verified medications and those that were verified using another method (5.6%) was significant (Z = 41.42, P < .05). The results show that nurses generally tend to follow the standardized procedure for verifying high-risk, high-alert medications in the four ICUs.

  19. High biologically effective dose radiation therapy using brachytherapy in combination with external beam radiotherapy for high-risk prostate cancer

    PubMed Central

    Wada, Akinori; Kohno, Naoaki

    2017-01-01

    Purpose To evaluate the outcomes of high-risk prostate cancer patients treated with biologically effective dose (BED) ≥ 220 Gy of high-dose radiotherapy, using low-dose-rate (LDR) brachytherapy in combination with external beam radiotherapy (EBRT) and short-term androgen deprivation therapy (ADT). Material and methods From 2005 to 2013, a total of 143 patients with high-risk prostate cancer were treated by radiotherapy of BED ≥ 220 Gy with a combination of LDR brachytherapy, EBRT, and androgen deprivation therapy (ADT). The high-risk patients in the present study included both high-risk and very high-risk prostate cancer. The number of high-risk features were: 60 patients with 1 high-risk factor (42%), 61 patients with 2 high-risk factors (43%), and 22 patients with 3 high-risk factors (15%) including five N1 disease. External beam radiotherapy fields included prostate and seminal vesicles only or whole pelvis depending on the extension of the disease. Biochemical failure was defined by the Phoenix definition. Results Six patients developed biochemical failure, thus providing a 5-year actual biochemical failure-free survival (BFFS) rate of 95.2%. Biochemical failure was observed exclusively in cases with distant metastasis in the present study. All six patients with biochemical relapse had clinical failure due to bone metastasis, thus yielding a 5-year freedom from clinical failure (FFCF) rate of 93.0%. None of the cases with N1 disease experienced biochemical failure. We observed four deaths, including one death from prostate cancer, therefore yielding a cause-specific survival (CSS) rate of 97.2%, and an overall survival (OS) rate of 95.5%. Conclusions High-dose (BED ≥ 220 Gy) radiotherapy by LDR in combination with EBRT has shown an excellent outcome on BFFS in high-risk and very high-risk cancer, although causal relationship between BED and BFFS remain to be explained further. PMID:28344597

  20. 7 CFR 331.10 - Restricting access to select agents and toxins; security risk assessments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...; security risk assessments. 331.10 Section 331.10 Agriculture Regulations of the Department of Agriculture... individual is approved by the Administrator or the HHS Secretary following a security risk assessment by the... risk assessment to the Attorney General. (e) A person with valid approval from the HHS Secretary...

  1. 7 CFR 331.10 - Restricting access to select agents and toxins; security risk assessments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...; security risk assessments. 331.10 Section 331.10 Agriculture Regulations of the Department of Agriculture... individual is approved by the Administrator or the HHS Secretary following a security risk assessment by the... risk assessment to the Attorney General. (e) A person with valid approval from the HHS Secretary...

  2. High Risk of Depressive Disorders in Patients With Gout

    PubMed Central

    Changchien, Te-Chang; Yen, Yung-Chieh; Lin, Cheng-Li; Lin, Ming-Chia; Liang, Ji-An; Kao, Chia-Hung

    2015-01-01

    Abstract Metabolic abnormalities are common in patients with depressive disorders. However, the relationship between gout and depression is unclear. We explored the causal relationship among gout, antigout medication, and the associated risk of incidental depressive disorders. In this nationwide cohort study, we sampled data from the National Health Insurance Research Database to recruit 34,050 patients with gout as the gout cohort and 68,100 controls (without gout) as the nongout cohort. Our primary endpoint was the diagnosis of depressive disorders during follow-up. The overall study population was followed up until depression diagnosis, withdrawal from the NHI program, or the end of the study. The differences in demographic and clinical characteristics between both cohorts were determined using the Chi-square test for categorical variables and the t-test for continuous variables. Cox proportional hazard regression models were used to examine the effect of gout on the risk of depression, represented using the hazard ratio with the 95% confidence interval. Patients with gout exhibited a higher risk of depressive disorders than controls did. The risk of depressive disorders increased with age and was higher in female patients and those with hypertension, stroke, and coronary artery disease. Nonsteroidal antiinflammatory drug and prednisolone use was associated with a reduced risk of depression. Patients with gout who had received antigout medication exhibited a reduced risk of depressive disorders compared with nongout patients. Our findings support that gout increases the risk of depressive disorders, and that antigout medication use reduces the risk. PMID:26717394

  3. Molecular genotyping of HPV L1 gene in low-risk and high-risk populations in Bangkok

    PubMed Central

    Leaungwutiwong, Pornsawan; Bamrungsak, Busara; Jittmittraphap, Akanitt; Maneekan, Pannamas; Kosoltanapiwat, Nathamon; Kalambaheti, Thareerat; Kelley, James F.

    2015-01-01

    Background Human papillomavirus (HPV) infections in Thailand are a public health concern but information on HPV infection in sex workers and men who have sex with men (MSM) is limited. The aim of this study was to measure the prevalence and genotype distribution of HPV among low- and high-risk, HIV-negative populations. Methods A total of 300 participants were categorized as general women, female sex workers, MSM, and MSM sex workers. HPV infections were identified by the Papanicolaou (Pap) test and nested-PCR. A phylogenetic analysis of partial HPV L1 genes was performed. Results Abnormal cytology was found in 5% of general women, 10% of female sex workers, 24% of MSM and 28% of MSM sex workers. HPV was detected in 9% of general women, 13% of female sex workers and 30% in both MSM and the MSM sex workers. The prevalence of HPV high-risk genotypes was significantly higher in female sex workers and MSM while low-risk genotypes and genital warts were significantly higher in MSM sex workers. Significantly more patients with genital warts and CIN I/AIN I harbored low-risk genotypes while those with CIN II/AIN II harbored high-risk genotypes. Conclusion High- and low-risk HPV genotypes persist in high-risk groups in Bangkok. Some genotypes infecting at-risk populations are not vaccine-preventable. These findings may help to elucidate the prevalence of HPV infections in Thailand and serve as the basis for additional investigations into risk factors for these populations. PMID:25763674

  4. A pilot study of tandem high-dose chemotherapy with stem cell rescue as consolidation for high-risk neuroblastoma: Children's Oncology Group study ANBL00P1.

    PubMed

    Seif, A E; Naranjo, A; Baker, D L; Bunin, N J; Kletzel, M; Kretschmar, C S; Maris, J M; McGrady, P W; von Allmen, D; Cohn, S L; London, W B; Park, J R; Diller, L R; Grupp, S A

    2013-07-01

    Increasing treatment intensity has improved outcomes for children with neuroblastoma. We performed a pilot study in the Children's Oncology Group to assess the feasibility and toxicity of a tandem myeloablative regimen without TBI supported by autologous CD34-selected peripheral blood stem cells. Forty-one patients with high-risk neuroblastoma were enrolled; eight patients did not receive any myeloablative consolidation procedure and seven received only one. Two patients out of 41 (4.9%) experienced transplant-related mortality. CD34 selection was discontinued after subjects were enrolled due to serious viral illness. From the time of study enrollment, the overall 3-year EFS and OS were 44.8 ± 9.6% and 59.2 ± 9.2% (N=41). These results demonstrate that tandem transplantation in the cooperative group setting is feasible and support a randomized comparison of single vs tandem myeloablative consolidation with PBSC support for high-risk neuroblastoma.

  5. [Accident risk perception in high-voltage electrical maintenance workers].

    PubMed

    Micheli, M; Zanaletti, W; Giorgi, I; Argentero, P; Candura, S M

    2006-01-01

    Promoting safety at work represents a fundamental task for achieving improvement in the quality of working life and preventing accidental injuries at work. Nevertheless, over the last few decades injuries at work have continued to constitute a significant problem. The aim of this study was to examine accident risk perception in a sample of 45 subjects employed in the electricity sector and to relate their risk perception to personality characteristics, cognitive functioning, and personal and professional history. The instruments used were: "Cognitive Behavioral Assessment 2.0", the "Workplace safety questionnaire" (an Italian questionnaire on safety at work), and a battery of neuropsychological tests. Findings show that electricity (current variability) was perceived as the most serious risk factor, while the most frequent perceived risk factors for accidents were accidental falls, cuts and bruises. The subjects of our sample showed a good awareness of risk perception, and good mood response and augmented psychophysiological activation during accidental injuries.

  6. Establishing a Program for Individuals at High Risk for Breast Cancer

    PubMed Central

    Cadiz, Fernando; Kuerer, Henry M.; Puga, Julio; Camacho, Jamile; Cunill, Eduardo; Arun, Banu

    2013-01-01

    Our need to create a program for individuals at high risk for breast cancer development led us to research the available data on such programs. In this paper, we summarize our findings and our thinking process as we developed our own program. Breast cancer incidence is increasing worldwide. Even though there are known risk factors for breast cancer development, approximately 60% of patients with breast cancer have no known risk factor, although this situation will probably change with further research, especially in genetics. For patients with risk factors based on personal or family history, different models are available for assessing and quantifying risk. Assignment of risk levels permits tailored screening and risk reduction strategies. Potential benefits of specialized programs for women with high breast cancer risk include more cost -effective interventions as a result of patient stratification on the basis of risk; generation of valuable data to advance science; and differentiation of breast programs from other breast cancer units, which can result in increased revenue that can be directed to further improvements in patient care. Guidelines for care of patients at high risk for breast cancer are available from various groups. However, running a high-risk breast program involves much more than applying a guideline. Each high-risk program needs to be designed by its institution with consideration of local resources and country legislation, especially related to genetic issues. Development of a successful high-risk program includes identifying strengths, weaknesses, opportunities, and threats; developing a promotion plan; choosing a risk assessment tool; defining “high risk”; and planning screening and risk reduction strategies for the specific population served by the program. The information in this article may be useful for other institutions considering creation of programs for patients with high breast cancer risk. PMID:23833688

  7. Do couples at high risk of relationship problems attend premarriage education?

    PubMed

    Halford, W Kim; O'Donnell, Charlotte; Lizzio, Alf; Wilson, Keithia L

    2006-03-01

    The effectiveness of premarriage education is limited by whether couples at high risk of future marital problems attend such education. In the current study, 374 newly married couples were assessed on a range of risk factors for future marital problems as well as whether they had attended marriage education. Couples with certain indices of relationship risk (nonreligious and premarital cohabitation) were underrepresented in premarriage education. Suggestions are offered to attract more couples, particularly those at high risk for future problems, to relationship education.

  8. Selected electrical properties of high ohmic thick-film resistors

    NASA Astrophysics Data System (ADS)

    DÄ browski, Arkadiusz; Tatar, Adam; Dziedzic, Andrzej

    2016-12-01

    Results of fabrication as well as electrical and stability characterization of thick-film high ohmic resistors are described in this paper. Five commercially available resistive compositions with sheet resistance of 1, 10, and 100 MΩ/sq were applied. The best properties were obtained for the lowest sheet resistance pastes, for which voltage coefficient of resistance (VCR) was lower than 3 ppm/V and hot temperature coefficient of resistance (HTCR) below 50 ppm/°C. Effect of resistor length on sheet resistance and impact of termination material were analyzed. High voltage pulse stress at 2 kV had negligible influence on resistors' properties.

  9. High yield sample preconcentration using a highly ion-conductive charge-selective polymer.

    PubMed

    Chun, Honggu; Chung, Taek Dong; Ramsey, J Michael

    2010-07-15

    The development and analysis of a microfluidic sample preconcentration system using a highly ion-conductive charge-selective polymer [poly-AMPS (2-acrylamido-2-methyl-1-propanesulfonic acid)] is reported. The preconcentration is based on the phenomenon of concentration polarization which develops at the boundaries of the poly-AMPS with buffer solutions. A negatively charged polymer, poly-AMPS, positioned between two microchannels efficiently extracts cations through its large cross section, resulting in efficient anion sample preconcentration. The present work includes the development of a robust polymer that is stable over a wide range of buffers with varying chemical compositions. The sample preconcentration effect remains linear to over 3 mM (0.15 pmol) and 500 microM (15 fmol) for fluorescein and TRITC-tagged albumin solutions, respectively. The system can potentially be used for concentrating proteins on microfluidic devices with subsequent analysis for proteomic applications.

  10. Alcohol consumption and high risk sexual behaviour among female sex workers in Uganda.

    PubMed

    Mbonye, Martin; Rutakumwa, Rwamahe; Weiss, Helen; Seeley, Janet

    2014-01-01

    Alcohol consumption has been associated with high risk sexual behaviour among key populations such as female sex workers. We explored the drivers of alcohol consumption and its relationship to high risk sexual behaviour. Participants were drawn from a cohort of 1027 women selected from 'hot spots' in the suburbs of Kampala city. We conducted 3 in-depth interviews with 40 female sex workers between 2010 and 2011. Data were analysed thematically, focusing on alcohol use within the context of sex work. Alcohol consumption was very high with only seven women reporting that they did not drink. Alcohol consumption was driven by the emotional and economic needs of the participants, but also promoted by clients who encouraged consumption. Many sex workers only started drinking alcohol when they joined sex work on the advice of more experienced peers, as a way to cope with the job. Alcohol was blamed for unsafe sex, acts of violence and poor decision making which increased sexual and physical violence. Alcohol was reported to affect medication adherence for HIV-positive women who forgot to take medicine. The findings suggest that the drivers of alcohol consumption are multifaceted in this group and require both individual and structural interventions. Alcohol reduction counselling can be supportive at the individual level and should be an integral part of HIV prevention programmes for female sex workers and others such as patrons in bars. The counselling should be addressed in a sensitive manner to bar owners and managers.

  11. Rural and Nonrural African American High School Students and STD/HIV Sexual-Risk Behaviors

    ERIC Educational Resources Information Center

    Milhausen, Robin R.; Crosby, Richard; Yarber, William L.; DiClemente, Ralph J.; Wingood, Gina M.; Ding, Kele

    2003-01-01

    Objective: To determine differences between African American adolescents on STD/HIV sexual-risk behaviors and precursors to these risk behaviors. Methods: Six hundred sixty-three rural and 3313 nonrural adolescents who completed the 1999 YRBS Survey were selected. Results: Rural females and males were more likely to report ever having coitus and…

  12. Correspondence between Psychometric and Clinical High Risk for Psychosis in an Undergraduate Population

    PubMed Central

    Cicero, David C.; Martin, Elizabeth A.; Becker, Theresa M.; Docherty, Anna; Kerns, John G.

    2014-01-01

    Despite the common use of either psychometric or clinical methods for identifying individuals at risk for psychosis, previous research has not examined the correspondence and extent of convergence of these two approaches. Undergraduates (n = 160), selected from a larger pool, completed three self-report schizotypy scales, the Magical Ideation Scale, the Perceptual Aberration Scale, and the Revised Social Anhedonia Scale, and were administered the Structured Interview for Prodromal Syndromes (SIPS). First, high correlations were observed for self-report and interview-rated psychotic like experiences (rs between .48 and .61, p < .001). Second, 77 percent of individuals identified as having a risk for psychosis with the self-report measures reported at least one clinically meaningful psychotic-like experience on the SIPS. Third, receiver operating characteristic curve analyses showed that the self-report scales can be used to identify which participants report clinically meaningful positive symptoms. These results suggest that mostly white undergraduate participants identified as at risk with the psychometric schizotypy approach report clinically meaningful psychotic-like experiences in an interview format and that the schizotypy scales are moderately to strongly correlated with interview-rated psychotic-like experiences. The results of the current research provide a baseline for comparing research between these two approaches. PMID:24708081

  13. Social Capital Role in Managing High Risk Behavior: a Narrative Review

    PubMed Central

    Afzali, Mansoure; Shahhosseini, Zohreh; Hamzeghardeshi, Zeinab

    2015-01-01

    Background: Social capital as a social context based concept is a new component in addition to the previous factors including the biologic–environmental, the genetic and the individual behavior factors that influence health and society. Social capital refers to the information that makes people believe being interesting & being paid attention to, & respected, valued, and belonging to a network of bilateral relations. Health issue is greatly affected by the existence of social capital. High risk behaviors refer to the ones enhancing the probability of negative and devastating physical, psychological and social consequences for an individual. Negative & overwhelming results mean keeping one’s distance from social norms as a result rejection and labeling (social stigma) and finally, to distance oneself from the benefits of social life in the individuals with high risk behaviors. The present study reviews social capital in the groups having high risk behaviors. Methods: The present study is a narrative review in which researchers conducted their computer search in public databases like Google Scholar, and more specifically in Pubmed, Magiran, SID, Springer, Science Direct, and ProQuest using the keywords: social capital, social support, risk behaviors, addicts, HIV, AIDS, and selected the articles related to the study subject from 2004 to 2014. Overall 96 articles have been searched. Researchers reviewed the summary of all articles searched, & ultimately, they applied the data from 20 full articles to compile this review paper. Results: Article review results led to organizing the subjects into 6 general categories: Social capital and its role in health; Social capital in groups with high risk behaviors (Including: substance abusers, AIDS patients, the homeless and multi-partner women); Social capital in different social groups; measurement tools for social capital and risk behaviors; the role of health in helping people with risky behaviors with the focus on

  14. Mid-childhood outcomes of infant siblings at familial high-risk of autism spectrum disorder.

    PubMed

    Shephard, Elizabeth; Milosavljevic, Bosiljka; Pasco, Greg; Jones, Emily J H; Gliga, Teodora; Happé, Francesca; Johnson, Mark H; Charman, Tony

    2016-11-29

    Almost one-in-five infants at high familial risk for autism spectrum disorder (ASD), due to having an older sibling with an ASD diagnosis, develop ASD themselves by age 3 years. Less is known about the longer-term outcomes of high-risk infants. To address this issue, we examined symptoms of ASD and associated developmental conditions (attention-deficit/hyperactivity disorder (ADHD); anxiety), language, IQ, and adaptive behaviour at age 7 years in high- and low-risk children studied from infancy. We compared outcomes between high-risk children who met criteria for ASD at age 7, high-risk children without ASD, and low-risk control children. Diagnostic stability between 3 and 7 years was moderate. High-risk siblings with ASD showed elevated levels of ADHD and anxiety symptoms and lower adaptive behaviour than low-risk control children. High-ris